Standard 8

Field Work Experience

The program provides candidates with a broad range of hands-on school nurse field experiences in a variety of settings. Candidates are provided with a preceptor for mentoring and supervision during the field experiences. The program has a clearly defined and systematic process for the identification, selection and assignment of qualified preceptors. The program bases field experience assignments on an individual assessment of each candidate’s prior background and experiences.

Working collaboratively, course instructors and preceptors encourage and enable candidates to function appropriately and effectively in a school nurse role.

Criterion 1: The program provides candidates with a broad range of hands-on school nurse field experience in a variety of setting.

School nursing candidates are required to complete two practicum courses—NURS 186 (School Nurse Practicum I) with an elementary school focus in the fall, and NURS 187 (School Nurse Practicum II), with a secondary school focus in the spring—for a total of 6 units and 135 practicum hours each semester (see Catalog).  Of the 135 hours in each practicum, candidates spend ten (10) of those hours participating in online class discussion relevant to their clinical experiences in the field and five (5) hours are spent in conferences and in communication with the candidate’s clinical instructor. Of the 135 hours, candidates without previous school nursing experience spend the remaining 120 hours in an on-site, guided practicum with a school nurse preceptor. Candidates currently employed as school nurses spend 80 hours in a supervised, guided practicum with their preceptor. Experienced school nurse students, those with more than two years of school nursing practice at a given educational level (elementary or secondary) are given the opportunity to spend up to twenty (20) of their practicum experience working on a special project that would benefit school nursing, their school district and/or other school nurses. Both the preceptor and the clinical instructor must approve this project. The special project gives experienced candidate an opportunity to work on something challenging and beyond the usual school nurse responsibilities. All candidates, regardless of number of required practicum hours, are required to spend 8-10 hours of practicum time (with preceptor approval) out in the community visiting local referral agencies, participating in relevant community activities such as health fairs, clinics, and/or relevant community meetings. Between 10-12 hours of practicum time may be spent attending district/local/state school nurse meetings, in-services, and/or conferences where candidates have the opportunity to learn and network with other school nurses. Candidates are encouraged to select a different preceptor and clinical sites for each practicum course experience in order to give them a broader perspective on school nurse roles and to increase their experience through working with different school nurses and with various cultural groups.

Integration of knowledge, theory and role concepts: In the practicum courses candidates integrate knowledge, theory and role concepts from courses they have previously taken (Phase I courses) and from NURS 184 (Introduction to School Nursing and NURS 185 (School Nurse Seminar), apply different theories in their client care. From class discussions, reading current journal articles, website searches, researching answers to questions in NURS 184 and NURS 185 (seminars), completing other various assignments, visiting community agencies, participating in community activities, and in attending school nurse in-services/conferences, candidates gain knowledge and insight into contemporary school nursing and child/adolescent health related issues. In core school nurse courses students learn about the importance of comprehensive and coordinated school health programs and services, about collaboration with other school professionals, and community resources that are needed to assist children and families. In NURS 186 (School Nurse Practicum I), candidates have an assignment in which they interview other school personnel and the school principal regarding their perception of the role of the school nurse. This is knowledge that candidates have the opportunity to use in their field experiences (NURS 186, NURS 187), i.e., inductive problem solving (nursing process), health promotion and teaching, counseling clients and their families, and caring for clients with special needs.

With regard to innovations in practice, more experienced school nurse candidates (those with two or more years of school nursing practice at a given educational level) are given the opportunity to contribute to school nursing by going beyond the usual role of the school nurse to work on a special project that would benefit school nursing or their school district. Candidates are required to have knowledge of the California Education Code and other state and federal codes/laws that apply to school nursing practice. Candidates are expected to have good communication skills. Written work is graded down or returned to candidates to be rewritten if it does not come up to acceptable standards. In NURS 186 and NURS 187 (practicum courses), under the watchful eye of the preceptor, candidates must satisfactorily complete skills and competencies found in the Preceptor Checklists of Skills and Competencies in the NURS 186/NURS 187 Preceptor Syllabus.

Criterion 2: Candidates choose a preceptor for mentoring and supervision during the field experience.

Candidates choose a preceptor for mentoring and supervision during the field experience. In this online program candidates are mentored and supervised by qualified school nurse preceptors at school sites in the area of the state in which the candidate plans to practice school nursing. A comprehensive NURS 186/NURS 187 Preceptor Syllabus, along with a person to person phone conference with the candidate’s a clinical instructor, orients the preceptor to roles and responsibilities for the preceptor, the student, and the clinical instructor. A Preceptor Checklist of Skills and Competencies and a Suggested Guidelines for Time Spent in Clinical Practice (see Preceptor Syllabus) are utilized by the preceptor to guide the development of student goals and objectives and attainment of skill and competencies. At the end of the practicum experience, the preceptor meets with the candidate to review the Preceptor Checklist of Skills and Competencies and Preceptor Evaluation of Student Professional Dispositions. At the end of the Preceptor Checklist of Skills and Competencies, the question is asked if the preceptor would recommend the candidate for the Clear Professional School Nurse Services Credential relevant to that practicum experience. These evaluation forms must be returned to the clinical instructor, along with a Preceptor Evaluation of the Course, by the end of the semester before a final grade can be posted. The program coordinator uses these evaluation tools in conferencing with candidates and in completing exit evaluations for candidates after program coursework has been completed.

Criterion 3: The program has a clearly defined and systematic process for the identification, selection and assignment of qualified preceptors:

Before official arrangements can made between a candidates and a preceptor, a Student Intern Agreement (University-Agency Contract) must exist between the agency in which the field experience is expected to take place and university. To begin the process, candidates are notified in their April Program Acceptance Packet of the need for this agreement. Because these agreements often need Board of Education approval, and may take 6-8 weeks to complete, candidates are advised to begin as soon as their packet is received to determine if such a contract exists between the agency in which he/she is interested in taking field experience and the university. To do this candidates are asked to contact the individual in the CSUF Department of Nursing, whose responsibility it is to initiates these contracts, to enquire as to the existence of such a contract which is in effect for 5 years once initiated. If a contract is not in place, a contract will be initiated by the Department of Nursing and sent to the responsible administrator in that agency (clearly defined steps are included in packet information and in the NURS 186/NURS 187 Preceptor Syllabus). It should be noted that an agreement must be in place even if the candidate takes field experience in the district in which he/she is employed, as that candidate is not an employee during the time he/she is a student school nurse working with a preceptor away from the candidate’s worksite.

To qualify as a preceptor, a school nurse must have five full years of school nursing experience, hold a Clear Professional School Nurse Services Credential, and have the approval of their immediate supervisor to act in that capacity. Preceptors must also provide vitae that are reviewed by the program coordinator or the candidate’s clinical instructor.

Candidates are advised by program faculty regarding the steps involved in obtaining a qualified school nurse preceptor:
(1) It is recommended that candidates speak to the program coordinator regarding assistance in obtaining a qualified preceptor. In this case the program coordinator will assist the candidate by contacting directors of health services in school districts in the area where the candidate plans to take his/her field experience to discuss the need, explain the criteria, and to ask the director to pole qualified school nurses in the district regarding interest. Or, since the candidate is permitted to have a preceptor in the district in which he/she is employed, candidates may discuss the need for a qualified preceptor with his/her immediate supervisor, who in turn is asked to contact the program coordinator for details and to pole qualified school nurses regarding interest. Occasionally, candidates have someone in mind who they would like to invite to be their preceptor, in which case, that school nurse must meet the criteria and have written approval from his/her immediate supervisor to act in that capacity. (2) In determining a school nurse’s qualifications to act in the capacity of a preceptor, the student’s clinical instructor confirms the existence of a signed “Immediate Supervisor Approval for Employee to Act as Preceptor” document and reviews the potential preceptor’s vitae qualifications. (3) When a perspective preceptor agrees to precept a candidate, that school nurse is asked to email the clinical instructor as soon as possible to notify the instructor of his/her interest. The clinical instructor can then respond in a timely fashion to express appreciation and to discuss roles and responsibilities.  Once the perspective preceptor is found to be qualified, the clinical instructor notifies the candidate. (4) Candidates are then responsible for setting down with their new preceptor and to thoroughly review NURS 186/NURS 187 Preceptor Syllabus details, as well to go over their own course syllabus to give the preceptor insight into course assignments and objectives so the preceptor can assist the candidate with experiences and time management to accomplish these. (5) Preceptor vitae are kept on file for four years in the Credential Program office. At the end of each clinical course, students complete an evaluation on their preceptor experience. If preceptors receive unfavorable comments from a candidate, that school nurse will not be invited back to act as a preceptor for future students.

Criterion 4: The program bases field experience assignments on an individual assessment of each candidate’s prior background and experience:

The candidate’s practicum experience is geared to his/her personal learning and experiential needs based on prior school nursing experience. At the beginning of each practicum course, with input from a school nurse preceptor, candidates are expected to develop personal student goals and learning objectives that reflect areas where experience is lacking and/or areas of interest. The opportunity for candidates to have personal input in the development of their goals and learning objectives allows them to assess their current levels of school nursing knowledge and competencies, and to go beyond that to gain new knowledge and to strengthen other areas of weakness in their school nursing practice. For candidates new to school nursing, goals and objectives must address basic school nursing experiences. To ensure a well rounded clinical experience for those new to school nursing, a suggested breakdown of hours related to school nursing practice is included in the NURS 186/NURS 187 Preceptor Syllabus. Experienced school nurse candidates, those with two or more years of school nursing practice at a given educational level, are expected to reach beyond basic school nursing practice to new and different experiences in creating their goals and objectives. Candidates are expected to develop at least three global clinical goals each semester, which must include meaningful learning objectives and learning activities to fulfillment of each of these goals.  Student goals and learning objectives are meant to supplement course objectives and candidates are expected to satisfactorily demonstrate required skills and competencies for each practicum course. With approval from the candidate’s clinical instructor, school nurse students new to school nursing are encouraged to use up to 10 practicum hours participating in leadership activities relevant to school nursing, such as presenting at a faculty meeting or spear heading an activity or clinic; while experienced school nurse students, those with two or more years of school nursing experience in at a given educational level, are given the opportunity to use up to 20 practicum hours participating in an Experiences School Nurse Project that is meaningful to other school nurses or health services, and which requires writing a proposal which must be approved by the candidate’s preceptor and clinical instructor.  With their preceptor, candidates are expected to review their goals and objectives periodically throughout the semester to be sure progress is being made. During a mandatory mid-term conference between candidate, preceptor, and clinical instructor, candidate progress is reviewed and discussed; and again at the end of the semester at which time the candidate critiques his/her personal learning experience and writes a Final Narrative Self Evaluation, in which the candidate cites his/her accomplishments and identify strengths and areas of weakness the candidate will continue to work on to improve.

Criterion 5: Working collaboratively, course instructors and preceptors encourage and enable candidates to function appropriately and effectively in a school nurse role:

Along with having a qualified school nurse preceptor to supervise and mentor each candidate at a school site(s), the candidate also have an experienced clinical instructor who holds a master’s degree or higher, a professional School Nurse Services credential, and who also has extensive school nursing experience in the community. In the online program the importance of keeping lines of communication open between the candidate, the preceptor, and clinical instructor cannot be over emphasized in order to provide quality guidance and supervision. Contact information i.e., telephone numbers, email addresses, and mailing addresses, are shared as soon as possible in the beginning of the semester. Prior to the candidate’s field experience, clinical instructors are expected to contact preceptors to go over roles and responsibilities of the preceptor, the candidate, and the clinical instructor, to ensure that there is a clear understanding on the part of all parties. Candidates are not expected to begin field experience until the 3rd week of the semester to give them ample time to make all the necessary arrangements and to turn in the required documentation to their clinical instructor, though candidates are free to begin their field experience sooner if everything is in order.  Roles and responsibilities for all parties are clearly outlined in the NURS 186/NURS 187 Preceptor Syllabus. Preceptors are expected to act as role models for candidates, as well as to mentor and supervise. Candidates are informed that they are expected to conduct themselves responsibly, ethically, and professionally, and to abide by school site standards. Clinical instructors are to be available to preceptors to provide ongoing support and to respond to any questions and concerns, as well as to supervise the candidates learning experience. 

Conferences between clinical instructor, preceptor and candidate are encouraged throughout the semester whenever there are questions, a need or concern. Initial conferences between the clinical instructor and the candidate focus on assisting the candidate in gaining the best possible clinical experience. An example of this would be assisting students with locating clinical sites and a qualified preceptor in their geographical area. An example of an initial conference between a candidate and a preceptor would be to work together in identifying meaningful student goals and learning objectives to be accomplished during the semester.  Clinical instructors review the student’s goals and learning objective, giving final approval or making recommendations for changes before the student begins his/her clinical practice. There is a mandatory 3-way conference that must take place in mid-semester between the candidate, the clinical instructor, and the preceptor. This is an opportunity for the student to review progress towards accomplishing goals and objectives and, if necessary, to revise a goal, learning objective, or learning activity that will lead to a better learning outcome. To prepare for this conference, candidates are asked to meet with their preceptor to go over accomplishments and any problem areas that need to be discussed during the conference. For candidates within reasonable driving distance of the university, the conference will take place at a school site where the candidate is taking his/her field experience, for distance learners, this will be a 3-way telephone conference. Telephone conferences may take up to an hour to accomplish. Mid-term conference notes are kept by the clinical instructor and place in the candidate’s university file.

Preceptors work with, and meet to conference with, candidates throughout the semester to mentor and assist candidates in meeting their goals and objectives, as well make progress toward accomplishing required skills and competencies as spelled out in the Preceptor Checklist of Skills and Competencies located in the NURS 186/NURS 187 Preceptor Syllabus. At the end of the semester, another meeting must take place between the candidate and preceptor to review accomplishment of skills and competencies and to discuss strengths and those areas needing further improvement.

Throughout the semester, clinical instructors read through the candidate’s weekly journal entries and provide written feedback to the candidate in a Student Progress Report provided to the candidate at the end of each of the four semester modules. Clinical instructors are available to candidates throughout each week in the semester in “Ask Your Instructor” in the online Blackboard program, by email, telephone, or in person during office hours, to give candidates feedback, make recommendations, assist them in working out clinical time issues, and/or complement them on the work that they are doing. Clinical instructors monitor online class participation in discussion and post weekly prompts and problem solving scenarios to stimulate candidate participation. Candidates are also encouraged to come up with subject matter for discussion, pose questions of classmates and request feedback.

Strengthening faculty, preceptor, candidate connections in the online program: Preceptors are invited to network with faculty during arranged meetings with candidates who attend annual CSNO (California School Nurse Organization) conferences. Program faculty members also network with preceptors in the Central Valley at local school nurse meetings and Central Valley Section CSNO conferences. Students are encouraged to invite their preceptors to student networking meetings in their local areas, as well as to consider inviting preceptors to an appreciation luncheon on completion of clinical experience. At the end of the semester, the program coordinator writes a letter of thank you to all preceptors, and sends a Certificate of Appreciation. Preceptors who receive positive evaluations from candidates are strongly encouraged to return to precept other candidates in the future. The ongoing willingness and professional commitment of school nurses to take on the role of preceptor cannot be over stated.

See Sec. 3 (p. 380): NURS 186/NURS 187 Preceptor Syllabus for guidelines related to preceptor, candidate, and clinical instructor roles and responsibilities;

See also Sec. 3 (p. 216 and p. 346): NURS 186 and NURS 187 course syllabi for guidelines for candidate responsibility with regard to journaling, class participation, and communication.

See also Sec. 3 (p. 412): Initiating a University-Agency Agreement.

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