Tallahassee Community College
Spring 2013	
Course Name, Prefix &  Reference No.	Clinical Practice V
RET 2878
Ref #: 115400 Tuesday 8-11:30 & 11:45 – 3:20
Ref #: 115401 Thursday 8-11:30 & 11:40 - 3:20	
Instructor Name and Contact Information	Eileen Durant  
Email: durante@tcc.fl.edu 
GCHE  Room 309
Office Phone:  850-558-4504   
Office Hours:  Monday 2:30 – 4, Tuesday 8:30 – 11, Wednesday 9 – 11, Thursday 11 – 11:30, Friday 8:30 – 12

Helen Dorman 
Email: dormanh@tcc.fl.edu 
GCHE 315
Office Phone: 850-558-4512
Office Hours: 

John Elam 
Email: Elamj@tcc.fl.edu
GCHE Room 323
Office Phone:
Office Hours: 	
Teaching Mission	The faculty is committed to creating a learning environment for all students which promotes, encourages, and fosters higher order and critical thinking skills that are grounded in an understanding of the fundamental concepts of disciplines in which they are taught.	
Course Description	Catalog Course Description:   
This course will prepare students for intubations and code management.  Once the course is completed students will receive a certificate of completion in intubation, and will be certified in ACLS.  The students will attend 16 hours of clinical rotation each week in the Intensive Care Units.  They will also attend a weekly 4 hour lab using the Human Patient Simulator.  In lab they will participate in a variety of scenarios, practicing crisis management and teamwork, as well as present case studies.  Contact: 20 hours	

Learning Outcomes:  At the end of the course the student will be able to:
		 Learning Outcomes
	Upon completion of this course, the student should be able to:	
1.	Practice accurate and effective patient charting in the critical care setting. 
2.	Create patient care plans for patients presented in the clinical setting, which will be presented in lab.
3.	Demonstrate proper procedure for taking and giving report on patients. 
4.	Recognize proper initiation and monitoring of the End-tidal CO2 monitor. 
5.	Demonstrate proper initiation and management of the BIPAP machine and its accessories.  
6.	Evaluate ventilator waveform graphics and hemodynamic values.
7.	Analyze hemodynamic values and formulate a treatment plan.
8.	 Recognize the significance of a brain death protocol and effectively manage patients with closed head injuries.
9.	Manage mechanical ventilation using a double lumen endotracheal tube. 
10.	Participate in and critique various simulation exercises.
11.	 Practice team work and crisis management.
12.	Perform ACLS skills.
13.	Perform intubation skills on the normal and difficult airway.
14.	Identify various mass casualty events.
15.	Practice and identify leadership and interview skills.
16.	Identify various sleep study procedures.
17.	Practice setup and monitoring and takedown of various sleep patients.
18.	Document goals and objectives of sleep studies.
19.	Make rounds with pulmonary physicians within the office environment.
20.	Identify various pulmonary function testing parameters.
21.	Perform various pulmonary function tests.
22.	Practice setup and monitoring of various patients obtaining pulmonary function tests.
23.	Understand universal characteristics of disasters
24.	Understand the role of the Respiratory Therapist in disaster response and emergency management.
25.	Explain various levels of equipment and support Respiratory Therapists utilize in responding to mass casualty incidents and disasters.
26.	Discuss the implication of Pandemic Influenza related to planning and response capability and capacity.
27.	Describe the impact of Bioterrorism and man-made disasters to health care systems, providers, and disaster preparedness plans.
28.	Conduct a job search.
29.	Complete a job application correctly.
30.	Demonstrate competency in the job interview process.
31.	Identify or demonstrate appropriate responses to criticism from employer, supervisor, or other persons.
32.	Identify acceptable work habits.
33.	Demonstrate knowledge of how to make job changes appropriately.
34.	Recognize appropriate professional behavior.
35.	Write an appropriate resume.
36.	Identify psychological reactions to illness including defense mechanisms.
37.	Recognize the steps in the grief process
38.	Explain basic concepts of positive self image, wellness and stress.
39.	Explain the nutrition pyramid
40.	Discuss the adverse effects of the use of alcohol, illegal drugs and steroids on the human body.
41.	Effectively communicate with individuals, groups and diverse populations. 	
How To Be Successful in this Class	•	Respiratory Care requires the student to not only learn the facts but also apply those facts to a variety of clinical situations.  It is imperative that the student utilizes knowledge learned in the past semesters.  Students are held responsible for this information and future exams will build on this information.  Students who are unable to demonstrate this utilization of past knowledge maybe at a disadvantage and are asked to seek assistance from a variety of sources.  Those include: TCC learning labs, course faculty, other students and possibly tutors.
•	The student is strongly advised to take notes on information being presented.  Bring a copy of the unit objectives and outline to the class.
•	If any of the materials passed out in class are misplaced, the student should arrange to copy a classmates copy for replacement rather than replacing them from the school's supply.  If the student is absent, it is the student's responsibility to obtain the handouts from a classmate.  Most of the handouts will be available on blackboard.
•	Students are considered to be adult learners who will assume responsibility for their own progress throughout the course.  This means that if a student is having difficulty in any area of the course, that student is responsible for seeking out appropriate resources to help with the problem.  The first step in this process should be to meet with the course faculty to discuss the problem.  Tutoring and other resources are available.
•	Tape recording devices are welcome in the classroom.  Laptop computers or other electronic devices should be used for course content only.  The student who uses these devices for any activity not directly related to classroom content or discussion may lose the privilege of bringing these devices into the classroom.
•	Attendance is per the attendance policy in student handbook
•	Fortify your notes with reading assignments; rewrite your notes and process the material (don’t just memorize); this should be done before the next class meets – in other words – keep up with the material!
•	Try to eat and sleep correctly.

I want students to learn and receive the good grades that they deserve.  Please make an appointment with me should you have undue difficulty with your work in the course.	
Communication with the Instructor	General Course related question/comments can be asked in class or by posting to the FAQ forum on blackboard.  If your question in of a personal nature, please contact me through the TCC e-mail at durante@tcc.fl.edu: dormanh@tcc.fl.edu: or elamj@tcc.fl.edu   or come by one of the teacher’s office.  We will try to respond to all emails within 12 to 24 hours, Monday thru Friday.  
              1. Please put RET2878  in the Subject matter section
              2.  If  you expect a call about the matter, please include your
                   number
              3.  Please send communication for you TCC e-mail account	
Course Prerequisites	The student must have successfully completed RET 1026, RET 1026L, RET 2485, RET 2486, RET 1293, RET 2265, RET 2265L, RET 2876	
Required Text &
Additional Req. Materials	 Anyone can Intubate. Whitten 4th Edition. Mooncat Publishers. 
Respiratory Notes 2007, Davis.
Reference Books:
Egan’s Fundamentals for Respiratory Care.  St. Louis, MO:  Mosby, Inc. (Previously Purchased in 1st Semester)
Clinical Notebook will continue to be used to document competency check-off. (Previously Purchased in Fall of second Year)	
Course Goals 	1.	Expose the student to advanced scenarios using the Human Patient Simulator.  More of a focus will be on prioritizing and decision making, by using more than one patient at a time for the student to manage.
2.	Prepare the student for the Exit Exam.
3.	Introduce the student to proper CODE procedures.
4.	Practice ventilator management and troubleshooting
5.	Prepare the student for ACLS certificate
6.	Introduce the student to Mass Casualty concepts.
7.	Introduce the student to wellness, job placement, leadership skills and interview process.
8.	Introduce the student to Sleep Studies in the clinical setting.
9.	Introduce the student to physician office procedures.	
Critical Thinking:	Higher order and critical thinking skills are defined as applying theories or concepts to practical problems or new situations; analyzing the basic elements of an idea, experience, or theory; making judgments about the value or soundness of information, arguments, or methods; and synthesizing and organizing ideas and information in new ways.  Critical thinking skills will be utilized in the classroom using patient scenarios involving hemodynamic and mechanical ventilation. 	
Methods of Instruction:	•	Lecture
•	Required reading and assignments textbook and handouts
•	Class discussion concerning various topics
•	Collaborative Learning exercises in case studies format
•	Computer simulation exercises
•	Computerized written exam exercises	
Web Assisted	This is a "WA" class - web-assisted - the class has a website using Blackboard. The site is used to post materials, assignments and grades. You are expected to use the website as part of this class. If you do not have access to a computer and/or the Internet off-campus, be sure to note the hours of the open-access computer labs on campus. Not all class materials will be available in electronic format. Do not count on simply accessing the class website to obtain all that was done during class. NOTE: each instructor may use the BlackBoard environment differently, so be sure to pay attention to the instructions given in each of your WA classes.

Course Schedule & Outline	DATE	
TOPIC	
ROOM	

Week 1
	
Review syllabus, Review clinical information; scenario handout; Review/practice procedures	
118	

Week 2	
Asthma/Complete care of pt from admit to discharge/PFT	
118	

Week 3	
Emphysema/Complete care of pt from admit to discharge/PFT	
118	

Week 4	
Neuromuscular Complete care of pt from admit to discharge
	
118	

Week 5	
Burn pt Complete care of pt from admit to discharge/PFT
	
118	

Week 6	
Cystic fibrosis/Complete care of pt from admit to discharge/PFT
Article I.		
118	

Week 7	
Tuberculosis/Complete care of pt from admit to discharge/PFT
	
118	

Week 8	
Epiglottitis/Complete care of pt from admit to discharge/PFT
	
118	

Week 9	
Pneumonias/Complete care of pt from admit to discharge/PFT
	
118	

Week 10	
ARDS/Complete care of pt from admit to discharge/PFT
	
118	

Week 11	
Independent lung ventilation/Chest tube ventilation
	
 118	

Week 12	
NICO monitor of volumetric CO2

Week 13	
Home health simulation/Pulmonary rehab

Week 14	
Review 

Week 15	
Final Exams	

	
Evaluation	Evaluation and Grading
	 Clinical:                                                  10 @ 40 points each = 400 points
	Soap Notes:                                            10 @ 10 points each =    100points
	Critical Care Ventilator Sheets:             10  @ 10 points each =   100 points
            Physician Rounds    (4 hours)                  1 @ 40 points each =   40 points 
	Pulmonary Function Rotations	     1 @ 40 points each =    40 points
	Clinical Scenarios			    13 @ 40 points each =  520 points
	(20 points for scenario participation and 20 points for clinical review)
	10 Simulation lab quizzes		     10 points each          = 100 points
            Mass Casualty quiz                                  1 @ 50 points         =   50 points
            Wellness, job placement, 
             Leadership, interview skills Quiz        1 @ 100 points        =  100 points
            Intubation Quizzes      7 quizzes
               No points will be awarded for
               quizzes. You must be successful
               on all quizzes to pass course.
           Intubation competency examination.
               No points will be awarded for
               examination. You must successfully
               complete competency examination
               to pass course.
           ACLS certification             
               No points will be awarded but
               ACLS training must be successfully
               completed to pass course.

		                                                       TOTAL POINTS = 1450
Grades will be calculated according to below:

91% – 100% 	 = A 
81% –   90	 = B  
75% –   80	 = C   
70% –   74 	 = D   
69% & below	 = F

Remediation Policy
	Remediation of this course is not allowed.  A grade of “C” or better must be earned before beginning courses in the summer semester.

Exam Policy
	 Due to the nature of the examinations, attendance, for examinations, is mandatory.  Make-up examinations will not be scheduled without written documentation.	

Attendance Policy on Clinicals
 	Attendance is necessary to complete the course.  If you must miss a clinical at one of the off-campus sites, you need to do the following in order to be eligible to receive credit:
1.	You must log in and log out for each clinical session. The date AND time that you came in, and left must be clearly legible, OR IT WILL NOT BE COUNTED! If you make an error using the time stamp cross-out the error skip a space on the Clinical Attendance Sheet and re-stamp it. Use a highlighter or other means to ensure that you have entry and exit times lined up for each clinical. If it is not possible to ascertain readily when you clocked in or out, you will not receive credit for it. No exceptions.

2.	As far as being late to Clinicals:
1.	 “Tardy” or “Late” means you arrived more than 5 minutes after the start of report.
2.	After the first incident each tardy will result in a deduction of 10 points.
3.	Leaving early will also result in a deduction of 10 points.

3.	Contact the Clinical Instructor within 24 hours of missing the clinical, by calling Lorraine Nichols 489-0681 or John Elam 489-0058. These are the pager numbers of our Clinical Instructors.  Once you are given permission to reschedule, you must do so through the Clinical Instructor.  You CAN’T reschedule clinicals on your own.  If you are unable to get in touch with a Clinical Instructor, contact Eileen Durant.
4.	If you reschedule a clinical with the Clinical Instructor and then you are a “NO SHOW” you will no longer be able to make that clinical up, and you will lose ALL points associated with that clinical. No excuses or exceptions.
5.	If you are absent from a clinical and do not make it up, 40 points will be deducted for each occurrence.  SOAP notes and Critical Care Ventilator sheets will not be accepted on days in which a student was absent from clinical rotation.  
6.	Incomplete SOAP notes or Critical Care Ventilator Sheets will lose 5 points for each occurrence. You must make sure that the information is accurate, or else you will lose points for providing inaccurate information.
7.	HIPPA Log
                        No points assigned.  Must complete log as assigned per clinical hospital 
		rotation to pass course.                    

Regarding arrival times to each clinical site:

1.	TMH – arrive 15 minutes prior to beginning of shift.  Ex:  2:30p-11p shift should arrive at 2:15 pm (YOU MUST BE STAMPED IN).
2.  CRMC, Select, & HS – arrive 15 minutes prior to beginning of shift.  Ex:  3p-11p shift        should arrive at 2:45 pm.
*Once again, arrival and departure times must be legible.  Make sure to include the affiliate and area you were in.

-Sleep Lab Clinical is at TMH in the POB on the 8th Floor.  The days you may attend are Monday through Thursday. You are to arrive between 8:00pm.  You may leave as soon as they have set up the appropriate NCPAP equipment on their patients. This may take until 1:00 am.  This is your only visit, so make it worth your while!  Attendance is mandatory to complete the course.  Make sure they sign your clinical book and write “Sleep Study” next to it. Fill out a SOAP Note about the client/clients you saw. Place a blank Critical Vent Sheet behind that SOAP note and write “Sleep Study Rotation” on it. 
 
-Physician Rounds -  With Tallahassee Pulmonary doctors you will arrive at the POB office and the physician will be contacted and you will do rounds in the hospital with the physicians.  Time is from 8:00 a.m. until 12:00 noon.

-Pulmonary Function Clinical Rotation. You will report to the Pulmonary Function lab at the Tallahassee Pulmonary Clinic, Mitchum office.   

-Delodge Home Health: Located off of Miccosukee Road across from Riggins Road.  Clinical arrival time is 8:00 am – until about 1:00 p.m 

Policy on Competencies
	The clinical book must have the Lab instructor’s signature on each competency before it may be performed at the clinical site.  All three signatures for competency must be signed before the competency may be performed without supervision.  This excludes any invasive procedures such as arterial blood gas draw, suctioning, intermittent positive pressure breathing, and ventilator changes.

Attendance Policy on Scenario

Attendance is mandatory.   If the student is going to miss a scenario day, arrive late or leave early, then the student must provide documentation of a medical excuse.  If you arrive more than five minutes late to class you will not be able to take the daily quiz. If you are absent from any scenario, 40 points will be deducted from your grade. There will be no make-ups for scenarios. 

Intubation, Wellness, ACLS, Employability Skills, Job Placement, Leadership, Interview skills, Mass Casualty portion of Clinical V.

Intubation:
Topics:
1.	 Anatomy and Physiology and ECG Recognition
2.	Establishing and Airway – Difficult Airway  -  Equipment
3.	Adult Intubation  -  Errors in intubation
4.	Pediatric Intubation  -  Nasal Intubation
5.	Difficult Intubation  -  Trauma Management  -  Specialized Techniques
6.	Special Equipment  -  Awake Intubation
7.	Rapid Sequence Induction  -  Tube Exchangers  -  Extubation  -  Complications
8.	Prepare for practical examination

Mass Casualty:
Topics:
1.	Understand universal characteristics of disasters
2.	Understand the role of the Respiratory Therapist in disaster response and emergency management.
3.	Explain various levels of equipment and support Respiratory Therapists utilize in responding to mass casualty incidents and disasters.
4.	Discuss the implication of Pandemic Influenza related to planning and response capability and capacity.
5.	Describe the impact of Bioterrorism and man-made disasters to health care systems, providers, and disaster preparedness plans.

Wellness:
Topics:
1.	 Demonstrate and understanding of and apply wellness and disease concepts.
2.	Identify psychological reactions to illness including defense mechanisms.
3.	Recognize the steps in the grief process
4.	Explain basic concepts of positive self image, wellness and stress.
5.	Explain the nutrition pyramid
6.	Discuss the adverse effects of the use of alcohol, illegal drugs and steroids on the human body.

Employability Skills:
Topics:
1.	Conduct a job search.
2.	Complete a job application correctly.
3.	Demonstrate competency in the job interview process.
4.	Identify or demonstrate appropriate responses to criticism from employer, supervisor, or other persons.
5.	Identify acceptable work habits.
6.	Demonstrate knowledge of how to make job changes appropriately.
7.	Recognize appropriate professional behavior.
8.	Write an appropriate resume.

Retention Policy	The process identified in the steps below will be afforded to every student if it is felt that he or she is not making satisfactory progress as outlined in the course syllabi:
1. Identification of the problem
When serious concerns have been raised about a student's academic, laboratory or practicum (Clinicals) performances (by TCC faculty or clinical affiliates), then TCC faculty will meet to determine a plan for assisting the student. Notes of the meeting will be placed in the student's file in the central office.
2. Meeting with the student: Plan of Assistance for Improvement
The TCC faculty will schedule a meeting with the student to discuss the specific concerns within one week of the development of the concerns; specific documentation of the nature of the concerns will be available at the meeting. The TCC faculty member will inform the student of the concerns and include specific suggestions for improvement in a Plan of Assistance for Improvement. A copy of this plan will be placed in the student's file in the central program office. 
3. Execution of the Plan of Assistance for Improvement
Changes that must occur in the student's performance in order for him/her to be retained in the program will be identified in writing. A date will be set when the student's performance will be reevaluated in the light of the Plan of Assistance for Improvement. The student will be expected to carry out the plan of Assistance within the given time frame or must schedule additional meetings with the faculty to modify the plan.  	
Withdrawal Policy	Instructor will not withdraw you from class. Last day to withdraw this semester is 3/28/2013. This is your responsibility.	
College Policies 	All college policies, listed in the TCC Student Handbook and TCC Catalogue, concerning academic honor code, withdrawal deadlines, incompletes, audits, academic dishonesty and other policies are in effect for this course.	
Incumbent Weather
Information	During the course of the year, the city of Tallahassee can expect to be affected by a wide variety of weather events.  While the Florida Panhandle is best-known for being at risk to hurricanes and tropical storms, it also experiences its share of thunderstorms, tornadoes, flooding, wildfires and on the rare occasion, snow.

To that end, Tallahassee Community College is committed to the safety of its students, faculty, staff, visitors and families and, when conditions warrant, will be in constant communication with the appropriate state and local agencies. Through TCC ALERT and the College's Alerts Web site, TCC will communicate important emergency information during weather-related emergencies such as tropical storms and hurricanes, flooding, severe thunderstorms and tornadoes.

During an emergency event, TCC's Alerts Web site www.tcc.fl.edu/alerts, is your source for up-to-the-minute information from Tallahassee Community College. Within minutes of an emergency event, TCC will post details regarding the emergency, protective action recommendations and official announcements regarding cancellations, closures, etc. This page is available 24/7/365. Students, faculty and staff are encouraged to bookmark this page for quick access.
	
Continuation Policy:	CONTINUATION POLICY
o	All students must receive a 75% or higher on the final exam to pass any RET prefix course.  If you receive below a 75% on the final exam, the student will not receive a passing grade for the final course grade.
o	All general studies courses should be completed within (or before) the scheduled semester they are assigned, as listed in the program of study.
o	All Respiratory Care courses must be completed within or before the designated semester before continuing into the next semester.
o	A grade of “C” or better must be obtained in each of the courses listed below to continue to the second semester of the Respiratory Care Program.  The student “May Not” repeat any of these courses.  Any student failing any of the following courses may begin the program with the next admitted class depending on space availability.

               RET 1026         FUNDAMENTALS OF RESPIRATORY CARE
               RET 1026L      FUNDAMENTALS OF RESPIRATORY CARE LAB
               RET1874         CLINICAL PRACTICE IN RESPIRATORY CARE
               RET1483         CLINICAL ASSESSMENT IN RESPIRATORY CARE I
               RET2485          CARDIO-PULMONARY PHYSIOLOGY I

o	A student earning a grade of “F” in any Respiratory Care course, including clinical rotations, will not be permitted to continue the Program regardless of the semester.
o	A student may repeat two respiratory courses, where a “D” grade has been earned.  If more than one “D” is earned within the semester, the student must start the program from the beginning.
o	If a student makes a grade below a “C” on an exam, the student must contact the Instructor of the class.  This meeting will be between the student and the Instructor to outline the student’s options for the particular course.
o	The student must earn a cumulative grade point average of 2.0 or greater to be awarded an Associate in Science Degree in Respiratory Care.