Nursing Internship Log-Book For the Bridging Program

1

وزارة التعليم

جامعة طيبةالتمريض كلية

زوحدة الامتيا

Kingdom of Saudi Arabia

Ministry of Education

Taibah University

College of Nursing

Internship Unit

(الامتياز)الإلزامي لتدريبا كتيب

للبرنامج التكميلي )التجسير(

Nursing Internship Log-Book

For the Bridging Program.

First Edition - 1437 H (2015 G)

Name of Nurse Intern ………………………………………………………..

Date Started (from) ………………… Date completes (To) ……………

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Taibah University

College of Nursing

Internship Unit

Prepared by:

Dr. Khaled Mohammed Al-Sayaghi

Associate Professor of Critical Care and Emergency Nursing

Supervisor of the Internship Unit.

Reviewed by:

Mr. Abdullah Alhujaili Dr. Mohammed S. Aljohani

Lecturer of Medical Surgical Nursing Assistant Professor of Emergency Nursing

Vice Dean for Academic Affairs Head of the Medical Surgical Department

Dr. Waleed H Mahallawi

Assistant Professor of Medical Immunology

Vice Dean for Quality and Hospitals Affairs

Approved by:

Dr. Omar M. Al Nozha

Assistant Professor of Medicine & Consultant Endocrinologist

Dean of the College of the Nursing

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Taibah University

College of Nursing

Internship Unit

CONTENTS

Item Page No

Personal details of nurse intern 4

List of abbreviations 5

Rotations achieved by the nurse intern 6

Introduction 7

Objectives of the internship program. 7

Purpose of the log book 7

Internship training period 8

Internship clinical area rotation (time distribution) 8

Instructions for the clinical instructor’s 8

Example for clinical instructor signature in the log book 9

Attendance record form 10

Clinical skills for:

Clinical skills for the basic nursing care 11

Clinical Skills for Medical Department. 12

o Clinical Skills for Dialysis Unit 15

Clinical Skills for Surgical Department. 17

Clinical Skills for Operation Room. 20

Clinical Skills for Emergency Department. 22

Clinical Skills for Intensive Care Unit. 24

Clinical Skills for Pediatric Department 26

Clinical Skills for Maternity and Obstetric Department. 28

Clinical Skills for Labour Room. 30

Clinical Skills for Primary Health Care Center. 32

Clinical Skills for Psychiatry Department. 34

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Taibah University

College of Nursing

Internship Unit

Personal Details of the Nurse Intern

Name: __________________________________________

National ID number: _________________

University Number: _________________________________

Date of Joining in the Program: _________________________________

Date of Completion of Bachelor Requirements: _________________________

Permanent Address: ___________________________________________

__________________________________________________________

Present Address: ________________________________________________

___________________________________________________________

Phone Number:_____________________________________

Mobile Number:____________________________________

E-mail Address: ____________________________________

Signature of the Nurse Intern

Passport Size Photo

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Taibah University

College of Nursing

Internship Unit

List of Abbreviations

ABCDE Airway, Breathing, Circulation, Disability, and Exposure,

ADHD Attention Deficit Hyperactivity Disorder

AV Graft Arteriovenous Graft

ACLS Advanced Cardiac Life Support

BP Blood Pressure

BLS Basic Life Support

CS Caesarean Section

CTG Cardiotocography

CT scan Computed Tomography Scan

CVC Central Venous Catheter

CVP Central Venous Pressure

DBT Dialectical Behavior Therapy

ECG Electrocardiography

ECT Electro-Convulsive Therapy

ED Emergency Department

ERCP Endoscopic Retrograde Cholangiopancreatography

ETT Endotracheal Tube

ESWL Extracorporeal Shock Wave Lithotripsy

GCS Glasgow Coma Scale

GI Gastrointestinal

GIT Gastrointestinal Tract

HEENT Head, Eyes, Ear, Nose and Throat.

HD Hemodialysis

HME Heat and Moisture Exchanger

Per OS By Mouth

ICP Intracranial Pressure

ICU Intensive Care Unit

IM Intramuscular

IV Intravenous

IVP Intravenous Pyelogram

MRI Magnetic Resonance Imaging

NGT Nasogastric Tube

NST Non-Stress Test.

OB Obstetric

OPD Out Patient Department

ORS Oral Rehydration Fluid

OR Operation Room

PA catheter Pulmonary Artery Catheter

PPE Personal Protective Equipment

PPN Peripheral Parenteral Nutrition

SC Subcutaneous

TPN Total Parenteral Nutrition

https://en.wikipedia.org/wiki/Heat_and_moisture_exchanger

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Taibah University

College of Nursing

Internship Unit

Rotations Achieved by the Nurse Intern

Sl. No Name of Rotation Period

Duration Hospital From To

Medical Department

(including of hemodialysis unit) …..weeks

Surgical Department …..weeks

Operation Room (OR) …..weeks

Emergency Department (ER) …..weeks

Intensive Care Unit …..weeks

Pediatric Department …..weeks

Obstetric & Gynecology

Department …..weeks

Primary Health Care Center …..weeks

Department of Psychiatry and

Mental Health. …..weeks

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Taibah University

College of Nursing

Internship Unit

Introduction.

The internship program is a prerequisite for the terms of the Ministry of Education in

Saudi Arabia for the bachelor's degree in nursing and a prerequisite for the terms of the

Saudi Commission for Health Specialties in Saudi Arabia to obtain a license to practice the

nursing profession in the Kingdom. Internship field experience gives the student an

opportunity for training in the different departments which helps to gain practical

experiences. It also gives the opportunity for actual application of all that have been learned

during the study years in the college. By successful completion of this internship period the

graduate is expected to fulfill the objectives of the program and will be awarded the

certificate.

This logbook is designed to provide a guideline for nurse intern during the internship

program. The logbook includes a list of major skills/procedures to ensure the achievement

of clinical objectives of each specific unit rotation. Each specific procedure checklist differs

from one hospital to another thus refer to policy & procedure for details.

The log book is kept by the nurse intern. After completion of skill/task, it is the

responsibility of nurse intern to take the signature from immediate staff nurse trainer

(clinical instructor). The log book must submitted by nurse intern to the internship unit at

the end of the internship.

General Objectives for the Internship Program:

The program aims to:

1. Enable the nurse intern to apply learned theoretical knowledge into practice in various

clinical setting.

2. Improve and refine the nurse intern communication skill and professional relationships

with patients and members of the multidisciplinary health care providers.

3. Improve the nurse intern ability to act independently and as a member of a team in

providing professional nursing care.

4. Acquaint the nurse intern with various hospital policies and procedures.

5. Help the nurse intern to develop the necessary skills and competencies that make

him/her safe practitioners.

Purpose of the Log-Book:

1. To emphasize major competencies and clinical skills in each unit rotation.

2. To assist in the follow up / progress of nurse intern throughout internship program.

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Taibah University

College of Nursing

Internship Unit

Internship Training Period.

All interns in bridging program are expected to work 40 hours a week in a total of 26

weeks.

Internship Clinical Rotations (Time Distribution) for the Bridging Program.

Main Departments

Number of

weeks Specific Areas

Number of

weeks

Girls Boys Girls Boys

Medical Department 4 4 Medical department 3 3

Hemodialysis (HD) 1 1

Surgical Department 2 4 Surgical department 2 4

Operation Room (OR) 2 2 OR 2 2

Emergency Department (ED) 2 4 ED 2 4

Intensive Care Unit (ICU) 2 4 ICU 2 4

Psychiatric Department 4 4

Inpatient department 2 2

Emergency department 1 1

OPD 1 1

Primary Health Care Center 2 2 Vaccination room 1 1

OPD 1 1

Pediatric Department 4 2 Pediatric department 4 2

Obstetrics & Gynecology 4 ------ Maternity & Obstetric 2 ------

Labour Room 2 ------

Instructions for the Clinical Instructors (Preceptors).

All clinical instructors/preceptors need to follow the following key assessment procedure in

assessing nurse interns' performance on each skill in the log book.

Level of Performance: The nurse intern performed the skill task independently under

supervision (including team-work skills, as part of the team).

Performance is measured on two dichotomy:

- Satisfactory: the nurse intern completed the skill task successfully.

- Unsatisfactory: the nurse intern failed to perform the skill task successfully

Not Applicable: the skill is either not applicable or not available at clinical setting and

the nurse intern was not able to observe and perform it. Once selected, the nurse intern

will not be assessed for this skill.

For each skill/task performed by intern, the immediate trainer (clinical instructor/

preceptor/staff nurse trainer) will sign (with initials and date) in the appropriate column

under the level of performance (see the example in the next page).

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Taibah University

College of Nursing

Internship Unit

Example for the Clinical Instructor Signature in the Log Book

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Taibah University

College of Nursing

Internship Unit

Attendance Record Nurse intern name: ____________________________________________________________

Department/Unit: _________________________________ Month ________________ Days Clinical Department Time in Time out Signature Remarks

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31.

Days Absent

Sick Excused Unexcused Vacation

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Taibah University

College of Nursing

Internship Unit

Basic Nursing Care Skills

The following are basic nursing skills that normally repeated in each rotation. To avoid the

repetition of these skill in this logbook, clinical instructor needs to refer to this list when

assess the nurse intern in these basic care skills in each rotation.

Performing admission procedures.

Performing discharge procedures.

Receiving and handover of patient (end of shift endorsement).

Complying with infection control and safety measures.

Performing documentation.

Using effective therapeutic communication skills.

Complying with hospital policies and procedures.

Adhering to professional standers of legal and ethical practices in providing culturally

sensitive care that respects patients' rights, values customs and religious beliefs.

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Taibah University

College of Nursing

Internship Unit

Medical Department

Period of rotation: From _______________________ To _______________

No. of days absent with leave _____________ without leave__________

Attendance: a) Regular / Irregular. b) Punctuality – Yes / No

Objectives of training in the Medical Department.

By the end of the training in the medical department, the nurse intern will be able to:

1. Follow rules and regulation of infection control.

2. Demonstrate skill of history taking and physical examination.

3. Use the nursing process in providing patient care.

4. Perform the routine nursing care (hygienic, feeding, positioning, elimination, …..)

5. Prepare and assist with diagnostic and therapeutic procedures in medical department.

6. Demonstrate a basic level of proficiency in prerequisite mathematical calculations

for medication administration.

7. Demonstrate skills of medication &IV therapy administration.

8. Safely initiate, maintain, and terminate the hemodialysis treatment.

9. Adhere to hospital policies and procedures.

For each skill/task performed by intern, the immediate trainer (clinical instructor/preceptor/staff nurse

trainer) will sign (with initials and date) in the appropriate column under the level of performance.

Clinical Skill/Task Level of Performance Not

Applicable Satisfactory Unsatisfactory

Basic nursing care skills (refer to page 11)

Measure and Document the Vital Signs

Axillary/oral temperature

Radial pulse (rate/rhythm/force/volume) & apical pulse

Use of pulse amplitude

Respiration rate/character/pattern

Blood pressure (manual and automatic)

Utilizes the Nursing Process in the Care of the Patient

Obtains comprehensive patient’s health history.

Perform Complete Physical Assessment

- HEENT assessment

- Respiratory assessment.

- Cardiovascular assessment.

- Neurological assessment and GCS.

- Musculo-skeletal assessment.

https://en.wikipedia.org/wiki/HEENT_examination

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Taibah University

College of Nursing

Internship Unit



- GIT and abdominal assessment.

- Genitourinary assessment.

Formulate nursing diagnosis and sets attainable and

measurable objectives.

Develop a nursing care plan appropriate for identified

nursing diagnoses

Implement the nursing care plan.

Evaluate effectiveness of the nursing care.

Prepare and Administer Medications:

Calculation of medication dosage

Per OS (by mouth).

Per NGT

Per rectum

Subcutaneous injections.

Intravenous injections.

Intramuscular injections.

Topical: skin, eye, nose, and ear.

Mixing two insulins in one syringe

Chemotherapy

Collect the Samples (Specimen) for Laboratory Tests:

Blood samples.

Blood culture.

Swabs: ear, nose, throat, wound.

Drainage fluid sample.

Sputum sample by expectoration.

Urine samples: random, mid-stream clean catch, first

morning, and catheter collection.

Stool sample.

Assisting with Safe Preparation and Post Procedure Care for the following Procedures:

CT Scan/MRI.

Endoscope/Bronchoscope.

Extracorporeal shock wave lithotripsy (ESWL)

Prepare Patient and Equipment and Assist with:

Lumbar puncture

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Taibah University

College of Nursing

Internship Unit



Bone marrow puncture

Thoracentesis

Paracentesis

Liver biopsy and liver abscess aspiration.

Prepare and Perform the following Procedures:

Gastric tube (inserts, care, and remove).

Gastric wash/lavage.

Bolus enteral tube feeding.

Recording the 12-leads ECG.

Monitors blood sugar by gulco-check machine.

Indwelling urinary catheter (insert, care, & remove).

Condom catheter to male patient.

Urine screening for sugar, albumin, acetone.

Bed making (unoccupied/occupied)

Name Signature Date

Clinical Instructor

Head Nurse/Charge Nurse

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Taibah University

College of Nursing

Internship Unit

Hemodialysis Unit (Artificial Kidney Unit)



Attendance: a) Regular / Irregular. b) Punctuality – Yes / No

For each skill/task demonstrated by intern, the immediate trainer (clinical instructor/preceptor /staff

nurse trainer) will sign (with initials and date) in the appropriate column under the level of performance.




Set up and Test the Delivery System.

Perform system start up procedure

Priming dialyzer

Perform alarm systems function test

Perform manual conductivity test

Perform manual temperature test

Perform manual pH test

Perform manual pressure holding test.

Perform basic operator troubleshooting

Administers heparin bolus through venous line.

Perform the Vascular Access Procedures.

Assesses access for function and lack of pathology.

Cleans needle site with appropriate disinfectant.

Cannulates fistula at 25 angle and AV graft at 45

angle.

Pre-dialysis CVC care and dressing change.

Initiates dialysis with internal vascular access/with CVC

Collect Blood Specimens

Care and Monitor the Patient and Equipment During Hemodialysis.

Systemic assessment of patient and the patient

subjective response to treatment.

Monitor volume status.

Assess vascular access function.

Monitor the arterial and venous pressures and the

blood flow rate.

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Taibah University

College of Nursing

Internship Unit



Management of anticoagulation.

Ultrafiltration calculation

Administer mannitol, blood & blood product.

Perform Machine Alarm Troubleshooting Procedures

Blood leak alarm.

Arterial pressure alarm.

Venous pressure alarm.

Conductivity alarm.

Ultrafiltration alarm.

High temperature alarm.

Air/foam detector alarm.

Power failure alarm.

Blood pump alarm.

Properly Discontinues Dialysis with Internal Vascular Access/with CVC.

Return of blood.

Performs post dialysis vascular access care.

Properly assesses access for function and cessation

of bleeding from needle sites.

Perform the Equipment Clean Up and Sterilization.

Properly cleans and disinfects exterior of machine.

Perform the machine chemical disinfection.

Perform the standard rinse/ acetic acid rinse/

bleach rinse procedure

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Surgical Department



Attendance: a) Regular / Irregular b) Punctuality – Yes / No

Objectives of training in the Surgical Department.

By the end of the training in the surgical department, the nurse intern will be able to:

1. Provide preoperative nursing care.

2. Provide immediate and routine post-operative nursing care.

3. Provide the care for patient with common surgical disorders.

4. Prepare and assist with diagnostic and therapeutic procedures in surgical department.

5. Provide direct nursing care for patients with common surgical interventions.

6. Provide wound care and the care for diabetic foot.

7. Demonstrate skills and roles of scrub nurse and circulating nurse in operation room.






Safely lifting a patient:

Bed to chair/chair to bed.

Trolley to bed/bed to trolley.

Transporting patients on a stretcher and in wheel chair

Insert, maintain & remove the peripheral IV cannula.

Apply the external heating/cooling device (use of

hyper/hypothermia blanket).

Perform blood and blood products transfusion.

Preoperative Management.

Organize chest x-rays, ECG, blood work and check

pre-operative checklist.

Teach patient and prepare the patient’s skin.

Prepare and administer the enema.

Transfer patients to OR and from recovery room.

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Taibah University

College of Nursing

Internship Unit



Post-Operative Management

Receive the patient from OR, position the patient in

bed and provide the immediate post-operative care.

Assess the pain level.

Assess the neurovascular status.

Guide the patient using of incentive spirometry.

Measure fluid intake and output.

Wound Care and Surgical Dressing.

Setup of sterile surgical field, add the supplies and

pour solution aseptically.

Change surgical dressing aseptically.

Cleanse, irrigate, pack, and dress the open wound.

Monitor and care of drains/hemovac devices.

Remove sutures and staples.

Care and change dressing for diabetic foot.

Irrigate the colostomy and perform stoma site care

Apply/change the stoma appliances for the

colostomy (bags, wax).

Provide the care of the patient with a chest tube and

underwater seal drainage system.

Prepare and assist with pleural/ mediastinal chest

tube removal.

Renal/Urologic Management.

Insert, care, and maintain the three way indwelling

urinary catheter.

Perform and maintain intermittent/continuous

closed bladder irrigation

Provide the care of nephrostomy tube

Prepare & assist with suprapubic catheter insertion

Provide the care of the suprapubic catheter.

Orthopedic and Care of Tractions

Prepare patient for traction application

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Taibah University

College of Nursing

Internship Unit



Maintain and care of traction (skin and skeletal)

Provide the pin care.

Prepare materials and patient for cast application.

Provide plaster cast care & after cast removal care

Assisting with Safe Preparation and Post Procedure Care for the Following Procedures:

Colonoscopy

Endoscopic Retrograde Cholangiopancreatography

(ERCP).

Upper GI Series (barium swallows)

Lower GI Series ( barium enema )

I.V.P. / Excretory urography

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Operation Room Period of rotation: From _______________________ To _______________


Attendance: a) Regular / Irregular b) Punctuality – Yes / No






Before the Operation

Receive patient from surgical department and

provide psycho-social support for patients.

Prepare operation table.

Prepare operation instrument tables/trolleys

(sterile field), sheets and instruments (circulating

nurse).

Anticipates, provides and arranges properly the

needed supplies and equipment for the operation.

Perform vital signs and haemodynamic

monitoring.

Position patients for operative procedures –

standard surgical positions.

Perform surgical scrubbing using correct

technique and timeframe (scrub nurse)

Perform sterile gowning and gloving (scrub

nurse)

During the Operation:

Keeps track of instruments as to location and

numbers (scrub nurse/circulating nurse)

Anticipates the needs of the surgeon and the

surgical team with confidence (scrub

nurse/circulating nurse)

Accurately counts and promptly records sponges

and instruments before the cutting time, and the

closing time.

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Taibah University

College of Nursing

Internship Unit



Maintain sterile field-aseptic technique:

maintains sterility of supplies, equipment and

area at all times

After the Operation:

Accurately counts and promptly records sponges

and instruments after closing time (scrub

nurse/circulating nurse).

Helps in application of dressing.

Provide immediate post-operative care.

Assist in cleaning the OR suite/theater after use,

in preparation the OR for the next case/use.

Disposes waste material properly

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Emergency Department (ED) Period of rotation: From _______________________ To _______________


Attendance: a) Regular / Irregular. b) Punctuality – Yes / No.

Objectives of Emergency Department:

By the end of the training in the department of emergency, the nurse intern will be able to:

1. Receive patient at triage area and categorize them.

2. Identify the appropriate action for the emergency situation.

3. Provide nursing care for patients with common emergency problem.

4. Prepare equipment and assist in emergency procedures.

5. Document clearly according to hospital policy.

6. Calculate and administer the common emergency medication.

7. Communicate effectively with patients and their families, and other colleagues.

8. Develop leadership skills.






Check crash cart contents, test the defibrillator safely,

and accurately reporting any discrepancies.

Perform emergency primary assessment (ABCDE)

Perform emergency secondary assessment.

Perform triaging: able to demonstrate & assist in

prioritizing patients management

Perform BLS procedures

Provide bag-valve-mask ventilation

Participate in ACLS and administer the ACLS drugs

Prepare and assist with defibrillation/cardioversion.

Insert the nasopharyngeal and oropharyngeal airway.

Prepare and assist with the tracheal intubation.

Prepare and assist with the tracheostomy.

Perform naso- and oropharyngeal suctioning.

Insert the peripheral IV catheter, withdraw blood

sample and provide the IV fluid resuscitation.

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Taibah University

College of Nursing

Internship Unit



Prepare and assist with insertion and set up of the

central venous line and the Quinton catheter.

Prepare and assist with cutdown

Perform Allen's test and obtain arterial blood sample

Apply pulse oximetry to the patient

Provide O2 therapy by simple face mask, venturi

Mask, and by nasal cannula.

Prepare patient, equipment, and chest drainage system

(Pleurevac drainage) & assist with chest tube insertion

Prepare patient and equipment, and assist with

pericardiocentesis.

Administer medication by inhalers and nebulizer.

Administer common emergency medications.

Administer the thrombolytic therapy.

Prepare and assist with esophagogastric Tamponade

Tube insertion (Sengstaken-Blakemore tube).

Provide the care for open and traumatic wound.

Set up suture tray and assist with wound closure (by

suturing and staples).

Perform eye irrigation and apply the eye patch.

Perform nasal packing

Immobilize cervical spine by cervical collar and

immobilize spine with the long spine board.

Stabilize fractures with splints (including cast splint)

Receiving and transferring patient from the ambulance

or private car to the emergency trolley

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Intensive Care Unit Period of rotation: From _______________________ To _______________



Objectives of Intensive Care Unit Rotation.

Upon completion of the clinical training in the ICU, the nurse intern will be able to:

1. Demonstrate high technical skills in caring for critically ill patients in ICUs.

2. Prioritize care to critical care patients.

3. Demonstrate confidence in clinical decision making within the professional nursing role

in the critical care setting.

4. Integrate knowledge from nursing science in the nursing care of critically ill patient.

5. Prepare equipment and assist in critical care procedures.

6. Calculate and administer the common ICU medication.

7. Communicate effectively with patients and their families, and other colleagues.






Set up ventilator, adjust the ventilator setting as

prescribed and test the alarm system.

Provide the care of mechanically ventilated patient.

Trouble shooting the ventilator alarms.

Perform endotracheal tube care (changing position,

changing the tie and fixation)

Perform tracheostomy and tracheostomy tube care.

Perform ETT/tracheostomy tube suctioning.

Collect sputum sample by suction.

Perform extubation according to physician order.

Perform chest physiotherapy.

Provide O2 therapy by tracheotomy mask/trach

collar and T-piece

Prepare and assist with insertion and set up of:

Arterial line

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Taibah University

College of Nursing

Internship Unit



PA catheter/Swan-Ganz catheter.

Temporary pacemaker transcutaneous

/transvenous.

Set up and zeroing a pressure transducer and

monitoring system for the CVP and arterial line.

Obtains CVP readings using a water manometer and

pressure monitor.

Provide care for the central venous line/PA catheter.

Provide care for arterial catheter and arterial line.

Flush central venous line

Draw blood from central venous line/ PA catheter

Administer IV push medications and fluids through

the central venous line.

Draw blood from arterial line

Remove central venous line.

Remove arterial line

Set up cardiac monitor, adjust and test the alarm

system and initiate the cardiac monitoring.

Use IV infusion pumps and IV syringe pumps

Administer continuous enteral feeding by pump

Administer TPN, PPN and lipids.

Provide perineal care

Provide eye care

Provide oral care

Provide hair care

Provide complete/partial bed bath.

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Pediatric Department




Objectives of training in the Pediatric Department.

By the end of the training in the pediatric department, the nurse intern will be able to:

1- Assess growth and anthropometrics & recording on graph.

2- Demonstrate skills of history taking (assessment of newborn, preterm & pediatric).

3- Perform physical examination for every child correctly and completely.

4- Assess the signs and symptoms of common serious childhood illnesses.

5- Perform nursing care for common pediatric medical and surgical disorders.

6- Assist in common diagnostic and therapeutic procedures.

7- Provide health teaching to the parent.






Take health history and perform complete pediatric

physical assessment.

Assess infant/child growth & development:

Weight and height.

Head, chest and abdominal circumference.

Record on growth graph.

Measure & document vital signs.

Pulse, respiration, and B.P.

Temperature: axillary and rectal by glass and

electronic thermometer, and by tympanic probe.

Apply the pulse oximeter to the neonate, infant and child

Administer oxygen therapy by simple face mask, nasal

cannula, and head box/hood.

Obtain capillary blood sample from the heel.

Perform vein puncture and withdraw blood sample

Insertion of peripheral IV cannula and provide the care of

IV Heplock/cannula and cannula flashing.

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Taibah University

College of Nursing

Internship Unit



Prim & regulate the flow rate of IV fluids.

Calculate the pediatric medication dosage

Prepare and administer medications (oral, SC, IV & IM).

Administer medication by nebulizer/inhaler

Prepare and administer the ORS.

Prepare and provide bottle feeding.

Insert, care, and remove gastric tube.

Prepare and administer feeding through the gastric tube

and gastrostomy.

Administer TPN/PPN.

Provide the phototherapy.

Use radiant warmer.

Perform chest physiotherapy.

Perform passive exercise/guide the child for active exercise

Perform the paediatric/neonate hygiene

Complete/partial bath.

Diaper care.

Make up a bed/cot, use the bedrails and restraints

appropriately when required.

Lift and transport pediatric patient.

Provide nursing management for child with common

medical disorders

Provide pre-operative and post-operative care for the child

with common surgical disorders.

Prepare patient for discharge (give patient & parents health

teaching about appointments, medications, diet & any

special instruction)

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Maternity/Obstetric Department (for female nurse interns)




Objectives of the Maternity/Obstetric Department Rotation

By the end of maternity/obstetric clinical training, the nurse intern will be able to:

1. Take complete history and perform physical assessment and examination for

pregnant woman and mother’s in the postpartum period.

2. Formulate nursing diagnosis addressing woman unmet need according to priorities.

3. Perform nursing interventions and nursing care based upon the formulated plans.

4. Provide nursing care by applying nursing process for high risk pregnant women.

5. Provide nursing care for post partum women.

6. Provide antenatal and postnatal health education regarding breast feeding, schedule

of immunization, family planning methods, nutrition and exercise.





Basic nursing care skills (refer to page 11) Antenatal. Obtain the estimated date of delivery and the OB history.

Perform physical examination of pregnant patient/

obstetric examination.

Perform breast examination

Perform Leopold's maneuvers (abd. maneuver)

Assist with pelvic examination during pregnancy.

Auscultate & record fetal heart rate using Pinard

stethoscope & doppler

Test urine for protein & sugar using urinary dipstick.

Assist with non-stress test (NST)

Perform the external cardiotocography (CTG):

Set–up the and apply CTG machine

Monitor contraction and fetal heart rate

Interpret CTG reading & reporting abnormalities.

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Taibah University

College of Nursing

Internship Unit



Assist with self-care, breast care, and perineal care.

Observe & recognize blood loss through vagina (P.V loss)

Assist with Prostin vaginal tablets insertion.

Prepare patient for CS (preoperative care)

Post-Natal.

Administer of oxytocin injection and infusion as prescribed

Perform postpartum assessment:

Vital signs and pain level

Examine the abdomen and fundal height

Perineum condition, lochia and assess for vaginal

bleeding/perform the pad measurement

Perform uterine massage

Perform episiotomy care

Assist with self-perineal care

Provide breast care

Assist/support breast feeding

Provide postoperative care for patient with CS

Provide postpartum health education about the:

Routine newborn care & hygiene

Breast care and establishment of breast feeding

Post-natal exercise

Milk Formula’s: types & rationale, preparation, and

sterilization of bottles & teats

Immunization schedule

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Labour Room (for female nurse interns)




Objectives of the Labour Room Rotation.

By the end of training in labour room, the nurse intern will be able to:

1. Prepare woman for normal vaginal delivery and for emergency cesarean section.

2. Perform vaginal examination during labour.

3. Assess mother's general & local condition during labour (using partogram).

4. Provide nursing care during stages of labour.

5. Prepare and assist in episiotomy incision and repair.

6. Perform immediate newborn baby assessment and care.






Measure and record vital signs

Palpate abdomen and determine the fetal position

Assess uterine contractions

Establish an IV line/ collect of blood works

Administer fleet enema as indicated

Insert urinary catheter and test urine

Management of Patient in Labour: Monitor contraction and fetal heart rate

Use/fill the Partogram

Perform vaginal examination & assess cervix dilation

Set up the delivery table

Set up the trolley and instruments for delivery,

episiotomy and suturing.

Assist with normal vaginal delivery

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Taibah University

College of Nursing

Internship Unit



Assist with episiotomy & repair

Prepare patient for emergency caesarian section

Administer the drugs (Syntocinon and Methergin)

Provide the Immediate Baby Care Suction the baby and clear the airway.

- Bulb syringe/nasal suctioning/ oral suctioning

Measure the Apgar score

Dry and wrap the baby

Administer of oxygen as indicated

Prepare for and assist with newborn resuscitation.

Provide eye care

Assess/examine the newborn baby

Measure the baby head circumference, weight & height

Collect of blood from umbilical cord

Apply identification of newborn

Fill in the proper documentation

Immediate Postpartum Care of Mother. Inspect the placental membranes

Assess the uterus and perform uterus massage

Assess Lochia/check for post-partum hemorrhage

Provide the perineal - episiotomy care.

Check criteria for transfer to obstetric unit.

Filling in the birth register and the obstetrical booklet

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Primary Health Care









Assess and Record the Vital Signs

Temperature by axillary, oral, rectal, or tympanic

Pulse: apical rate and the radial rate

Respiration

Blood pressure

Antenatal Care.

Measure the mother’s weight and height.

Measures correctly mother blood pressure & pulse

Perform physical examination.

Perform Leopold maneuver

Auscultates abdomen to listen to fetal heart sound

Checks the woman fore danger signs of pregnancy

Assess for pitting edema

Gives the woman the necessary instructions & date

of next visit

Obtain the pediatric anthropometric measurements

Measures weight and length

Measures head, chest, and abdomen circumference

Fill the growth chart and assessing for the normal

growth & development

Vaccination Clinic

Administer IM injection

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Taibah University

College of Nursing

Internship Unit



For Infants:

- Rectus femoris (mid anterior thigh)

- Vastus lateralis (middle third thigh)

For Toddlers and school age (poster dose).

- Poster gluteal ( Upper outer quadrant )

- Ventro gluteal

- Deltoid

- Lateral and anterior aspect of the thigh

Administer intradermal injection

Administer subcutaneous injection

Provide health education to mothers about normal

reaction of vaccine and action

Dressing Room

Provide wound care.

Remove the sutures.

Chronic Diseases Clinic

Screen urine for glucose, ketones, and protein.

Collect urine sample: mid-stream or random

Check blood glucose by using gluco-check machine

Administer oxygen therapy by low devices system:

nasal cannula/ simple face mask

Administer medications by small volume nebulizer

Administer medications by IM, IV, SC injections

Name Signature Date

Clinical Instructor


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Taibah University

College of Nursing

Internship Unit

Psychiatry Department Period of rotation: From _______________________ To _______________



Objectives of the Psychiatry Department Rotation.

Upon completion of the training in psychiatry department, the nurse intern will be able to:

1. Apply, with direction, the principles and concepts of primary health care specific to

nursing contexts at a beginning level.

2. Use reflective practice, critical thinking and evidence-based practice in clinical

decision-making.

3. Demonstrate the knowledge and skill necessary for nursing assessment and screening

with children and adults.

4. Demonstrate skills of therapeutic communication and needs assessment when

working with children, adults, families and communities.

5. Apply principles of social justice, cultural safety and equity in primary health care

6. Demonstrate, with guidance, clear and accurate documentation in line with legal and

ethical requirements in the primary health care setting.





Basic nursing care skills (refer to page 11).

Perform the initial nursing assessment

Perform mental status and neurological examination.

Perform the suicide risk assessment.

Use the Therapeutic Approaches:

Behavior therapy (behavior management techniques)

Cognitive-behavioral treatment

Dialectical behavior therapy (DBT)

Hypnosis

Therapeutic limit settings

Group psychotherapy.

Family therapy

Individual psychotherapy

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Taibah University

College of Nursing

Internship Unit



Milieu therapy (use of milieu to enhance patient care

and to decrease confusion and tension)

Impulse control techniques

Relaxation therapy

Activity and recreation therapy

Social and vocational training

Patient teaching

Use therapeutic communication skills

Use therapeutic verbal communication

Limits use of non- therapeutic verbal communication

Use non- verbal communication: uses of appropriate

gestures and distance for patient personal space.

Administer and monitor for the following medications:

Controlled medicine (Narcotics)

Antabuse

Anticonvulsants

Antidepressants

Antipsychotics

Benzodiazepines/Anxiolytics

Anti-cholinergic drugs

Methadone

Mood stabilizers

Attention deficit hyperactivity disorder (ADHD)

medications

Prepare and assist in electro-convulsive therapy (ECT)

Apply suicidal precautions and manage patient with

assaultive behavior

Apply seizure precautions and manage patient with seizures

Manage drug/alcohol detox/withdrawal symptoms

Perform rapid tranquilization as prescribed.

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Taibah University

College of Nursing

Internship Unit



Perform chemical restraints (by drugs) as prescribed

Perform isolation procedures (seclusion) & observation.

Apply and assess the physical restraint:

Ambulatory cuffs

Full restraints.

Wrist restraints

Care and handles patient with: Anxiety and anxiety disorders

Schizophrenia

Mood disorders and suicide

Personality disorders

Cognitive disorders

Substance Abuse (alcoholic patient and drug

dependent patient)

Eating disorders

Somatoform disorders

Perform discharge planning

Name Signature Date

Clinical Instructor


Documents

Nursing Internship Log-Book For the Bridging Program