Course Description

This capstone course will include experiences similar to those students are likely to confront as newly employed baccalaureate-prepared registered nurses. Students will have one-on-one work experience with baccalaureate nurse preceptors in selected clinical settings. An emphasis is placed on the development of personal and professional strategies needed to make the transition from student to graduate nurse by highlighting role development skills of bedside nurse leaders.

Course Objectives

• Integrate theoretical concepts from nursing and other disciplines in understanding nursing practice issues.
• Refine personal leadership abilities based on self-assessment and analysis of personal leadership styles.
• Evaluate the health care environment utilizing a systems framework to consider policy, resources, and quality and safety concerns related to the selected nursing practice setting.
• Propose improvements for safe nursing practice using national patient safety initiatives and evidence based research.
• Evaluate and incorporate evidence based research related to professional development for the practice setting.
• Provide evidence based patient centered nursing care for a variety of a patients.
• Evaluate the utilization of patient care technological support systems that support patient care and prevent medical errors in the practice setting.
• Develop collegial relationships with inter- and multidisciplinary team members using management and leadership concepts and therapeutic communication skills while adhering to professional standards and behaviors.
• Prioritize and implement nursing aspects of multidisciplinary health plans which reflect legal and ethical standards of care and practice.
• Perform reflective ongoing self-evaluation of growth in professional nursing practice and attainment of professional practice goals.
• Provide for the safe and effective care of multiple patients and their families through direct care and delegation of care to other members of the health care team.
• Demonstrate the use of critical thinking and clinical judgment as a basis for decision making in clinical practice.

When it Occurs

The capstone course is held after the junior-level courses, either in the summer between junior and senior year, or during January-term of senior year. You are given the opportunity to choose when you would like to take it. The summer capstone course will be held during Summer Session I, and will not conflict with the summer Population-Based Care courses (N420 & 421) that are held in Nottingham, England. When considering your options, please keep in mind that the summer course is not included in your tuition and you will need to pay an additional summer fee.

Summer vs January-Term

Students have different reasons for wanting to take it at one time over the other. Previous students who have taken the course over the summer have done it to allow time to travel in January with another course or college music ensemble, to allow more time for their team sport, to graduate mid-year, or to stay home and work and prepare for applying for jobs and studying for the NCLEX.

Additional Considerations

The decision as to when to take your capstone is an important one. Once you submit your intent, it should only be changed in extenuating circumstances and in collaboration with your advisor. Additionally, you are responsible for finding your own housing during your capstone experience. If you believe you will have difficulty with that, share this with the course instructor or your advisor. They may be able to put you in contact with alumni from the area that are willing to host you during your time.

Choosing a Capstone Site

We make every effort to help you have a meaningful experience. You will be asked to consider possible specialties and locations for your capstone. When thinking about locations, please take into account that your capstone instructor will try to plan a site visit with you during your experience. Because of state laws regarding nursing education and nursing licenses, you will be limited to considering a capstone location in Iowa, Minnesota, or Wisconsin. More information on locations are on pages 4-5.

Some students feel that choosing a practicum site is one of the hardest things that they have to do before graduation! If you are having trouble deciding what to request you are not alone. Here are some tips to think about as you get ready to make a request.

1.       If you are shaky and/or feel at all weak in your basic nursing skills, have a low G.P.A., or need to improve organization and priority setting skills, then we recommend that you request a basic medical-surgical nursing unit experience.

2.       If you feel you have strong clinical skills and you have a strong G.P.A., perhaps you might consider a specialty placement such as an ER or ICU. While typically placement in a specialty area is your choice, if a clinical site limits the number of students in a particular setting, the placement will be at the discretion of the instructor. Your previous clinical instructors may be contacted to determine appropriateness.

3.       There are times when students feel an inpatient setting is not for them. That’s okay! Historically, students have had challenging experiences when in a home health care, hospice, or public health placements. However, outpatient clinics, procedural areas, and long term care facilities are viable options.

4.       Consider the location. If location is an issue due to costs or commuting, please consider this and indicate your needs when completing this request. Be sure to explain your facility preference as a strong factor in your rationale statement.

5.       Already know what nursing area you want to practice in? Then be sure to list the area as your top rationale and then provide choices of hospitals/agencies that provide that experience.

6.       Haven't a clue? Think about what is important to you--geographical area? Size of hospital? Type of care model seen in hospital? Patient population? Readiness to take NCLEX exam? Ask your advisor, clinical instructors, and people who know you best to help you brainstorm. Then carefully craft what you feel would be best, second best and third best for you.

7.       We will do all that we can to place you in your first choice location. However you must know that there is no guarantee that you will be successful in first choices. There are several reasons for this––one is that we are very dependent on the availability of slots in the various hospitals/agencies and we do not have control over their decision to take a student.

8.       The primary reasons that slots are not made available have a lot to do with what is going on on the unit we requested. The nurse managers or nursing educators have the final say because they know the upcoming activities planned, the number of orienting nurses, and the availability of seasoned preceptors. It would not be fair to anyone to place a student with an inexperienced preceptor or on a unit that is stressed out for whatever reason.

9.       Another reason is that we are in competition with other schools for the same type of experience and there are only so many resources available. As our classes have increased in size, so has the number of requests for placements. Carefully choose for your second and third choices as well as your first choice. We will do the best we can to get you what you want within reason and availability of resources.

10.    Your second and third choices must be viable options! For example, if it’s required for us to move to your third choice, you cannot say it’s not a possibility because of lack of housing, etc.

11.    If you have someone in mind to be your preceptor, please include a name and work location. But PLEASE DO NOT APPROACH ANY NURSE MANAGER, STAFF NURSE OR FACILITY. It is the faculty responsibility to coordinate this with the designated facility. We want to avoid any conflicting communication. For example, a nurse you know who would be a good preceptor might already be slated to precept a new graduate or a student from another school. Please give us the information and let us use the organization's process.

12.    Preceptor placements may be confirmed as late as a couple of weeks prior to practicum. You may refer questions to the faculty member who will be teaching the course during your semester.

13.    If you choose to remain local to Decorah for a music or athletic related reason, please remember that your capstone experience must take priority over any of those other events. If you are having difficulty scheduling shifts around your other events, again, the capstone must come first.

Sites for Capstone Experiences

Iowa

Aase Haugen long-term care facility (Decorah)
Finley Hospital (Dubuque)
Gundersen Lutheran Palmer Hospital (West Union)
Mercy Medical Center (Des Moines)
Mitchell County Regional Health Center (Osage)
Pella Regional Health Center (Pella)
University of Iowa (Iowa City)
Veterans Memorial Hospital (Waukon)
Wellington Place long-term care facility (Decorah)
Wheaton Franciscan Healthcare (Waterloo)
Winneshiek Medical Center (Decorah)

Minnesota

Abbott Northwestern Hospital (Twin Cities)
Mayo Clinic (Rochester)
St. Crox Hospice (Plymouth)

Wisconsin

Aspirus Wausau Hospital (Wausau)
Children's Hospital of Wisconsin (Milwaukee)
Columbus Community Hospital (Columbus)

Please note: If you want an inpatient setting in the Twin Cities, Abbott Northwestern is the ONLY option for a hospital setting. If you request placement there and are denied, you will have no other inpatient options in the area. Additionally, Gundersen Lutheran and the Mayo Health System in LaCrosse, Wisconsin, are currently not accepting additional students.

Some hospitals in larger cities first look at the requests from their current school affiliations, then consider ours. Because of this, you may not find out your placement until late in the semester.

Capstone Expectations

You will be expected to do the following during your capstone:

●     Work your preceptor’s hours

●     Complete weekly assignments, including self-evaluations

●     Keep in communication with the instructor about any events

The syllabus for the Capstone will be shared with you prior to the start of your experience.

Communication 

Closer to the time of your capstone experience, you will likely need to complete forms, registration with the institution, or an orientation for the clinical site prior to your starting date. This information is sometimes known far in advance and other times is not known until days before your capstone. During your break, please pay daily attention to your school emails for any notifications from your instructor regarding your experience. Additionally, you will be expected to be in communication with your instructor throughout the experience, keeping them informed of any schedule changes or troubling situations.