Application for Clinical Students

 

Application Steps

Complete the steps in order below:

 

Clinical Instructors

• Act professionally and maintain a caring attitude while interacting with patients, patient’s families, physicians, and employees of MMH.
• Adhere to general rules, policies, and regulations of Madison Memorial Hospital.
• Work under the direction of the assigned staff member who retains responsibility for the patient.
• Receive patient information as per unit protocol and abide by all HIPAA regulations.
• Immediately inform the patient care provider of significant changes in a patient’s condition.
• Wear uniforms, scrubs, or conservative business attire at all times while representing the school at the hospital.
• Educational institution photo ID or MMH photo ID at all times must be worn and visible at all times.
• Respectfully support the patient’s right to refuse to have students participate in their care.
• Work within the appropriate level of education, seeking direction and validation from the MMH preceptor/supervisor or his/her instructor.
• Not give any medication (PO, IV) or perform any invasive procedures unless the MMH provides direct supervision (physically standing next to the patient) and only in accordance with the student’s syllabus.
o EXCEPTION: In conjunction with a school course description, nursing students in the final semester of their educational program may, with oversight of their preceptor/supervisor, administer medications independently after verifying correct medication, dose, route, time, and patient.
• Utilize the materials and/or orientations provided to become knowledgeable of facility safety procedures, which include:
• Know how to handle emergencies, hazardous materials, or disasters.
• Know of and follow facility security, safety, and infection control procedures
• Have CPR certification, if providing direct patient care.

EMS

• Act professionally and maintain a caring attitude while interacting with patients, patient’s families, physicians, and employees of MMH.
• Adhere to general rules, policies, and regulations of Madison Memorial Hospital.
• Work under the direction of the assigned staff member who retains responsibility for the patient.
• Receive patient information as per unit protocol and abide by all HIPAA regulations.
• Immediately inform the patient care provider of significant changes in a patient’s condition.
• Wear uniforms, scrubs, or conservative business attire at all times while representing the school at the hospital.
• Educational institution photo ID or MMH photo ID at all times must be worn and visible at all times.
• Respectfully support the patient’s right to refuse to have students participate in their care.
• Work within appropriate level of education, seeking direction and validation from the MMH preceptor/supervisor or his/her instructor.
• Not give any medication (PO, IV) or perform any invasive procedures unless the MMH provides direct supervision (physically standing next to patient) and only in accordance with the student’s syllabus.
o EXCEPTION: In conjunction with school course description, nursing students in the final semester of their educational program may, with oversight of their preceptor/supervisor, administer medications independently after verifying correct medication, dose, route, time, and patient.
• Utilize the materials and/or orientations provided to become knowledgeable of facility safety procedures, which include:
o Know how to handle emergencies, hazardous materials, or disasters.
o Know of and follow facility security, safety, and infection control procedures
o Have CPR certification, if providing direct patient care.

Laboratory Science

• Act professionally and maintain a caring attitude while interacting with patients, patient’s families, physicians, and employees of MMH.
• Adhere to general rules, policies, and regulations of Madison Memorial Hospital.
• Work under the direction of the assigned staff member who retains responsibility for the patient.
• Receive patient information as per unit protocol and abide by all HIPAA regulations.
• Immediately inform the patient care provider of significant changes in a patient’s condition.
• Wear uniforms, scrubs, or conservative business attire at all times while representing the school at the hospital.
• Educational institution photo ID or MMH photo ID at all times must be worn and visible at all times.
• Respectfully support the patient’s right to refuse to have students participate in their care.
• Work within the appropriate level of education, seeking direction and validation from the MMH preceptor/supervisor or his/her instructor.
• Not give any medication (PO, IV) or perform any invasive procedures unless the MMH provides direct supervision (physically standing next to the patient) and only in accordance with the student’s syllabus.
o EXCEPTION: In conjunction with a school course description, nursing students in the final semester of their educational program may, with oversight of their preceptor/supervisor, administer medications independently after verifying correct medication, dose, route, time, and patient.
• Utilize the materials and/or orientations provided to become knowledgeable of facility safety procedures, which include:
• Know how to handle emergencies, hazardous materials, or disasters.
• Know of and follow facility security, safety, and infection control procedures
• Have CPR certification, if providing direct patient care.

Nursing

• Act professionally and maintain a caring attitude while interacting with patients, patient’s families, physicians, and employees of MMH.
• Adhere to general rules, policies, and regulations of Madison Memorial Hospital.
• Work under the direction of the assigned staff member who retains responsibility for the patient.
• Receive patient information as per unit protocol and abide by all HIPAA regulations.
• Immediately inform the patient care provider of significant changes in a patient’s condition.
• Wear uniforms, scrubs, or conservative business attire at all times while representing the school at the hospital.
• Educational institution photo ID or MMH photo ID at all times must be worn and visible at all times.
• Respectfully support the patient’s right to refuse to have students participate in their care.
• Work within the appropriate level of education, seeking direction and validation from the MMH preceptor/supervisor or his/her instructor.
• Not give any medication (PO, IV) or perform any invasive procedures unless the MMH provides direct supervision (physically standing next to the patient) and only in accordance with the student’s syllabus.
o EXCEPTION: In conjunction with a school course description, nursing students in the final semester of their educational program may, with oversight of their preceptor/supervisor, administer medications independently after verifying correct medication, dose, route, time, and patient.
• Utilize the materials and/or orientations provided to become knowledgeable of facility safety procedures, which include:
• Know how to handle emergencies, hazardous materials, or disasters.
• Know of and follow facility security, safety, and infection control procedures
• Have CPR certification, if providing direct patient care.

Pharmacy

• Act professionally and maintain a caring attitude while interacting with patients, patient’s families, physicians, and employees of MMH.
• Adhere to general rules, policies, and regulations of Madison Memorial Hospital.
• Work under the direction of the assigned staff member who retains responsibility for the patient.
• Receive patient information as per unit protocol and abide by all HIPAA regulations.
• Immediately inform the patient care provider of significant changes in a patient’s condition.
• Wear uniforms, scrubs, or conservative business attire at all times while representing the school at the hospital.
• Educational institution photo ID or MMH photo ID at all times must be worn and visible at all times.
• Respectfully support the patient’s right to refuse to have students participate in their care.
• Work within the appropriate level of education, seeking direction and validation from the MMH preceptor/supervisor or his/her instructor.
• Not give any medication (PO, IV) or perform any invasive procedures unless the MMH provides direct supervision (physically standing next to the patient) and only in accordance with the student’s syllabus.
o EXCEPTION: In conjunction with a school course description, nursing students in the final semester of their educational program may, with oversight of their preceptor/supervisor, administer medications independently after verifying correct medication, dose, route, time, and patient.
• Utilize the materials and/or orientations provided to become knowledgeable of facility safety procedures, which include:
• Know how to handle emergencies, hazardous materials, or disasters.
• Know of and follow facility security, safety, and infection control procedures
• Have CPR certification, if providing direct patient care.

Physical Therapy

• Act professionally and maintain a caring attitude while interacting with patients, patient’s families, physicians, and employees of MMH.
• Adhere to general rules, policies, and regulations of Madison Memorial Hospital.
• Work under the direction of the assigned staff member who retains responsibility for the patient.
• Receive patient information as per unit protocol and abide by all HIPAA regulations.
• Immediately inform the patient care provider of significant changes in a patient’s condition.
• Wear uniforms, scrubs, or conservative business attire at all times while representing the school at the hospital.
• Educational institution photo ID or MMH photo ID at all times must be worn and visible at all times.
• Respectfully support the patient’s right to refuse to have students participate in their care.
• Work within the appropriate level of education, seeking direction and validation from the MMH preceptor/supervisor or his/her instructor.
• Not give any medication (PO, IV) or perform any invasive procedures unless the MMH provides direct supervision (physically standing next to the patient) and only in accordance with the student’s syllabus.
o EXCEPTION: In conjunction with a school course description, nursing students in the final semester of their educational program may, with oversight of their preceptor/supervisor, administer medications independently after verifying correct medication, dose, route, time, and patient.
• Utilize the materials and/or orientations provided to become knowledgeable of facility safety procedures, which include:
• Know how to handle emergencies, hazardous materials, or disasters.
• Know of and follow facility security, safety, and infection control procedures
• Have CPR certification, if providing direct patient care.

Radiology

• Act professionally and maintain a caring attitude while interacting with patients, patient’s families, physicians, and employees of MMH.
• Adhere to general rules, policies, and regulations of Madison Memorial Hospital.
• Work under the direction of the assigned staff member who retains responsibility for the patient.
• Receive patient information as per unit protocol and abide by all HIPAA regulations.
• Immediately inform the patient care provider of significant changes in a patient’s condition.
• Wear uniforms, scrubs, or conservative business attire at all times while representing the school at the hospital.
• Educational institution photo ID or MMH photo ID at all times must be worn and visible at all times.
• Respectfully support the patient’s right to refuse to have students participate in their care.
• Work within the appropriate level of education, seeking direction and validation from the MMH preceptor/supervisor or his/her instructor.
• Not give any medication (PO, IV) or perform any invasive procedures unless the MMH provides direct supervision (physically standing next to the patient) and only in accordance with the student’s syllabus.
o EXCEPTION: In conjunction with a school course description, nursing students in the final semester of their educational program may, with oversight of their preceptor/supervisor, administer medications independently after verifying correct medication, dose, route, time, and patient.
• Utilize the materials and/or orientations provided to become knowledgeable of facility safety procedures, which include:
• Know how to handle emergencies, hazardous materials, or disasters.
• Know of and follow facility security, safety, and infection control procedures
• Have CPR certification, if providing direct patient care.

Respiratory Therapy

• Act professionally and maintain a caring attitude while interacting with patients, patient’s families, physicians, and employees of MMH.
• Adhere to general rules, policies, and regulations of Madison Memorial Hospital.
• Work under the direction of the assigned staff member who retains responsibility for the patient.
• Receive patient information as per unit protocol and abide by all HIPAA regulations.
• Immediately inform the patient care provider of significant changes in a patient’s condition.
• Wear uniforms, scrubs, or conservative business attire at all times while representing the school at the hospital.
• Educational institution photo ID or MMH photo ID at all times must be worn and visible at all times.
• Respectfully support the patient’s right to refuse to have students participate in their care.
• Work within the appropriate level of education, seeking direction and validation from the MMH preceptor/supervisor or his/her instructor.
• Not give any medication (PO, IV) or perform any invasive procedures unless the MMH provides direct supervision (physically standing next to the patient) and only in accordance with the student’s syllabus.
o EXCEPTION: In conjunction with a school course description, nursing students in the final semester of their educational program may, with oversight of their preceptor/supervisor, administer medications independently after verifying correct medication, dose, route, time, and patient.
• Utilize the materials and/or orientations provided to become knowledgeable of facility safety procedures, which include:
• Know how to handle emergencies, hazardous materials, or disasters.
• Know of and follow facility security, safety, and infection control procedures
• Have CPR certification, if providing direct patient care.

Clinical Student Application

List(Required)