Guidelines for Graduate Nurse
Position:
Graduate nurses provide delegated patient care activities and expand their knowledge, skills and experiences in critical thinking and judgment. These activities support the transition to Registered Nurse once the R.N. license is acquired.
Requirements:
- Duration of employment is four calendar months.
- Failure to obtain a Michigan professional nurse license within 45 days of commencing employment will result in termination.
- Access to scheduled paid time off is at the University's discretion
- The title of “Graduate Nurse” will be changed to Registered Nurse level A . Pay wil be adjusted with first bi-weekly pay period following the University’s receipt of the evidence of licensure.
- Upon licensure, the employee will be subject to the probationary period as outlined in Article XXV.
- Following successful completion of probation, the employee will accrue seniority from the original date of hire as a GN.
- One attempt to successfully pass boards will be given during the 45 day period. If the employee is not successful, he/she will be terminated.
- If the employee is terminated, he/she is eligible to apply for other positions within UMHS for which he/she is qualified. Seniority would not carry over, however, since seniority does not accrue until licensure.
- It is recommended that the GN be hired once they have their exam test date.
Duties/responsibilities
Graduate nurses work under the direction and supervision of a Registered Nurse, who delegates activities and assumes accountability for the care provided by the GN.Duties and responsibilities emphasize assistance and participation in patient care activities.
Key points
As part of the graduate learning experience, the GN may participate in all delegated activities of the R.N. with the following exceptions:
- R.N. will review the patient’s condition, and review and co-sign the following patient care documents prepared by the GN:
- Nursing Assessment
- Plan of Care
- Progress Notes
- Flow sheets
- The GN may not:
- Receive any verbal or telephone orders
- Administer Medications including blood and blood products
- Process written medication orders
- Document on the Medication Administration Record
- Receive an Ominicell password
- Initiate seclusion or restraints
- Delegate or supervise nursing service personnel
- Engage in high risk procedures that place the patient at risk for harm without direct supervision by the RN
- The Graduate Nurse may, and should:
- Identify rationale for medication use on all their patients
- Verify and calculate appropriate medication doses and IV flow rates
- Identify intended effects as well as potential side effects of all medications
- Participate in monitoring patients for side effects and response to medications
- Assist in the preparation of medications and IV solutions under the direct observation of the R.N. preceptor (Note: The R.N. preceptor must double check all IV flow rates and infusion pump settings. Only the R.N. may start IV infusions, whether running on an infusion pump or by gravity flow. Only the RN may “push” IV medications.)
- Monitor patients receiving blood products after the first 15” of the infusion process is completed
- Apply and remove patient restraints (only the R.N. can make the assessment for the initial application of the restraint)
- Each unit must review its orientation competency expectations to determine which activities are appropriate for a GN. A current copy of the Graduate Nurse Orientation Competencies is to be kept on file with Educational Services for Nursing.
- Each unit is responsible for assuring that the above stated guidelines are followed, especially with regard to medication administration. The GN and R.N. preceptors must acknowledge their understanding by signing the Graduate Nurse Orientation competency form.
