Preceptor-Student-Faculty Agreement

Bon Secours Memorial College of Nursing
NUR 4143: Clinical Immersion

Preceptor/ Faculty/ Student Agreement
I. Purpose: To provide students with opportunities to enhance practicum learning experiences while
practicing under the guidance of practicing professional nurses.
II. Role and Responsibilities of Preceptor:

 Registered nurse with a Bachelor of Science in Nursing preferred.
 Preceptors shall provide to the nursing education program evidence of competence to
supervise students’ clinical learning experience for quality and safety in each specialty area
where they supervise students.
 Participate in a preceptor orientation facilitated by the nursing education program.
 Agrees to function as a designated student clinical preceptor by completing the preceptor
agreement at the beginning of each semester.
 Facilitate clinical learning experiences for no more than two nursing students at a time.
 Orient nursing student(s) to the clinical agency and its policies and procedures.
 Serve as a role model, resource person, and be present with the nursing student in that
setting providing clinical supervision.
 Guide and supervise the student’s performance of skills and other nursing activities to
ensure patient safety.
 Provides direct supervision of the student, particularly with medication administration
and/or invasive nursing interventions.
 Provide on-site supervision in the clinical care of clients and be responsible and accountable
for the assignment of clients and tasks based on their assessment and evaluation of the
student’s clinical knowledge and skills.
 Preceptors shall also monitor clinical performance and intervene if necessary for the safety
and protection of the clients.
 Provide feedback to the nursing faculty member, assigned to the student, regarding clinical
experience for student and suggestions for program development.
 Provide the nursing student with feedback on his/her progress, based on the clinical
preceptor’s observation of clinical performance, assessment of achievement of clinical
competencies, and patient care documentation.
 Retain ultimate responsibility for the care of the patients/clients. Fulfill nursing duties as
determined by the clinical agency’s policies and procedures.
 A preceptor may not further delegate the duties of the preceptorship.
 Contact nursing faculty member by telephone if faculty assistance is necessary.
 Provides informal verbal and written feedback in an on-going basis to the student and
faculty regarding student performance.
 Provides formal written feedback at mid-point and completion of the student’s practicum
hours regarding student performance on the Practicum Evaluation Tool.
 Communicates with the Clinical Immersion Lead and the nursing faculty member within the
course to provide feedback regarding the preceptor experience.
 Participates in an annual evaluation of the preceptor program.
BSMCON NUR 4143 Clinical Immersion MSH 7/20/23
 Responsible for co-signing all student nurses’ documentation.
III. Role and Responsibilities of Nursing Program
 Prior to placement of the student in a specific clinical environment, the course lead faculty
ensures that the clinical site is an effective learning environment that will allow students to
demonstrate the required competencies of the nursing program.
 Faculty shall be responsible for the designation of a preceptor for each student and shall
communicate such assignment with the preceptor.
 Faculty will ensure that clinical experiences using clinical preceptors occur only after the
student has received applicable theory and clinical skills lab experiences necessary to safely
provide care to clients, as appropriate
 Faculty will provide the preceptor with:
o Written objectives, methodology, and evaluation procedures for a specified period
of time to include the dates of each experience;
o An orientation program;
o A skills checklist detailing the performance of skills for which the student has had
faculty-supervised clinical and didactic preparation.
 Faculty will provide the student with:
o Written objectives and evaluation procedure as defined in the syllabus.
o An orientation program to precepting and the role of the student nurse.
 Faculty will ensure the ratio of student to preceptor shall not exceed two students to one
preceptor at any given time.
 Faculty will meet periodically with clinical preceptor and nursing student to determine
student progress.
 During the period in which students are in the clinical setting with a preceptor, the faculty
member shall be available for communication and consultation with the preceptor. The
designated nursing faculty member shall be available to provide assistance or supervision of
the student at the clinical site, should a problem arise that cannot be resolved by telephone.
 Faculty is responsible for the overall coordination of the preceptorship and assumes
ultimate responsibility for implementation, periodic monitoring, and evaluation.
IV. Role and Responsibilities of Student

 Adheres to the policies and procedures of the practicum facility to which the student is
assigned.
 While enrolled in an approved nursing program, may perform tasks that would constitute
the practice of nursing.
 Demonstrates professional behavior appropriate to the environment of the facility,
including protecting the confidentiality of patient information and maintaining high
standards of patient care.
 Attends an orientation program for the precepted experience.
 Communicates with the course faculty regarding the preceptor practicum experiences on an
ongoing basis.
 Seeks appropriate learning opportunities that assist in meeting the learning objectives for
the precepted experience.
 Takes responsibility and is accountable for individual actions in the practicum setting.

 Performs skills within the guidelines of the facility and for which the student has had
faculty-supervised practicum and didactic preparation.
 Does not perform skills such as medication administration and/or invasive nursing
interventions without direct preceptor supervision.
 Fulfills the course requirements as outlined in the course syllabus.
Preceptor Website: https://bsmcon-preceptor.weebly.com
By signing below, we understand and agree to perform the role and responsibilities as outlined above for the
precepted practicum experience.
Student Printed Name: __________________________ Date: ______________________
Student Signature: _____________________________
Preceptor Printed Name: ________________________ Date: ______________________
Preceptor Signature: ____________________________
Faculty Printed Name: __Michelle Hence, DNP, RNC-OB__ Date: _____8/15/23_________
Faculty Signature: __Michelle Hence, DNP, RNC-OB_________

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Bon Secours Memorial College of Nursing

NUR 4143: Clinical Immersion

II. Role and Responsibilities of Preceptor:

III. Role and Responsibilities of Nursing Program

IV. Role and Responsibilities of Student

BSMCON NUR 4143 Clinical Immersion MSH 7/20/23

Preceptor Website: https://bsmcon-preceptor.weebly.com

Student Printed Name: ____ Date:

Student Signature: _____________________________

Preceptor Printed Name: __ Date:

Preceptor Signature: ____________________________

Faculty Printed Name: Michelle Hence, DNP, RNC-OB Date: _8/15/23_____

Faculty Signature: Michelle Hence, DNP, RNC-OB_______

BSMCON NUR 4143 Clinical Immersion MSH 7/20/23

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