This website orientation is intended for use by nursing students with clinical rotations at Craig Hospital. All information presented is the property of Craig Hospital and cannot be reproduced without permission.
This orientation is general and meant to give you an overview of Craig Hospital and provide links to specific information on spinal cord injury and traumatic brain injury. Further orientation will be provided at Craig Hospital on the first clinical day. On the first day, you will be required to sign a document stating you reviewed and understand the website orientation information. Review of the online orientation and completion of the in-house orientation are mandatory for participation of clinical at Craig Hospital.
Craig Hospital is a world-renowned hospital and research center specializing in the care of people who have sustained a spinal cord and/or brain injury. An interdisciplinary team cares for the patients at Craig Hospital and includes Medicine, Nursing, Physical Therapy, Occupational Therapy, Speech Therapy, Respiratory, Pharmacy, Therapeutic Recreation, Dietary Services, Neuropsychology, Psychology, Clinical Care Managers and Outpatient Services.
Craig advocates for, and provides exceptional patient and family-centered care to, those affected by spinal cord and brain injury. Together we strive bravely for optimal health, independence and life quality with unyielding determination.
- Foster independence through education and experiences
- Encourage peer support
- Develop a family atmosphere where caring for others is shared
- Embrace a culture of safety
- Put fun into the process of rehabilitation
- Advance rehabilitation through research
- Enhance life quality through advocacy and education
Craig will be recognized internationally as a leader in providing innovative rehabilitation and health care services through an interdisciplinary team approach focused on delivering exceptional life quality and independence outcomes for people affected by spinal cord and brain injury.
Information for Clinical Shifts
- Students will complete their paperwork on the first day of clinical/orientation.
- Craig follows the Clinical Scholar model and has no instructors from outside of Craig. If we accept a rotation, we are providing the clinical scholar. The exception to this rule may be for CNA rotations.
- Craig hosts rotations for Med/Surg II, Senior Practicum/Internship, Community Health, Leadership, Nursing Education, Nurse Practitioner and CNA rotations.
- You must arrive 10 minutes before the start of your clinical shift. Late arrivals may be sent home.
- Bring your completed prep sheets each clinical shift.
- Bring your stethoscope daily.
- It is not necessary to bring all of your textbooks and drug references, as we have this information available to you on the units.
- Lockers are not available for student use. Please do not bring valuables or large backpacks with you. Do not leave keys or wallets lying around in lounges or nursing stations.
- Refrigerators and microwaves are available on each unit in the staff lounges if you wish to bring your own food. The Craig cafeteria does not provide 24-hour service, but is open for breakfast, lunch and dinner. The small cafeterias on the units are open for patients and families only. Vending machines are available in the East lobby. The gift shop is open Monday-Friday 0900-1700 and Saturday 1000-1600. (Sometimes the gift shop times vary.)
- Specifics about your clinical rotation, assignments due, and when to pick up patient assignments will be discussed during orientation on the first clinical day.
Communication and Report
Report is done verbally. You will be expected to take report from the outgoing nurse and to give report to the incoming nurse regarding your patients. After verbal report, safety checks are done by going room to room. Please review the RN Guidelines for shift report. At 1830 each day, report is done at the bedside so that the patient and their family can participate.
RN Safety Checks
S - Settings (TF, IV, Specialty Bed)
A - Airways (Vent, 02 needs, Pulse Ox, Trach)
F - Fall Risk (Transfer Status, ADL status, Transfer Sheets, Helmet, Orthotics, Collar)
E - Environment (Restraints in room and applied correctly, bed in lowest position, bed rails up, bed alarm, code alert, call light in reach, declutter room)
T - Tube check (catheter draining, TF running, G-tube position, IV/PICC site)
Y - Yellow binder - Plan of Care
SBAR is a method used to communicate information to physicians. We encourage you to be familiar with this method. Review the SBAR Report.
Patient Units at Craig Hospital
Craig Hospital has four inpatient nursing units and an outpatient clinic. The majority of the admissions are newly injured patients with spinal cord injury and/or traumatic brain injury.
- 3 West is a unit for traumatic brain injury with an average census of 20-22 patients. 3 West uses RNs, Rehab Techs and Behavior Attendants to provide the necessary care to patients. Behavior Attendants (BAs) are used to provide the necessary safety and/or behavioral interventions for patients.
- 2 East is a unit, with an average census of 16, for patients with spinal cord injuries. Many of the rooms on 2 East are designed like a studio apartment and allow the patient and family to live together in the space to practice everything prior to discharge. 2 East uses RNs and Rehab Techs to provide care to patients.
- 4 West is an acute spinal cord injury unit, with an average census of 22-24 patients. Newly injured spinal cord patients are admitted to 4 West, including patients requiring mechanical ventilation. 4 West uses RNs and Rehab Techs to provide the necessary care.
- 3 East is a unit, with an average census of 17 patients, for brain injury patients. The rooms on 3 East are designed like a studio apartment and allow the patient and family to live together in the space to practice everything prior to discharge. 3 East is staffed with RNs, Rehab Techs and occasional behavioral attendants.
- Outpatient Clinic sees a variety of patients for re-evaluations, medical check-ups and history/physicals. The clinic includes a genitourinary clinic which sees inpatients as well as outpatients for bladder management issues. The clinic also runs a skin clinic and neurosurgery clinic each week. The clinic has a physician, Nurse Practitioners, RNs and Rehab Techs.
All 5 of these areas can be utilized for nursing student rotations. You will be notified of which unit you are on during the first clinical day. Each unit is unique and therefore differences do exist in how they do report, where supplies are kept, etc. The specifics and a tour will be provided to you during orientation on the first clinical day.
Experiences for Students (varies by unit)
- Spinal cord injury (SCI)
- Traumatic brain injury (TBI)
- Traumatic injuries, disability
- Ventilator and tracheostomy management
- Medication management including oral, IV, SubQ, IM, G-tube, topical, etc.
- Unique medications, large quantity for each patient
- Central line and peripheral IV management
- IV antibiotics, maintenance IVs, TPN, Lipids, etc.
- Tube feeding management
- Patient/family education
- Collaboration with interdisciplinary team including physician report
- Behavior management
- Extensive time management and organizational skills
- Wound management including Wound Vacs and other complex dressings
- Pre- and post-op care
- Extensive care plans and discharge planning
- Continuum of care post-discharge
- Management of complications from spinal cord injury and/or traumatic brain injury
- Spasticity clinic
- Genitourinary clinic in outpatient clinic
- Craig Hospital follows and takes seriously the HIPAA regulations regarding confidentiality and security of patient information.
- All information you learn while at Craig Hospital is confidential and cannot be discussed or shared with anyone.
- No patient information can ever be placed in the trash; Shred-it bins are available at each nursing station to place patient information in. Your worksheets, prep guides, care plans, etc. need to be placed in the Shred-it bin when you are done with them.
- When completing your required paperwork for school, never include the patient name, initials or any other identifying information. You may refer to the patient as "patient," "patient A" or an alias such as "Bob."
- If you need to email an assignment do so from your school account, not your personal email, as it will not have enough security to protect the confidential patient and/or student information.
- Please do not answer the phones at the nursing stations. But you should know we have a process where patients can give a code to their family and friends allowing them to have access to their health information status. Staff will ask for this code prior to disclosing any information over the phone.
- You will be required to sign a confidentiality agreement prior to starting your clinical rotation.
- If you did not complete the Craig-approved HIPAA education at your respective school of nursing, you will be required to complete a HIPAA education module on your first day.
Please review the following policies:
- General Confidentiality Rules for Use and Disclosure of Protected Health Information
- Access to Medical Records by Students in Educational Programs Assigned to Craig Hospital
- Patient Rights & Responsibilities
- Confidentiality Agreement
Please dress in business casual attire for your first clinical day/orientation day. To pick up your patient assignments, please dress in your school uniform (if you have one) or in business casual. YOU MUST HAVE A PHOTO ID ON AT ALL TIMES WHEN YOU ARE IN OUR FACILITY. Our staffers dress casually and do not typically wear scrubs or uniforms. You may wear scrub bottoms and colored tops, business casual or jeans. You are encouraged to dress comfortably yet look professional. The following is a list of items you may not wear:
- Open-toed shoes or sandals
- Tank tops or any shirt exposing the underarm area
- Low-cut and/or tight-fitting shirts
- Low-waisted pants or jeans exposing your abdomen, back or buttock(s)
- Short shirts exposing your abdomen or back
- Artificial nails of any kind. Nails must be trimmed short. Nail polish is allowed, but must have no chips
- Tattoos must be covered up with clothing or a bandage if considered offensive
- Facial piercings are limited to one stud in each ear; please remove all other piercings for clinical
- Keep long hair tied back
- No perfume or cologne
Body Substance Isolation (BSI)
You are expected to follow Body Substance Isolation (BSI) at all times. Sinks are available in every patient room and alcohol hand sanitizer is readily available.
All Craig Hospital patients require Body Substance Isolation (BSI), whether or not they have a diagnosed infectious disease. Assume that every patient is infectious and use appropriate BSI. Patients at Craig Hospital infected and/or colonized with antibiotic-resistant organisms such as MRSA, VRE and Clostridium difficile are managed based on this philosophy. Hospital Associated rates for these microorganisms are closely monitored and have remained low. The key to success is staff compliance. Please review the following document: Standard Precautions.
There are a variety of emergency codes that may be called at Craig. The codes are always preceded by chimes, after which the operator will announce one of the following:
CODE BLUE is for a respiratory or cardiac arrest. The Swedish Medical Center Team will respond to our Code Blue; however, Craig staff is trained and will initiate the Code Blue while waiting for the Swedish team.
EMERGENCY STAT is called for any patient emergency requiring additional assistance from nursing, respiratory and physicians (falls, seizures, respiratory problems, etc.).
CODE RED is the code for a fire/fire drill. These occur regularly. All doors must be closed and hallways cleared of equipment; staff then meets behind the nursing station for further instructions.
CODE BLACK is the code for a bomb threat. You are asked not to answer the phones, but if this should occur you need to get as much information as possible from the caller (i.e., where is the bomb, what does it look like, does it have a timer, when is it supposed to go off, etc.). Keep the person on the phone while having a staff member call the Code Black. Security will get involved and give further instructions.
CODE SILVER is the code for a weapon in the building.
Nursing Student Policy
Please read the policy regarding Nursing Student Rotations so you are familiar with our policy/procedure. This policy provides instructions on student behaviors and co-signing student documentation, as well as a list of items students are not allowed to do at Craig Hospital. You are expected to follow the policies and procedures of Craig Hospital at all times. These are available to you from any computer at the nursing stations using the following steps:
- Click on the Internet Explorer icon.
- From the top toolbar, choose Policies & Forms.
- Choose All Policies and then Patient Care Policies.
- The policies are listed by category, so choose the appropriate category.
- Choose the specific policy needed.
- Staff is always available to help you, as well as your Clinical Scholar. Your Clinical Scholar at Craig is an employee of Craig Hospital, therefore she knows hospital policy and procedure well.
Resources for Cultural Diversity
- Interpreters for non-English-speaking patients
- Staff interpreters available
- Translator phone for non-English-speaking patients
- Words and phrases guides
- Cultural books on units
- Internet access
- Specific information in patients' plan of care
- Chaplain services
- Dietitian for specific food preferences/needs
Medication Administration Information
It is the policy of Craig Hospital that all medications given by a nursing student will be verified for correct dose by the Clinical Scholar or RN preceptor prior to the student administering the medication. Administration of all IV medications must be supervised. Craig Hospital does have a bar coding system for medication administration and you will access the bar coding system for giving medications. Please review the following two policies on medication administration:
Information Specific to SCI and TBI Patients
The information below is a resource for you to complete your assignments as well as gain understanding of spinal cord injury and traumatic brain injury.
- Bladder Management
- SCI (Spinal Cord Injury)
- TBI (Traumatic Brain Injury)
- Bowel Program and Digital Stimulation
- Autonomic Dysreflexia (AD)
- Halo Brace Management and Nursing Care
For any questions or concerns regarding your clinical rotation, please contact your Craig Clinical Scholar.
We look forward to having you as part of the team. Welcome to Craig Hospital!