SLHD Nursing Work Experience - Sydney Local Health District · within the Sydney Local Health...
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Reviewed June 2011 Reviewed November 2014 Reviewed September 2016 SLHD Nursing Work Experience Orientation Booklet
Transcript of SLHD Nursing Work Experience - Sydney Local Health District · within the Sydney Local Health...
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SLHD Nursing Work Experience
Orientation Booklet
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Contents
Welcome to Sydney Local Health District .................................................................................. 3
Nursing Work Experience Coordinators of SLHD…………………………………............................……4
The Philosophy of NSW Health………………………………………………………………………………………………5
The Objectives of Your Nursing Work Experience ..................................................................... 6
Nursing Work Experience Student Rights and Responsibilities ................................................. 8
Fire Procedures ........................................................................................................................ 13
Security Awareness .................................................................................................................. 14
Manual Handling ...................................................................................................................... 15
Suggested activities for students…………………………………………………………………………………….…..16
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Welcome to SLHD
Welcome to your nursing work experience placement at one of the many health facilities
within the Sydney Local Health District (SLHD). We hope this placement provides you with a
realistic opportunity to experience first hand the science of practicality of a nursing career.
Nursing isn’t for everyone. It is important to obtain a realistic idea of what it is like to be a
nurse before you embark on further studies. We hope to be able to assist you in this process.
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After downloading and completing all documentation applications to attend a nursing work experience placement can be made directly to the following contacts.
Sue Field Nurse Educator
Balmain Hospital Booth Street Balmain NSW 2041
Ph.: Rozelle 87553503 / Balmain 95152171 E-mail: [email protected]
Kate Gilbert Nurse Educator Canterbury Hospital Canterbury Road Campsie NSW 2194 Ph.: 9787 0168 E-mail: [email protected]
Debra Hutch A/Nurse Educator RPA Hospital Missenden Road Camperdown NSW 2050 Ph: 8755 3537 Email: [email protected]
Nursing Work Experience is not offered at Concord Hospital
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The philosophy of the NSW Health system is “Better Health, Good
Health Care”
To achieve this SLHD have identified the following issues that will assist with its success:
• Working with our community and staff to develop a shared sense of responsibility and direction
• Working in partnership with other agencies to improve health
• Ensuring that people in SLHD access health services according to need
• Developing effective and efficient health services, which focus on improved health
outcomes • Attracting, developing and retaining the best staff
• Becoming a learning and teaching organisation
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Objectives of Your Nursing Work Experience Placement
At the end of the placement the student will have:
• Been provided with a planned and supported opportunity to experience Nursing as a profession
• Participated in clinical and administrative nursing activities under direct supervision
• Observed any clinical or administrative activity with the consent of the patient, the approval from their Nursing Work Experience Preceptor and where appropriate with approval from other health professionals undertaking the activity
• Been provided with a mentor for each placement to ensure their Nursing Work Experience is consistent
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• Been informed that Nursing is a valued, rewarding and challenging career that is both scientific and humanistic
• Been provided a broad overview of nursing as a career by providing the student with
information on what nursing is and what nurses do
• Been provided access to information regarding the different aspects of nursing as a career to students and thereby promote informed career decisions
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Nursing Work Experience Student Rights and Responsibilities
SLHD is committed to providing you with a Nursing Work Experience placement that is
realistic and provides an interactive experience that includes ‘hands on’ nursing. To do this,
you will need to interact closely with patients, the patients’ relatives, nursing staff and other
allied health professionals. This Rights and Responsibilities Agreement informs you of your
rights and responsibilities as a participant in the Nursing Work Experience programme within
one of our Hospitals.
Your rights and responsibilities are:
Confidentiality
In your application package you were required to sign a ‘Protection of Confidential
Information Declaration’. During your work experience placement you will have access to
confidential information about the LHD, the hospital, the patients and/or the staff.
Information that you may hear, read or be told concerning the hospital, the patients and/or
the staff must NOT be disclosed to anyone other than approved hospital nursing, medical or
allied health personnel. You cannot copy, photograph or remove any documents from the
LHD or hospital other than the documents given to you as part of your Nursing Work
Experience Programme for personal educational purpose only.
Work Health and Safety
Work Health and Safety is an important part of Nursing and the hospital environment. While
in this environment you may need to adhere to a few Infection Control requirements. These
requirements are:
• Wash hands before and after patient contact and normal hand washing requirements
• Wear gloves, protective eyewear and protective apparel in all patient care areas
• Sharp objects are to be placed in yellow sharps containers
• Contaminated waste is disposed in labelled contaminated waste bins
• General waste is disposed into general waste bins
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• Exposure to blood and body fluids are to be reported to your ward manager
Immunisation
Your Nursing Work Experience will require hands on experience in different clinical settings.
The NSW Health Department Policy Directive PD2011_005 requires that you must be fully
immunised against:
• Hepatitis B
• Diphtheria, Tetanus & Pertussis (Whooping Cough)
• Measles, Mumps, Rubella
• Varicella (Chicken pox, or have had the disease)
• Influenza (if the placement falls during terms 2 and 3 covering the Flu season)
• You may be required to be screened for Tuberculosis (TB) – this decision will be made
when you submit your application as well as form 2 and form 3 (TB Declarations)
Fairness and Equity
Whilst on Nursing Work Experience you have the right to be treated fairly and with respect.
If you believe that you are being unfairly treated then you should discuss this with your
nurse preceptor and/or your facility Coordinator for Nursing Work Experience.
Participation and observation in Nursing Activities
Your Nursing Work Experience is about a ‘hands on’ experience and you are encouraged to
participate and observe all nursing activities that are offered to you. You do however, have
the right to choose not to participate or observe. Before you participate in or observe an
activity, you must get approval from the patient and your nurse preceptor (or the health
professional performing the activity). To do this you must ask both your nurse preceptor
and the patient if your involvement is permitted.
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Dress Code
Nursing is a profession and you need to dress accordingly. Therefore it is a requirement that
all nursing work experience students wear appropriate and professional clothing to a nursing
work experience placement. This allows staff to easily identify you as a nursing work
experience student and to provide easier interaction between yourself, the staff and the
patients in our care. You will need to remove cardigans and/or jumpers when assisting with
patient care so make sure you are wearing something appropriate underneath. Jewellery
must also be kept to a minimum. This means minimal facial piecing and necklaces, rings,
necklaces, bracelets and earrings. If you have long hair you must tie it back so as that it
doesn’t dangle in anything. Ensure any make-up is discreet and appropriate.
Personal and Professional Behaviour
Whilst on your placement, you must behave in a manner that does not cause offence or
embarrassment to yourself, your school, members of the public and the staff with whom you
are working, the hospital or the LHD. You are expected to treat and speak to the people with
whom you interact with respect and dignity.
Relationships with Patients
During their time in hospital, patients are very vulnerable and often scared and anxious. You
must not develop a personal relationship with the patients and you must avoid any
unnecessary or inappropriate physical contact or communication.
Rewards and Gifts
Patients often like to reward those who have helped them with gifts. As professionals we
perform the activities we do because we choose to, therefore it is inappropriate to accept a
gift from a patient and must be reported to your Nurse Preceptor or Facility Coordinator.
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Attendance
If you are going to be absent while on your placement for a day, you, or someone on your
behalf must notify your Facility Coordinator for Nursing Work Experience. If you need to
arrive late or leave early, you must also make your Facility Coordinator for Nursing Work
Experience aware. Your Facility Coordinator for Nursing Work Experience will make your
Ward/Unit and nurse preceptor aware of what is happening. If you need to be away from
your Ward/Unit for a period of time, you must let your nurse preceptor know that you will
be out of the Ward/Unit. This is essential as it is in regard to your safety and a requirement
of Work Health and Safety legislation. Someone must know where you are at all times.
Security and Corrupt Conduct
Hospitals are crowded with people, such as staff, approved visitors like yourself and the
general public. Some people have no real reason for being in the hospital. Therefore, if you
see anyone behaving suspiciously or acting inappropriately or witness a criminal activity you
must report them to your Nurse Preceptor or an appropriative Staff member as soon as
possible. If you, on the other hand, are the one suspected of corrupt conduct or alleged
inappropriate behaviour, the hospital will follow its usual processes. If indicated, Security
and/or the Police will be contacted. Your school and Careers Adviser will be notified and a
teacher may be asked to come to the hospital and take you back to school.
Travel
As a way of offering you a variety of experiences and to ensure that you get the most out of
your Nursing Work Experience placement, you may be required to travel within SLHD in
approved transport. The purpose of this travel will be to visit patients in their home or to
travel between hospital or community sites.
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Failure to Meet the Expectation of Conduct
These expectations are easy to meet and are no more than any future employer would
expect from you. They are not designed to make your nursing work experience difficult, but
more to ensure that you, the staff and the patients are safe and that your experiences whilst
on placement, are positive ones. If you do not seem to be to meeting these expectations,
you will be given a reminder of them by either your Nurse Preceptor or by the Facility
Coordinator for Nursing Work Experience. However, if you do not adhere to the warnings
and/or are involved in a serious breach of these expectations, then your school will be
notified and you will be asked to leave the Hospital.
EAT BREAKFAST BEFORE EACH DAYS PLACEMENT!
Make sure you eat breakfast before each day’s placement. Nursing is a physically challenging
job so you need energy to start your day. In addition, low blood sugar levels contribute to
faints and dizzy spells.
Other Important Information Whilst on Your Nursing Work Experience
Keys and Computer Passwords
You may need to access your ward area using a ‘keypad lock’. Do not write this number
down or disclose to any other person. If you are given a locker key, please ensure you return
it to the ward staff when completing your placement.
Meal Breaks
You are entitled to a 20-minute morning tea break and 30-minute lunch break. Ask your
preceptor for directions to the staff cafeteria or café located on site. Students are not to
leave the health facility during work time, unless they have permission from the Facility
Coordinator for Nursing Work Experience.
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Debriefing and Evaluation
Feel free to approach the manager on your ward or your Facility Coordinator for Nursing
Work Experience to discuss any matters. We understand this is an exciting time and you may
have issues to discuss. A formal debriefing session will be conducted on the last day of your
placement.
Commencement Time
The commencement time varies with each facility and the coordinator of nursing work
experience will be able to advise you of start times. Not all areas of clinical specialities are
available to nursing work experience students and your placement will be dependent on
available places within the hospital that allow work experience students at the time you
request to attend.
Immunisation Policy Directive
Remember, it is MANDATORY that all grades of students entering any NSW Health Facility
are fully immunised as per NSW Health policy directive PD2011_005. Documentation will be
required to be completed by your GP providing evidence testifying to this fact and returned
to the work experience facilitator prior to work experience commencing.
Failure to provide this documentation prior to the placement will result in the placement
being cancelled.
Fire Procedures
R Remove people from immediate danger
A Alert switchboard – on the emergency number – and nearby staff
C Confine fire and smoke
E Extinguish or control fire – if safe to do so
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In the event of a Fire, the switchboard operator will call New South Wales Fire and Rescue
and alert all hospital staff according to the fire control orders. During normal working hours
the Hospital Fire Officer will take charge until the arrival of the team from New South Wales
Fire and Rescue.
Before a fire you should know:
• Where all the fire fighting equipment is kept
• Where all the fire exits are located
In a fire Staff should:
• Prevent panic amongst patients and visitors,
• Remain calm,
• Stop people shouting fire, reassure patients,
• Assist as required.
Code Red is a Fire/Smoke alert. Code Purple is a Bomb Threat alert.
Check with your coordinator what the emergency number is at the facility hosting your nursing work experience placement as they are different at each site.
Security Awareness
Prevention
• Whilst on duty wear your IDENTIFICATION BADGE.
• Ensure your personal belongings are locked away.
• Report all SUSPICIOUS incidents IMMEDIATELY.
• Please return your identification Badge at the end of your work experience
placement to your facility coordinator.
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What should I do if I witness an incident?
Do not approach the person or persons; instead contact your supervisor or the switchboard immediately and then provide the following information:
• Identify yourself and state you need security.
• Describe the incident.
• Give the location of yourself and the building.
• Description and number of offenders.
• If a vehicle is used, registration number, colour and make.
Manual Handling
As a nursing work experience student you are advised to refrain from attempting any
activity, which meets the following definition as a Manual Handling task:
“Any activity that requires the use of force to; Lift, lower, push, pull, carry or to otherwise
move, hold or restrain people, animals or objects”.
Manual Handling activities come under the authority of the Work, Health and Safety Act
(2011). It is an employers’ responsibility to prevent the occurrence of injury and /or to
reduce the severity of injuries resulting from manual handling tasks in workplaces.
Employers and Employees have a duty of care under the act to each other, visitors and the
General Public to take the necessary steps to:
• Consult with each other regarding safety and Manual Handling issues, and to Identify
Risks, to Assess Risks and to take steps to Control Risks,
• Evaluate all Risk Control activities and to Design and Re-design the means to
effectively control safety risks.
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As a nursing work experience student your interests are best served by not placing yourself
“at risk” by undertaking any activity for which you have not been trained. Please discuss any
queries that you have regarding Manual Handling with your preceptor in the ward/unit
where you are allocated to work.
DO NOT LIFT OR MOVE ANYTHING OR
ANYONE WITHOUT SPEAKING TO SOMEONE FIRST!
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Suggested activities for nursing work experience students
Always under the supervision and observation of an RN or EEN
Correctly wash your hands Wound Dressings
Assist with bed making Removal of drains, sutures and clips
Search and feel for a pulse rate Medication rounds/watch different methods of drug
administration
Listen to heart sounds during blood pressure reading
Change of intravenous therapy
Read a thermometer Oxygen and nebulisation therapy.
Count a respiratory rate Hair and Skin care
Assist a patient with personal hygiene Mouth and teeth care
Assist with a patient escort Pressure area care
Assist at meal times Repositioning a patient in bed
Feed a baby with your preceptor Patient transfer techniques
Change a baby Collection of specimens
Palpate a fundus with your preceptor Testing of blood glucose levels
Listen to foetal heart sounds Blood taking for pathology
Read to a patient Urinalysis
Attend a ward round ECG
Help check and test equipment Procedures for admitting and discharging a patient
Find the fire extinguisher Pre-op and post-op procedures
Attend an in-service education session Documenting nursing care
Watch a patient education video Any other procedure that the nurse and patient are
happy for you to watch
Attend the handover report Talk to patients and relatives
Interview a nurse or patient Complete the workbook activities in the “Dare to Care”
Student Handbook
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ENJOY YOUR NURSING WORK
EXPERIENCE PLACEMENT
Assistant in Nursing
Enrolled Nurse
Registered Nurse
Registered Midwife
Certificate III/ Certificate IV
Aged Care Work/ Health Services
Assistance
Diploma of Nursing (Enrolled/Division 2
Nursing)
Bachelor of Nursing
Bachelor of Midwifery
Clinical Nurse Specialist **
Clinical Nurse Educator **
Nurse Educator **
Clinical Nurse Consultant **
Nurse Unit Manager **
Researcher
Academic
Nurse Practitioner
Overseas Travel! Reciprocal working holiday agreements with UK, NZ, Canada, The Republic of Ireland, Japan, The Republic of
Korea, Malta, The Netherlands, Germany, Sweden, Denmark, Norway, The Hong Kong Special Administrative Region (HKSAR)
of the People’s Republic of China and Finland
Nurse Manager
Director of Nursing
District Director of
Nursing
Chief Nurse
** when in a midwifery context, the term midwife is used e.g. Midwifery Unit Manager etc
Eligible Midwife
Graduate Diploma/Master
of Midwifery
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Nursing Work Experience Handbook
for High School Students Nursing Work Experience Checklist
Before submitting your documents please make sure you have completed this checklist.
Ensure you have completed these forms prior to submitting your application *
Yes No
Student Placement Record (SPR) or equivalent
Insurance policy form provided by your school
Protection of Confidential Information Declaration
Immunisation screening documents
I have read the NSW Health Code of Conduct and signed the declaration form http://www0.health.nsw.gov.au/policies/pd/2015/pdf/PD2015_049.pdf
If you are over 18 years of age, you will be required to complete a Criminal Record Check https://npcoapr.police.nsw.gov.au/aspx/dataentry/Introduction.aspx
No N/A
* Please note if you have answered “no” to any of the above, or failed to submit the required information, your application for Nursing Work Experience will be rejected.
All documentation must be supplied no later than one (1) month prior to the proposed commencement date to ensure that the student has met all requirements.
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Work Experience Application Form
Please complete all forms and return to the Work Experience Coordinator
Given Name/s:
Family Name:
Date of Birth:
Country of Birth:
Home Address:
Postcode: Home Telephone:
Email Address: Name and address of parent/guardian if you are less than 18 years old:
Daytime contact details of parent/guardian:
School/Institution at which you are enrolled: Year:
Careers Adviser/Head teacher:
School Address:
Postcode: Telephone:
***Please give second choice of dates in case your first choice is unavailable*** Note applications must be received in full no later than one-month prior to the start date of your placement Dates requested (Monday – Friday):
Second choice of dates:
Preferred Nursing Specialty Area (not applicable to Canterbury Hospital): We will try to accommodate your request, however cannot guarantee a specific area.
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Protection of Privileged and Confidential Information
I _________________________________________________________________ a student
enrolled at __________________________________________________ will be undertaking Work
Experience at RPAH, CRGH, Balmain Hospital or Canterbury Hospital (circle one) from
___________________ to ____________________.
I am aware that in the course of my placement in the hospital that I may have access to privileged and confidential information in respect of patients, staff or hospital matters.
I therefore agree that as a condition of my being accepted into the Workplace Learning Program that I will not divulge any information concerning patients, staff or hospital matters to anyone other than authorised personnel of SLHD Facilities since to do so may involve me in civil legal proceedings. Additionally, if I am found to be in breach of this undertaking that the placement shall immediately terminate.
Student’s Signature: _______________________________________________________________
Parent/ Guardian Signature (if under 18 years of age): ____________________________________
Date: ____________________________
This form must be signed by the Student and their Parent/Guardian (if applicable) and must be returned with the application pack documents to the respective facility that you have applied to undertake a work experience placement. If this form is not returned the placement will not proceed.
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Remuneration and Workers Compensation Waiver
To whom it may concern
I ____________________________________________________________ hereby agree that whilst I am undertaking Clinical Work Experience RPAH, CRGH, Balmain Hospital or Canterbury Hospital I am not entitled to any remuneration or entitled to claim against the hospital’s Workers Compensation Policy.
Name: __________________________________________________________________________
Signature: _______________________________________________________________________
Parent/Guardian Signature (if under 18 years of age): ____________________________________
Date: _______________________
This form must be signed by the Student and their Parent/Guardian (if applicable) and must be returned with the application pack documents to the respective facility that you have applied to undertake a work experience placement. If this form is not returned the placement will not proceed.
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Conditions of Participation Part 1 – General Information
Introduction This document has been prepared for students wishing to undertake nursing work experience in the NSW public health system. It aims to make you aware of the conditions of your participation in a nursing work experience program and helps ensure that your experience is beneficial. Please read both parts thoroughly, show it to your parents/guardians and then sign the document to let us know that you have understood and agree to the conditions under which nursing work experience is offered. If you would like to ask any questions, please contact the nursing work experience facilitator in your Local Health District administration. Reasons for offering nursing work experience Local Health Districts in NSW want to assist school students considering a career in nursing to gain first-hand knowledge about the profession. We want to do this in the safest, most helpful and interesting way possible. That is why we have developed nursing work experience programs for you to access. We hope they will encourage you to pursue nursing studies once you leave school. Objectives of nursing work experience The student will:
• learn that nursing is a scientific and humanistic
profession
• observe nurses at work
• carry out some actual nursing activities under
supervision of a nurse
• gain insight into the ways in which you can
study to become a nurse and the employment and career opportunities available once qualified
• review your tentative career choice against the
experience you receive.
Responsibilities of student The student participating in nursing work experience will:
• demonstrate an interest in nursing as a
possible career option with the intention of participating in the program
• provide all the necessary information that will
assist in processing the application for placement
• agree to abide by the conditions of their
placement as set down by the organisation
• agree to abide by the code of conduct
• report any treatment that you consider to be
unfair or unjust to the nursing work experience coordinator
• evaluate the program to assist the Local Health
District in providing the best experience for students. Responsibilities of employer The Local Health District will:
• provide opportunities for the student to
explore nursing as their tentative career option within the framework set down by the organisation
• allocate a nurse to supervise and mentor the
student whilst on placement
• permit students to carry out nursing activities
under supervision when patient consent has been given
• protect the rights of patients, staff and the
Organisation
• treat all students fairly and with respect
• communicate directly with the school careers
adviser, in the first instance, in matters requiring intervention and solution.
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Conditions of Participation Part 2 – Specific Information
Hands on activities Nursing work experience is about observation, fact finding and participation and you will be encouraged to do all of these. However, it is generally necessary to seek the approval of the patient and your supervising nurse beforehand. Behaviour Remember, that while undertaking nursing work experience, you are also representing your school and your peers. You are expected to behave in a manner that does not cause offence or embarrassment to yourself, your school, staff, patients or the public. Unacceptable behaviour will be reported to the school and may result in termination of your nursing work experience. Security Hospitals are filled with lots of people, many are staff, some are approved visitors (like work experience students) and then there are others who may have no reason for being on the premises. If you see anyone acting suspiciously, please inform one of the nurses. Corrupt conduct If you are suspected of corrupt conduct or inappropriate behaviour whilst in the health facility, a representative from the school will be called in to resolve the situation in line with the protocols set down by the respective school authorities. Relationships with patients Patients in health facilities are often scared and anxious. It is inappropriate for students to develop a personal relationship with the patients and, therefore you should avoid any unnecessary or inappropriate physical contact or communication. Rewards and gifts Patients often like to reward those who help them, with gifts. However, students are discouraged from accepting gifts.
Attendance If you are going to be absent for a day, you or someone on your behalf needs to notify the nursing work experience coordinator and the school. The same applies if you need to arrive late or leave early. In the interests of your safety, if you need to be away from the workplace for a period of time, you must let your supervising nurse know that you are leaving and when you have returned. Confidentiality In the course of your nursing work experience program, you may have access to privileged and confidential information in respect to Local Health District or health facility matters, patients and staff. You are expected to refrain from discussing any of this information with anyone other than authorised personnel of the Local Health District or health facility. Dress code Nursing is an active job requiring a lot of time on your feet. Students are required to present in suitable attire which is clean, neat and tidy. Wear comfortable and practical clothing that is washable. Avoid restrictive clothes and very short skirts, short shorts and low cut tops that reveal your midriff. Most health care facilities do not allow jeans to be worn while at work. Shoes with a covered toe to protect your feet must be worn. If you have long hair, please tie it back. Jewellery should be kept to a minimum. Work health & safety Within the Local Health District there are clear guidelines to ensure your safety. These will be explained to you at orientation. Evaluation All students will receive a formal assessment on their performance at the end of their placement, which will be placed in your school records. Your assistance may also be requested by the health facility to evaluate both the nursing work experience program and the student handbook
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so that they can be improved for the benefit of future students. Termination of work experience There may be circumstances, some of which are mentioned above, when it may be necessary to terminate your placement. In other instances, for personal reasons, you may not wish to continue with your placement. You are not under contract to the Local Health District during nursing work experience so you are not bound to complete the program. Read and sign I have read this document and understand the conditions of my participation in the nursing work experience program within SLHD. I agree to these conditions. Student name (print name) Student’s signature Date Parent/Guardian name (print name) Parent/Guardian signature Date
-*
Student Placement Record Original to be held by the school Copy 2: for the parent or caregiver Copy 1: for the host employer Copy 3: for the student
Student’s name:
School: Host business:
Tick more than one if applicable HSC VET work placement Work experience Other Accommodation away from home
Section 1: Student placement summary Start date Starting time
Finish date Finishing time
Total number of days Lunch break
Related course/activity Student’s total hours
Tick where relevant Block One day per week Split shifts eg Hospitality
Shift details (times/location) Host employer on-site address
Mobile Contact person Phone Email
Student details Year (eg 10,11) Date of birth Student’s mobile no. Medicare no. Details below (or attached) of any adjustment, medication or medical condition (eg severe asthma, type 1 diabetes, epilepsy, anaphylaxis or other severe allergy), disability, learning and support need or factors the school or employer should know: ..
Please tick where applicable: I am at risk of an anaphylactic reaction and will carry an adrenaline auto-injector, eg EpiPen and relevant ASCIA Action Plan. Yes No The host employer requires evidence of vaccination compliance. Yes No The placement includes out of normal business hours, eg 6-9pm Yes No
If yes, name of student’s emergency contact out of normal business hours
Parent/caregiver/other Home phone Mobile Work phone (if relevant)
I have completed all pre-placement activities. I have been issued with a Student Safety & Emergency Contact Card. I know who to contact in case of emergency. I will inform both the host employer & my teacher as soon as possible if I am unable to attend the workplace. I am aware of my rights and responsibilities. I am aware of the contents of the Privacy Notice on Page 3. I will comply with all reasonable directions of the host employer & their employees. I understand that if I feel unsafe during the placement, I have the right to not undertake the task & report the issue, as soon as possible. If I have access during the placement to business or personal information which is private or confidential, I will not pass on that information to any person outside the host employer’s workplace.
I will not use any mobile device to record conversations, video, or take photos without the permission from the host employer or supervisor. I will inform my supervisor immediately of any injury or accident that involves me. I will inform the school within 24 hours. (Revised) I understand and will follow the safety requirements for the host workplace and will not undertake unauthorized works or activities that may jeopardise the safety of myself or others. (Revised) I know I must contact my school if I have any concerns about my placement. I understand that there are no negative consequences to me in reporting health & safety issues to my school, the host employer or to my parent(s) /caregiver(s).
Student signature
Date
Section 2: School details School Email
Address School phone number
Front office hours
School’s nominated contact during normal business hours
Contact’s position Contact phone/mobile
The school undertakes to ensure that: the student is prepared for the workplace to optimise the student’s safety and achievement during their placement the employer is provided with a copy of The Workplace Learning Guide for Employers the student’s parents or caregivers are provided with a copy of The Workplace Learning Guide for Parents and Caregivers If the placement involves accommodation away from home, additional preparation occurs and relevant documentation is completed & attached the travel form is completed, where relevant any adjustments required by the student have been discussed with the student, their parent/caregiver and the employer. (New)
Page 1 of 4 Student Placement Record - May 2017
Student’s name: School: Host business:
Section 3: Host employer details (This first section may be completed by the student) Name of organisation or trading name
Address Contact person
Position
Postcode Phone
Email Mobile
Website Fax
Location of placement (if different from above address)
Request is for: HSC VET work placement or Work experience or Other
Dear Host Employer: Please complete all the following responses to give the school important information about the proposed placement. If more space is needed please attach the information. This will assist the school to manage their duty of care to the student and your responses will help you satisfy your relevant workplace obligations. You may wish to keep a file copy as a guide for any future placements. Thank you.
Overview Type of industry Main activity
Approx. no. of years in current operation Approx. no. of employees at proposed worksite
Government enterprise Private enterprise Self-employed Other
Tick only if you have hosted school students for work experience or work placement in the last 12 months.
Supervision and student hours Name of the experienced employee who will provide on-going supervision. The supervisor would not be a trainee or an apprentice.
Supervisor’s name Position Phone number
Student’s start time Finishing time Lunch break Total hours
Tick where relevant: Block One day per week Split shifts
Shift details and location
Please note: there are a number of hazardous activities which are prohibited for students undertaking placements. These are listed at:
Prohibited activities and activities that need special consideration Or see website: http://bit.ly/ProhibitedActivities Description of the proposed placement – in detail
See Completion of the Student Placement Record to meet the Department’s standards or see website: http://bit.ly/WorkLearnPolicy Activities/duties to be undertaken by student
Any activities or tasks the student is not to undertake eg no-go areas, machinery or equipment that is too dangerous for new or young workers to operate. Please be specific.
Indicate any risks to the student in the planned activities eg manual handling, repetitive activities, exposure to sun, chemicals, fumes, use of particular tools or equipment, proposed horse riding or use of farm vehicles. Please be specific.
How will those risks be eliminated or controlled? Please be specific. Eg WHS Induction on Day 1
Special conditions eg clothing, footwear, equipment, pre-training, vaccinations, transport, multiple sites, routine car travel or individual student needs.
Page 2 of 4 Student Placement Record - 2017
Student’s name: School: Host business:
Please tick if these are available to the student: Essential: First aid facilities Suitable toilet facilities Drinking water
Other: Lunch room Staff canteen Lockers
Please tick this box if you wish the student’s school to contact you prior to the placement eg to provide you with information about the student such as their experience, skill level, any adjustment required, or for you to discuss aspects of the student’s safety in the workplace.
Section 3: Host employer details (continued)
Host employer/workplace supervisor to complete the following declaration:
I have read The Workplace Learning Guide for Employers and am aware of the host employer’s rights and responsibilities outlined in it and the need to provide a safe and positive environment for the student, free from harassment and discrimination.
I will provide planned learning and skill development activities appropriate for the student under the supervision of myself or a capable and trustworthy employee briefed for the task.
I confirm that the activities assigned are suitable for the student and that WHS risks have been assessed and managed in accordance with the requirements of the Work Health and Safety Act 2011 (NSW) and Completion of the Student Placement Record to meet the department’s standards.
I will check any health care concerns with the student and ensure they and their supervisor knows what to do in the case of a medical event i.e. where the student will keep their medication, eg an adrenaline auto-injector-EpiPen.
I will consult and cooperate with the school and will notify the school immediately of any health and safety incidents involving a student while on placement, including near misses, to enable the Department of Education to fulfil its WHS obligations.
I will see that the student is first provided with a site-specific workplace induction and then with the appropriate information, instruction, training, supervision (and personal protective equipment where needed) throughout the placement.
I acknowledge that the student will not be paid in relation to the placement.
I will notify the school if the student is ill, injured, absent without explanation or behaving inappropriately.
I will notify the school immediately if I need to change sites, redirect students to another location or find asbestos on the site.
I have read and understood the special responsibilities associated with working with children and young people as detailed in the section related to child protection on page 9 in The Workplace Learning Guide for Employers. I understand students must report incidents to their school.
I am not aware of anything in the background of any staff member or other person who will have close contact with the student that would preclude that staff member or person from working with children.
I have informed employees of their responsibilities when working with children and young people.
I am aware of the specific restrictions and prohibited activities for students and will ensure students are not asked to carry out any of these activities. (New)
Additional Information for Employers is available at: http://bit.ly/Employers-Additional-Info
Signature of host employer/workplace supervisor Date
Print name Position
Privacy notice - for all parties The information provided by students, parents/caregivers and host employers is obtained for the purpose of coordinating a workplace learning opportunity for the school student. The NSW Department of Education will use the information to meet student health, duty of care and child protection responsibilities and to support the information needs of the student, host employer and the parent/caregiver. The Work Placement Service Provider might access information related to HSC VET work placements but only with the approval of the principal.
Providing this information is voluntary. However, if you do not provide any of the information requested then the student may not be able to undertake the planned workplace learning.
The information you provide will be stored securely and kept for a minimum of two years where there is no further action relating to the placement. The information will only be disclosed for purposes directly related to the purpose for which it is collected.
You may correct any personal information by contacting the student’s school.
Page 3 of 4 Student Placement Record - 2017
Student’s name: School: Host business:
Section 4: Parent/caregiver permission (Must be completed for students aged under 18 years) Name Relation to student
Address Mobile
Work phone
(optional) Home phone
Medicare no.
Postcode Contact phone number after normal business hours Email
I have read The Workplace Learning Guide for Parents and Caregivers and understand my role and responsibilities. I have read the Additional Information for Parents and Caregivers including the insurance and indemnity arrangements as outlined on Page 2.
More information is available at: http://bit.ly/WorkLearnPolicy I will immediately notify the school if I have any concerns and the school will follow up and action. I am aware of the contents of the Privacy Notice on Page 3.
Tick if the placement includes out of normal business hours eg 6-9pm If ticked, please respond to either 1 or 2 below:
1. Years 11-12: where relevant: I agree to make myself available as a contact for the student after normal business hours in the event of an emergency OR
I nominate on telephone to be the willing and reliable contact out of normal business hours.
Their relationship to my child is and they have accepted these responsibilities.
2. Years 9-10: contact arrangements must be negotiated with the Principal by the parent/caregiver and student. The arrangements are:
The workplace requires evidence of vaccination compliance. No Yes (Please ring the school for more information)
Tick if the student has the following medication, medical condition (eg severe asthma, type 1 diabetes, epilepsy, anaphylaxis or other severe
allergy), disability or learning and support need that may affect their safety during the placement. or N/A
If so what support or adjustment do you think the student will need to make their placement successful?
If more space is needed, please attach the information
I understand that if the student is diagnosed as being at risk of anaphylaxis, I will provide an adrenaline auto-injector for the student for the placement. The student has a current ASCIA Action Plan or individual health care plan. Yes No I consent to a copy being provided by the school to host employer eg health care plan cover sheet Yes No
Tick if the placement choice includes overnight accommodation away from home. I understand this will need special approval and additional documentation.
I consent to the student in Year undertaking the placement outlined on this Student Placement Record.
Signature of parent/caregiver Date
Where relevant: Years 11-12: signature/date of adult approved by the parent to be the after normal business hours contact.
Section 5: School approval of the placement • The student has been prepared for the workplace by the school to optimise the student’s safety and achievement during their placement. • The placement is supported according to the department’s Workplace Learning Policy and Associated Documents and Forms. • The school will report incidents affecting the safety of students, including near misses, while undertaking workplace learning in accordance with the
department’s Incident Reporting Policy and Procedures. In accordance with the policy, incidents must be reported as soon as possible but within 24 hours.
• The student has been issued with a personal Student Safety and Emergency Contact Card and trained how to use it. • If medical information, support or adjustments are to be provided this has been shared with the host employer. If the student is diagnosed as being at
risk of anaphylaxis, the school has confirmed that the parent or caregiver has provided an adrenaline auto-injector to the student for the placement. • The school has provided a copy of the student’s current ASCIA Action Plan or health care plan cover sheet to the host employer and has discussed it
with them. Tick: N/A Yes No
• Where the placement mandates a general construction induction training card/white card, it has been sighted. • Where the placement involves accommodation away from home, relevant documentation is completed and attached. • Where the employer has been asked to be contacted, the employer has/has not been contacted by phone/visit. See check box page 3. • Arrangements are in place for a teacher to conduct a supervisory visit or phone call to the employer and student to check on their program and safety.
(New) I am satisfied that all the above have been completed and that all parts of this Student Placement Record are complete and signed as required and
that the placement is suitable for this student.
Signature of Principal/Nominee Print name Date Nominee position in school
Page 4 of 4 Student Placement Record - 2017
NSW Health Code of Conduct Agreement for Students
Step 1: Read the NSW Health Code of Conduct
The NSW Health Code of Conduct is available here:
https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2015_049.pdf
Step 2: Enter your details
Name: ____________________________________________________________________________
Date of Birth: ______________ Gender: ______ Student ID: ____________________
University/TAFE/Training Organisation: __________________________________________________
Email address: _____________________________________________________________________
Step 3: Declaration and signature
1. I have read and understood the NSW Health Code of Conduct, and agree to comply with its
provisions at all times whilst attending student placements in NSW Health.
2. I undertake that if I am charged or convicted of any criminal offence after the date of my
National Police Certificate that I will notify NSW Health before continuing with my clinical
placement.
3. I declare that the information I have provided to NSW Health for the purpose of undertaking
student placements is correct to the best of my knowledge. I understand that if I am found to
have deliberately withheld or provided false information, my placements may be withdrawn.
Signature: _____________________________________ Date: _______________________
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