STEP 1: Complete the clinical/residency placement request process.
- You must have a current contract / affiliation verification (Updated 6/24/2022) with the health care organization to proceed. Please check with your school/residency program reps to confirm whether or not your school/residency program has a current affiliation agreement with the health care organization.
- Complete the clinical / residency placement request form (Updated 6/24/2022). This Excel form has two sheets; 1) Preceptor Requests, 2) Groups with Instructor Requests. For preceptorships, requests should be submitted 10-12 weeks before the clinical start date. If you haven’t heard back in a reasonable amount of time, please contact the facility representative directly.
- Email the completed form to the clinical/rotation agency contact.
- If approved, continue to Step 2. If denied, the facility will contact you.
ADVOCATE AURORA HEALTH CARE
For all Advocate Aurora undergraduate nursing requests, please see the AAH website:
Advocate Aurora Epic/Pyxis Request Form (for non-nursing students) – Updated 10/23/2020
Laura Janssen (Inpatient Undergraduate Requests) email@example.com
Kristine Kuhfuss (Preceptor Led Requests) Kristine.Kuhfuss@aah.org
Any questions regarding graduate level, non-clinical students can be directed to:
Karen Ganey, Nursing Professional Development Specialist
STEP 2: Complete the clinical/residency program placement process (after you receive approval).
- Complete and submit the affiliation verification (Updated 6/24/2022) form to the clinical agency contact. Form is to be submitted on or by the clinical/residency program start date and no more than two weeks before the clinical/residency program start date.
- Contact the clinical agency contact to insure computer access and training.
STEP 3: Complete the orientation modules.
Prior to working at a clinical site, the following orientation modules must be completed annually by students / residents / advanced practice providers / faculty. After completing all four modules and you understand the information presented, complete, sign, and submit to your school or faculty member the confidentiality agreement and acknowledgement of orientation modules – (Updated 6/24/2022) form. The school will retain the signed/dated forms. Do not submit this form to the health care facility.
ORIENTATION MODULES 1-4:
- HIPAA Privacy & Security – Updated 3/25/2022
- Infection Prevention – Updated 3/25/2022
- Professional Expectations in the Workplace – Updated 3/25/2022
- Safety in the Workplace – Updated 3/25/2022
Student Evaluation of the Clinical Experience (Group or Precepted) (Reviewed 6/24/2022) Students are to complete this form and return it to their college instructor. Faculty should submit the completed ‘Student Evaluation of the Clinical Experience (Group or Precepted)’ forms to the healthcare facility’s clinical site coordinator no later than TWO WEEKS after completion of the clinical. (Resident coordinators see ‘Residents’ webpage for ‘Evaluation of Rotation Site’ form to be completed by residents.)
RN Preceptor Handbook Updated 10/22/2021
Preceptor Agreement Updated 10/22/2021
Preceptor Evaluation of the Precepted Clinical Experience Updated 10/22/2021
Epic & Pyxis Access Requests Reviewed 6/24/2022 – Listed below are emails where Epic access requests can be sent. For Advocate Aurora, please use their new ‘Advocate Aurora Epic/Pyxis Request Form’ located in step 1.
Epic Trained Instructors Updated 6/9/2022
ABMC – Epic
ABMC Epic Site-specific Resource 8/2/2022
BELLIN Health – Epic
Bellin Health Epic Site-specific Resource 8/2/2022
firstname.lastname@example.org – Pyxis and glucose monitor requests also need to be requested at the same time and are included on the Epic email.
Glucose Monitor: Mindy.Mayo@bellin.org
HSHS – Epic
HSHS Epic Site-specific Resource 8/2/2022
HSHS Epic Student Instructor Co-sign Handout 8/2/2022
HSHS Epic Student Nurse Clinical Instructor Outline 8/2/2022
Epic Access, Help Desk – email@example.com
HSHS Gaining Student Epic Access Updated 8/3/2022