School of Nursing STUDENT HANDBOOK 2017-2018, Study notes of Nursing

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School of Nursing

STUDENT HANDBOOK

CONTENT

ABOUT THE SCHOOL OF NURSING

Program Summaries Terminal Objectives by Program SON Administrative Structure Faculty Advisement Preceptors ADMISSIONS DIRECT ENTRY MASTER’S STUDENTS Admission Requirements Admission Process BACCALAUREATE STUDENTS Admission Requirements and Process for Baccalaureate Students REGISTERED NURSE STUDENTS Admission Requirements and Process for RN Students with a Baccalaureate Degree Admission Requirements and Process for RN Students without a Baccalaureate Degree CERTIFICATE OF ADVANCED STUDIES (CAS) Admissions Requirements and Process for CAS Course of Study DOCTOR OF NURSING PRACTICE STUDENTS Admission Requirements and Process for Doctoral Course of Study REGISTRATION Technical Standards Students Unable to Meet the Requirements/Skills HEALTH AND SAFETY REQUIREMENTS CLINICAL EDUCATION REQUIREMENTS Annual Required Training HIPPAA/OSHA (Infection Control) Requirements Expenses Travel Contacting Clinical Facilities Licensure as a Registered Nurse Criminal Background Check Requirement

Auditing Courses Changing Specialization GRADUATION Time for Completing Program Course Requirements Participation in Graduation Ceremony CURRICULUM Course Requirements and Options Curriculum Plans Scholarly Project for MS Program Independent Study Format for Written Work Course Credit / Contact Hour Ratio Theory Credit Ratio Clinical Credit Ratio Lab Credit Ratio Practice Credit Ratio Privacy Rights Clause SCHOOL OF NURSING GOVERNANCE Curriculum Committee Policy Committee Evaluation Committee Judicial Board EVALUATION Course and Faculty Evaluation APPENDICES A. Notification of Change of Academic Advisor B. Consent Form for Physical Examination C. Consent Form for Participation in Learning Activities D. School of Nursing Honor Code E. Incident Report

School of Nursing Administrative Structure Dr. Inez Tuck serves as the Dean of the School of Nursing. She is responsible for the overall direction and management of the School. Working with the faculty, Dr. Tuck is responsible for the content, scope, and quality of the curriculum, academic standards, and the degree requirements of the programs, including both clinical and academic components. She hires, evaluates, and supports the development of faculty in teaching, scholarship/research and service. As a member of the Institute’s senior administrative team, she works closely with the Provost and Vice-President of Academic Affairs on the development and administration of the academic programs in the School of Nursing and in coordination with the other academic programs of the Institute. Additionally, she provides leadership in professional and academic areas through active involvement in external educational and professional organizations, representing the Institute in these endeavors. Dr. Leslie Neal-Boylan serves as the Associate Dean for Academic Affairs and Program Innovation. She has broad responsibility for providing leadership in curriculum development, evaluation, and revision for all programs; for providing leadership in evaluation of all aspects of the SON; and in mentoring faculty in teaching, scholarship, and research. Dr. Lussier-Duynstee serves as the Assistant Dean for Student Support and Clinical Facilitation. She has leadership and administrative responsibilities for: student recruitment, admissions, and retention, through purposeful student engagement, advocacy and advisement; oversight of academic support services and interface with faculty on student academic issues. The Graduate Programs are led by Dr. Margaret Sipe, Director of the Doctor of Nursing Practice Program and Dr. Patricia Reidy, Director of the Advanced Practice Level of the Master’s of Science in Nursing Program. Dr. Suellen Breakey is the Director of the Pre-licensure Programs at the Accelerated Bachelor of Science in Nursing and Generalist Level of the Direct-Entry Master’s of Science in Nursing Program. The Directors report to the Dean of the School of Nursing and are members of the Executive Leadership Council in the School of Nursing. The Assistant Dean and Directors are responsible to the Dean for faculty team development, oversight for curriculum at their level of study, student and faculty liaison, faculty orientation and development, development and revision of nursing program policies and implementation of curricula, and resource projection and management for their respective programs. The Clinical Education Department, consisting of Ms. Katherine Socha, Ms. Claire Sonnenberg, and Ms. Linda Henry develops contacts with a wide variety of clinical venues that serve as sites for student learning at both prelicensure and advanced practice levels to appropriately match students and clinical sites. Specialization Coordinators are faculty with expertise and certification in a specific advanced practice specialty. These faculty monitor certification requirements for the specialization and provide guidance on curriculum and content issues appropriate to the specialization. The Specialization Coordinators are: Dr. Joshua Dion (Adult Gerontology Acute Care NP); Dr. Amy Bruno, Antonia Makosky, and Kathryn Hall (Adult Gerontology Primary Care NP); Dr. Clara Gona and Mr. Jason Lucey (Family Specialty NP); Dr. Mary Thompson (Pediatric Specialty NP); Dr. Susan Stevens (Psychiatric/Mental Health-Lifespan NP); Ms. Katherine Simmonds (Women’s Health NP and Dual Adult Gerontology/Women’s Health NP).

J. Alexander Hoyt, PhD, RN Assistant Professor Kristine Ruggiero, PhD, RN, PNP- BC Assistant Professor Susan Jussaume, MS, RN, FNP-BC, AHN-BC Instructor Meredith Scannell, PhD(c), MSN, MPH, CNM, SANE Instructor Debra Kelly, MS, RN Assistant Professor Katherine Simmonds, MS, MPH, RN, WHNP-BC Assistant Professor Elissa Ladd, PhD, RN, FNP-BC Associate Professor Margaret Sipe, DNP, RN Assistant Professor Director, DNP Program Ruth Palan Lopez, PhD, RN, GNP-BC, FAAN Professor Susan P. Stevens, DNP, MEd, RN, PMHNP-BC Instructor Jason Lucey, MSN, RN, FNP-BC Assistant Professor Casey Sweeney, PhD, RN, FNP-BC Assistant Professor Patricia Lussier-Duynstee, PhD, RN Assistant Professor Assistant Dean, Student Support and Clinical Facilitation Nancy Terres, PhD, RN Associate Professor Carine Luxama, RN, MSN, ANP-BC, PMHNP-BC Instructor Mary Thompson, PhD, RN, PNP-BC Assistant Professor Antonia Makosky, DNP, MPH, RN, ANP-BC Assistant Professor Inez Tuck, PhD, RN, MBA, MDiv Professor Dean Talli McCormick, MSN, RN, GNP, APRN-BC Assistant Professor Lisa Wood, PhD, RN, FAAN Professor Peabody Chair in Nursing Research Part-time Faculty Kathryn Atkin DNP, ANP-BC, WHNP-BC Assistant Professor Kathryn Sabo, MS, RN-BC Instructor Jean Bernhardt, PhD, RN, NHA, NEA-BC, FNP-BC Assistant Professor Emily Karwacki Sheff, MS, CMSRN, FNP-BC Instructor

Faculty Emeriti Linda Andrist, PhD, RNC, WHNP-BC Professor Emerita Arlene Lowenstein, PhD, RN Professor Emerita Alexandra Paul-Simon, PhD, RN Professor Emerita Jean E. Steel, PhD, RN, FAAN Professor Emerita Diane Mahoney, PhD, ANP-BC, FGSA, FAAN Professor Emerita Barbara K. Wilson, PhD, RN, CS Assistant Professor Emerita Yvonne L. Munn, MS, RN Professor Emerita Margery Chisholm, EdD, RN, CS, ABPP Professor and Dean Emerita Joshua Dion, DNP, RN, ACNP-BC Clinical Assistant Professor Sara Smoller, MS, RN. ANP-BC, CCD Instructor Kathryn Hall, MS, RNCS, ANP-BC Assistant Professor Sheila Swales, MS, RN, PMHNP-BC Instructor Maureen J. Marre, MSN, RN, FNP-BC Instructor Mertie Potter, DNP, RN, PMHNP-BC Instructor John Wong, PhD Instructor Trisha A. Zeytoonjian, MS, RN Instructor

A. Technical Standards Nursing education requires the completion of a professional program that is both intellectually and physically challenging. Students must be able to take part fully in the academic and clinical life of the program to benefit from the educational activities, and to succeed in fulfilling requirements for a degree or certificate. In accordance with the provisions and philosophy of the Americans with Disabilities Act (ADA), faculty are committed to providing appropriate learning experiences that maximize every student’s potential, and working with students with disabilities to determine if there are ways to assist them in performing essential requirements and skills to meet educational standards. All students will be held to the same standards and must be able to meet the essential requirements and perform essential skills of their positions with or without reasonable accommodations. Technical standards refer to those physical, cognitive and behavioral abilities required for satisfactory completion of all aspects of the curriculum as a student in the nursing program. The qualified student must possess the mental, physical, and emotional capacities essential to attaining the competencies required to function as a nurse. These abilities enable the student to perform tasks required to meet professional requirements and work demands of the practicing nurse. Candidates who possess any disability that would potentially interfere with the attainment of such competencies are encouraged to contact the Manager of Student and Disability Services, or the Dean of the Nursing program, to discuss and identify possible accommodations. Observation: Candidates must have sufficient sensory capacity to observe in team-based learning and lecture settings, the laboratory, and the health care or community setting. Sensory abilities must be adequate to perform appropriate examination and assessments including functional vision and tactile sensation to observe, diagnose, and treat a patient's condition. Communication: Candidates must possess sufficient ability to communicate one-on-one and in small and large group settings. As a student, one must demonstrate effective and professional verbal and non-verbal communication in academic, community, educational, and health care settings, and be able to demonstrate proficiency in written and spoken English. Motor: Candidates must have the ability to participate in diagnostic and therapeutic maneuvers and procedures. They must be able to negotiate patient care environments, and be able to move between settings such as the classroom, health care facility, educational, or community setting. Physical stamina sufficient to complete a rigorous course of didactic and clinical study is required. Long periods of sitting, standing or moving are required in a variety of learning sites. Candidates must be able to coordinate both gross and fine muscular movements, maintain equilibrium, and possess functional use of the senses of touch and vision. Intellectual: Candidates must be able to measure, calculate reason, analyze, and integrate information as well as be able to comprehend temporal and spatial relationships. Social: Candidates must exercise good judgment and be able to function effectively in the face of stress, taxing workloads, and the uncertainties inherent in clinical practice. They must be able to maintain mature, sensitive and effective professional relationships with faculty, staff, students, patients, family members, and other members of the health care and/or educational team. Compassion,

integrity, concern for others, interpersonal skills, interest, and motivation are all qualities that will be assessed during the admissions process and throughout the student’s nursing education. The following requirements are considered necessary for full participation:  Students must be able to read, write, speak and understand English at a level consistent with successful course completion and development of positive patient-nurse relationships  Students may attend classes 30 hours or more each week, including combinations of lecture, discussion, laboratory and clinical activities  Preparation for class typically requires an additional 20-30 hours per week. The curriculum may also require scheduled classes or laboratory experiences at local facilities in the early morning, evening or weekends  Students will participate in intellectual activities requiring critical thinking, judgment, analysis, arithmetic competency, and conceptualization of spatial relationships, problem solving and planning within reasonable time frames within a complex environment  Students will be required to participate in clinical and laboratory experiences that involve exposure to and palpation of patients’ and simulated patients’ body parts by faculty and students  Students must have verbal and non-verbal interpersonal and communication skills that are consistent with productive classroom participation, respectful interactions with faculty, students, staff, patients, and development of appropriate therapeutic relationships Students must possess the emotional health required for full use of their intellectual abilities, adaptation to unexpected change, exercise of good judgment, and safe completion of all responsibilities. Students Unable to Meet the Requirements / Skills Upon request of persons unable to meet the above requirements, the MGH Institute of Health Professions will provide reasonable accommodations that allow the individual to fulfill the essential requirements and skills within the program. However, the School of Nursing is unable to make accommodations that impose an undue burden, present a threat to the health or safety of the individual or others, or fundamentally alters the nature of the curriculum including didactic component, laboratory sessions and clinical experiences. [Policy updated Sept. 2017] HEALTH AND SAFETY REQUIREMENTS Students must meet all health and safety requirements of the clinical education facility and of the Institute, prior to beginning any clinical education experience. Students must remain in compliance with all Immunization, CPR and Centralized Clinical Placement (CCP) requirements at all times. Failure to do so may result in a delay in clinical placement. Students are advised to also maintain their own copies of all immunization records, certifications, and documentation of physical exams and to make their available if asked by their preceptors and clinical agencies.

HIPAA/OSHA (Infection Control) Requirements The Institute requires that all new degree/certificate students verify that they have completed HIPAA, and OSHA (Infection Control) training by the first day of class. The Health Insurance Portability and Accountability Act (HIPAA) is federal legislation that mandates the standards and requirements for the electronic transmission of certain health information. This act seeks to insure all patients, clients and research subjects' health information is protected. Occupational Safety and Health Administration (OSHA) training is essential in health care and educational environments. This training instructs students about general infection control principles and their management. Students will view the HIPAA and OSHA Training in HealthStream which is a learning management system (LMS) used for online training. Approximately two weeks prior to your start of classes, the Institute’s Office of Information Technology will provide information about how to access HealthStream. As mentioned above the School of Nursing also requires all its students to complete annually the Centralized Clinical Placement Online Orientation in addition to the HealthStream training in order to satisfy SON’s additional HIPAA and OSHA training requirements. Needle Stick Procedure In the event of a needle stick injury to a student, the student is responsible for notifying the clinical instructor or the preceptor of the incident. Costs associated with health care services associated with a needle stick are the responsibility of the student. The clinical instructor/preceptor advocates for the student as follows: a. assures that the student receives timely services and complies with the procedures in place at the organization where the needle stick occurred; b. assures that testing and counseling are offered to the student; c. reports the incident to the faculty of record; d. reviews the incident with the student prior to the next clinical day to assure that undue risk is avoided in the future. The faculty of record completes an incident report for the SON. This report must include: the student name, date, time, place, organizational process, whether testing and counseling occurred. [Appendix F] [Updated 5/27/2011; Reviewed Sept. 2017] EXPENSES Students are responsible for all expenses associated with clinical education. The cost associated may include but are not limited to, transportation, parking, meals, and any additional expenses assigned by the facility (for example out of state RN licensure/reciprocity). Students are advised to plan ahead for such expenses, as students may be assigned to clinical facilities requiring travel outside of the Boston area or outside the public transportation system.

TRAVEL

Students are responsible for all travel to and from clinical education experiences. Every student should anticipate needing access to a car for some portion of the clinical education component of the curriculum. Students assigned to the same facility for a clinical experience are encouraged to share travel resources when possible. CONTACTING CLINICAL FACILITIES Any student wishing to contribute to the process of identifying potential clinical education facilities, including a potential preceptor, is invited to communicate this information to the SON clinical education office and the specialty track coordinator at least six weeks in advance of the planned clinical experience. The clinical education office and track coordinators will contact the potential facility and preceptor and are responsible for ensuring the appropriateness of a preceptor and agency relative to the student’s educational program and objectives and for establishing a contractual relationship with the clinical agency. No student, family member of a student, or friend/acquaintance of a student is permitted to arrange a clinical placement directly. [Policy under review February 2018] LICENSURE AS A REGISTERED NURSE Students who enter a program as a licensed registered nurse must present their nursing licenses to the Program Coordinator of the School of Nursing, or their designee, prior to their first clinical practica. When relevant, it is the student’s responsibility to provide evidence of license renewal at the time of its expiration. Direct Entry students must present their licenses as soon as they are issued by the Board of Registration in Nursing. All RN licenses must be unrestricted. Students may be required to apply for reciprocity in states to satisfy other clinical agency requirements. A student must pass NCLEX before they can enter their first advanced clinical placement. CRIMINAL BACKGROUND CHECK REQUIREMENT All Degree/Certificate Students at the MGH Institute of Health Professions are required to complete a Criminal Background check before the first day of your matriculation. The MGH Institute uses HireRight, the Partners HealthCare provider of extensive background checks, to complete this process. The HireRight Criminal Background check will include the following:  Criminal Felony & Misdemeanor (7 years, unlimited counties as revealed by SSN trace)  Social Security Number Trace  Social Security Number Validation  Widescreen Plus National Criminal Search  National Sex Offender Search Newly admitted students will also be required to complete a Massachusetts CORI check as well. A CORI (Criminal Offender Record Information) is a person's criminal history. You will have a Massachusetts CORI if you have ever been charged with a crime in a state or federal court in Massachusetts, whether your case ended with a conviction, a finding of not guilty, charges were dismissed, or another outcome.

Jeans, exercise outfits, T-shirts, sweatshirts, revealing or provocative clothing should not be worn at any time. Please be sure shirts are of an appropriate length that can withstand bending over and lifting. Midriffs should not be exposed, clothing, buttons/pins or accessory items displaying graphic or written material that may be construed as harassment or offensive is not allowed. Tattoos should be discreet and covered if offensive/inappropriate language or design is displayed. This may be further restricted by clinical placement. Classroom: Students must wear their MGHIHP identification badges which must be visible at all times. Students are expected to dress conservatively. Jeans are permitted; shorts and shirts should cover upper thigh and midriff respectively. No provocative dress is allowed. Any clothing, buttons/pins or accessory items displaying graphic or written material that may be construed as harassment or offensive is not allowed. Noncompliance with the policy for professional attire may result in dismissal from the classroom, clinical or lab experience and count as an unexcused absence. This policy will be at the discretion of the course faculty. [Revised October, 2016, Reviewed Sept. 2017] CODE OF PROFESSIONAL BEHAVIOR FOR STUDENTS The MGH Institute of Health Professions (IHP) School of Nursing abides by the American Nurses Association Code of Ethics and expects students also to abide by the Student Nurses Association code of ethics. The School of Nursing (SON) community is a microcosm of the professional arena. In addition to the requirements for conduct articulated in the HIPAA privacy rules, and the IHP Catalog: Safety and Security section, this SON Code of Professional Behavior (hereafter known as the “Code”) is aimed at assuring an environment that is conducive to optimal student learning and professional development, thereby protecting patient, student, faculty, and staff safety. In addition, the Code assures that graduates of the IHP uphold the highest standards of personal and professional integrity. Toward that goal, the SON must evaluate students’ professional conduct in the same way it does scholarship and clinical proficiency. Evaluation is focused on the student’s obligations toward the IHP community of faculty, students and staff across learning and professional environments. Professional environments include, but are not limited to, the classroom (in person or online), the laboratories, and inpatient, outpatient, and community clinical sites. The clinical environment also includes any volunteer efforts where students are representing the IHP. It is the goal of Partners HealthCare System Inc. (PHS) and its affiliate, the IHP, to provide a safe, comfortable, productive, professional and educational environment that is free from disrespectful, harassing, and offensive behavior, both in person, or via information communication technologies such as social networking sites and other electronic and digital media. This means that all students must treat one another and all other members of the IHP and PHS communities with dignity and respect, and, as a health care professional, adhere strictly to all requirements directed at protecting patient health information, safety, and confidentiality. Furthermore, students are expected to adhere to professional boundaries. As

per the National Council of State Board of Nursing (NCSBN) standards in their document on professional boundaries: “As a health care professional, a nurse strives to inspire the confidence of clients, treat all clients and other health care providers professionally, and promote the clients’ independence. Clients can expect a nurse to act in their best interests and to respect their dignity. This means that a nurse abstains from obtaining personal gain at the client’s expense and refrains from inappropriate involvement in the client’s personal relationships.” (2007). HARASSMENT No form of harassment will be tolerated, including, but not limited to, disrespectful and/or abusive conduct and associated retaliatory behavior or harassment based on an individual’s status (race or ethnicity, color, religion, creed, age, national origin, gender, sexual orientation, disability, veteran status, marital/relational status, genetic background, health condition or physical attributes). All allegations of such behavior are taken seriously, investigated, and where it is determined that such behavior has occurred, the SON will take all steps it deems necessary, including but not limited to acting promptly to ensure the conduct ceases and continuing effects are eliminated. Definitions Harassment or physical conduct that:

1. Has the purpose or effect of creating an intimidating, hostile, or offensive educational or professional environment;
2. Has the purpose or effect of unreasonably interfering with an individual's work performance; or
3. Otherwise adversely affects an individual's educational opportunities. Examples of harassing conduct include but are not limited to:
4. Epithets, slurs, negative stereotyping or threatening, intimidating or hostile acts that relate to race or ethnicity, color, religion, creed, age, national origin, gender, sexual orientation, disability, veteran status, marital/relational status, genetic background, health condition or physical attributes.
5. Written, electronic or graphic material that denigrates or shows hostility or aversion toward an individual or group because of race or ethnicity, color, religion, creed, age, national origin, gender, sexual orientation, disability, veteran status, marital/relational status, genetic background, health condition or physical attributes. Electronic media includes, but is not limited to social networking sites such as Facebook and Twitter. “Cyber bullying refers to any harassment that occurs via the internet, cell phones or other devices. Communication technology is used to intentionally harm others through hostile behavior such as sending text messages and posting ugly comments on the internet”. Retrieved from https://definitions.uslegal.com/c/cyber-bullying
6. Threatening or intimidating behavior or words (electronic, written or oral) directed at another person.
7. Taunting, jeering, mocking or humiliating another person through words/texts or actions.
8. Insulting someone, in any form, especially in the presence of others.
9. Screaming or yelling at or around others.
10. Endangering the safety of an individual or individuals.

SOCIAL AND PROFESSIONAL ETIQUETTE

Students are expected to:

1. Come to class on time and enter the room with minimal disruption.
2. Avoid leaving the classroom except during designated breaks.
3. Treat speakers with dignity and respect.
4. Silence cell phones and other electronic devices during class.
5. Determine from each faculty member the acceptable boundaries of behavior or the class, Examples to inquire about include, but are not limited to:  Eating in class;  Bringing visitors to class; and  Rules for group process in discussion.
6. When in clinical sites students are always to remember they are guests of the site and are to behave with politeness and respect for the site’s employees and staff, and show respect for the site environment as well as possessions belonging to the site’s employees and staff.
7. Demonstrate the ability to give and receive constructive feedback. BEHAVIOR ON SOCIAL NETWORKING SITES The Board of Registration in Nursing (BORN) has alerted Schools of Nursing to caution students about their use of social networking sites. Such sites (including, but not limited to Facebook, My Space, Twitter) are not considered private. The BORN reminds us that employers, as well as admissions committees in graduate programs, can and do use the sites to screen candidates, make employment or admissions decisions, or as the basis to rescind offers of employment or admission to candidates whose social networking images reflect poorly on them as professionals or potential professionals. Students or faculty cannot use personal cell phones or tablets for any type of client recording (audio or image). IHP/Partners approved devices will be available if visual images or audio recordings are components of a client’s treatment plan. If a client or client’s family requests video, audio or still pictures that include students and/or faculty appropriate written authorization must be obtained from the institution or practice facility. No images or recordings of clients or family members should be requested or be posted on social media. For further clarification on protecting patient confidentiality, please refer to HIPAA guidelines. *This Code of Professional Behavior is drawn directly from the corporate policies of the Partners HealthCare System Inc. (PHS) and its affiliates, in concert with the stated policies for professional conduct from the American Nurses Association, and NCSBN on Professional Boundaries. [Policy reviewed Sept. 2017] DUTY TO REPORT In accordance with the Massachusetts Board of Registration in Nursing (BORN) Professional Standard of Conduct governing a Nurse’s Duty to Report 224CMR 9.03(26) and the MGH IHP Substance Abuse Policy, students are expected to immediately report to a clinical instructor and/or faculty member any instances where they personally observe abuse of a patient; the practice of nursing while impaired by chemical substances including alcohol or drugs, or both; or diversion of controlled substances. Any concerns students may have about what they observe in the practice setting, particularly as it relates to patient safety, should be brought to the attention of the clinical instructor.

1. Should a student observe a nurse, nursing student, or other health provider engaged in behavior involving abuse of a patient, the student should immediately notify his or her clinical instructor.
2. Should a student observe a nurse, nursing student, or other health provider practicing while impaired by chemical substances including alcohol or drugs, or both, or engaged in diversion of controlled substances, the student should immediately notify his or her clinical instructor.
3. The clinical instructor is responsible for taking action as appropriate including investigating and reporting such student observations and concerns within the clinical setting.
4. In addition to reporting their observations to the clinical instructor, students who are licensed as Registered Nurses are expected to comply with the Nurse’s Duty to Report such observations to the BORN in accordance with 224CMR 9.03(26).
5. In addition to notifying the clinical instructor, students are encouraged to discuss any clinical situation they find troubling with their course faculty, academic advisor, or Assistant Dean. Abuse of a patient is defined by the BORN as “...contact or communication with a patient or resident, which in any way harms or intimidates, or is likely to harm or intimidate, a patient or resident. Abuse may be verbal or non-verbal, and may cause physical, sexual, mental, or emotional harm” (EOHHS, 2000, para. 5). Practicing while impaired “means the inability to practice nursing with reasonable judgment, skill, and safety by reason of alcohol or drug abuse, use of other substances, a physical or mental illness or condition, or by any combination of the foregoing. The duty to report does not apply to impairment resulting only from a physical or mental illness or condition” (EOHHS, 2000, para. 7). Controlled substance means “any drug or medication requiring a prescription in Massachusetts” (EOHHS, 2000, para. 10). Diversion means “the unauthorized removal of a controlled substance from a patient or resident supply or care setting” (EOHHS, 2000, para. 9). Massachusetts Executive Office of Health and Human Services. (2000). Guideline for compliance with the standard of conduct at 244CMR 9.03(26) – Governing a nurse’s duty to report to the Board of Registration in Nursing. Retrieved from http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/dhpl/nursing/nursing- regs/policies/standard-of-conduct/public-health-regulations-nursing-duty-conduct.html [Policy adopted May 2013, Reviewed Sept. 2017] PROGRESSION A. Pre-Registration All current students are expected to pre-register within the period specified by the Office of Enrollment Services (OES). Students intending to enroll in a clinical course requiring a precepted clinical placement must pre-register. A clinical placement cannot be guaranteed if the student fails to pre-register by the deadline set by the OES. B. Continuous Enrollment Continuous enrollment is defined as enrollment in two consecutive academic terms per year. If a student does not plan to register for any course in a semester, a leave of absence must be approved by the School of Nursing. See Leave of Absence Policy below.