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Family Nurse Practitioner Technical Standards

ADA Guidelines
Definitions
Title III of the Americans with Disabilities Act provides comprehensive civil right protections for
qualified individuals with disabilities. An individual with a disability is a person who:
  1. has a physical or mental impairment that substantially limits a major life activity, or
  2. has a record of such an impairment, or
  3. is regarded as having such an impairment.

The ADA Handbook published by the Equal Employment Opportunity Commission and the
Department of Justice states: examples of physical or mental impairments include, but are not
limited to, such contagious and noncontagious diseases and conditions as orthopedic, visual,
speech, and hearing impairments; cerebral palsy, epilepsy, muscular dystrophy, multiple
sclerosis, cancer, heart disease, diabetes, mental retardation, emotional illness, specific learning
disabilities, HIV disease (whether symptomatic or asymptomatic), tuberculosis, drug addiction,
and alcoholism. Homosexuality and bisexuality are not physical or mental impairments under the
ADA.

"Major life activities include functions such as caring for oneself, performing manual tasks,
walking, seeing, hearing, speaking, breathing, learning, and working. Individuals who currently
engage in the illegal use of drugs are not protected by the ADA when an action is taken on the
basis of their current illegal use of drugs.

Qualified individuals are defined as follows:

  1. A qualified individual with a disability is one who meets the essential eligibility requirements for the program or activity offered.
  2. The essential eligibility requirements will depend on the type of service or activity involved.

The stated mission of the family nurse practitioner program in nursing at Samuel Merritt University
is to educate and prepare family nurse practitioners with advanced theory and practice in primary
health care. FNPs provide ongoing comprehensive care to individuals, families, and
communities. Potential family nurse practitioners are expected to complete all the academic and
clinical requirements of an accredited family nurse practitioner program before they meet state
certification requirements and are eligible to take the national exam for certification as a family
nurse practitioner. The purpose of this document is to delineate the cognitive, affective and
psychomotor skills deemed essential to the completion of this program and to perform as a
competent certified registered family nurse practitioner.

If a student cannot demonstrate the following skills and abilities it is the responsibility of the
student to request an appropriate accommodation. The University will provide reasonable
accommodation as long as it does not fundamentally alter the nature of the program offered and
does not impose an undue hardship such as those that cause a significant expense, difficulty or
are unduly disruptive to the educational process.

Cognitive Learning Skills
The student must demonstrate the ability to:

  1. Learn, integrate and analyze large volumes of complex, technically detailed information to perform clinical problem solving. Synthesize and apply concepts and information in formulating diagnostic and therapeutic judgments.
  2. Learn and perform common diagnostic procedures (laboratory, cardiographic, radiologic, and to interpret the results, recognizing deviations from the norm and identifying pathophysiologic processes).
  3. Evaluate patient status and make responsible decisions regarding appropriate courses of action/treatment within given time constraints.
  4. Effectively synthesize data from the patient, charts, verbal reports, medical history and observation for the purpose of recommending or maintaining treatment.
  5. Solve practical problems and deal with a variety of variables in situations where only limited standardization exists.
  6. Differentiate multiple patient situations simultaneously.
  7. Interpret and implement a variety of instructions furnished in written, oral, diagram, or schedule form.
  8. Apply critical reasoning and independent decision making skills.
  9. Apply quantitative methods of measurement, including calculation, reasoning, analysis, and synthesis. Comprehend three-dimensional relationships and spatial relationships of structures.

Psychomotor Skills
The student must demonstrate the ability to:

  1. Sitting: Maintain upright posture.
  2. Standing: Maintain upright posture.
  3. Locomotion: Ability to:
    1. Get to lecture, lab and clinical locations, and move within rooms as needed for changing groups, partners and work stations, and perform assigned clinical tasks.
    2. Physically maneuver in required clinical settings, to accomplish assigned tasks.
  4. Manual tasks:
    1. Maneuver or move an individuals body parts or clinical equipment to effectively perform evaluation and treatment techniques, including palpation, percussion, auscultation, and other diagnostic maneuvers.
    2. Maintain an object in a constant position for an extended period.
    3. Competently perform advanced cardiac life support (ACLS) using guidelines issued by the American Heart Association or the American Red Cross.
    4. Pushing/Pulling ability to exert force against a small or large object to move it closer or further away.
    5. Coordination of both gross and fine motor movements, equilibrium, and functional use of the special senses sufficient to provide general care and emergency treatment for patients (the opening of obstructed airways, the suturing of simple wounds, and the performing of simple obstetrical maneuvers).
    6. Apply adequate pressure to arrest bleeding,
  5. Small motor/hand skills:
    1. Legibly record/document history and physical examinations, patient care notes, consultations, etc., in standard medical charts in hospital/clinical settings in a timely manner and consistent with the acceptable norms of clinical settings.
    2. Legibly record thoughts for written assignments and tests within reasonable tim expectations.
    3. Apply a firm grasp.
    4. Operate a push-button telephone.
    5. Perform precision movements (venipuncture, catheterization, IV regulation, dressing changes, instrument usage) which may further include invasive procedures into the central circulation or highly specific body cavities/spaces.
    6. Sense through palpation changes in an individuals muscle tone, soft tissues, skin quality, and temperature and sense responses to environmental changes and treatment.
    7. Manipulate a blood pressure cuff, stethoscope, thermometer (digital, tympanic, glass); insert catheters, IVs, NG tubes; perform injections and adjust IV drips or other equipment as required.
    8. Carry out basic laboratory tests (urinalysis, CBC, wet mount, gram stain, etc.)
    9. Carry out diagnostic therapeutic procedures (phlebotomy, venipuncture, placement of catheters and tubes).
  6. Visual acuity to:
    1. Legibly record/document evaluations, patient care notes, referrals, etc., in standard medical charts in hospital/clinical settings in a timely manner and consistent with the acceptable norms of clinical settings.
    2. Perform precision movements.
    3. Identify tiny markings and inscriptions (i.e.., on syringes, thermometers, IV bags, etc.).
    4. Identify color changes and codings.
    5. Read ECGs and X-rays.
  7. Exteroceptor and proprioceptor senses sufficiently intact to:
    1. Evaluate changes in patients body temperature, muscle tone, turgor, position, etc.
  8. Hearing or ability to receive and:
    1. Effectively respond to verbal requests from patients and team members.
    2. Interpret the language used to communicate lectures, instructions, concepts, narratives, questions and answers.
    3. Auscultate and percuss for internal body sounds, e.g.. heart, bowel, lungs.
  9. Communication Ability:
    1. Effectively and sensitively communicate to other students, teachers, patients, peers, other staff and personnel to ask questions, explain conditions and procedures, and teach home programs in a timely manner and within the acceptable norms of academic and clinical settings.
    2. Receive and interpret written information in both academic and clinical settings in a timely manner. Communication in oral and written form with health care team must be effective and efficient.
    3. Should be able to speak, to hear, and to observe patients in order to elicit information, perceive non-verbal communication, and describe changes in mood, activity, posture, color, and physical presence.
  10. Self Care:
    1. Maintain general good health and self care in order to not jeopardize the health and safety of self and individuals with whom one interacts in the academic and clinical settings.

Affective learning skills
The student must be able to:

  1. Maintain composure and emotional stability during periods of high acute stress as well as periods of chronic stress.
  2. Possess and maintain the emotional health required for the full utilization of his/her intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients, and the development of mature, sensitive and effective relationships with patients.
  3. Tolerate physically and intellectually demanding workloads (averaging 50 – 60 hours/week).
  4. Adapt to constantly changing environments, display flexibility, and learn to function in the face of uncertainty or ambiguity.
  5. Demonstrate the personal qualities of compassion, integrity, concern for others, openmindedness, self-discipline, focus, and self-motivation.