Plan for Remediation. For Current Quarter: 1. Practice for a minimum of 1 hour per failed skill in the skills lab with another student nurse. SN Partner: Date 2.Successfully check off on the relevant skill(s) with ▇▇▇▇▇▇ ▇▇▇▇▇▇. 2. For Next Quarter: 3. Log 10 hours of practice on skills in Lab (not study time for classes, etc.) The hours of practice must be recorded and cosigned by ▇▇▇▇▇▇ ▇▇▇▇▇▇. This record must be turned into Lead Instructor before finals week. 4. During skills testing in the next quarter you will be tested for a total of 4 skills: A. You will be tested on 3 skills from previous quarters, AND B. One skill from your current quarter (per skills testing guidelines). Student's Signature Evaluator's Signature Outcome of PI Date Initials The student must provide a copy and discuss all PIs with all instructors involved during the time frame in which the PI is in force. I, , understand that I am responsible for keeping current during my absence from the nursing program due to: Leave of Absence Withdrawal • I understand that it is vital to my success to stay as current as possible with program information and skills. • I understand that the skills lab is available to me to practice my skills in order to keep current with them. • I understand that the Student Handbook is a valuable resource for program policies and any changes to those policies. The Student Handbook can be accessed at: ▇▇▇.▇▇▇▇▇▇.▇▇▇/▇▇▇▇▇▇▇/▇▇▇▇▇▇▇▇▇▇▇▇ • I understand that I will notify the Director of Nursing, in writing, of my desire to return to the nursing program no later than one month before the end of the preceding quarter (excluding Summer Quarter). For an anticipated Fall Quarter readmission, I must notify the Director of Nursing one month before the end of Spring Quarter. • I will read and follow the Readmission Policies as outlined in the Student Handbook. Student Signature Date Print Name Print E-mail Address: Current Address: Current Phone Number: Director of Nursing Date I, understand that I have the right to request a meeting with the nursing faculty (file a “petition”) regarding my withdrawal with penalty/disqualification from the nursing program. My options and their consequences have been explained to me. If I choose to request such a meeting, I must inform the Director of Nursing, in writing, by (date/time). My current street address to receive certified mail is (must be a street address – not a P.O. Box): My current telephone number is: Student: Date: Print Name: Director of Nursing: - Date: I, understand that I have the right to request a meeting with the nursing faculty (file a “petition”) regarding my withdrawal with penalty/ disqualification from the nursing program. My options and their consequences have been explained to me. If I choose to request such a meeting, I must inform the Director of Nursing in writing by Due to the inability to meet in person, I understand that I must agree to follow the Student Handbook rules and procedures for petitioning via a Zoom meeting. To this end: I understand: 1. I must attend the meeting on a computer with a camera and cannot record any part of the meetings
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Sources: Nursing Student Handbook, Nursing Student Handbook Agreement