Nursing Students

Nursing Students/Instructors: Process for Graduate/Undergraduate Student Rotations

Process for Clearance prior to nursing clinical experiences:

Undergraduate Nursing Students/Nursing Instructors:
All forms should be returned to your School Program Director.

RN>BS or RN>MS students
Return materials as directed in the email you were provided with the link to this webpage.

Please follow the steps below and complete all paperwork as directed. Incomplete materials will not be accepted.

Steps To Be Completed
1.	Registration & Records Verification Form (updated 8/23/17) Complete the entire form, ensuring a start and anticipated graduation date are listed. Please print and return the registration to your School Program Director.
2.	a. Criminal History Clearances to be completed, then submit the originals to your school program director. (updated and expanded on 6/23/14) FBI Fingerprinting through the Department of Public Welfare: Please follow the process detailed in the FBI Clearance Handout to ensure you complete the correct clearance. PA State Criminal History Check Child Abuse Clearance (it can take up to 30 days to receive the clearance) b. Universal Child Protective Services Law Affirmation Form (updated 4/25/15) Please print and return to your School Program Director.
3.	a. Commitment to Privacy Please print and return to your School Program Director. b. Student Statement of Responsibility Please print and return to your School Program Director. c. Information Technology Security Form Please print and return to your School Program Director. d. Student Volunteer Instructor Research Consent and Release Form (updated 3/23/2016) Please print and return to your School Program Director.
4.	a. Immunization History Form (updated 05/22/2014) Please ensure your health history meets the requirements outlined in the Immunization History form. Students are responsible for paying for additional immunizations or testing. It is important to note that all students are to have the most current, annual flu shot during flu season. Exemptions (religious or medical) may be submitted to your school program director and will be reviewed by St. Luke’s personnel for review. Your school program director will be notified if the exemption is approved. For those with questions regarding new flu requirement, please review this FAQ developed by our Employee Health Department. b. Drug Screen Requirements Form Your School Program Director can provide you with the names of approved facilities to have the drug screening completed.
5.	Standards of Performance Booklet Please read this booklet as it contains the guiding principles of St. Luke's University Health Network which student interns are expected to uphold.
6.	Essentials Newsletter Please read the newsletter; it explains important safety practices and policies every student must be aware of during your internship at St. Luke's University Health Network.
7.	Orientation - Review the following pages. Building Blocks 7-11 Rule St. Luke's Basics Student Nurse Guidelines Patients' Rights Infection Control Print and sign the Orientation Completion Acknowledgement document.
8.	Return all fully completed materials to your School Program Director. Incomplete materials will not be accepted, which will delay your start date.
9.	Students assigned to Warren Campus are to complete these additional requirements. In addition to meeting the Network requirements, the State of New Jersey has additional requirements which include: NJ Department of Treasury (SDN) NJ Consolidated Debarment Report NJ State Police Name Check - Those students with a significant likelihood of contact with children must also complete New Jersey State Police Criminal History Check. Printed copies are to be provided to your school program director.