Get Missouri State University Respiratory Therapy Job Shadowing Form

Missouri State University-West Plains Respiratory Therapy Program Job Shadow Form Applicants for the Missouri State University-West Plains Respiratory Therapy program should job shadow Respiratory Care Practitioners in 2 hospitals for a minimum of 4 hours each. When possible the job shadowing should include adult pediatric and neonatal patient care in both routine and critical care settings. Missouri State University-West Plains Respiratory Therapy Program Job Shadow Form Applicants for the Missouri State University-West Plains Respiratory Therapy program should job shadow Respiratory Care Practitioners in 2 hospitals for a minimum of 4 hours each. When possible the job shadowing should include adult pediatric and neonatal patient care in both routine and critical care settings. The specific areas of care and procedures observed should be documented by checking the places below. After completing each job-shadowing day please return this form to Gary Barker Missouri State University-West Plains 128 Garfield Ave. West Plains MO 65775 or FAX to 417-255-7270. If you have not yet turned in your application for the program you may include this with the application* You may copy this form as needed for additional job shadow experiences. Applicant s name Date Hospital Amount of time spent wit the preceptor Clinical preceptor Print Name Procedures SVN MDI PFT ABG O2 Therapy Incentive spirometry Patient assessment Airway care Bronchial hygiene Bronchoscopy NIPPV Mechanical ventilation adult Other Revised 11/17/2009 Patient care areas Pulmonary Cardiac Neurology Pediatrics Rehabilitation Emergency/Trauma Recovery room Intensive care area Neuro Neonatal Medical Surgical Burn. When possible the job shadowing should include adult pediatric and neonatal patient care in both routine and critical care settings. The specific areas of care and procedures observed should be documented by checking the places below. The specific areas of care and procedures observed should be documented by checking the places below. After completing each job-shadowing day please return this form to Gary Barker Missouri State University-West Plains 128 Garfield Ave. After completing each job-shadowing day please return this form to Gary Barker Missouri State University-West Plains 128 Garfield Ave. West Plains MO 65775 or FAX to 417-255-7270. If you have not yet turned in your application for the program you may include this with the application* You may copy this form as needed for additional job shadow experiences. West Plains MO 65775 or FAX to 417-255-7270. If you have not yet turned in your application for the program you may include this with the application* You may copy this form as needed for additional job shadow experiences. Applicant s name Date Hospital Amount of time spent wit the preceptor Clinical preceptor Print Name Procedures SVN MDI PFT ABG O2 Therapy Incentive spirometry Patient assessment Airway care Bronchial hygiene Bronchoscopy NIPPV Mechanical ventilation adult Other Revised 11/17/2009 Patient care areas Pulmonary Cardiac Neurology Pediatrics Rehabilitation Emergency/Trauma Recovery room Intensive care area Neuro Neonatal Medical Surgical Burn.