NURSING PROGRAMS - Santa Fe College

Santa Fe College
ASN & PN Nursing Programs
Plan of Action
Student: _________________________________ Signature: ___________________________
Instructor: _______________________________ Signature: ___________________________
Date: ___________________________________
1. Student’s perception of the situation.
2. Faculty’s perception of the situation.
3. Goals/plan of action (should include remediation of any unsafe behaviors, meeting
objectives of the course, use articles for review of techniques/behaviors, use of
Nursing Lab, etc. include dates of completion and consequences if any)
This form will be utilized when a student’s performance and/or behavior falls outside the realm of
acceptable behavior as determined by the SFC Nursing Program Student Handbook and/or at the
discretion of the PN faculty.
The student will complete the section labeled “Student’s perception of the situation”.
The faculty initiating the form will complete the section labeled “Faculty’s perception of the situation”.
The Goals/plan of action will be completed by the faculty initiating the form, including a date of
completion and any consequences if not completed.
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