I did meet with Gena regarding concerns about her health and performance in both clinical and class.  It has been noticed by several instructors that Gena appears pale and fatigued quite often, and actually appears to be sleeping at times.  Additionally she has missed multiple days of clinical reaching the maximum allowed for this program.  She has submitted to drug testing as per school policy which showed no evidence of use.  We did discuss the concerns and the effect that has been noted in her performance, especially in the clinical setting.  Gena did state child care and personal issues which interfere with her getting adequate rest, as well as a brief period of illness but that she does not have health issues at present.  She does state clearly that she is aware of the required objectives of the PN program and feels that she can meet all satisfactorily.