NURSING 3020 Clinical Evaluation

Clinical Evaluation Process Nursing 3020

Instructions

The Mid-Term Evaluation will be completed by students at the mid-point of the clinical placement to assist students to take
inventory of their current development and assist them to make plans for future clinical practice. The student will use a
reflective process to help assess progress in meeting established program, year, and course objectives. The student will submit
an electronic copy of the Mid-Term Evaluation document to the clinical instructor prior to the formal mid-term student
evaluation. Because the document is to be completed electronically, the student and instructor can take as much space as
they need to provide appropriate evidence and feedback.

After receiving the students Mid-Term Evaluation, the clinical instructor will complete the comment section providing
feedback and evaluation of the students progress. The clinical instructor will provide suggestions for improvement. The
instructor will place a check in the S column if progress is satisfactory, and in the U column if progress is unsatisfactory. If
a student demonstrates unsatisfactory progress at mid-term, the student and instructor will develop a Learning Plan outlining
strategies in which the student will engage, along with clear expectations that must be met for the successful completion of
the course. The course professor may be involved in developing the learning plan.

The student and instructor should save and print a copy of the mid-term evaluation. Printed copies must be submitted to the
course professor within a week of completion.

At the end of the rotation, students will complete a Final Evaluation. Students will use a new copy of the evaluation template
to archive their achievements and areas for future development. The student will submit an electronic copy of their final
evaluation to the instructor; this will help the instructor complete an assessment of the student.

In order to complete the final evaluation, the clinical instructor will provide additional evidence by completing the comment
section, providing feedback and evaluating the students progress. The clinical instructor will collect evidence in the form of
the student self-assessment, comments of the health care team members, patient input, student submissions (including
portfolios) and observations. A summary of achievement as well as implications for future learning should be included in this
1

NURSING 3020 Clinical Evaluation

document. The attendance section and record of completed hours is to be filled in completely. The completed document is to
be printed, shared with the student and signed. The signed copy must be returned to the TFSON within 10 days.

The Year Lead, lab instructor, and/or course professor will assess the completion of the Learning Center Component, if
applicable.

Students and instructors will complete both the mid-term and final clinical evaluation
documents electronically. An electronic copy of the completed (student and instructor) final
evaluation should be submitted to the course professor within 48 hours of the final evaluation
delivery. A printed and signed copy should follow within 10 days of the evaluation meeting.
y

NURSING 3020 Clinical Evaluation

NURS 3020H

Clinical Evaluation

(Check one) Midterm ___Final _____ ___

Student Name: Melissa Amos

Clinical Instructor: John Corso

Missed Clinical Hours: 0 Missed Lab Hours: 0

NURSING 3020 Clinical Evaluation

Program Goals
Graduates are generalists entering a self-regulating profession in situations of health and illness.
Graduates are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a
variety of settings.
Graduates continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their
practice.
Graduates will demonstrate leadership in professional nursing practice in diverse health care contexts.
Graduates will contribute to a culture of safety by demonstrating safety in their own practice, and by identifying, and mitigating risk for
patients and other health care providers
Graduates will establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based
upon relational boundaries and respect.
Graduates will be able to enact advocacy in their work based on the philosophy of social justice.
Graduates will effectively utilize communications and informational technologies to improve client outcomes.
Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed
interventions and outcome measures.

NURSING 3020 Clinical Evaluation

Objectives
1 Explain the experience of acute illness in individuals
receiving care in acute setting

Progress
Indicators/Evidence
Midterm self-
Almost all the patients that I have cared or helped to care for at this point
in my clinical rotation appear to experience a loss of independence. A
patient that I cared for seemed to have a very difficult time after their
surgery. The patient had undergone a total knee replacement and was
experiencing a great deal of pain. The patient rated their pain as a 5/10
while under the influence of medication and a 7/10 an hour before the
next dose was to be administered. The patient was using their PCA but
was still experiencing a great deal of pain. This patient attempted to cope
by reading, sleeping or entertaining visitors. The patient stated that the
pain interfered with his ability to focus on tasks because the pain was too
great. Even under the influence of multiple pain relievers this patient still
experienced a great deal of pain.
Midterm Clinical Instructor
Melissa has shown progress in explaining the relationship between a
patients diagnosis and their co-morbidities
-she ensures her pre-clinical is put into her own words that allow her
understanding of diagnosis to be easier explained to her patients
-demonstrates an understanding of medications and their use with her
patients
Final Self
- Caring for patients with various conditions with the aim to better
understand the experiences of those in acute care
- Researching medications and procedure in order to better understand
the needs of the acute care patients
- Researching underlying conditions to understand if the patients
behaviors/symptoms are a result of possible complications or if they are
normal for the patient individually.

S U
S

NURSING 3020 Clinical Evaluation

2 Interpret critical aspects of the persons experience of acute Midterm Self

illness in relation to common signs and symptoms,
responses to treatment, patterns of coping, and impact on
individual and family relationships

In my fourth week of clinical I had a patient that had recently undergone a

total knee replacement. This individual appeared to handle the event well.
The patient had undergone a variety of surgeries in the past and was used
to the post operative procedure. As the patient had only had surgery in
the morning of that day the block was still affecting their body. The
patient had no feeling in his leg below the incision site, was using a
catheter and was not using the PCA. The inability to feel the limb after
surgery due to the medication is not unusual and despite asking why they
did not have feeling they were not concerning. Overall the patient was
coping well post surgery. However the patient was not using the PCA, this
was most likely due to the blocking agent interfering with pain
transmission, so they did not feel the need to use the PCA as they could
not feel any pain. In addition to this it was evident that the patient did not
like the use of the catheter. I believe that the patient was not coping well
with the lose of independence that they felt by needing assistance to void,
as it was a task they were used to performing by themselves. The patient
appeared to have strong social supports in the form of family
relationships. The experience in acute care did not appear to have an
impact on the individuals relationships with others.
Midterm Clinical instructor
Melissa is prepared to do her assessments with a stethoscope and pen
and paper and ensures she understands normal results that allow her to
understand any abnormal values
-she then ensures she treats the abnormal values within her scope of
practice whether it is to replace O2 on her patient or report to her clinical
instructor or a nurse immediately
-researched signs/symptoms of DVT, PE, infection and relating the vitals to
her patients admission and diagnosis
Final Self
- I have developed a firm understanding of common symptoms as a result
of surgery and feel confident identify deviations from these normals. For
example I am aware of normal drainage from a hemovac, ooze on
dressings and adverse reactions to morphine

NURSING 3020 Clinical Evaluation

3 Identify common medical treatments and potential

consequences/complications of selected acute illnesses

- I am aware of common complications and there signs such as DVT,

swelling, redness, tenderness and activity intolerance
-I have also witnessed and have a better understanding of various coping
strategies used by patients after surgery and this will help me to care for a
variety of other patients in my future as I know have a larger bank of
knowledge to draw upon.
Midterm Self

I have demonstrated knowledge of common medical treatments and their
possible complications through head to toe assessments. With each
patient I look for common post surgical complications resulting from their
surgery. For example when the patient has undergone a knee
replacement surgery I look for CMS in the affected leg and compare it
bilaterally to the non affected leg. I also look for signs of DVT such as
swelling, redness, and tenderness below the site of the surgery.
Midterm Clinical Instructor
researches any surgeries he patients may have had
-researches their co-morbidities to further understand the complications
that may occur with her patients
-researches clinical lab values and attempts to link them to her patients
diagnosis and co-morbidities
Final Self
- I have researched the conditions that my patients have ahead of time or
in clinical in order to understand complications that may arise in their
care. For example I understood the effects of Parkinsons before caring for
a patient with this condition to understand what may complicate care so
that I could anticipate possible difficulties.
- I continue to look for common post operation complications that affect
patients paying specific attention to concerns related to my patient
- I have developed a firm understanding of the common orthopedic
operations and how to care for them within my scope of practice

NURSING 3020 Clinical Evaluation

4 Demonstrate selected nursing and collaborative

interventions related to clinical pathways, peri-operative

care, IV medication administration, cardiac assessment and
rhythm strips, neurological assessment, wound care, blood
component therapy, TPN and central lines, pulmonary care
including chest tubes and tracheotomy, initiating IVs,
rapidly changing conditions, and resuscitation

5 Under the supervision of a Registered Nurse, demonstrate

safe, competent, evidence-based, holistic nursing practice
with clients with acute illness
1. Apply relevant nursing models, philosophical
frameworks, theories and evidence
2. Demonstrate therapeutic use of self
3. Engage with patients in an ethical and culturally
safe manner

Midterm Self
S
During the fourth week of placement I demonstrated that I know how to
properly administer IV medications as well as other medications. I used
the ADU under the supervision of my instructor to dispense medications
that I then administered to the appropriate patient. In addition to this I
have also demonstrated the ability to remove dressings, apply mepores,
as well as empty and remove hemovac drains from patients. On multiple
occasions I have removed dressings or zimmer splints from patients,
cleaned the wounds using aseptic techniques and reapplied a new
dressing. I have also demonstrated the ability to do a complete head to
toe assessment including neurological, cardiac, GI, urinary, respiratory and
integumentary assessments.
Midterm Clinical Instructor
- ensures she is prepared for clinical by completing her labs so that she is
better prepared for sterile dressings, which she has demonstated well
-demonstrated improving skills and an increasing skill base for acute
patients
Final Self
- I have demonstrated my ability to use IVs within my scope and the
hospital policy
- I have properly performed wound care on a variety of patients including
those with knee and hip surgeries as well as TURP maintenance.
- I have properly performed and charted neurological and cardiac
assessments on patients and consulted with the staff, my peers as well as
the instructor to make sure that I am properly charting and performing
the assessments.
Midterm Self
S
Whenever I am introduced to a new patient I introduce myself as well as
state that I am a nursing student. I do this in order to practice ethically. I
do not introduce myself as a nurse, I make it clear that I am a student in
order to represent myself properly and to make sure that the patient is
comfortable with a student providing care. If the patient is not
comfortable having a student provide care it would be unethical for me to
continue care, as I have to respect the patients right to choose for
8

NURSING 3020 Clinical Evaluation

4. Understand and anticipate emerging bio-psychosocial needs of persons with acute illness and apply
this knowledge to care:
a. Plan appropriate nursing care
b. Predict outcomes of nursing care
c. Evaluate client response to nursing care
5. Demonstrate health promotion and illness
prevention practices
a. Engage with patients and families to identify
health-related situational challenges
b. Work with patients and families to create
reasonable and effective solutions
6. Demonstrate patient advocacy
7. Demonstrate accountability
8. Demonstrate reliability

themselves.
After the time spent on the unit I now feel as though I can predict the
needs of the patient to some degree. By this I mean that I understand
what the normal level of mobility, sedation, and pain should be for a
patient that underwent knee or hip surgery recently. This allows me to
plan for the typical interventions that may be necessary and implement
them into my plan of care. For example I know that typically a knee
replacement patient post op day 1 will typically have the dressing
removed for the first time, go to physiotherapy and should be weight
bearing as tolerated.
I demonstrate health promotion behavior by educating the patients that I
am working with. Some examples of this include explaining the purpose of
deep breathing coughing exercises, calf pumps and other exercises. By
informing the patients of the reasoning behind these exercises I am able
to hopefully prevent the formation of DVTs which can commonly
occurring after surgery. In addition to this I aim to help the patient regain
as much mobility as tolerated. I do this by assisting them walking and
encouraging them to weight bear if tolerated.
I demonstrate accountability and reliability by charting regularly, updating
the nurse about any changes in patient status, and following through on
promises made to the patient and agreements reached with the nurse.
For example when a patient asks me about something that the nurse
would know, but I do not I ask said nurse and report the answer back to
the patient.
Midterm Clinical Instructor
- by witnessing her practice, it is readily apparent that Melissa has a good
base of theory to draw from in her clinical placement, she is aware of her
patients needs and necessary requires to improve and with more practice
she will become much more confident.
-charting and documentation is improving each week during clinical
-she seeks out opportunities to improve her knowledge base and skill set
-medications were done properly and within her scope of practice,
ensuring all patient and patient identifiers were checked at all times,
researching the medications she was dispensing was done before
9

NURSING 3020 Clinical Evaluation

6 Critically appraise own practice in relation to nurse-

client/family interactions and as a member of the health

care team

administration
Final Self
- I have interacted with patients and their families to understand possible
needs they might have related to their care in the hospital as well as
outside of the hospital. I have also witnessed a variety of home care visits
in the hospital to understand some of the possible barriers the patients
may face when they return home.
-I have theories examined in the corresponding course to help improve my
practice.
- Charting on other patients as well as my own when I perform tasks that
should be charted such as drainage amounts or dressing changes.
- I have sought out opportunites form the nursing staff in order to help my
practice evolve. For example I have gone with a nurse when she changed a
PCA pump to help understand the protocol but did not touch the pump
myself.
- I have followed protocols administering medications and providing
patient care.
Midterm Self
S
While interacting with a patient I also had to interact with their
family/friends. Initially I entered the room and introduced myself to the
other individuals in the room, explained that I was going to do an
assessment on the patient, and asked the patient if they would like
privacy. I did this to allow the individual to make the decision instead of
making it myself. Not only do I feel like this helped me to maintain the
patients autonomy I also feel that it helped to form a trusting relationship
with both the patient and their family/friends. My actions showed respect
for the patient as well as the other individuals which is a key factor in the
development of a healthy relationship. In the future I could be more
forceful in announcing myself to the family/friends.
As a member of the health care team I feel that I behave in the proper
manner. For example I inform the nurse of an pertinent information
regarding the patient or their condition, I also give report at the end of
shift. Additionally I ask the nursing staff if there is anything they might
need help with. I feel that this helps the nursing staff, and because I am
10

NURSING 3020 Clinical Evaluation

7 Participate in professional development based on reflective

practice and critical inquiry

available by me taken it upon myself to reduce the workload of these

nurses they are able to spend more time with patients that may need
their care more, or help other nurses performing tasks that I am not able
to.
Midterm Clinical Instructor
- all pre and post clinicals are handed in on time and done properly
-Melissa works well within her peer group, staff nurses and
multidisciplinary team.
Final Self
- I interact with patients and family members in a respectful and
understanding matter, explaining what I am able to with my knowledge
and scope of practice and when I do not feel confident in my knowledge I
use the resources available to me to provide the patient with the
appropriate information.
- I have worked with the staff to help care for my own patient as well as
other patients on the floor, offering to do vitals or care in order to reduce
the nurses work load and let them focus on patients with more focused
care.
- I continue to consult with the nursing staff regarding patient information
and any variations in status and consult with them about any concerns I or
the patient has.
Midterm Self
S
I have participated in developing my skills as a nurse by acting as team
leader. In week 3 I was the team leader for my clinical group. While in this
position I had to gather report from all the other students, help them with
any tasks that they may need a second person for and act as a source of
information. For example while I was team leader a student was doing her
first dressing without the clinical instructor, while she was confident in her
ability to perform the skill she asked me to come along with her to the
patients room. The other student did do the dressing change individually
however I helped to make her more comfortable by confirming that she
was doing it properly whenever she was concerned. Additionally I was
able to share different ways of performing the task that I found more
comfortable for myself. By doing this I was reflecting on my own
11

NURSING 3020 Clinical Evaluation

experiences of dressing changes, sharing what I learned from critically
appraising these situations with my peer and help my peer develop her
own skill set. This experience helped me develop the skill to share my
knowledge with other students/peers and overall improve my ability to
perform in the professional setting.
In addition to this I have also administered medications to patients under
the supervision of my instructor. This relates to professional development
as I had to seek out information regarding the medications such as: route
of administration, contraindications, dosages and adverse effects. After
administering these medications I then had to critically look at the
resulting vitals in order to eliminate adverse effects.
Midterm Clinical Instructor
- Melissa displays a professional appearance while on A5. Her uniform is
clean, shoes are proper, nails and hair well groomed and off the collar.
She reports to work on time and ready to work
-her written work is progressing each week in its depth and precision,
flow chart is clear and Melissa is demonstrating some confidence in
completing it
-she obtains and accepts positive feedback and incorporates it into her
future work
Final Self
- Since midterms I have been able to chart without consulting my
instructor beforehand and feel much more comfortable performing
charting on my patient as well others on the floor
- I continued to administer medications under the supervision of my
instructor
- After the submission of my first reflection I have attempted to apply
what I learned to my clinical practice
- I continue to attempt develop skills learned in placement throughout my
work and apply these skills during new experiences.

Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)


12

NURSING 3020 Clinical Evaluation

Melissa is progressing well in this half of clinical. She helps her peers when she is done her own work, looks for help when needed and answers call
bells for the staff. She is gaining confidence in her own abilities. She needs to seek opportunities to improve on these gains during the second half of
the semester.





Signature of Instructor___________________________________________________
Date _____________________________


Signature of Student: Melissa Amos Date November 17th, 2014

13