DEPARTMENT OF NURSING
JAMES MADISON UNIVERSITY
Student:
Emily C. Lawler
Name of Preparer:
Practicum Site:
Section #: 3
Date:
March 4, 2015
CLINICAL HOURS
Simulation: 0.5
Precepted: 0
Criteria: Students must achieve a passing rating in every outcome in order to pass a practicum course
Pass
Demonstrates satisfactory development of knowledge and skills. Objectives are met consistently and comprehensively, with progressive
independence and self-direction. Shows insight into strengths and areas for growth.
Fail
Mastery of skills and objectives inconsistent. Conduct is unsafe, unprofessional, offensive, or fails to maintain therapeutic alliance with clients
or resource personnel. Fails to construct or submit documentation in a professional or timely manner.
Outcomes/Objectives
Student Outcomes
Student Self-Evaluation of Performance
1/26: Washed my hands multiple times, could have told patients to do the
same
1/26: Positive team player, role model to clients
2/2: Spoke to client about their depression and was able to help to identify
triggers and ways to handle them
Respectful to staff and patients- creating a therapeutic environment and
role model skills
2/2: Spoke to client about their depression and was able to help to identify
triggers and ways to handle them
2/2: Respectful to staff and patients- creating a therapeutic environment
and role model skills
2/9Watched hands frequently
Taught patient hand washing to decrease spread of germs
2/16 Taught patient how to manage anger appropriately
Helped patient with activities to maintain positive coping skills after they
leave clubhouse
2/23- helped patient fill out a wrap plan and identify triggers, thought him
ways to cope with the separation of his wife- group therapy, individual
counseling, marital counseling, journaling.
3/2/15-Taught patient how to better care for his diabetes and symptoms
that denote hypoglycemia and hyperglycemia that can impede the patients
mental status.
Rating
Pass/Fail
PASS
Outcomes/Objectives
Page 2 of 9
Student Outcomes
Student Self-Evaluation of Performance
1/26: Tried to use therapeutic communication taught in Townsend book
1/26: Was able to pick up on most nonverbal communication (ex. Lack of
eye contact, fidgety)
2/2: Was able to do half of the MSE exam successfully with some
reminders was able to complete the rest of it
2/2: Was aware about TDOs and ECOs and the credentials the patient
must meet to be administered voluntary and involuntarily
2/9 Getting better at my physical assessment, becoming more thorough
when listening to the heart and lungs
MSE- getting better at remembering the steps now its time to fine tune them
and make sure I am able to elaborate on them and correctly convey what
my exam found
2/16 my process recording has helped me recognize my verbal therapeutic
and non-therapeutic communication skills and helps me advance better
practice
2/23- performed a full MSE without needing a cheat sheet, better
understanding how antipsychotics and other psych meds effect the brain
and their side effects and interventions I should perform when the patient is
taking that medication.
3/2/15- able to perform a thorough and in depth MSE, was able to
understand that the patient could be thought blocking and increased my
knowledge of the meaning of it by talking to my professor and reading a
summary of it in Townsend.
Rating
Pass/Fail
PASS
Outcomes/Objectives
Page 3 of 9
Student Outcomes
Student Self-Evaluation of Performance
1/26: Felt I was equally respectful to all patients however, I didnt take into
account their cultural background so I should be more conscious about that
2/2: Began mimicking the patients eye contact to promote a more
therapeutic environment
2/2: Was able to keep the conversations and teaching patient orientated
and only spoke about myself when the patient asked or when it would bring
positivity to the conversation
2/9 When talking to patient I do not lie to them, in the past patient said she
wanted to tell me something but if I could keep a secret, I told her I cannot
keep a secret if it effects her diagnosis or is imperative information but if it is
neither of those then I can keep it to myself
2/16 Getting better and therapeutically sitting with the patient- at their eye
level, not crossing arms or leg(which could come off as cold and
uninterested)
2/23- was able to emphasize with patient about his recent separation
without coming off at sympathetic (which I had problems with in the past)
was able to ask questions that did not come off at judgmental or intrusive
when asking about the process and the events that led up to it.
3/2/15- Told the patient what I was doing prior to performing the physical
exam as not to startle him and to reduce any possible discomfort. Told
patient (who was depressed and wanted to sleep all day) that it was
important to participate because it will help relieve some of the patients
depression and it is an appropriate activity to partake it, I would not stay in
the patients room if he did not want to go to group because that would be
giving into his poor behavior and impede on the patients recovery. Pt.
eventually decided to go to group and appeared less anxious after talking to
other patients.
Rating
Pass/Fail
PASS
Outcomes/Objectives
Page 4 of 9
Student Outcomes
Student Self-Evaluation of Performance
1/26: Feel like I did a good job motivating them and remaining positive with
open body language and eye contact
2/2: Maintained open body language, sat at eye level with the patient to
prevent me from looking down at her which could have caused anxiety or
intimidation from the patients point of view
2/2: Regarding HIPPA laws- was able to keep the clients confidentiality and
explained to her that I could not promise to keep a secret if the secret was
imperative to her life or diagnosis, which she understood and appreciated
my honesty
2/9 Conscious of HIPPA regulations and do a good job about maintaining
patient autonomy and privacy, need to work on my hand-off skills because I
have forgotten in the past to tell the nurse
2/16 Use effective expression- when patient tells me something sad I make
sure I am showing that I understand and am empathetic through non-verbal
communication, and make sure to smile and try mirroring their excitement
when they are talking about something they are passionate about
2/23- need to work on my therapeutic body language because there was
not a seat for me so I sat on the patients bed, which not recognizing this
was inappropriate and although I found a chair and changed position I
should have done that from the beginning. Would like to work on my handoff communication more,. I would say my HIPPA skills are significantly
improving. I know they say not to use names, but if by telling the story you
are not identifying the person or putting that at risk (slander/ liable) that it
can be a good learning experience for other students, but now I try not even
to say a word about my patient other than their gender and the diagnosis.
3/2/15- learned from the previous week, to make sure not to sit on the
patients bed, so I made sure a chair was in there. Tried to remain eye level
with the patient entire time because its therapeutic and patient seemed to
respond better. My documentation in improving, my teaching interventions
are becoming stronger and more focused. Maintained HIPPA regulations.
Rating
Pass/Fail
PASS
Outcomes/Objectives
Page 5 of 9
Student Outcomes
Student Self-Evaluation of Performance
1/26: Felt I was professional, maintained properly distance between me and
patients/ staff.
1/26: Was eager to learn from staff memories and flexible with changes in
the schedule
1/26: Followed dress code
2/2: Respectful, eager to learn, and helpful to the staff members
2/2: Maintained JMUs dress code policy
2/9 Feel comfortable starting my own assessments without asking the
professor and create nursing interventions with less assistance
2/16 Do all I can to make the volunteers jobs at the club house easier and
am willing to help them if they need it and eager to learn from them
Follow JMU dress code every week
2/23 my interventions are getting stronger and I am understanding the
importance of them, and recognizing the ones that are most important to
the patient
3/2/15- continue to follow JMU dress code, maintained professionalism
throughout entire practicum, increased independence and confidence in my
skills.
Rating
Pass/Fail
PASS
Outcomes/Objectives
Page 6 of 9
Student Outcomes
Student Self-Evaluation of Performance
1/26: Attempted to learn how to properly verbalize a scenario or event that
pertained to my interaction with my patient while simultaneously being
aware of their confidentiality
1/26: Make sure I am aware of HIPPA regulations as to not tell personal
stories about patient as they are confidential
2/2: Was very aware to maintain the clients safety, when assessing I made
sure that the patient was lying at the center of the bed rather than the end
to prevent falling, and was aware of any objects I had on me and made
sure that I left with them (ex. Pen, ID badge)
2/2: Maintained a respectful and autonomous relationship with that patient,
giving her the opportunity to decide what she wanted to do, within reason.
2/2: Asked questions to help my understanding of the imperativeness of
this rotation and to provide further safety and proper behavior when
communicating with staff and patients
2/9 Always on time
Performing my duties and tasks that I must obtain as well as sitting and
talking to the patient
Participate in post conference, giving feedback and information that I have
obtained to add to the conversation and propel it forward
Participate in the group therapies as well by helping hand out papers and
answering the MHC questions if patients are not
Completely fine with receiving constructive criticism, its the only way I will
learn and get better!
2/16 made it effort to talk to as many patients as I could to learn about
different illnesses and how they affect individuals socially
2/23 My parent today was being discharged and his psychotic symptoms
were minimal so I took it upon myself to talk to other patients and take note
on their psychosis, and did a MMSE, really enjoy feedback/ constructive
criticism- it can be hard sometimes because when you put in a lot of work it
can be a challenge not doing as well as you hoped but it is the only way
you can enhance your skill and become efficient so the more the merrier!
3/2/15- Actively share my experiences with other students as a teaching
guide as the proper way to do something or to teach them that there are
better ways to help or communicate with patients. Sound like a broken
record but the more feedback and critique I receive the more confident I will
feel because I am learning the means of best practice
Rating
Pass/Fail
PASS
Outcomes/Objectives
Page 7 of 9
Student Outcomes
Student Self-Evaluation of Performance
1/26: Spoke to a patient about their WRAP plan
1/26: Used therapeutic communication skills that I learned from our psych
textbook in my encounter with my patient. (I used active listening and open
posture)
2/2: Maintained a professional patient-nurse boundary
Allowed to patient to have maximum control as to what she did and did not
want to do/ partake in
2/9 Use Townsend book to promote teaching to the patients and also for
me to learn how to more appropriately and efficiently help these patients.
Every week we have new chapters to read and I try to use something I
learned that week and apply it to my next clinical
2/16 Today I helped a patient express his feelings when he is upset and
things he can do to cope with this, he told me his social worker and
psychiatrist have been trying to help him with that but my goals for him
were the most realistic (Milieu Therapy)
2/23- assisted patient write wrap plan because he wasnt able to read the
print well. I was able to help give him examples of triggers and coping
mechanisms without guiding him in a specific direction. Also used
document Professor ONeill emailed us last week to enhance my skills.
3/2/15-contributed to the Milieu therapy- worked with art therapy and group
therapy to increase my patients knowledge about the underlying cause of
his depression and ways of coping with illness. Told patient the average
day at Crossroads because today was his first day and he seemed anxious
so I attempted to relieve some of this stress.
Rating
Pass/Fail
PASS
Areas of strength:
Page 8 of 9
Page 9 of 9
Areas for growth: Continue to expand and refine use of therapeutic communication techniques in all clinical settings. Continue to refine
ability to construct written SMART goals and SMART nursing interventions.
MCAST Grade:
Final Grade:
PASS