Self Assessment

2015 - 2015 - Final NURS-151 Course Learning Outcomes

NURS 151 Practical Nursing Practice 2 (PN, 13-Jan-2015 - 30-Jun-2015)
Student :
Clinical Teacher/Preceptor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Hoa My Tang

Weston Terrace Care Community

Agency
151-1
12-Apr-2015 To 24-Apr-2015
168
168
168

I declare that this is my original work and the sources used are acknowledged.

Abilities and Outcomes / Learning Outcomes

Student Rating

Teacher Rating

1. COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK

1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies

Satisfactory

Satisfactory

and procedures.
H.M.T. : Complying with regulatory standards and the policies and procedures are my priorities before providing care to patients.

C.C. : Student continually improve each week on complying with the facility policies and procedures.

1. 2 Act in a responsible, ethical and accountable manner.

Satisfactory

Satisfactory

H.M.T. : I'm accountable for my actions including preparing medication cards, understanding patient's diagnosis and specific care for each
patient.

C.C. : Each week student maintained her accountabiltiy by ensuring that she was very knowlegeable on her medication and resident
diagnosis.

1. 3 Determine strengths and limitations and when to consult and seek assistance from other

Satisfactory

Satisfactory

professionals.
H.M.T. : I'll seek assistance when I'm not sure. For example, seeing the doctor's order for lactulose with D/C, because I'm not familiar with
this abbreviation, so after consulting with my teacher, I know it stands for discontinue. By clarifying this, I think I have to be more alert and
look for consultant (if needed) while administering medication to the patients to avoid any mistakes.

C.C. : Continue to seek clearification but also take some time and review the various acceptable abbreviation in nursing this was also
including your theory class.

1. 4 Use evidence informed practice and a theory-based approach to care.

Satisfactory

Satisfactory

H.M.T. : I learned at school and am ready to apply to practice, that is after administering medication via a metered dose inhaler, I should
provide some water for patient to rinse their mouth to reduce chance of oral fungal infections.

C.C. : Having this knowledge was good because you gave so many of this medications, but also remember that you had challenges with
your residents that was not willing to open their mouth. still you were able to put in practice this theory-base approach.

1. 5 Ensure client safety and a safe environment.

Satisfactory

Satisfactory

H.M.T. : I understand and always keep in mind to ensure client safety such as applying medical alarms next to the patient in order to be
aware of patient's fall or moving out of bed without the staff's notice.

C.C. : Continue to maintain patient safety at all times and also maintain good body mechanic .

1. 6 Ask relevant questions to clarify understanding of the plan of care and whenever

Satisfactory

Satisfactory

uncertain.
H.M.T. : I learned to slow down and ask questions in a clear manner by thinking about the way of asking questions before approaching my
teacher for answers.

C.C. : This have been noted since the midterm and you have done very well with practicing this .

1. 7 Identify ethical and unsafe situations and seek appropriate assistance to resolve these.

Satisfactory

Satisfactory

H.M.T. : I'll seek assistance to ensure my patient's safety. For example, when helping patient to the toilet, I observe the situation and
patient's condition, to know if it's safe for me to help him transfer to the toilet. And one of my patient is blind but he's still able to walk. So I
slowly instruct him step by step to reach to the toilet safety rail, and slowly let his other hand reach to the toilet seat, and help him to adjust
the right position safely along with his walker.

C.C. : Student demonstrate understanding of her role and took the steps to ensure patient safety by seeking assistance from instructor
and staff.

1. 8 Demonstrate understanding about the role of the student nurse.

Satisfactory

Satisfactory

H.M.T. : As a student nurse, I need to apply what I learned to real practice in order to ensure patient's safety and able to enhance my
knowledge of care from the clinical practice.

C.C. : Student consistenly demonstrate working withing her student nurse role.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Student has made several changes since the midterm and continue to show growth even towards the end of this clinical rotation.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

H.M.T. : For the post conference, we learned from each other by sharing information, I learned from one of my friend's presentation about
the care for patient with colostomy, I find it very helpful to me because 2 weeks after, I have a patient experiencing the same situation, so I
feel more certain in providing this colostomy care.

C.C. : Student still needed at times to be remainded to share in the discussions during post conference.

2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic

Satisfactory

Satisfactory

methods.
H.M.T. : I learned where to document by using electronic methods, and in a timely manner such as after administering medication, after
checking blood sugar level, and vital signs.

C.C. : Each new skill learned student was able to document clearly and in a timely manner.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

H.M.T. : I know who I should approach for help and report, get to know the charged nurse during my shift for getting my patient's daily
report. If I found something not sure, I consult my teacher first before making actions.

2. 4 Utilize communication techniques with the client and inter-professional health care team.

Satisfactory

Satisfactory

H.M.T. : I've learned that providing care needs a whole group's effort. Communication techniques with client, and staff plays a very
important role to improve patient's care in an accurate way and timely manner.

2. 5 Maintain privacy and confidentiality according to the Personal Health Information

Satisfactory

Satisfactory

Protection Act (PHIPA)

H.M.T. : Beside providing privacy for patient while giving them personal care, I'm also aware of keeping information recorded from my
patient confidential.

2. 6 Use technology to retrieve information including research, data and other information.

Satisfactory

Satisfactory

H.M.T. : In order to improve my knowledge of care (for example tube feeding, colostomy care), I use additional websites to help me
understand more about the proper techniques of care, so as to improve my patient's well being.

C.C. : Has demonstrated compliance with using the pointscare system.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Student has demonstrated on several occasion her abiltiy to make changes and fullfil the requirement set out by the facility

3. CARING RELATIONAL PRACTICE

3. 1 Utilize effective communication techniques.

Satisfactory

Satisfactory

H.M.T. : I understand the importance of using effective communication, and gradually I learned to calm down, to make up precise
questions so that clients and staff feel less tension and more understanding about my concerns.

C.C. : Student communication skill has improved since midterm where the ability to speech slowly and clearly has been practice regularly

3. 2 Demonstrate therapeutic caring, compassionate, and culturally safe relationships with

clients and health care team members.
H.M.T. : I am always treating my patients with respect and dignity through my care and concerns.

C.C. : Consistencly showing compassion, respect and politeness towards each of her clients.

Satisfactory

Satisfactory

3. 3 Apply knowledge of therapeutic use of self and identify its effect on client well-being.

Satisfactory

Satisfactory

H.M.T. : I learned that the practice of deep breathing and exhaling through pursed lip can help patients feel less nervous, more relaxed
and able to control their own breath.

C.C. : Student demonstrated understanding by using her knowledge therapeutically.

3. 4 Use self-awareness to identify the effects that beliefs, values, and personal experiences

Satisfactory

Satisfactory

have on relational practice.

H.M.T. : I keep talking to my patient, as long as you think you're young, strong, and happy, you will be young, strong and happy despite
your age. They all agree and we laugh and share with each other.

C.C. : Student was able to care for each of her residents without any difficulty, no sign of issues with resident belief or valves. Each
resident was treated with respect.

3. 5 Interact with clients and members of the inter-professional health care team; and, consult

Satisfactory

Satisfactory

appropriately.
H.M.T. : Participate in client's activities (activity room) with other heath care team makes me understand more about my patient's well
being and their interests because I find it helpful to improve my care for patients.

C.C. : Student took time with residents that were not assign and also was very helpful with health care team on the unit.

3. 6 Apply knowledge of practices and systems that support the diversity of clients and the

Satisfactory

Satisfactory

inter-professional health care team.

H.M.T. : From my learning experience of the elderly that their skin is mostly dehydrated, has poor elasticity, poor skin turgor, and easy to
tear, with high chance of developing pressure ulcer. Thus, applying more fluid by encourage them to drink more fluid, increase diet intake,
changing position often and applying moist (moisture cream) are some of the solutions to reduce skin break down and infection.

C.C. : This is great to know that you completed this request.

3. 7 Apply knowledge of clients cultural, religious, and other beliefs and values as these

Satisfactory

Satisfactory

influence clients choices and decisions.

H.M.T. : One of my patient asked me about lactulose, he said lactulose is too sweet, I got diabetes already, I don't want to drink it. I let him
know that I understand him, but I explained to him that the doctor and staff always keep track with his blood glucose daily, and especially,
if the blood glucose is changing, sometimes low or high. Doctor already has his adjusted his amount for the sugar intake (contained in
lactulose) within the safe range (based on patient's blood sugar baseline) for the purpose of providing the bowel movement. I let the patient
know that this medication is common to use for long term constipation, but if his bowel movement is getting more frequent (daily and well
formed, without any difficulty), this lactulose will be reviewed to hold back. One of the method I encouraged him is to drink more fluid (such
as water, or prune juice which can provide more fiber) to help make bowel movement easier.

C.C. : This was a great attempt at health teaching.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

H.M.T. : I understand majority of patients get constipation problem due to medication's effects and especially less fluid intake or lack of
exercise. Thus, during the meal time, I encourage patients to drink more fluid and about 2 hours after meals, I encourage them to do some
ROM depending on their current condition, in order to increase the frequency of bowel movements.

C.C. : Taking this step to health teaching was a good begin. In order for this to be effective it will be the responsibilty of the nurses to
ensure that resident is drink enough fluids.

Teacher comments for CARING RELATIONAL PRACTICE :

Noticable change in student ability to practice safe and relevant care.

4. LEADERSHIP AND ADVOCACY

4. 1 Recognize conflicts and strategies for resolution.

Satisfactory

Satisfactory

H.M.T. : So far, I've had the chance to work with one of my colleague (helping him to give his patient bed bath and wound care) ,
sometimes we have time conflicts, but we try to work it out together, and finally, we can resolve the time and still be able to give our
patients a complete care within the time allowed.

4. 2 Demonstrate leadership skills that foster group work and a positive learning environment.

Satisfactory

Satisfactory

H.M.T. : I've been learning to calm down and practice myself to relax and think ahead while communicating with clients and staff, because I
believe that too much tension and nervousness will distract the effectiveness of communication.

C.C. : Mini presentation gave student an opportunity to participate in group learning

4. 3 Identify opportunities to improve health care service and nursing interventions by

Satisfactory

Satisfactory

advocating for client, self, others, and quality practice.

H.M.T. : I try to limit chances to make my patient's discomfort by being certain with what I want to say and explain how I provide the care
before taking actions. Especially, I spend time to talk about their interests, asking how they're feeling, and what makes them feel better so
that I can improve my care to them.

C.C. : Consistenly seek opportunities to improve resident care.

4. 4 Provide feedback to peers and accept feedback from peers and members of the inter-

Satisfactory

Satisfactory

professional health care team.

H.M.T. : I appreciate the peer feedback and take it into consideration to modify and improve my practice, it also means that I value what I
think about my peer and want them to improve.

4. 5 Support clients rights for self-determination and choice.

Satisfactory

Satisfactory

H.M.T. : I am aware and understand patient's right. For example, they have the right to refuse medication. Although, I try to negotiate,
explain, and use motivate methods to change their decision, if they still don't want, I have to agree their decision and document that the
medication is refused.

C.C. : Continue to seek out ways to utilize theory

4. 6 Respond appropriately to unsafe, unacceptable, and unprofessional behaviours.

Satisfactory

Satisfactory

H.M.T. : I keep reminding myself to use the clinical hand sanitizer before and after entering the patient's room in order to limit the chance
of transmitting pathogens to my patients, and to others and myself.

4. 7 Consult and collaborate when carrying out health care and nursing practices that are in

Satisfactory

Satisfactory

the best interests of the public and protect the public through collaboration and consultation.
H.M.T. : When I and my teacher helped a patient to relieve from constipation by inserting fleet enema (medication), I can see the
effectiveness of working together, one person keeps patient in sim's position (patient lies on her left side, left hip and lower extremity
straight, and right hip and knee bent), the other person inserts the medication, and working collaboratively to transfer her to the toilet
safely.

C.C. : Team work is what nursing is all about.

Teacher comments for LEADERSHIP AND ADVOCACY :

Student have demonstrated on several occasion her abiltiy to advocate for her resident by taking on a leadership role.

5. PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES

5. 1 Incorporate the unique needs and expected outcomes into individual clients plans of

Satisfactory

Satisfactory

care.
H.M.T. : I can see the effects of working on care plan (2 steps) helps me see a whole picture of my patient's condition, and from that I can
recommend some of intervention in order to improve patient's problems as well as limit the risk of unsafe situation that might hurt or
worsen the patient's condition. For example, one of my patient has a seizure disorder, from step 2, I recommend how to care for her by
minimizing the objects around her from which she might got injured, loosening her clothes, not applying any restraint and providing
oxygen as needed for possible respiratory distress occurs caused by seizure effects.

C.C. : Step 1 and 2 have provided student with a better understanding of focusing on resident needs and various ways for others to
follow, this will leads to good outcome.

5. 2 Develop theory-based plans of care that are holistic and client centered and are

Satisfactory

Satisfactory

articulated competently in writing and orally.

H.M.T. : Different patients have different conditions, and various manifestation; thus, the holistic care for patient should be different. For
example, a patient who can walk and patient are paralyzed by stroke, with the same diagnosis of diabetes mellitus type 2, will have different
ways of care. One thing I learn is that exercise can help body to take up glucose and use it for energy whether insulin is available or not, so
I can apply it to the patient who can walk, educate him about the effect of exercise (10-30 minutes a day) to improve his blood glucose but
not strenuous exercise ( causing hypoglycemia). The other patient, I can help him and teach his family member to do several ROM in order
to reduce pressure ulcer and improve blood glucose level.

5. 3 Use knowledge, skill and judgment to assess clients, prioritize needs and outcomes.

Satisfactory

Satisfactory

H.M.T. : Daily organizational plan helps me to prioritize care for my patient besides what should be done for him/her in a daily basis.

5. 4 Provide information that contributes to the evaluation and refinement of plans of care.

Satisfactory

Satisfactory

H.M.T. : After the clinical practice, self reflecting based on the current plan helps me evaluate and improve for a better care to my next
organizational plan.

5. 5 Safely and competently carry out nursing assessments and nursing interventions that are

Satisfactory

Satisfactory

theory-based and within skill abilities.

H.M.T. : I applied theory of wound assessment into the clinical practice safely and competently. For example, when making the wound
dressing close to the coccyx area for a patient, I assessed the size, odor, color of skin and drainage (if occurs), and learning the use of
cotton swab tip for knowing the wound depth. From this assessment, it shows the wound is at stage 4, since I see a full thickness skin
loss with muscle exposure (though bone or tendon not seen yet). Thus, based on stage 4, there is a specific dressing standard for nursing
intervention. I learned the use of alginate which helps to absorb the fluid excreted from the wound very effectively. Besides, I'm also aware
of not packing the wound too tight so that it won't interrupt the blood flow or delay the process of healing.

C.C. : Continue to keep up your assessments.

5. 6 Carry out nursing care that reflects the practice decision-making framework.

Satisfactory

Satisfactory

H.M.T. : I agree with the importance of using the organizational plan. It helps me be more organized and guide me in providing the best
care to my patients.

C.C. : Using your organization plan really allow you to make the changes since midterm. Continue to utilize these skill in your next
rotation.

5. 7 Complete nursing care responsibilities and nursing interventions in an organized and

Satisfactory

Satisfactory

timely manner.
H.M.T. : With the guide of daily plan, all the cares which are needed to be done are listed in a timely manner. Back to the patient from
Jackson unit, she had constipation and doctor ordered fleet enema, my teacher assigned me to be with her to complete the task of
inserting this laxative saline for inducing bowel movement. Having an awareness of the time of medication given within 30 minutes before
and after is acceptable by the facility policy, I'm ready to take this task without any delay.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Student demonstrate several changes since the midterm she have been utilizing the daily plan more regularly.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

6. 1 Work with clients and members of the inter-professional health care team to assess

Satisfactory

Satisfactory

clients, determine health needs, and to achieve mutually agreed expected outcomes.
H.M.T. : In order to provide the better care, I find the report about patients before every shift is very important. It's a message between staff
member to let each other keep track with patient's current condition. Thus, always report and report what happens to the patients is
considered valuable message to help to improve the patients' well beings.

6. 2 Contribute as a member of the inter-professional health care team to respond to the

Satisfactory

Satisfactory

changing needs and expected outcomes of clients.

H.M.T. : Though still being a student, I find myself in a role in where I feel more responsibility for the safety and well-being of the patients. I
try my best to use my time valuable and meaningful to collaborate with the health care team to provide the best care for my patients.

6. 3 Seek out assistance and consult with members of the inter-professional health care team.

Satisfactory

Satisfactory

H.M.T. : I feel that seeking out assistance is encouraged, especially in this nursing field, because I wouldn't want to put the patient at risk
with actions which I'm not familiar. For example, I ask for assistance if my patient's condition needs 2 persons for transfer and lifting.

C.C. : Student utilize the instructor and the staff on the unit during difficulty.

6. 4 Use teamwork, consensus building, and conflict resolution skills.

Satisfactory

Satisfactory

H.M.T. : If there is a conflict among the teamwork, I need several developing skills to address any unethical, unprofessional or unsafe
behavior of colleagues and immediately take action when clients are at risk of harm from colleagues.

6. 5 Describe effective, collaborative, and consultative strategies to meet clients needs within

Satisfactory

Satisfactory

a changing environment.
H.M.T. : Being alert to the changing environment such as client's condition changes (for example, when providing care for client
diagnosed with DM type 2, after his breakfast around 2 hours, he tends to be weak, confused to answer my questions). For this situation, it
needs some effective and collaborative as well as consultative strategies to do an assessment to understand more about the client's
manifestation. We check vital signs and his fasting blood glucose (is 9.2), everything seems in normal range compared to his baseline vital
signs, and blood glucose. So, we decide to transfer him to bed to let him rest and let the PSW to notice and we keep monitor him.

C.C. : Working with staff to ensure resident safety and in this case you were able to provide a effective solution.

6. 6 Interact with members of the health care team respecting their unique role and

Satisfactory

Satisfactory

competencies.
H.M.T. : Collaborating and effective communication play important roles to accomplish the task with competence and in a timely manner.
Also, having respect and aware of not interrupting the other' s work is one of the main concerns, especially when preparing the medication
administration for patients.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Student demonstrated her ability to work well with staff on the unit and participate in other activities by the inter professional health care
team.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

7. 1 Act in the best interests of clients and protect clients from harm through collaboration

Satisfactory

Satisfactory

and consultation with members of the inter-professional health care team and through
competent and safe practice.
H.M.T. : For example, on the first day of being with my new patient, I don't know her level of impaired physical mobility, so I asked the PSW
to know what safe transfer techniques for my patient. From effective communication and consultation, I learned that my patient can stand
with a help of 1 person. Besides that, I observe the patient's consciousness, and her ability to stand by asking her straighten and rotate her
legs, after that, I successfully assist her to wheelchair with a proper technique (wheel chair plugged next to her bed and bed level is
comfortable for patient to stand).

C.C. : Good collaboration with the staff and you for the safety of the patient.

7. 2 Participate in self-reflection to identify strengths, areas for improvement.

Satisfactory

Satisfactory

H.M.T. : This practice of self reflection help me understand my strength such as ability to provide basis care for patients (tube feeding
techniques, ROM, providing hygiene) as well as other cares including wound care and medication administration. Besides, I also find some
areas that I need to improve such as time management, understand more about patient's diagnosis and manifestation after administrating
medication).

C.C. : Each week a self reflective was completed and noted changes were implemented on the unit.

7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance

Satisfactory

Satisfactory

program (CNO).
H.M.T. : It requires several steps including: making a clear learning goal, within time needed to achieve these goals as well as applicable
and attainable methods of accomplishing the goals.

C.C. : Using your step 1 & 2 was created and implemented during the clinical setting.

7. 4 Seek out learning opportunities and feedback that foster professional development; and,

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Satisfactory

integrate these into practice.

H.M.T. : I keep looking for opportunities to learn and integrate theory into practice. Besides, feedback from teacher and peer can help me
reflect and improve my professional development for my nursing career in future. For example, I learned that I should be patient to wait for
my peer to finish the medication preparation since one small mistake of medication can cause a huge unwanted harmful effect sto the
patient.

7. 5 Utilize nursing, health and other theory and literature to improve nursing practice.

Satisfactory

Satisfactory

H.M.T. : Understand what care is provided in the unit (wound care for example) and compared to what it should be done provided from
theory so that I can either integrate or be able to provide a better understanding of a proper and safe technique for the patient. For
example, providing wound dressing care, according to theory, we need to apply sterile gloves which are not provided from the clinical
facility. I understand but due to financial concern for the facility, I replace by using regular gloves but still provide proper procedure of
cleaning and packing the wound.

C.C. : Continual improvement was noted since midterm, more aware of expectation .

7. 6 Use a theory-based approach and evidence-informed practice.

Satisfactory

Satisfactory

H.M.T. : I am aware of my practice by always going back to the theory taught in school. Before providing insulin injection, I have to know
his current blood glucose, based on her baseline to decide if holding her insulin if blood glucose is less than 4 mm Hg, or if giving but
based on the sliding scale to change the units for injection. Also, including steps for this procedure such as my understanding about what
function of insulin, what type of insulin for this particular patient is, how it works, how many units, the location, type of injection
(subcutaneous) and what supply needed like alcohol swab and needle. So that, I can provide a safe injection for the patients.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Continue to use the theory from the class in your practice,

8. USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING EFFECTIVELY

8. 1 Utilize problem-solving skills to inform decision making in all aspects of nursing care.

Satisfactory

Satisfactory

H.M.T. : I continually try to practice on the situation which I think need more improvement, so that I feel more confident in providing
problem solving skills.

8. 2 Use problem-solving and decision-making skills to assess clients and to determine

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Satisfactory

nursing diagnoses, expected outcomes, nursing interventions, and evaluative criteria.

H.M.T. : To improve communication with my patient who has difficulty of speech or talk too little, I assess her condition by asking more
open- ended question like "do you have any pain?" or " would you like any drink?" or did you sleep well? or do you feel itchy since I saw
she scratched her skin and assess her by gestures like eye contact or nodding her head to show her agreement. From this, I can provide
care to her in a cooperating way.

8. 3 Use self-reflection to design a plan to improve problem-solving and decision-making

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skills.
H.M.T. : By using self reflection from daily care plan, it can help me build up my problem solving and decision making skills. For example,
talking about providing hygiene care for patients such as washing face, or brushing teeth for my patient. After self reflection, i find it
should be done in another effective way in order to improve patient's independence by letting her washing her face, brushing her teeth
(since she's able to do it) and drying by herself, it not only helps her improve her muscle strength but also her autonomy and strengthen
her self control.

8. 4 Utilize knowledge from variety of nursing, health, and other theory into nursing practice

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Satisfactory

to provide safe and competent care.

H.M.T. : Based on patient condition such as high risk for fall, I learned use proper transfer techniques like lift transfer, apply safe sponge
into patient's underwear along with having a safe carpet around the bedside or putting up the bed's side rail in order to limit the injury from
falling.

8. 5 Use prioritization strategies for client care.

Satisfactory

Satisfactory

H.M.T. : In order to provide the best care for client, based on the patient's diagnosis, her current medication, we can see a whole picture of
her condition so that to prioritize the care for particular patient. For example, patient diagnosed with depression, her priority is to have
someone beside; so I try my best to make conversation with her more, encourage her to participate in group activities, help her calm down,
and let her do according to her interest.

8. 6 Demonstrate professionalism and accountability.

Satisfactory

Satisfactory

H.M.T. : I'm aware of acting with high responsibility, and be one time at the unit as well as for giving medication.

8. 6 Recognize strengths and limitations and seek appropriate assistance and support.

Satisfactory

Satisfactory

H.M.T. : I learned to prepare more before providing the care at beginning. After the first time experience, I find it more comfortably to
provide a better care and improved gradually within a timely manner.

Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING EFFECTIVELY :
Making the right decision is sometimes not easy so it will be very important to ensure that your are very knowledgeable with the theory in
order to think about what you will have to do.

Student Final Summary with Strategies for Continued Growth

SUMMARY OF SELF EVALUATION
What are my strengths at the end of the semester?
There are several experiences and knowledge I have gained from providing care including giving bed baths, changing wound dressing, setting up the
pump for tube feeding, using high and low lift with the assistance of a second person for transferring patient, medication administration, documenting,
checking blood sugar, caring for colostomy as well as changing, inserting the saline laxative (fleet enema), giving eye drop, administering medication
by using metered dose inhaler for patient with asthma or respiratory diseases. Especially, the last experience that I learned is giving insulin pen to
diabetes type 1 patient. Knowing what type of insulin, its onset, peak and duration as well as the manifestation of hypoglycemia as well as
hyperglycemia to help me understand and see the effect of the medication. Before the injection, I understand that checking patients BS current level
is very important before administering ordered insulin so that patient will receive an appropriate amount needed to control their blood glucose at this
certain time. Also, to avoid injecting to the same area, or an area that is bruised, tender or swollen because it will interrupt the absorption of the
insulin and cause pain or discomfort. Moreover, I learned the importance of priming before giving injection to get rid of the bubble for the purpose of
giving accurate and safe dose.
Also, while taking care of the elderly people, I can see my interest of conscientiousness and enthusiasm. I want to treat my patient with respect and
dignity with the best care as for my grandmother or grandfather. I wouldnt be irritated if they feel uncomfortable and even getting mad at me, because
I can understand when people dont feel well, they behave in the way which they dont really mean it. I would never ignore them due to their
uncontrolled temper or put them at risk due to some of the care which Im not familiar with.
What are my areas at the end of the semester?
The first area that I need improvement is able to do several assessments accurately without looking at the check lists. For example, when patient falls,
I should know what assessment is my priority check, especially, for doing neurological check, I should implement the assessment method called
Glasgow Coma Scale. I should know right away what its about in order to assess my patient. I should know how to check some areas related to the
response of eye, the verbal response as well as the motor response so that I can monitor, provide care and report about the patient's current condition
more accurately.
I also need to be more assertive to adhere to my teachers instruction. For example, since patient wants to have injection right after her breakfast
which is applicable. Especially, due to the insist of the charged nurse for insulin injection at this time, she assured to monitor and assist me though this
is my first injection practice, while my teacher is not there. The nurse pressure for the need of injecting immediately made me uncertain to follow her
guide. However, since I observed my friend giving insulin and the steps she explain to me very clear. Thus, though I hesitate to implement but I'm
confident in my knowledge for this administration. From this, I should be aware more of letting others creating pressure and bending my teachers
instruction. For the sake of patients safety and my learning development, I need to stick with my teachers instruction.

Teacher Final Summary with Strategies for Continued Growth

During the last part of the clincial setting you were able to express your self much more clearly. Now try to work the area that you found more
challenging during this semester.

Student's References
http://www.cno.org/en/learn-about-standards-guidelines/standards-and-guidelines/
Lewis, S. L. (2014). Medical-Surgical Nursing in Canada, 3rd Edition. [VitalSource Bookshelf version]. Retrieved from
http://pageburstls.elsevier.com/books/978-1-926648-70-5/id/B9781926648705000643_f0065

Grade

Satisfactory

Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

Grade

Satisfactory

Program Coordinator Feedback

The Program Coordinator has reviewed the evaluation

Yes

No

Student Sign Off

I met with my Clinical Teacher/Preceptor and discussed my evaluation

Yes

No

In general this evaluation accurately reflects my performance

Yes

No