Self Assessment

2015 - 2015 - Final NURS - 208 Course Learning Outcomes (201509)

NUR 208 Practical Nursing Practice 4 (PN, 06-Sep-2015 - 31-Dec-2015)
Student :
Clinical Teacher/Preceptor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Valentina Ramirez
Yeu Yin Hwang
Judy Martin
William Osler Health Centre/Etobicoke General
Hospital
Agency
L7W NM
06-Sep-2015 To 31-Dec-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.
V.R. : I comply with regulatory standards, relevant legislation and the practice setting's policies and procedures every time I put on my
gown and gloves before entering a patients room that has contact precautions.

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

Satisfactory

Satisfactory

V.R. : I act in a responsible, ethical and accountable manner every time I meet with the patient for the first time. I introduce myself and my
role as a Humber nursing student.

1. 3 Determine how the three factor and practice decision-making frameworks influence client

Satisfactory

Satisfactory

care.
V.R. : I determine how the three factor and practice decision making frameworks influence client care by asking help from a more
experienced nurse. For example, I was caring for a client who was experiencing pain at their IV site, so I assessed the site for redness and
tenderness. Then I consulted an experienced nurse with my findings so that we could come up with interventions.

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

Satisfactory

Satisfactory

V.R. : I use evidence informed practice and a theory-based approach to care every time I anticipate the need for pain management for
clients. For example, I had a patient who had recently had surgery. They had an incision in their right lower abdomen so The nurse and I
provided the patient with pain medication to maintain their level of comfort.

1. 5 Carry out safety-based practices and risk management principles to ensure client safety
and a safe environment.

Satisfactory

Satisfactory

V.R. : I carry out safety-based practices and risk management principles to ensure client safety and a safe environment every time I
transfer a patient that requires more than a one person assist. For example, I had a patient with an amputated leg that needed to use the
bathroom, so I brought the commode over and locked the wheels to help transfer them into the commode. The transfer was tolerated well
by the patient; however, when they were finished and needed to be returned back to the bed they did not have the same strength as before,
so I asked another nurse in the room to assist me with the transfer.

1. 6 Ask questions and clarify the plan of care, unclear orders or directions, and whenever

Satisfactory

Satisfactory

uncertain.
V.R. : I ask questions and clarify the plan of care, unclear orders or directions, and whenever uncertain. For example, I received a new
order for my patient after 1200hrs and the order said to start the first dose of antibiotics at 1000hrs that day; however, I did not recieve the
medication until 1400hrs. I was unsure whether I should start the dose as soon as I received it or allow for the next dose at 2200hrs to be
considered the first dose. So I confirmed the order requirements with an experienced nurse and she told me to give the medication as soon
as I receive it from pharmacy.

1. 7 Demonstrate professional behavior by seeking assistance in situations in which there is

Satisfactory

Satisfactory

unsafe,
unacceptable and/or unprofessional behavior.
V.R. : I demonstrate professional behavior by seeking assistance in situations in which there is unsafe, unacceptable and/or
unprofessional behavior. For example, I was caring for a patient who was able to feed themselves; however, when I went into the room they
were eating while lying down. I put the patients head of the bed up and showed them how to use the bed buttons. I also educated them on
the risks of aspiration or collecting fluid in the lungs because of the way they were eating. They acknowledged what I had to say and
agreed that It was unsafe to have the bed lowered while eating. When I came back to check on them, the bed had been moved back down to
a lying position and their gown was soaked in fluids. I asked the patient what happened, they later explained that they felt comfortable lying
down. I repeated my educational teachings to them and then notified the nurse about this patients unsafe habits and she told me to lock
the bed with the head up the next time a meal tray comes. When lunch came, I notified the patient that I was going to place their head in a
higher position and that they needed to call me using the call bell once they were done so I could change the position on the bed.

1. 8 Demonstrate understanding about the role of the nurse within health care.

Satisfactory

Satisfactory

V.R. : I demonstrate understanding about the role of the nurse within health care every time I consult with the team about changes in my
clients heath. For example, I had a patient who had not had a bowel movement in four days. They did not have any medications on their
chart that would help with their constipation, so after reporting it to the nurse, the doctor was notified and an order for the medication came
through.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Throughout the term you were consistent in practicing in a safe manner by working well with peers, staff RNs and teacher. You never
performed a skill that you were unfamiliar with without clarification and/or supervision if needed. You understand your limits and
knowledge of a student and practiced within that scope.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

V.R. : I participate in team sharing and discussions when I give peer feedback to my classmates as required by the quality assurance
program. A colleague of mine was also able to give me feedback on my strengths and weakneses. They identified my need for better time
management. I used this knowledge to develop my nursing skills and become more efficient in planning my day.

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

Satisfactory

Satisfactory

methods.
V.R. : I document clearly, accurately, concisely in a timely manner using written and electronic methods. For example, in my clinical
placement all patient vital signs are required to be electronically documented before the nurses attend bullet rounds. The nurse also
requires a copy of the vitals on their own sheet of paper. I share my patients vitals with them before they attend bullet rounds. I also make
sure to input my patients vitals correctly in the system and into the correct patient file.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

V.R. : I report relevant information to the appropriate personnel. For example, when my patients medications are not in Pyxis or in the
medication cart I ask the pharmacist to confirm if it is still on the way up.

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

Satisfactory

Satisfactory

team.
V.R. : I use communication techniques with the client and the inter-professional health care team by providing patient education. For
example, I had a patient who verbalized concerns of not being able to have a bowel movement in four days. They were given medication for
the constipation, but they still had concerns on not being able to go to the bathroom. I took a moment to explain how the drug works in
their body. I told them that results may take awhile and that they should continue to take their fluids to help with the process. They were
less anxious about their constipation when I gave them the added information.

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

Satisfactory

Satisfactory

Protection Act (PHIPA).

V.R. : I ensure privacy and confidentiality according to the Personal Health Information Protection Act every time I ask the patient for their
permission to provide care while they have a visitor present. For example, I had a client that needed to receive an injection in their
abdomen. They had a visitor present, so I told the patient that I would be exposing their abdomen. I let the patient decide whether they
wanted their spouse to be present during this time. They did not mind having them there, so I informed the visitor of what I was going to be
doing to make sure they were comfortable with being there too.

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

Satisfactory

Satisfactory

information.
V.R. : I use technology to retrieve and share information including research, data and other information whenever I use meditech or the
Osler website. For example, when I need to share and record information on my patient I place it under nursing notes in the patients file
using meditech. When I need to find out drug interactions for various types of IV medications I use the program called monographs that
can be found on the William Osler website.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

You consistently communicated with your patients and staff RN. You explained the patients clearly on regarding their medications and
nursing interventions prior to performing them. Also you kept your clinical teacher and staff RN updated on your patients progress. You
became more proficient with documenting electronically and giving verbal reports.

3. CARING RELATIONAL PRACTICE

3. 1 Use effective communication techniques.

Satisfactory

Satisfactory

V.R. : I use effective communication techniques when I have patients who have difficulties expressing their thoughts. For example, I was
caring for a patient who was confused and had difficulty speaking their words clearly. I would often repeat my clients sentences just to
make sure that it was what they were trying to say to me. They would often repeat themselves and I would make sure I listened carefully
and stayed quiet so that they could finish their sentence without any interruptions.

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

Satisfactory

Satisfactory

and health care team members.

V.R. : I establish therapeutic caring, compassionate, and culturally safe relationships with clients and health care team members every
time I change a clients brief with a collegue. For example, I had a female client who needed to have their briefs changed. They had a
previous stroke on the left side of their body, so I required some help to turn the patient. I asked a male collegue of mine to assist me.
Before I continued with my patients changing I introduced my collegue and made sure it was alright to have a person of the opposite sex
help me with their care.

3. 3 Demonstrate therapeutic use of self to foster client well-being.

Satisfactory

Satisfactory

V.R. : I demonstrate therapeutic use of self to foster client well-being by showing sensitivity and respect for clients choices, which have
grown from the clients individual values and beliefs, including cultural and/or religious beliefs. For example, I was assisting a patient into a
new position when I saw a rosary underneath the blankets, so before removing it I asked the patient if they would like me to place it on the
table so it doesn't get lost or if they wanted to hold onto it. The patient wanted to hold onto it. They said it made them feel better.

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

Satisfactory

Satisfactory

have on relational practice.

V.R. : I use self awareness to identify the effects that beliefs, values, and personal experiences have on relational practice. For example, I
was looking after a patient who suffered from dementia. They had their watch removed so that an IV line could be started on that hand. The
patient was very focused on their watch, they kept asking where it was and why it wasn't on their arm. I realized how much this watch must
have meant to them and I kept reassuring the patient that I would place it on the other arm once my teacher and I removed the occluded IV
line on the other hand. The patient asked several times for their watch, so I decided to lay it beside them in a spot where they could see it
and I told them not to worry because I would put it on their wrist as soon as I was done cleaning up their hand.

3. 5 Collaborate with clients and members of the inter-professional health care team and

Satisfactory

Satisfactory

consult appropriately.
V.R. : I collaborate with clients and members of the inter-professional health care team and consult appropriately. For example, I was
instructed by the nurse to help a client take a shower. After gathering all the equipment and locking the commode in place the patient
requested for me to leave them. This patient has been feeling dizzy since they arrived to the hospital and so I asked if they felt okay to
shower without assisstance, they said yes. I also asked them to stay seated in the commode chair and if they needed assisstance then they
could call me using the call bell. When I informed the nurse of the clients request she told me it would be better if I was helping the patient.
So the nurse came with me to the patients shower room to inform them that I would be holding the shower head as they bathed. The patient
agreed that it was easier to have someone holding the shower head up for them.

3. 6 Support the diversity of clients and the inter-professional health care team.

Satisfactory

Satisfactory

V.R. : I support the diversity of clients and the inter-professional healthcare team by working together with everyone and welcoming ideas
that are different from my own. For example, a team member and I were cleaning up a patient who continued to spit on the side of their
pillow, so I placed a blue pad beside them. My fellow team member suggested that I use a large towel instead since it could absorb more
saliva. I thought it was a better idea so I went with it.

3. 7 Display sensitivity and respect for clients cultural, religious, and other beliefs and values

Satisfactory

Satisfactory

influencing their choices and decisions.

V.R. : I display sensitivity and respect for clients cultural, religious, and other beliefs and values influencing their choices and decisions
when I keep their privacy. For example, I was helping a collegue with a patient who needed to have their briefs changed. The client asked
where his wife was and I told him that she was sitting right behind the curtain. He then said that that was good and for me to keep the
curtain closed. My collegue needed more supplies and when they left, the curtain was moved just enough for me to see a portion of the
wife's face. I decided to close the curtain and I told my collegue to make sure it was closed all the way once they came back.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

V.R. : I provide effective client education when I transfer my patients to a commode chair. For example, I had a patient who needed to be
transferred to a commode. I told them to sit up at the edge of the bed and take their time on getting up. Getting up slowly decreases the
chances of a fall incase they got lightheaded.

Teacher comments for CARING RELATIONAL PRACTICE :

You consistently practiced good therapeutic communcation with your patients and their families, by asking their preferences,
accomodating their needs and respecting their wishes. You asked your patients if it was okay to do this... prior to doing it and treating
patients as unique individuals. You also became more comfortable collaborating with the interprofessional team.

4. LEADERSHIP AND ADVOCACY

4. 1 Apply appropriate conflict resolution skills in therapeutic client and other interactions.

Satisfactory

Satisfactory

V.R. : I apply appropriate conflict resolution skills in therapeutic client and other interactions. For example, there was loud construction
noise occuring in the room right next to my patients room. My patient was getting very agitated with the noise and asking why it's
happening. I said that its construction in the room next door. I closed my patients door so that it was only open slightly. When I came back
to check on my patient they became angry with me for not shutting the door all the way. I apologized and told them that I will make sure to
close it all the way next time and if there is a problem like that again then call me using the call bell so I can address it sooner.

4. 2 Evaluate and refine leadership skills to develop solutions and create a positive work

Satisfactory

Satisfactory

environment.
V.R. : I evaluate and refine leadership skills to develop solutions and create a positive work environment every time I help motivate my
peers. For example, I was passing by a colleague that looked a little sad, so I asked them if everything was okay. They were upset with an
incident that happened earlier. After hearing the story, I reassured them that it could have happened to anyone and that they should focus
their thoughts on how to make things better. I told them that I was here if they need my help.

4. 3 Provide feedback to peers and accept feedback from peers and members of the inter-

Satisfactory

Satisfactory

professional health care team.

V.R. : I provide feedback to peers and except feedback from peers and members of the inter-professional health care team when I am
giving peer feedback evaluations. For example, I spent time to write a peer feedback evaluation on one of my peers and they were able to
do the same for me. I found that we both need to work on time management.

4. 4 Advocate for clients, self, others, and quality practice environment.

Satisfactory

Satisfactory

V.R. : I advocate for clients, self, others, and quality practice environment. For example, I had a patient who was on a thickened fluid diet.
They said that they were hungry so I went to the nurse to ask if there was something else I could give them since they finished the three
containers of fluids they got for breakfast. The nurse told me to tell the client that they had already eaten. I knew the client was hungry so I
asked the nurse again if the patient was scheduled for any snacks and the nurse said she would look into it for me. The nurse then came
into the patients bedside to look at the menu for this patient and she realized that this patient should be getting more. The patient later
received more thickened fluids and was more content.

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

Satisfactory

Satisfactory

V.R. : I support clients rights for self-determination and choice. For example, I had a client who was particular on when they wanted their
medication, they preffered to take their medications once they were done their breakfast. I made sure to have their medications ready for
them as soon as they were finished.

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

Satisfactory

Satisfactory

V.R. : I respond appropriately to unsafe, unacceptable, and unprofessional behaviours when my patient needs assisstance with feedings
or when my patient is confused. For example, when I am feeding a patient I make sure their coffee or tea is not too hot before I give it to
them. I also had another patient who was confused and tried to bite at their IV site, so I gently held their hand down away from their mouth
and told them to avoid doing that since they could contaminate the site.

4. 7 Collaborate and consult when implementing health care and nursing practices that are in

Satisfactory

Satisfactory

the best interests of the public and protect the public through collaboration and consultation.
V.R. : I collaborate and consult when implementing health care and nursing practices that are in the best interests of the public and protect
the public through collaboration and consultation by throwing away sharp items like needles in the sharps container.

4. 8 Contribute to the creation of quality practice solutions and strategies.

Satisfactory

Satisfactory

V.R. : I contribute to the creation of quality practice solutions and strategies by adhering to the policy that requires nurses to change
intermittent IV tubing every 24 hours. For example, to decrease the spread of infection I prepared a new IV tubing set up for my patient
receiving their new order of antibiotics.

Teacher comments for LEADERSHIP AND ADVOCACY :

You developed as a leader among your peers and became more confident in your knowledge and skills. You advocated for your patients
when able to with the primary staff RN. You always were appreciative to accept constructive feedback and incorporated it to learn and
improve as a clinical student.

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

5. 1 Incorporate the clients unique needs and expected outcomes into holistic and client-

Satisfactory

Satisfactory

centred plans of
care.
V.R. : I incorporate the clients unique needs and expected outcomes into holistic and client centred plans of care when I crush my clients
medications. For example, I had a patient who required me to crush a large pill and mix it into apple sauce.

5. 2 Develop theory-based plans of care that are holistic and client centered and are
articulated competently in writing and orally.

Satisfactory

Satisfactory

V.R. : I develop theory based plans of care that are holistic and client centered and are articulated competently in writing and orally when I
address my patients concerns of being unable to have a bowel movement. For example, I had a patient who has not had a bowel movement
in 4 days, so I spoke to the nurse and documented in meditech. The patient then received an order for laxatives.

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

Satisfactory

Satisfactory

V.R. : I use knowledge, skill and judgement to assess clients, prioritize needs and outcomes every time my patient receives a stat order.
For example, the doctor had given one of my patients a stat order of IV antibiotics and my other patient needed to be transferred from the
chair to the bed, so I prioritized and gave the stat order first then tended to my other patient for their transfer.

5. 4 Collaborate in the evaluation and modification of plans of care.

Satisfactory

Satisfactory

V.R. : I collaborate in the evaluation and modification of plans of care when I have a patient who has urinary retention. For example, I had a
patient who had not voided in their brief 5 hours into my shift, so I did a bladder scan. Due to the amount of urine in the bladder it was
necessary for me to perform an in and out catheterization.

5. 5 Safely and competently implement and evaluate nursing assessments and nursing

Satisfactory

Satisfactory

interventions in a manner that demonstrates knowledge and skill.

V.R. : I safely and competently implement and evaluate nursing assessments and nursing interventions in a manner that demonstrates
knowledge and skill when I listen to my patients lung sounds. For example, I had a patient with respiratory problems and a history of
smoking so expected there to be abnormal breath sounds as well as laboured breathing.

5. 6 Use the Three-Factor and practice decision-making frameworks to guide practice.

Satisfactory

Satisfactory

V.R. : I use the Three-Factor and practice decision-making frameworks to guide practice when I monitor my patients cognitive status. For
example, as soon as I meet my patient I am assessing their level of consciousness. I had a patient who was diagnosed with dementia. They
became confused later in my shift. I informed the nurse. She told me the patients behaviour was expected. The patient constantly needed
to be reminded where they were. I was there to remind them that they were safe and that I was near by if they needed me. I made sure to
keep close observation on this patient until the end of my shift.

5. 7 Prioritize nursing care and nursing interventions in order to manage workload, time, and

Satisfactory

Satisfactory

physical
resources.
V.R. : I prioritize nursing care and nursing interventions in order to manage workload, time, and physical resources when I have to give an
insulin dose. For example, when I care for a diabetic patient I make sure to give them their insulin before their breakfast.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
You improved on your prioritization and critical thinking skills throughout the term. By the end of the term, you became proficient in caring
for a 2 patient assignent by completing all associated nursing care and interventions in a timely manner. As time progressed and your
comfort level working on the floor and with the staff, you became more confident in your nursing assessments and understanding your
patient's diagnosis, medications and plan of care.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

6. 1 Collaborate with clients and members of the inter-professional health care team to assess
clients, determine health needs, and to achieve mutually agreed expected outcomes.

Satisfactory

Satisfactory

V.R. : I collaborate with clients and members of the inter-professional health care team to assess clients, determine health needs, and to
achieve mutually agreed expected outcomes when I am giving medications through a patients IV line. For example, I had a patient who had
a slightly reddened IV site, so I did not proceed with flushing. I got the nurse and told them that the IV site may need to be changed. They
did their assessment and agreed with me.

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.

V.R. : I contribute as a member of the inter-professional health care team to respond to the changing needs and expected outcomes of
clients when they require repositioning. For example, my patient was too low in the bed and required to be lifted upwards, so I requested
the help of a collegue to help me move the patient up in the bed.

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

Satisfactory

Satisfactory

V.R. : I seek out assisstance and consult with members of the inter-professional heath care team when I need assistance with medications.
For example, my patient required all medications to be crushed and placed in apple sauce; however, I had a capsule that I was unable to
get open so I asked my nurse if she could show me how to get it open without cracking the outer layer. I was shown how to get all the
medication out with ease.

6. 4 Use teamwork, consensus building, and conflict resolution skills to meet expected client

Satisfactory

Satisfactory

outcomes.
V.R. : I use teamwork, consensus building, and conflict resolution skills to meet expected client outcomes when weaning a patient off
oxygen. For example, I was caring for a patient that was receiving oxygen via nasal prongs at the start of my shift. I was asked to turn off
the oxygen and monitor the patients oxygen saturation levels to determine if the patient was doing well without the use of oxygen. I
informed my nurse on how well the patient was tolerating being off their oxygen. The doctor was then updated of the patients status. I was
able to get a reading of the patients oxygenation saturation levels on room air.

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

Satisfactory

Satisfactory

changing
environment.
V.R. : I use effective, collaborative, and consultative strategies to meet clients needs within a changing environment when I provide the
nurse with assisstance. For example, I was helping a nurse move a patient up in bed when the patient started to vomit. The nurse quickly
turned the patient to a side lying position and I helped the nurse get a k basin for the patient to vomit in. Afterwards, I helped the nurse
change the patients linens.

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

Satisfactory

Satisfactory

competencies.
V.R. : I interact with members of the health care team respecting their unique role and competencies when I help housekeeping. For
example, housekeeping cleans up patient rooms and empties the garbage but I make sure I help out by replacing the linen bags or garbage
bin bags when they are full. I place the soiled bags in the proper soiled room.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

By the end of the term, I believe you were confident in consulting with not only the primary nurse, peers and teacher but also the
interprofessional team (SLP, pharmacist etc.) regarding your patient's status and plan of care.

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.
V.R. : I act in the best interests of clients and protect clients from harm through collaboration and consultation with members of the interprofessional health care team and through competent and safe practice when I perform a patient transfer. For example, I was transferring a
patient from the chair to the bed. The patient was able to follow directions correctly; however, they were struggling to hold their own weight
so I asked my collegue for extra support. The patient was safely transferred back to bed.

7. 2 Engage in ongoing reflective practice to identify strengths, areas for improvement; and,

Satisfactory

Satisfactory

integrate feedback into practice.

V.R. : I engage in ongoing reflective practice to identify strengths, areas for improvement; and, integrate feedback into practice when I
complete my learning goals. For example, one of the areas for improvement was time management. After considering ways on how to plan
my day more efficiently, I am now able to incorporate time for my breaks during each shift.

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

Satisfactory

Satisfactory

program (CNO).
V.R. : I create, implement, and evaluate a learning plan consistent with the Quality Assurance program (CNO). I make sure to complete an
updated version of my learning plan and I keep it in a portfolio. I have been successful in working on getting to know my patients
diagnosis. I am more comfortable and confident when caring for my patients.

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

Satisfactory

Satisfactory

integrate these into practice.

V.R. : I seek out learning opportunities and feedback that foster professional development; and, integrate these into practice whenever I
offer assisstance to my nurse. For example, I was helping my nurse with moving a patient up in bed. The nurse said it is easier to move the
patient when you lower the head of the bed further than the foot of the bed. It is less straining on our backs. I integrate this method in my
everyday nursing.

7. 5 Use nursing research to foster professional development.

Satisfactory

Satisfactory

V.R. : I use nursing research to foster professional development when I am administering crushed medications to my patient. For example,
I was caring for a patient who had a poor appetite and it was very difficult to get them to take all their medications since they did not like
the taste of apple sauce. So I asked the nurse if there was anything else I could mix the medication in. She told me I could use strawberry
jam. I made sure the patient liked strawberry before I mixed everything. The patient enjoyed this flavour and was able to finish all the
medications. I made sure to give this patient thickened fluids in between each spoonful of the jam since it had a thicker consistency than
the applesauce.

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

Satisfactory

Satisfactory

V.R. : I use a theory based approach and evidence informed practice when I am monitoring a patients fluid intake and output. For example,
I was caring for a patient that drinking only small amounts of fluids throughout my shift. Their diet was poor and they had not yet voided or
had a bowel movement since breakfast. I auscultated the patients abdomen for bowel sounds; they were present. I also noticed the patients
abdomen was distended and firm which could have been because of a full bladder. I proceeded to tell my nurse and we later performed a
bladder scan to confirm if their was any fluid retention.

7. 7 Apply knowledge of changes to the health care system, technology, and in society as

Satisfactory

Satisfactory

these affect nursing practice.

V.R. : I apply knowledge of changes to the health care system, technology, and in society as these affect nursing practice; such as being
required to get vaccinated. As a student I am required to be vaccinated if I want to work in the clinical setting. I have complied with the
mandatory policy to get vaccinated so that I can continue with my education in the clinical setting. I have a higher chance of not
contracting the virus. This can also protect the patients I work with.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

You were always eager and appreciative to observe or practice new skills which constributed to your overall learning and development.
You became more comfortable researching and building your knowledge of how theory applied to the clinical situation. You became more
efficient with accessing hospital policies and procedures i.e. IV monographs, to ensure safe implentation of interventions.

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

8. 1 Use critical thinking and problem-solving skills to inform decision-making in all aspects

Satisfactory

Satisfactory

of nursing care.
V.R. : I use critical thinking and problem solving skills to inform decision making in all aspects of nursing care whenever I check my
patients temperature. For example, I had a patient who was slightly confused and could not follow my instructions while I was taking their
temperature. I was informing my patient to place the probe underneath their tongue but they weren't doing so. Instead of placing the probe
in the patients mouth I decided to do an auxiliary reading. This way I could get an accurate reading of the patients temperature.

8. 2 Use critical thinking, problem-solving and decision-making skills to assess clients and to

Satisfactory

Satisfactory

determine nursing diagnoses, expected outcomes, nursing interventions, and evaluative

criteria.
V.R. : I use critical thinking, problem solving and decision making skills to assess clients and to determine nursing diagnoses, expected
outcomes, nursing interventions, and evaluative criteria. For example, I was caring for a patient who kept pointing at their right leg. I asked
them what was wrong but they were non verbal. I pulled up their sock and placed their foot on a pillow and asked if that felt better; they
nodded. Later I came back and they pointed at their foot again so I gently removed their sock and noticed the previous pressure bandage
was coming off, so I told my patient I would remove this one and clean it so I can put a new one for them. After I put a new bandage on
them my patient was noticeable happier and did not point at their foot again.

8. 3 Evaluate critical thinking, problem-solving, and decision-making skills and design a plan

Satisfactory

Satisfactory

to improve
these.
V.R. : I evaluate critical thinking, problem solving, and decision making skills and design a plan to improve these when I recieve a patient
who is uncomfortable with swallowing large pills. For example, I had a patient receiving a large tablet daily. They were unable to swallow
the large pill so I cut it in half for them. I gave them water to take the pill with and they were able to swallow it.

8. 4 Integrate knowledge from a variety of nursing, health, and other theory into nursing

Satisfactory

Satisfactory

practice to provide safe and competent care.

V.R. : I integrate knowledge from a variety of nursing, health, and other theory into nursing practice to provide safe and competent care
each time a feed my patient. I make sure the head of the bed is up to prevent aspiration. I also make sure my patient has swallowing
everything in their mouth before I give them the next spoonful.

Satisfactory

8. 5 Prioritize effectively.

Satisfactory

V.R. : I prioritize effectively when I get everything done for my patients during my shift. For example, I had a patient that needed their
insulin before breakfast. I was able to prepare the right dose and give it to them at the right time. I also provided a bed bath for them before
I went for my break.

Satisfactory

8. 6 Demonstrate professionalism and accountability.

Satisfactory

V.R. : I demonstrate professionalism and accountability when I start my shift on time. I am able to recieve a bedside report from the
previous nurse. I also make sure I tell me nurse when I am going for my breaks so that there is someone looking after my patient until I
come back.

8. 7 Use the practice decision-making and the nurse-client-environment frameworks to inform

Satisfactory

Satisfactory

and guide practice.

V.R. : I use the practice decision making and the nurse client environment frameworks to inform and guide practice whenever I am giving
injections. I make sure I perform hand hygiene and put on clean gloves. If I am giving oral medications at the same time then I will
administer those first. I start from the least invasive medication so that my patient is not in pain while taking their oral medications. This
strategy helps my patient stay more compliant with taking all medications that are prescribed within that same time frame.

Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING :

You showed improvement with your critical thinking, problem-solving and decision making skills with how you completed your tasks in a
timely manner. You were always professional with how you interacted with patients, peers and staff. Also, you showed accountablility for
your work by completing assigned work on time.

Student Final Summary with Strategies for Continued Growth

I will continue to show improvement throughout my clinical time. I am continuously learning and gaining experience through involvement with my
patients and other nurses. It will benifit me to shadow my nurses and collect positive and negative feedback from them so that I can safely and
confidently perform the same task on my own. I will strive for efficient nursing care by continuously performing self asessments and working with any
peer feedback provided to me.

Teacher Final Summary with Strategies for Continued Growth

Overall, you have showed great improvement in your overall knowledge and skills throughout the term. You were always a positive and eager learner
which allowed you to benefit from this clinical experience. You have a calming presence which definitely helped you when caring for your patients and
their family members. Continue to be interested in how learned theoretical concepts are manifested in the clinical setting. This will help you become
more comfortable taking care of different patients and increase your medical knowledge. I have no doubt you will continue to develop confidence in
yourself and be successful in your studies and career.

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