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 :

Monique Traezann Hall

Vertel Spence
Judy Martin
William Osler Health Centre/Brampton Civic Hospital
Agency
N4 PC
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.
M.T.H. : I comply with the standards and policies of the unit and the college. I show up to clinical on time, properly dressed and prepared. I
follow the unit policies, For example it is mandatory to check the unit I.V manual before administering the medication, so I made sure to
obliged by this rule.

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

Satisfactory

Satisfactory

M.T.H. : I acted in a responsible manner by maintaining a professional image and consulting my teacher or the primary nurse if I am
unsure about something or I just need clarity. Whenever I am providing care I often looked back on my own morals and ethical values
according Colleges of Nurses of Ontario. For example, I maintained respect for life when my patient died by providing hygiene care before
family members sees her.

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

Satisfactory

Satisfactory

care.
M.T.H. : The way I carried out care is based on the three factor framework. The client, nurse and the environment is very influential. I take
into account the complexity of the client, whether or not they are stable and the availability of resources to take care of each client. I also
consider my level of knowledge as a student nurse.

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

Satisfactory

Satisfactory

M.T.H. : Evidence informed practice and theory based approach is use to care for each patient. The first I administered medication
intravenously I was prepared. I had read my textbook which gave me a general idea of the equipment that i needed to use and how the
procedure is done. With the help of my instructor I was able to administer the medication safely. I also use my knowledge and
understanding of the patient's diagnosis and history when providing care.

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

Satisfactory

Satisfactory

and a safe environment.

M.T.H. : To ensure client safety at all time simple procedures were done. For example, I washed my hands before and after each patient
care, wear gloves when in contact with bodily fluid and giving injections. I made sure my clients fee safe by providing privacy when giving
care. I also, made sure at all time the bed is left in the lowest position, side rails up and call bell within the patient's reach. For patients who
are high risk for fall I made sure to put the bed alarm on and checked on the patient often.

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

Satisfactory

Satisfactory

uncertain.
M.T.H. : I seek clarity from my instructor or primary nurse whenever I am uncertain about anything pertaining to my clients. There was an
order for continuous infusion of a medication for one of my patients. The nurse showed me the order and we administered the first dose.
However, when I was going to give the second round of the medication I realized I did not really understand how the order was continuous
so I seek assistance from my instructor who helped me to understand the order. Another patient I had was NPO but was taking
antihypertensive medications, I clarified with the primary nurse who called the docotor and found out if the medications could be given.

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

Satisfactory

Satisfactory

unsafe,
unacceptable and/or unprofessional behavior.
M.T.H. : A situation that could have ended up in unsafe behaviour was identified. A nurse miscalculated the amount of insulin to give to a
patient and I caught on to it and told her it was wrong but she did not think it was wrong. I immediately sought my instructor's assistance
who calculated the insulin dosage and informed the nurse.

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

Satisfactory

Satisfactory

M.T.H. : There are two classifications of nurses: the Rn and Rpn. Both nurses are responsible for providing holistic care to patients while
maintaining a therapeutic relationship. Each nurse is responsible for making sure that at all time the care provided is client-centered care.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Monique demonstrated the ability to maintain competency by performing according to the Standards of Practice of the CNO. She adhered
to safe medication practice by performing the three checks and eight rights. Monique asked questions when necessary especially during
medication administration. She maintained professionalism and accountability by arriving to clinical on time and by dressing
appropriately. Monique maintained Ethical Standards by maintaining confidentiality and by not imposing her values on her patients. As
well, Monique endeavored to provide holistic care by not just focusing on the physical aspect of care but by also focusing on the mental,
spiritual aspect as well. Well done Monique!!!

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

M.T.H. : I constantly participate in discussions with my peers, instructor and members of the inter-professional team. For example, I share
information about my patient to my peers when giving report before going on my break. I constantly report to the primary nurse and my
instructor about my patient. For example one of my patient constantly refused a bath and repeatedly share this information with the
primary nurse and my instructor. I participated in discussion at post conference by sharing my experience for the day and also in the form
of a presentation. I presented the effects of bed-rest on the musculoskeletal system.

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

Satisfactory

Satisfactory

methods.
M.T.H. : At the beginning of the semester my documentation skills needed improvements. I worked on my documentation skills and I now
feel satisfactory in this area. I document events as they occur now as oppose to waiting until I provide all my care. For example, If i gave
my patient any prn medication I immediately documented the first half of the progress note which involves: Focus, data and action. After I
evaluate my patient I immediately documented their response to the medication therapy. Also, i documented clearly by using medical
terminology and limiting the number of time I edit things such as ADL'S and assessment. The medication administrataive record is signed
each time a medication is given, making sure proper credentials are there.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

M.T.H. : Relevant information such as changes in patient's condition is reported to the primary nurse and instructor at all time. For
example I was assigned a patient who started vomiting dark blood, I immediately seek the primary nurse who informed me that the patient
was dying. After we cleaned the patient a I reported this information to my instructor. Another patient who was suppose to be getting a
medication continuously wanted to wait until he used the washroom, so my instructor and I hang the medication but did not start it. I
reported this information to the primary nurse.

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

Satisfactory

Satisfactory

team.
M.T.H. : I used techniques that are familiar to both client and members of the inter-professional team. For example, medical terminologies
are used when talking to members of the healthcare team as oppose to clients. The nurse understands when I say vitals are stable or
unstable, however the client does not understand what vitals mean. Instead of saying to the patient that I would like to take your vitals I
break it down in simple language for the patient to understand and tell them what vitals means. Another example is when explaining the
mechanism of action of a medication the patient is on. For example giving a patient diuretic, I say to the patient that the medication will
cause them to lose water as a means of flushing their system which will cause them to urinate a lot.

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

Satisfactory

Satisfactory

Protection Act (PHIPA).

M.T.H. : Privacy is maintain throughout clinical by making sure that curtains are pull when providing care. Only the area that is being cared
for is exposed at all time. For example when giving a bed bath if the chest is being washed the rest of the body is kept covered with a towel.
Confidentiality is also maintained by not giving information to unauthorized personnel. For example, as a student nurse on the unit i was
not sure if I could tell family members code status of the patient so when a particular family member asked me I directed them to the
primary nurse. I demonstrated confidentiality for this patient.

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

Satisfactory

Satisfactory

information.
M.T.H. : Computers on the unit are used to access reliable sources such as online textbooks to research patient diagnosis, comorbidities
and medications. They are also use to relay information about patient's condition in the form of documentation. For example, I took my
patient blood pressure and it was high, i accessed the patient's file to find out the patient baseline blood pressure.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Monique provided accurate and concise computerized documentation in a timely manner. As well, she ensured that she maintained
confidentiality by not discussing her patients' conditions in the hall way and by providing privacy during patient care. She endeavored to
report relevant information to her instructor as well as to her patient's primary nurse.

3. CARING RELATIONAL PRACTICE

3. 1 Use effective communication techniques.

Satisfactory

Satisfactory

M.T.H. : Techniques used to communicate are effective because both clients and members of the health care team are able to understand
whenever I communicate with them. For example a patient is able to understand when I try to assess if they had any bowel movements
because I asked them in simple language such as have you used the toilet.

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

Satisfactory

Satisfactory

and health care team members.

M.T.H. : At the start of each clinical before caring for each patient I establish a therapeutic relationship with them by identifying who I am
by stating my name and credentials. I also inform them about what would be doing for them and obtain a verbal consent before providing
any care. The unit is culturally diverse, so I care for each patient individually while taking into account their own unique preferences
without imposing my values and beliefs on them. I also maintain a professional relationship with members of the health care team by being
respectful of each person's role and their culture.

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

Satisfactory

Satisfactory

M.T.H. : I demonstrated therapeutic use of self to foster client well-being by using self reflection. I reflected on my values and beliefs to
help me not to impose my preferences on the client. I put myself in the patient shoes and imagined how I would wanted to be treated and
use that as model to provide care. This helps to foster client well being as I am aware of my own values.

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

Satisfactory

Satisfactory

have on relational practice.

M.T.H. : I demonstrated therapeutic use of self to foster client well-being by using self reflection. I reflected on my values and beliefs to
help me not to impose my preferences on the client. I put myself in the patient shoes and imagined how I would wanted to be treated and
use that as model to provide care. This helps to foster client well being as I am aware of my own values.

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

Satisfactory

Satisfactory

consult appropriately.
M.T.H. : Collaboration was done with client by asking there preferences. For example, when giving bed bath to a patient I ask the client to
identify areas of the care they would like to do for themselves. When it comes on to administering medications I asked the client if they
would like to take them with apple sauce or water. I consult and collaborate with members of the inter-professional team to ensure patients
receive effective care. For example, one of my patient required insulin, however as a student nurse i was unable to take the blood sugar, I
consulted the primary nurse several times until the insulin was administer.

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

Satisfactory

Satisfactory

M.T.H. : I supported the diversity of client and the inter-professional health care team by understanding that each individual has unique
characteristics such as race, age, beliefs etc that distinguish them as an individual. This allowed me to treat everyone differently based on
their preferences. I did not apply any biases, discrimination or prejudice to any individual.

3. 7 Display sensitivity and respect for clients cultural, religious, and other beliefs and values
influencing their choices and decisions.

Satisfactory

Satisfactory

M.T.H. : I delivered culturally sensitivity care to each patient by incorporating their practices and beliefs in the care. For example, I was told
to take the oxygen saturation on my partner's patient, however the family was praying, I respected them and waited until they were
finished. These practices influences the patient's overall decisions. For example, one of my patient constantly refused a bath because my
partner was a male, so I informed my teacher and as soon as i entered the room with the nurse she agreed to have a bath. The fact that she
did not want a male nurse influence her choice of refusing a bath.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

M.T.H. : While providing care for patients I educate them about any procedure that I am doing and answer their questions. For example, the
most common time a patient is educated is during medication administration, I tell the patient exactly what the medication is for even if
they have been taking it for longtime. I also educate family members, for example, a family member was concern that their love one was
getting dehydrated because he was not eating and was confuse as to the solution that the patient was getting. I educated her on the use of
the normal saline that was infusing by telling her that the fluid will keep the patient hydrated.

Teacher comments for CARING RELATIONAL PRACTICE :

Monique engaged in conversations with her peers related to specific nursing care such as hanging an IV antibiotic or assisting patients
with feeding. She established an appropriate relationship with her patients who welcomed the care she provided.

4. LEADERSHIP AND ADVOCACY

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

Satisfactory

Satisfactory

M.T.H. : One conflict that constantly arise in clinical is patient's refusing to take medication. I resolve this conflict by educating each
patient about the importance of each medications.

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

Satisfactory

Satisfactory

environment.
M.T.H. : I got the opportunity to exercise my leadership skills by being a facilitator for the day. I made use of the open window when
reviewing peers medications by encouraging them to start gathering their medications one hour before the given time. I helped my peers
with their documentations by reviewing them and correcting them. I also, encourage them to take their breaks at a certain time to help
create a positive work environment that flows well.

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

Satisfactory

Satisfactory

professional health care team.

M.T.H. : As the facilitator for the day I provided verbal feedback to my peers during medication administration and whenever I help them
carryout a procedure. For example, one of my peer struggled with administering medications intravenously, so I guided him during the
process and then offer my feedback at the end. I accepted verbal feedback from members of the inter-professional team and also my
instructor. For example, the first time I administered heparin I was going to give the injection in the outer aspect of the arm
subcutaneously, however, my teacher told me it is better to give it in the abdomen. I accepted her feedback and incorporated it the next
time I gave heparin. I also provided written feedback to one of my peers to identify their strength and areas of development. One of my
peers also provided me with a written feedback.

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

Satisfactory

Satisfactory

M.T.H. : I advocated for clients, self and others for a quality practice settings. For example, a patient needed to have his breakfast but he
had to have his blood sugar taken to determine if he needed insulin, but his nurse was not yet on the unit, I repeatedly consult with the
charge nurse and my instructor to have his blood sugar test done. I advocated for myself and others by asking my instructor to set up a
practice setting for us to practice priming a primary line because most of us struggled with that task.

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

Satisfactory

Satisfactory

M.T.H. : I supported clients' right by respecting their choices as an individual. For example, often times clients refuse to have a bath in the
morning, I respected their wishes. I understand that everyone has their preferences. Another example is a patient who wanted to take her
cancer medications before the other ones, so I respected her wishes by administering that medication first and then the other half an hour
later.

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

Satisfactory

Satisfactory

M.T.H. : I demonstrated this behavior by responding appropriately to two unsafe behaviors. They both involved patients who were on high
risk for fall. One of repeatedly try to get out of bed, so I made sure the bed alarm was on and checked on the patient every 10-15minutes.
The other patient was very weak and tried to get out of bed to go to the washroom instead of using the urinal. I responded appropriately by
informing the primary nurse who said she would try to get an exit bed. Another unprofessional behavior that was identified is when the
primary nurse set up a patient I.V pump based on policy of another organization, I was familiar with the unit's policy so I informed my
instructor who changed the pump based on the orders.

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.
M.T.H. : I collaborate and consult appropriately when necessary to ensure clients receive the best possible care. For example, I was unsure
about an order that says medication was supposed to be run at 8mg/hr. This was confusing because I was used to running medication at
mls per hour, so I consulted my teacher who explained the order and showed me how to program the pump according to the order.

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

Satisfactory

Satisfactory

M.T.H. : I contributed to the creation of quality practice solutions and strategies when I was the facilitator for the day. I helped to get
medications done in a timely manner. I also contributed when ask my instructor to setup a practice settings for priming primary I.V lines.

Teacher comments for LEADERSHIP AND ADVOCACY :

Monique demonstrated leadership skills by assisting her peers to provide competent patient care. For example, in week 8 she was able to
assist her peers to administer medication by observing and guiding them to perform the 3 checks and 8 rights. As well, she collaborated
with her patients, staff and instructor to provide respectful professional nursing care. She demonstrated an eagerness to learn by voicing a
desire to learn certain skills when available.

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.
M.T.H. : I incorporated clients' unique needs and expected outcomes into holistic and client-centered plans of care. I do this by firstly
assessing the client to find out if they had any practices or beliefs that they would like to be incorporated into their care. After, assessing
the client I came up with plans to incorporate such values into practice.

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

Satisfactory

Satisfactory

articulated competently in writing and orally.

M.T.H. : I developed theory based plans of care that are client centered through the use of two written concept maps. One concept map
was developed to care for a patient with clostrium defficile and the other for a patient with hypertension. My instructor reviewed both of
them and gave me a satisfactory.

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

Satisfactory

Satisfactory

M.T.H. : Prioritization was done based on my knowledge and understanding of care each client requires. For example, i was assigned to
two patients, upon reviewing each kardex I saw that one patient was currently receiving blood so I used that to determine who's vitals will
be done first. Another example is when administering medications, if the patient is getting the medication more than once per day i
organize my time around that to ensure the patient receive the medication on time.

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

Satisfactory

Satisfactory

M.T.H. : This was done through the informal submission of a concept map which my teacher evaluated and provided feedback which I
incorporated into the formal concept map.

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

Satisfactory

Satisfactory

interventions in a manner that demonstrates knowledge and skill.

M.T.H. : This was done whenever I administered medication intravenuosly. I made sure to go back and check on the pump to see if it is
running on time. Another example is when i give prn medications, I checked on the patient to evaluate if the medication has help the
patient.

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

Satisfactory

Satisfactory

M.T.H. : The three-factor framework was use to guide the decisions I make. I used this by evaluating each factor of the three factor
framework, the nurse, the client and the environment. If my client becomes unstable or outcomes are no longer predictable I would inform
my instructor.

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

Satisfactory

Satisfactory

physical
resources.
M.T.H. : I prioritize nursing care by using an organizational worksheet. My organizational worksheet consisted of important patient
information and what needs to be done for each patient. This information helped me to prioritize my care accordingly. The organizational
sheet also served as a reminder to help me with time management. For example, it reminded me of the times I have to administer
medications.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Monique exhibits the knowledge, skills and judgement necessary to provide safe competent nursing care. She utilized the three factor
framework to guide her practice by ensuring that her patients were safe at all times and that the patients' environment was safe by
ensuring adequate lighting, making sure that the rooms were free from clutter and making sure that her patients were comfortable. Over
the course of the 14 weeks she learnt how to prioritize and organize her patients' care by utilizing an organizational plan and by performing
the most important task first. For example, hanging an IV hydromorphone before an IV antibiotic whenever both medications were
scheduled for the same time. Well done! As well, she prepared two concept mapping satisfactorily to include interventions necessary to
provide optimal health for her patients. Good Job!

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

6. 1 Collaborate 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.
M.T.H. : While working with clients I ensure that I engaged in continuous collaboration with clients and members of the inter-professional
team to achieve mutually agreed expected outcome. For client this was done by asking them about their preferences when providing care. I
collaborated with members of the team such as the primary nurse for each patient to ensure they receive the best care. For example, I was
unsure as to the type of solution to be use to mix a certain medication because the i.v manual said either normal saline or D5W, I consulted
the primary nurse who told me the one the unit use.

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.

M.T.H. : As a student nurse I contributed as member of the inter-professional team by constantly collaborating and consulting my
instructor and nurses on the unit to ensure clients receive the best care.

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

Satisfactory

Satisfactory

M.T.H. : I constantly seek assistance from my peers when doing care such as bed-bath or ambulating a patient who requires two assist. I
consult with my teacher at all times whenever I am unsure about anything. For example, I had difficulties reading a doctor's order and I
seek assistance from my teacher who help me to read and understand the order.

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

Satisfactory

Satisfactory

outcomes.
M.T.H. : I engaged in team weekly with my partner to care for each client. For example, we provided hygiene care to each client and
performed assessments together. We also decided among ourselves about who should take break at what time to ensure the patient
always have a nurse looking after them. We solve things together as a team. For example, my partner could not take his patient blood
pressure on either arm so I helped him figure it out by stating it can be done on the legs. We also work together as a team during the first
weeks of clinical when administering i.v medications by helping each other gather equipment.

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

Satisfactory

Satisfactory

changing
environment.
M.T.H. : I collaborated with clients constantly during the day especially when it gets really cold, I offer them warm blankets. I constantly
check on them to see if they needed anything such as help going to the washroom.

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

Satisfactory

Satisfactory

competencies.
M.T.H. : I respected each members of the health care team bearing in mind their different roles and competencies. For example if I am
unclear about a procedure or a doctor's order I consulted with my instructor and the primary nurse as oppose to my peers or secretary on
the unit.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Monique consistently collaborated with her instructor and with the inter-professional team to provide safe compassionate care for her
patients. She interacted with the team with much respect and ensured that she kept the team well informed about her patient's status.

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.
M.T.H. : I acted in the best interest of my patients to ensure that they are safe at all times during my shift. This was done by doing simple
things such as, keeping the bed in the lowest position, side rails up, call bell within reach and curtains drawn during procedures to ensure
that the client felt safe. When giving medications I ensure to check the six rights and perform three checks. I also, made sure to sign the
medication administration record each time I gave a medication to prevent the primary nurse from repeating the act. I also ensure a
collaborate with my instructor before doing control acts.

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

Satisfactory

Satisfactory

integrate feedback into practice.

M.T.H. : I engaged in this through the use of practice reflection and peer feedback. I identified my areas of strength and areas of
development. For example, one of my area of development was documenting intake and output, the following weeks I made it my priority to
learn that aspect of documentation from a peer who knew how it was done.

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

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Satisfactory

program (CNO).
M.T.H. : I created a learning plan that was consistent with Quality Assurance program that identifies two areas of development. These
included priming a primary I.V line and organizational skills. The learning plan outlines the resources that would be use to achieve learning
outcomes.

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

Satisfactory

Satisfactory

integrate these into practice.

M.T.H. : I seek out learning opportunities and feedback from my instructor and nurses on the unit. For example, I had a patient who died
and I volunteered to help cleanse and wrap the body. I sought learning opportunities by asking to administer another student's i.v
medication. I sought the opportunity to see how blood is drawn and how to admit a new patient.

7. 5 Use nursing research to foster professional development.

Satisfactory

Satisfactory

M.T.H. : The research done on each patient fostered my professional development by helping me to think critically and connecting the
dots. For example, sometimes I am giving my patient medications that is not treating their primary diagnosis but when I do my research I
realized that it is use to treat other comorbodities.

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

Satisfactory

Satisfactory

M.T.H. : I utilized nursing textbooks to research about patient's diagnosis and medications. The research done on each patient helped me
to improve my critical thinking skills. For example, whenever I research a medication I monitor the patient the patient for signs and
symptoms of adverse effects.

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

Satisfactory

Satisfactory

these affect nursing practice.

M.T.H. : Before midterm I bearly understand the Canadian health care system. I did my research which gave me a better understanding. For
example, i understand that individuals of free access to healthcare. I also understand that lack of resources such as technologies can
result negative patient outcome.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Monique participated in quality assurance by preparing a self evaluation which included her strengths and weaknesses and by participate
in peer review. As well, she utilized her theoretical knowledge to guide her practice and endeavored to practice according to the CNO
Practice Standards and within her scope of practice as a student.

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

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

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Satisfactory

of nursing care.
M.T.H. : My critical thinking has improved tremendously over the semester as I am now able to link things together. This was evident when
I told my partner that he could obtain the blood pressure on the leg, I made the decision to take the vitals of the client who was receiving
blood first as oppose to my other patient and when deciding which patient to administer medications to first.

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.
M.T.H. : Each patient I was assigned to help to improve my problem-solving and decision making skills. For example, my knowledge about
anti-hypertensive medications helped me to understand that I should know the baseline blood pressure of each patient and also to monitor
them for signs and symptoms of hypotension.

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

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Satisfactory

to improve
these.
M.T.H. : I evaluated my critical thinking through the use of practice reflection. I reflected on each day after clinical to see what I could have
done differently.

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

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practice to provide safe and competent care.

M.T.H. : The knowledge I gain from nursing classes and research done on each patient allowed me to provide safe competent care. For
example my knowledge about cancer helped me to understand that one of the psycho social problems newly diagnose face is depression,
so when I was providing care for a cancer patient I made sure to constantly talk to him and explore his feelings. My knowledge acquired
from my pharmacology class on dosage calculation helped me to administer medications safely.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

M.T.H. : I prioritized effectively by using an organizational sheet and concept map to provide care for each client. When I was given two
patients I looked at the care that is needed for each patient and prioritize accordingly.

Satisfactory

8. 6 Demonstrate professionalism and accountability.

Satisfactory

M.T.H. : This was demonstrated weekly by showing up to clinical on time, properly dressing and prepared. I showed accountability for my
actions by documenting assessments, interventions and evaluation on each patient.

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

Satisfactory

Satisfactory

and guide practice.

M.T.H. : I used the practice decision making and the nurse-client-environment frameworks to guide my practice as a student nurse. As a
student nurse we have limitations when it comes on to the scope of practice, so I made myself aware of the limitations and refrain from
them. For example, I know we are not allowed to transcribe new orders so when I see a new order I informed the primary nurse.

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

Monique's critical thinking skills have increased over the course of the semester as she has demonstrated an increased depth of
understanding and knowledge in all areas for nursing management. By week 14 she was making conscious decisions about her patient's
care while asking questions when unsure.

Student Final Summary with Strategies for Continued Growth

Continuing into the next semester I will focus more on building my critical thinking skills, as I believe this is an ongoing skill. I will continue to increase
my knowledge while keeping up to date with the Canadian health care system.

Teacher Final Summary with Strategies for Continued Growth

Monique is very accountable, responsible, respectful and professional. She maintained attendance over the full 14 weeks of clinical and was always
punctual and well dressed in full uniform with her name badge visible to identify herself as a student. Monique exhibits a wealth of knowledge in
nursing concepts and endeavored to utilize her skills to guide her practice. Monique has successfully met most of the goals and objectives that she
planned to achieve in the beginning of the semester. For example, she was able to administer oral and subcutaneous medications independently by
week 14, and was able to administer IV medication with minimal assistance from her instructor. She sometimes struggles with the programming of the
IV pump when hanging a secondary line, but for the most part was able to prime the line, prepare and mix the medication after having her instructor
double checking to ensure that she had the right medication for the right patient at the right time. Her documentation skills have improved as well as
her overall patient care abilities. Overall, Monique demonstrated the ability to function competently in all aspect of patient care in her scope of
practice. She was informed that her critical thinking skills, problem solving and decision making skills will develop overtime as she continues to review
and watch the nursing videos provided for her by the college.

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