Student Name ___Naomi Masuda___________________

Date__4/12/15__________

NURS 220 Weekly Self-Evaluation.

Complete each item (1 8) with three to four complete sentences.
1. Describe your ability to develop a professional relationship with your client, their family and
the hospital staff. Provide an example of how you used therapeutic communication this
week.
My patient was willing to learn about his medications, diet management, diabetes care, and
asthma management. He liked to talk and many times strayed from the topics. To establish
good relationship, I used active listening and clarifying skills to get him to refocus on the
topic and provided him the information. At the beginning of the shift, I explained him what I
was going to do, then I explained and got his consent each time.
2. Describe one assessment skill you performed well and another you need to improve. Include
your plan for improvement.
I auscultated slight wheezing to the bilateral upper lobe before the Atrovent, and I auscultated
clear lung sounds to the same area after the treatment. It was a very significant difference I
thought.
I conducted a psychosocial assessment to assess the patients depression status, because he
liked to talk and strayed the topics very often. I had some difficulty getting relevant
information and assessing him without interrupting his dialog. I need to improve my skills to
complete my assessment without spending too much time.
3. Describe a new skill you implemented this week and evaluate your performance in
completing it.
I gave a nebulizer medication for the first time via the wall air outlet. I knew how to
administer it and I was able to prepare it correctly. I set the airflow at 3L/min which was the
same air flow I used with a portable nebulizer machine that I am familiar with. When I
confirmed the flow rate with the assigned nurse, he told me to increase it to 6-7L/min. It was
much stronger than the portable nebulizer machine that I used before. I always need to check
with the staff or the professor if anything is in doubt.

4. Identify time management strategies that were and were not effective.
I was not able to do initial head-to-toe assessment including vital signs in a timely manner
because he was having breakfast. I reported the delay to the assigned nurse and Professor
Barone. I also asked my patient what his preference is and modified my schedule to provide

all my nursing interventions including assisting his daily cares. It was effective, although I
was not able to perform the12:00 and 14:00 medication skills unfortunately.

5. Were you involved in using interdisciplinary resoures for your client? What resources could
your client have benefitted from?
My patient was on PT, and I observed the therapy. He was advised to use a walker, however
he refused it, stated I dont want to rely on it. Once I start using it, then I cant go without
it. The physical therapist respected his choice and gave advice to him how to walk safely
without it.
6. Describe an actual or potential legal or ethical issue related to the care of the client. What is
your response to the issue you identified?
When I checked patients MAR in the morning before preconference, his ethylprednisolone
order was changed from Q12hr IV push to QD 50mL/30min. The order was changed again to
QD IV push later. According to the drug book, this medication was able to given either way.
If it was kept as piggy bag, I would definitely clarify it with the assigned nurse.
7. Identify a safety risk for your client (using the safety rubric) and describe how you reduced
the clients risk for injury.
Fall Prevention
My patient was refusing to use his cane at home and a walker at the hospital, although his
gait became occasionally unsteady. Also, his cognitive test revealed that he has a mild
cognitive impairment. We talked about maintaining a safe environment at home and driving
since he still wanted to drive even after the MVA. He at least agreed not to drive when it gets
dark. I asked him if there was anything he needed before I leave the room and asked him to
use call light when needed because he admitted that he still felt his legs are weak. He was
cooperative and used the call light when needed during the shift.

8. Reflect on your professional growth (using the professionalism rubric). What can you do
continue your professional growth outside of the clinical setting? What professional or
unprofessional behaviors did you see in the clinical setting, and how did you feel about it?
1

Advocacy

Identifies opportunities
for advocacy

Inconsistent
identification of
opportunities for
advocacy

Uncertain or misses
opportunities for
advocacy

He never had UTI before, however, he had a high risk of getting the infection d/t his chronic
DM 2, decreased lymphocyte counts, chronic asthma and CKD stage 3. I explained to him
about his infection risk with DM2, asthma, and CKD, and gave information about what he
can do to prevent further infection. I was happy that he appreciated my information and
verbalized that he would try these interventions when he discharged.
I was able to practice handoff reporting during the lab on 4/3/15. I experienced that many
times I knew my patients better than the night nurse, since I spent time reviewing their charts
prior the clinical days. I realized again that good handoff reports are very important to nurses
especially in acute clinical settings.