NURSING 4020/21/22 FINAL Clinical Evaluation
NURS 4020 Final Clinical Evaluation: Pass___
Student: Alicia Jeffery
Faculty Advisor: Jaime Sims
Nature of Clinical Practice (Check all that apply)
The setting is:
__x__Hospital/Inpatient Unit
_____Hospital/Ambulatory or Day Program
_____Hospital/Critical or Emergency care
_____Community/Community Health
_____Community/Home Care
_____Community/Long Term Care
_____Industry/Occupational Health
_____Other _________________
_ Fail_____
Preceptor: Pina Boni
Clinical Practice Site: KGH- Kidd 6
Practice hours completed _____300______
The population is primarily:
_____Adults with medically-related health needs
__x__Adults with surgery-related health needs
_____Children or adults with mental health needs
_____Intrapartum families/mothers and newborns (not NICU)
_____Older adults requiring support
_____Healthy adults
_____Families/Neonates requiring critical care
_____Adults requiring intensive or critical care
_____Persons requiring emergency care
_____Children with medically or surgically related health needs
1
NURSING 4020/21/22 FINAL Clinical Evaluation

2
NURSING 4020/21/22 FINAL Clinical Evaluation

Program Goals
Graduates are generalists entering a self-regulating profession in situations of health and illness.

Graduates are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a
variety of settings.
Graduates continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their
practice.
Graduates will demonstrate leadership in professional nursing practice in diverse health care contexts.

Graduates will contribute to a culture of safety by demonstrating safety in their own practice, and by identifying, and mitigating risk for
patients and other health care providers
Graduates will establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based
upon relational boundaries and respect.
Graduates will be able to enact advocacy in their work based on the philosophy of social justice.

Graduates will effectively utilize communications and informational technologies to improve client outcomes.

Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed
interventions and outcome measures.

Before completing the evaluation form, students and preceptors should review the objectives and sub-objectives. While students and
preceptors should comment on each of the seven course objectives, it is not necessary to write comments about each sub-objective. It is
better to provide specific and detailed comments about a few sub-objectives than to write broadly about many.

3
NURSING 4020/21/22 FINAL Clinical Evaluation
Objectives
1 Within the scope of practice and knowledge of a fourth year
BScN student, continually demonstrates professional conduct
in accordance with CNO standards for nursing practice and
ethics:
a. Critically appraises own interactions with clients and
team members
b. Demonstrates accountability and accepts
responsibility for own actions and decisions
c. Demonstrates a professional presence and models
professional behaviour
d. Consistently identifies self by first/last name and
student designation to clients and team members
e. Displays initiative, self-awareness, and with time,
increasing levels of confidence in role
f. Demonstrates effective and collaborative problem-
solving
g. Uses effective approaches to managing conflict
h. After critically reflecting on learning needs,
a. Recognizes individual competence within
scope of practice and seeks support and
assistance as necessary
b. Participates in professional development
Progress
Indicators/Evidence S U
- Since midterm, I have continued to practice the skills that
at the beginning of the semester I struggled with. I can
now set up IV fluids and secondary medications and use
the hospital’s online resources to look up the
compatibility of IV medications independently and with
confidence. I have set up feeds independently and always
ensure that the bags are full and being infused well. I
have cared for patients who are on TPN and lipids and
have connected and disconnected both of these IV fluids.
I have helped to change a large VAC dressing and have
completed sterile dressings, including a few wound
packings.
- I created new learning goals at midterm and have strived
to work towards them. On every patient, I complete a
respiratory assessment to practice this skill, and have
been practicing my assessment of wounds every time I
change a dressing. I now feel more confident knowing
how to document wound assessments. On night shifts, I
have practiced venipuncture and blood draws when
possible.
- During one clinical shift, I had a female patient who was
in a semi-private room with another female patient. The
one patient had visitors frequently throughout the day
and the other patient was frustrated and upset that they
were loud and that she couldn’t sleep. There was conflict
between the two patients. With the help of my preceptor,
I explained to the patient who was angry that most of the
beds on the floor were full, but that we would try to
move either herself or the other patient to another room
to manage the conflict. Although we could not do this on
our shift, I gave report to the next shift’s nurse that the
4
NURSING 4020/21/22 FINAL Clinical Evaluation

patients wished for one of them to be moved, if possible,

when a new room was free.
- I have continued to introduce myself to patients before
assessment, I explain what I will be doing, and I re-
introduce myself when patients appear confused/have
forgotten who I am

Preceptor: I can say that Alicia has gained so much confidence and
competence in delivering safe and effective nursing cares to patients.
She has been doing things with very minimal supervision and most of
the time, independently. She ensures that I am well informed of what
is going on and seeks support when needed.
2 Within the scope of practice and knowledge of a fourth year - I continued to always check arm bands for identifiers and
BScN student, continually demonstrates that the primary duty confirmed name and date of birth with the MAR before
is to the client, to ensure safe, competent, ethical nursing care administering medications. I continued to close the wall
a. Advocates and intervenes, as needed, to ensure safety desks to ensure the confidentiality of patients’ charts
of the person requiring nursing care
- I continued to always wear the correct PPE with correct
b. Uses effective strategies to maintain a patient's
donning and doffing technique. I practice the 4 moments
privacy and autonomy
of hand hygiene and wrote a reflection about the
importance of hand hygiene to prevent the transmission
of illnesses
- When completing nursing care, I usually would ask any
visitors to leave the room while I completed the care. I
would give them a specific amount of time (ex. Come
back in 15 minutes and I will be done). This allowed me to
be able to assess the patient and/or provide care while
maintaining their privacy. During a few of these
situations, certain patients wanted a family member in
the room with them. In these situations, I ensured that
the patient was comfortable with that and ensured that
the visitor would be comfortable observing the care (ex.
Sometimes visitors may not want to see certain dressing
changes or other care). I would also ask the visitor to

5
NURSING 4020/21/22 FINAL Clinical Evaluation

stand/sit back a bit so that I would have enough space to

provide care to the patient.
- Considering the feedback from my preceptor at midterm,
I strived to document my morning assessments more
promptly into the chart. This allows other healthcare
team members to use the chart and to read my
assessments and take this into account when they are
doing their care/assessments
Preceptor: Alicia has consistenly maintained patients’ privacy. If it’s
time for her to perform care to patients even if family is still visiting,
she politely asks them to step out so that she can do care
comfortably in a timely manner (ie. Needed to do dressing changes,
brief change or doing assessment).

3 Within the scope of practice and knowledge of a fourth year
BScN student, demonstrates safe, competent and ethical
nursing practice in the area of relational practice:
a. Engages in critical self-reflection
a. evaluates own emerging competence in the
area of relational practice
b. identifies personal, professional and systemic
barriers to development
c. prioritizes learning in the area of relational
practice
b. Effectively uses self to initiate, maintain and terminate
relationships
a. creates therapeutic, caring, and culturally safe
relationships
b. uses principles of supportive counselling and
motivational interviewing to help clients set
goals, identify problems, find solutions
c. Demonstrates
i. empathy
ii. attentive listening and sensitive
questioning
- Taking into account the feedback I received from my
preceptor at midterm, I tried to answer call bells for other
nurses whenever I was not busy. This allowed me to practice
my communication skills and allowed me to see more surgical
patients with different diagnoses/surgical procedures. This
also conveys to other staff that I am willing to learn and to
help.
- I have conveyed empathy and attentive listening to patients
and their family members. For example, I had one patient
who’s husband was emotional and upset about his wife’s
condition. I took the time to listen to him and to explain what
I was doing so that he could understand. I also strived to
spend time in the patient’s room and checked in frequently in
order to help them with care. For example, I checked in at
meal times to ensure that the husband felt comfortable
enough feeding his wife and to help encourage her to eat.
When I administered medications or did care such as dressing
changes, I always explained what I was doing and why I was
doing it.
- I have continued to use self-reflection and to complete
journals each week. This has allowed me to realize how much
6
NURSING 4020/21/22 FINAL Clinical Evaluation

iii. mutuality and reciprocity in
relationships
iv. advocacy
c. Works collegially and in concert with other health
professionals to facilitate appropriate, timely care
I have learned since the beginning of this semester and to
create new goals and new areas for improvement.
- During my next semester’s placement, my goal is to become
comfortable enough and to have developed time
management skills that will allow me to collaborate with
other members of the healthcare team to provide more
effective care. This will allow me to plan my day and
complete necessary tasks/skills to provide more patient-
centred care.

Preceptor: Alicia has done significant improvement on her time

management/prioritization skills. That being said, she is now more
flexible and been able to spend time talk and helping patients with
their ADLs and has been able to answer call bells for other patients.
She was able to demonstrate empathy to patient’s and family by
listening to their concerns and tried to give them some emotional
support. She was able to foster therapeutic, caring and culturally safe
relationships among patients and healthcare team members. She
collaborated with the team to provide prompt and effective nursing
care to patients.

4 Within the scope of practice and knowledge of a fourth year
BScN nursing student, demonstrates safe, competent and
ethical nursing practice in the area of clinical decision-making:
a. Informed by the discipline of nursing, integrates
nursing knowledge with knowledge from the basic
sciences, health sciences, humanities, research, and
ethics
a. Applies models, theories, and frameworks
from the discipline of nursing
i. Chooses appropriate models for
specific client situations and clinical
settings
b. Continuously demonstrates critical inquiry, scientific
inquiry, and clinical reasoning as evidenced by:
- Since midterm I have continued to apply nursing theories to
my practice. I have written a reflection about how I applied
Nightingale’s theory to my practice and have recognized the
importance of the environment on patients’ recovery. In the
future I will continue to make changes to the environment
around patients to ensure it is optimal for healing
- I have continued to complete and submit journals to my
faculty advisor every week on a timely manner. All of my
journals have received satisfactory marks and have
demonstrated critical reflection.
- I have continued to use research to help me to understand
diagnoses, diagnostic tests, treatment methods and
medications that I have not seen/used before. This allows me

7
NURSING 4020/21/22 FINAL Clinical Evaluation

a. Using new understanding to identify
problems, propose solutions, find evidence for
and against proposed solutions, and evaluate
proposed solutions
b. Challenging the status quo
c. Performing focused reflection, connecting new
experiences to existing knowledge, thinking
creatively, using nursing judgment
to continuously learn so that I am able to educate patients
and provide safe and effective nursing care
- I am able to identify and recognize objective and subjective
data which suggests issues/changes in status among my
patients and I am able to identify and implement
interventions to address these issues. For example, I had a
patient who stated feeling nauseous, having the chills and
who was vomiting. I assessed the patient by taking her vital
signs and assessed the colour and amount of emesis. The
patient was afebrile. I looked at the patient’s ordered PRN
medications and determined that either gravol or
ondansetron should be administered. I determined that
these medications would need to be administered via the IV
route due to her nausea and inability to ingest an oral
medication. I collaborated with the patient by asking which
medication usually works best for her, and worked with her
to determine that ondansetron should be administered to
avoid the drowsiness that she experiences after taking gravol.
I ask my preceptor for help when the acuity of the situation
rises and I am unsure what to do.

Preceptor: Alicia has been able to recognize deviations or changes to

patients’ clinical status and been able to demonstrate good nursing
judgment about how to address such situations. Before she asks
support from preceptor, she tries to assess patient by taking vital
signs and checks if PRN medications are available, then discusses it
with the preceptor.
5 Within the scope of practice and knowledge of a fourth year - Continued to document all assessments, input and outputs,
BScN student, demonstrates safe, competent and ethical IV fluids, medication administration, PRN administration. I
nursing practice in the area of planning, implementing and always evaluated the effectiveness of PRN administration to
evaluating nursing care: ensure symptoms are managed effectively and documented
a. Uses the nursing process to
administration and the effects in the patient’s chart.
a. recognize, gather and analyze data from
- I taught one patient how to self-administer insulin using her
multiple sources to develop a plan of care
insulin pen. This patient was going to be discharged, thus part

8
NURSING 4020/21/22 FINAL Clinical Evaluation

b. recognize actual or potential life-threatening of her care plan was to teach her how to do things at home
situations independently. My preceptor used the glucometer to get her
c. implement appropriate interventions to blood glucose reading and using the reading I showed the
prevent complications patient how to determine how many units of insulin to self-
d. document and communicate assessment data,
administer. In collaboration with the client, we determined
plan of care, interventions and patient
that she was unable to read the numbers on the insulin pen,
responses or outcomes
e. teach the client, consistent with the acuity, so I dialed up the correct dosage and observed her as she
complexity, readiness, ability and needs of the self-administered it. Afterwards, we talked about how
patient and family comfortable she felt doing so, and I documented this patient
b. Integrates own knowledge with the client’s knowledge education in her chart.
and preferences, and factors within the health care - I use many different kinds of evidence to inform my nursing
setting, to plan, implement and evaluate care actions. I have used my textbooks, online research, online
a. identifies gaps in own knowledge videos and knowledge from both my preceptor and from
b. Identifies client’s knowledge and preferences patients’ lived experiences.
c. Seeks and evaluates new evidence to support - I recognized when a patient was asking to void frequently
nursing action
and was only voiding small amounts each time with new
d. Uses many kinds of evidence to inform nursing
incontinence. I recognized that the patient may have had
actions
e. Recognizes the resources and limitations of urinary retention. I discussed this with my preceptor and
the health care setting determined that using the bladder scanner to assess this
c. Appraises outcomes of nursing care would be appropriate. I correctly used the bladder scanner
d. Demonstrates collaborative action within the nursing and determined that the patient had only ~80mL left in the
and health care team bladder after voiding, thus is considered a normal result. I
a. Collaborates with other providers to assess decided that no intervention at the time was necessary and
outcomes of health care decided to continue to monitor the situation and notify the
b. Identifies environmental, physical and next shift’s nurse.
psychosocial stressors affecting the inter-
professional team
Preceptor: Alicia continues to do a thorough assessment and
documents them properly in the progress notes. She knows how to
identify and provide nursing actions to actual or potential life-
threatening situations and evaluates the effectiveness of those
actions. She was also involved in educating patients and giving them
instructions about their discharge (Ie. Insulin and dalteparin
injections, trach and wound cares)

9
NURSING 4020/21/22 FINAL Clinical Evaluation

6 Within the scope of practice and knowledge of a fourth year
BScN student, demonstrates enhanced knowledge of nursing
and health related to indigenous populations, women's and
environmental health, aging and rural populations, and other
marginalized populations:
a. Identifies gaps in care delivery
b. Challenges status quo approaches to caring for
marginalized populations
c. Recognizes the unique pathophysiology of disease
states and implications for care of special populations
including those with prolonged lengths of stay,
bariatric patients and older adults
d. Consistent with student role and novice practitioner,
recommends and initiates changes in practice
- This term I have provided nursing care for diverse population
of patients. On this surgical floor I have provided care for
marginalized populations such as the Indigenous, aging
individuals, bariatric patients and individuals with ostomies.
- I have also had the chance to provide palliative and/or end-
of-life comfort care for patients. This has given me the
opportunity to observe and to experience how this care
differs from the care delivered to surgical patients.
- When initially looking at my Kardexes and when updating
them at the end of the day, I strive to think of barriers to
discharge for each of my patients and to think of a care plan
that could address these barriers. For example, for patients
who have or could have had muscle atrophy and who have
become deconditioned while in hospital (a barrier to
discharge), possible interventions that I would include in their
care plan is to encourage ambulation, to encourage the
patient to do as much as they can when completing ADLs,
repositioning and transfers/ambulation, and I encourage
them to perform bed/chair exercises that physio has taught
them.
- I have had the opportunity to care for a variety of different
ages, from young adults to older adults. I have recognized
how age can affect the healthcare decisions that are made
(ex. More extensive surgeries likely would not be performed
on older adults with many comorbidities) and how it can
affect care plans.

Preceptor: Alicia had the opportunity to experience and provide care

for more variety of patients like gen surgery, bariatric, ortho, ENT,
urology, medicine and palliative patients. She was able to provide
effective nursing cares and was able to recognize the differences on
the care to be provided to such kind of patients. Ex. For post-op
patient’s she knows that early mobility is very important for speedy
recovery and to prevent prolonged stay in the hospital.

10
NURSING 4020/21/22 FINAL Clinical Evaluation
7 Within the BScN student's scope of practice and knowledge,
assumes the responsibility and care of patients:
a. Demonstrates safe and effective care of patients:
a. Initially, and with a high level of supervision
and support from the preceptor, the student
will manage an assignment of two-three
clients
b. By midterm, the student will be managing at
least 2/3 (e.g. approximately 3-4 on day shift)
the preceptor’s client assignment with
frequent support and guidance by the
preceptor
c. By the conclusion of the practicum, the
student will independently and with minimal
supervision by the preceptor, manage an
assignment equivalent to 2/3 the preceptor’s
usual assignment.
b. A fourth year nursing student is able to carry out the
following nursing activities:
a. Assessment
i. Biopsychosocial, head-to-toe, focused,
mental status, pain
ii. Vital signs: TPR, BP, SaO2
iii. Situational stressors and coping
pattern
iv. Medication administration
v. Basic knowledge of the medications
prescribed
vi. Classification
vii. Purpose
viii. Possible side effects
ix. Adverse effects
x. Interactions with other drugs
xi. Appropriate dose/route
xii. Implications for nursing care
b. Health Teaching
i. Identify client/family learning needs
- I have been caring for a full patient load since around the 2 nd
or 3rd week of this placement. I have been completing all care
mostly independent, with guidance with new skills and use of
new equipment. My goal for next semester is to continue
providing all care, while making time to talk with patients and
their families and to do ‘the little things’ such as tidying up
rooms, helping patients wash their hair and do oral care, get
warm blankets, etc. This will help to provide more
individualized and better quality care for patients.
- I continued to always come to clinical shifts prepared, in
uniform and on time.
- I have cared for patients of many different types. I have cared
for pre-operative patients, post-operative patients, palliative
patients and a medicine patient during this placement. I have
recognized how the care needed for each different type of
patient/patients with different care goals differs.
- I assist patients with ADLs such as helping them to the
bathroom, changing briefs, repositioning patients, etc. I assist
patients and other staff members to ambulate and transfer
patients. Have assisted to transfer a patient with a slider
board.
- I observed the removal of two chest tubes
- Based on feedback from my preceptor, I have been practicing
venipuncture on night shifts. When I see that patients need
bloodwork taken, I get all supplies ready and I try to take it
via venipuncture in order to practice this skill. If I am
unsuccessful, I ask my preceptor for help and I observe how
she does it in order to look for new techniques to implement
when I do this skill
- I volunteered myself to help with patients that were assigned
to another staff nurse. She asked if I would want to try to
insert an IV on a patient who needed one, since she knew I
wanted more practice with this. I agreed and with my
11
NURSING 4020/21/22 FINAL Clinical Evaluation

ii. Collaborate with team to develop plan preceptor’s assistance, I successfully inserted an IV on the
to meet client’s learning needs first attempt
iii. Implement aspects of plan within - During one clinical shift when my preceptor was off from
scope of practice as a learner work sick, I worked with another nurse. I found this
c. Psychosocial/Relational Practice
experience to be beneficial because it allowed me to care for
i. Recognize and acknowledge client
new patients with new diagnoses that I had not yet seen,
distress as it arises
1. Demonstrate empathy, active allowed me to work with new members of the nursing team,
listening, sensitive questioning and allowed me to see how another nurse did certain things.
2. Apply principles of This allowed me to see different techniques and time
motivational interviewing management skills and possibly implement them into my
3. Offer support own practice.
4. Engage in problem-solving as
required, in collaboration with Preceptor: Alicia has been independently handling full patient assignment
others as needed (4-5 on days and 5-6 on nights). She seeks assistance if patient’s acuity or
ii. Team Communication when she’s uncertain how to do things. She collaborates and communicates
1. Discuss any abnormal findings with other healthcare team members to plan for better care for the patient.
related to the patient She reports any abnormal findings from patients and discusses it with
assessment with preceptor, preceptor or other team members. She’s always willing to be involved in
staff nurse, physician, team new learning opportunities. Alicia has maintained punctuality in her clinical
member shifts, she’d always informed preceptor ahead of time for her absence and
2. Seek assistance/ask questions has worked with the team professionally.
before doing procedures for
the first time, or for anything
about which is uncertain.
3. Report to team leader/staff
nurse when leaving the floor
and arrange for coverage of
patients
d. Basic Nursing Care/Activities of Daily Living
i. Hygiene, skin care
ii. Nutrition, elimination, intake/output
iii. Ambulation/transfers
e. Nursing and Collaborative Therapeutic
Interventions
i. Determine which interventions are
required, what resources, including
support and supervision are required,
12
NURSING 4020/21/22 FINAL Clinical Evaluation

and schedule interventions in

consultation with the client
ii. Complete interventions as appropriate
and within scope of learner practice
f. Relationships
i. Work with the staff to learn and
deliver excellent patient care
ii. Maintain a professional manner in
dress, behaviour and conversation
iii. Assist others with patient care as time
and scope of practice permit
iv. Welcome all opportunities to learn
and practice new skills
g. Evaluation and Documentation
i. Document vital signs and assessments
in the appropriate areas of the chart
for assigned patients, accurately and
concisely, ASAP after assessment
ii. Use institution’s system of
documentation for nursing process
and patient progress
iii. Reflect on own performance
independently during and after each
shift
iv. Reflect on and seek clarification of any
feedback from the instructor, who
may receive feedback from the staff.

13
NURSING 4020/21/22 FINAL Clinical Evaluation

Student and Preceptor Comments

Preceptor: Alicia has demonstrated excellent performance in her clinical shifts in Kidd 6 and I trust that she will do well in her next
clinical area.

Faculty Advisor Comments (All areas marked as unsatisfactory must have a comment)

Alicia has consistently taken responsibility and accountability for her actions and behaviors in the clinical setting and for her written assignments this semester.
Alicia accepts feedback and incorporates into her role as a student nurse by critically appraising her actions in the clinical setting by way of reflection.
Each interaction I have had with Alicia has been an absolute pleasure. Alicia has a warm and gentle approach.
Alicia has demonstrated a good sense of self-awareness and takes initiative to look for new opportunities to expand growth and knowledge base in the clinical setting,
leading to an overall level of confidence in her role as a year 4 nursing student.
Alicia has demonstrated the ability to integrate nursing knowledge from the basic sciences, health sciences, humanities, research and ethics into her written work and
care planning.
Each week she has consistently demonstrated a high level of critical inquiry. She is able to use focus reflection to connect new experiences to existing knowledge and
thinking using sound nursing judgement
Alicia uses the nursing process to develop a plan of care recognizing actual and or potential life-threatening situations. In collaboration (when required) with her
preceptor she is now able to predict and implement appropriate interventions to prevent complications
Alicia is able to document and communicate assessment data, plan of care, interventions and patient responses or outcomes
Alicia has demonstrated the ability to teach the client, consistent with the acuity, complexity, readiness, ability and needs of the patient and family in the clinical
setting
Alicia has consistently demonstrated the ability to engage in critical self-reflection in her weekly updates. She is able to with feedback from her preceptor and FA
evaluate her own practice and identify personal and professional areas for development.
Alicia has consistently used therapeutic and caring relationships to build trusting relationships with her patients and families to provide the best possible care for her
patients. She is always willing to advocate for her patients.
Alicia has demonstrated that she has been able to provide safe, competent and ethical nursing care by advocating and intervening in her client’s care while using
strategies to ensure patient safety and privacy

14
NURSING 4020/21/22 FINAL Clinical Evaluation

Alicia has been successful managing and caring for ¾ of her preceptors load of patients ( typical for the assigned area) in the clinical setting including medication
administration, head to toe focused assessments, health teaching for patients and families, recognizes patients who are in distress and collaborates with the team to
ensure safe provision of care.
Alicia consistently collaborates with her preceptor and FA when in doubt
It has been an absolute pleasure working with Alicia this semester. I wish her all the very best in the future. She has had a very successful semester in the clinical
setting. Well done Alicia –
Jaime

December 13th 2018

Signature of Preceptor_____________________________________________________ Date______________________________

Signature of Advisor______ _______________ Date _________________December 13th 2018____________

Signature of Student_____________________________________________________ Date ______________________________

15