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Student Name:

Micah Finney

Southwestern Oregon Community College Nursing Program


Nursing 111
Foundations of Nursing in Chronic Illness I

Clinical Evaluation Tool

The purpose of the weekly clinical performance evaluation tool is to provide feedback about achievement of the
course outcomes and competencies and to assist the student to meet the standards of care for nurses in Oregon as
outlined in the Nurse Practice Act.
Explanation of Rating Scale:
(S) Satisfactory = Clinical performance is safe and student adequately demonstrates application of the nursing
process/clinical judgment, required skills, and expected synthesis of learning appropriate to level in the program.
Verified by direct instructor observation.
(NI) Needs Improvement = Indicates that additional learning and attention to detail is required for a particular
item or that the overall performance for the week is at a minimum level. The instructor will write an explanation of
the rating on the comments page.
(U) Unsatisfactory = Clinical performance is unsafe and inadequately demonstrates application of the nursing
process/clinical judgment model, required skills, and expected synthesis of learning appropriate to level in the
program. The instructor will write an explanation of the rating on the comments page.
(NA) Not applicable = Particular item does not apply to the clinical performance.
(NO) Not observed = Instructor did not observe or has no knowledge of the students performance of the activity.
Students with a weekly grade of NI or U will be required to meet with their advisor and clinical instructor and
discuss a plan for change in their behavior before their next clinical experience.
Safety and legal/ethical concepts are considered critical to the profession and will be graded as NI or U if any
violation occurs.
If a student is assigned a U or NI for two weeks, the faculty will review the students clinical performance and
consider the options of either placing the student on probation or dismissing from the program.
In cases of potential failure, notification of the student by the instructor that she/he has been assigned a grade of U
or NI for one week constitutes proper warning of the grade status.
If a student is placed on probation and then receives a weekly grade of U, the faculty will review the students
performance and determine whether or not the student will be dismissed from the program.

Nursing 111 Clinical Evaluation Tool

Student Name:

.
Competen
cy (C)
Course
Outcome
(CO)

C9
CO 1, 2

C1, CO4

Micah Finney

Clinical Week
1

Dates

1/14

1/21

1/28

2/4

2/11

Attendance: P=Present, A=Absent, T=Tardy

Facility/Unit

3D

PSU

3C

IMCU

Applies concepts and theory to clinical practice in


client care and written assignments:
1. Collects data and conducts a health
assessment on a client with a chronic illness

1. Analyzes and interprets the data/assessment


findings.

1. Prioritizes health problems.

1. Develops a plan of care that considers the


individual, family, age of client,
developmental stage, psycho-socio-cultural
issues, and/or learning needs.

1. Evaluates and reflects on plan of care.

Applies ANA Code of Ethics in care of chronically


ill

Makeup

Identifies roles and functions of members of the


health care team involved in providing care for
the chronically ill.

C8, CO6

Uses therapeutic communication with patients


and agency staf

C4, CO7

Recognizes potential legal and ethical issues


related to client autonomy across the lifespan in
at risk populations.

NA

C5, CO5

C6, 7, 8
CO2

Recognizes cultural issues and interact with


clients in culturally sensitive ways

C10

Uses research and evidence to support clinical


decision making

C6

Utilizes resources as needed

Competenc
y (C)
Course
Outcome
(CO)

C9, CO2

C3

Demonstrates responsibility and accountability


for professional behavior:
1. Performs safely in clinical.

1. Prepared for clinical (Appropriate attire,


appropriate tools such as stethoscope, skills
list, evaluation tool, assessment tools).

Makeup

C4

1. Takes initiative in making decisions and


assuming responsibility for decisions.

C3

1. Looks for opportunities for continued learning


and self-development.

C4

1. Identifies behaviors and attitudes influencing


professional behavior.

C1

1. Demonstrates growth in coping with stressful


situations in a calm and dependable manner.

C1

1. Maintains patient confidentiality.

C3

1. Completes and submits assignments on time.

C2

1. Organizes and manages time efectively.

C4

1. Attends and participates at post-conference.

Instructor Initials

JT

JT

JT

JT

Student Initials

MF

MF

MF

MF

Week

Instructor Comments (Include Date/Signature)

Micah, your care plan and patho paper were great. From what I read, I could see a good
picture of your patient. I am pleased that you sought out opportunities to learn new things,
such as that dressing change. Your patient was quiet the character and you developed a
rapport with him easily. I like that you were working with the nurses and that you asked
questions. Nice job this week, and I hope that next week goes just as well for you.
Jenny Tausch RN MSN PCCN
1/18/2014

What a good week for you. I can see that you are becoming more comfortable in the hospital
setting and with your patients. I just had a few comments on your care plan please take note
of those. I felt that your interventions were appropriate and that they were pertinent to your
patient. When I rounded on the unit, I found you at the bedside providing care for your
patient. Good job this week, keep up the good work.
Jenny Tausch RN MSN PCCN
1/25/2014

Micah, This clinical week you seemed to open up and become more confident in the clinical
setting. I felt that you were looking for opportunities to do new skills and seeking out ways to
increase your knowledge. Your care plan and interventions were appropriate for this patient.
I feel that you are growing as a student nurse and that you will continue to find ways to
progress as a student nurse.
Jenny Tausch RN MSN PCCN
2/1/2014

I feel that you did an excellent job this week. You were able to care for your patient and ask
questions from the nursing staf regarding patient care and flow. I feel that you are becoming
more comfortable in the clinical setting. Your care plan and patho paper were appropriate for
your patient.
Jenny Tausch RN MSN PCCN
2/8/2014

9/1/09sw: revised 20110102kw, revised 12/17/12sw

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