Student:

Practical Nursing Diploma Program

Mid-term/Final Clinical Evaluation Form
Whitney Illsley
Student Number: 823-334-925

Course:

Practical Nursing

Dates:

Section

September 2014

S: Satisfactory

to

December 2014

U: Unsatisfactory

Summary of Areas of
Practice

Competent and safe practice

in a professional, legal and
ethical framework

Communication

Caring relational practice

Leadership and advocacy

Student Comments:
Summary of clinical
experience
S:

U:

Faculty Comments:
Summary of clinical
Experience
S: X

U:

- I have worked in a safe,

professional and ethical
manner.

vI This student comply with

the regulatory standards
relevant legislation, and the
practice settings policies and
procedures She ask questions
to clarify her client plan of
care regarding medication
administration directions or
activity of daily living

S:

S:X

U:

U:

- I continue to communicate
important and relevant
information with my
colleagues, as well as my
patients.

I) She participate in team

discussion especially when
receiving report in the morning
of the second day after she
has had information regarding
her clients. she also takes part
in post conference discussions
activity on a weekly basis

S:

S:X

U:

U:

- I have worked hard to

demonstrate to my patients a
caring, therapeutic
relationship.

vII) She has demonstrated

sensitivity, and respect to her
client cultural, religious belief
and values through the
semester. She has taken into
consideration the clients ,
choices and decision,

S:

S:X

U:

- I have continued to advocate

for my patients. When I have
seen things that I dont agree

U:

II Whitney evaluate and

refine leadership skills to
develop solutions and create

Plans of care: Meeting

Clients Needs and Mutually
Agreed Expected Outcomes

with or that I dont feel are the

best for my patients, I have
made sure to communicate
that and to take it upon myself
to provide the type of care for
my patients that I felt were
right.

a positive environment for her

client, She has been assign to
several clients and has
manage to complete her
assignment on time . in some
occasion if other student is
very busy she would offer to
assist them with their work by
doing the morning care for one
of their client so that their
assignment can be
completed on time

S:

S:X

U:

- I have done everything

possible to meet the needs of
my clients and went above
and beyond to ensure they
were properly cared for.

U:

ii) She has develop a theory

base plan of care pertaining
to one of her client and
submitted to the instructor
during the semester.
(II) She is has establish a
very good therapeutic and
caring relationship with her
client each week by
administering care, and
identifying the effect on her
client well-being

Collaborative Practice

Quality Assurance

Critical Thinking, Problem

Solving and Decision Making

S:

U:

S:X

U:

- I have worked as a member

of my team, helping my
colleagues when they needed
it and accepting help when I
needed it.

I) She collaborate well with

the interprofessionel health
care team on the unit to
achieve mutually the sane
agree expected outcome for
each client.

S:

S:

U:

U:

- I have and will continue to

reflect on my practice and
areas where I need to
improve.

II) She has created,

implemented , and evaluate a
learning plan as requested in
the UNB program and that of
Humbler college. This learning
plan is consistent with quality
assurance program and the
CMO

S:

S:

U:

- I have and will continue to

use my critical thinking to
solve problems and make
decisions that I feel are in the

U:

Vii )She is using the decision

making and the nurse client
environment frame work to

best interest of my patients.

inform and guide her clients

I) She is utilizing critical
thinking and problem solving
skill to inform decision- making
in all aspect of her nursing
care

I have read and understand this form and its contents

Very Good semester All the best in the future
Student Signature:

Date: December 3, 2014

Faculty Signature:

Date: