Self Assessment

2015 - 2015 - Final NURS-151 Course Learning Outcomes

NURS 151 Practical Nursing Practice 2 (PN, 13-Jan-2015 - 30-Jun-2015)
Student :
Clinical Teacher/Preceptor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Lara Pabandero-de Lasan

Yeu Yin Hwang
John Stone
Sunnybrook Veterans Centre
Agency
K3E
20-Apr-2015 To 02-May-2015
168
168
156

Teacher comment for validated hours:

No clinical on Good Friday (April 3, 2015)
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.
L.P.L. : I follow all student guidelines from Humber College and also the SunnyBrook Veterans hospital policy as well. E.g. Uniform, Id
Badge, etc. (As per Humber College policy, we have to bring an analog watch to clinical however, Sunnybrook veterans does not permit
staff or students to wear any hand jewelries so when in the clinical unit, I remove any jewerly on my hand and fingers and keep the watch in
my scrub pocket)

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

Satisfactory

Satisfactory

L.P.L. : Whenever I am looking at the client chart, I just put the initial of the clients and not add other information that can identify them to
other people. I do not discuss the client information with others, and all information stays at the unit.

I have been very punctual knowing that time is a very important part of accountability in school lab and at the clinical placement. I keep all
information about the residents confidential and all information stays in the hospital.

1. 3 Determine strengths and limitations and when to consult and seek assistance from other

Satisfactory

Satisfactory

professionals.
L.P.L. : Whenever I am unsure of anything, I clarify and ask for guidance from my clinical instructor or the nurses on the unit.

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

Satisfactory

Satisfactory

L.P.L. : When providing care to the client e.g. morning care (bed bath) I used what I learned from the textbook and my checklists knowing
of the rationales to why each step is important during giving care.

In addition to that, I have acquired more skills from being on the long term unit (e.g. for the different clients that I had to give subcutaneous
injections, nitropatch, catheter irrigation, wound care and management) that I did evidence informed practice and theory-based approach
to care, doing my research on the procedures from my textbook and nursing journals to help me with the procedure and rationale for each
individual nursing practice.

1. 5 Ensure client safety and a safe environment.

Satisfactory

Satisfactory

L.P.L. : At all times when giving care, the far side bedrail is up. Especially for clients that have risk for falls in their history, easily agitated,
the bed is put on the lowest level and both siderails up when the client is gonna be left in the room. (E.g. for most of the clients at the unit I
practice this, and even more mindful when the history says "risk for falls")

1. 6 Ask relevant questions to clarify understanding of the plan of care and whenever

Satisfactory

Satisfactory

uncertain.
L.P.L. : When filling out the care plan, when I had questions I asked for clarification with the clinical instructor (CI) and whenever I was
uncertain (e.g. with one resident he had two forms of the same medication, one was PO and one was SC, I asked how come there were two
routes and CI responded that the SC would be given if the resident is not able to take the PO route. And that was the reason why there was
a signature on the PO route and underneath it there was a line for the SC route, on the MAR from the previous dose.)

1. 7 Identify ethical and unsafe situations and seek appropriate assistance to resolve these.

Satisfactory

Satisfactory

L.P.L. : Another situation I encountered was when I had a resident who would punch and scratch staff when she was being given a bed
bath, so for the safety of the caregiver we would wear the yellow gowns to protect ourselves from the resident scratching us because she
would get really agitated.

(First resident assigned)

After lunch break, I found the nurse with the client and he had a stain of fresh blood on his pants (right knee area) and also some blood
behind the foot rest supporting his legs, however when she inspected the legs for any lacerations, there were none. She said he must have
gotten it from the equipment at the physiotherapy room. A few minutes later, the client's "sitter" came and she too inspected the client for
any open wounds to see where the blood came from, she also said that she did not find any. My professor was informed about the
situation when it was happening and also in post conference.

1. 8 Demonstrate understanding about the role of the student nurse.

Satisfactory

Satisfactory

L.P.L. : I am here to learn as much as I can in the unit to be able to go on and do more learning in the coming semesters, so that
collectively, after the two years I am equipped and able to practice my practical skills along with my knowledge from the lectures and
classes and become a competent and knowledgeable nurse that practices safely.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Consistently responsible and accountable with attendance, meeting deadlines and being prepared for clinical. Practised within the scope
of a PN student and followed rules outlined by the Humber handbook and Sunnybrook.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

L.P.L. : In addition to sharing with the group what I had done that I thought was new and exciting (fleet, injections, putting on a nitro patch,
using the ceiling lift, providing care to someone difficult etc.) I also provided some peer education for my topic of Type 2 Diabetes Mellitus.
And always participating in group discussions during post conference.

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

Satisfactory

Satisfactory

methods.
L.P.L. : I have the confidence to document electronically using the POC in the unit whenever I finished a task that was part of the care plan.
I also now have the confidence to write a nursing progress note when provided care such as PRN meds for pain or wound care etc.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

L.P.L. : I report relevant information such as food/fluid intake, urine output (when necessary), and care given to appropriate personnel.

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

Satisfactory

Satisfactory

L.P.L. : Communication techniques from the CNO, Therapeutic Nurse-Client Relationship, (2006), such as announcing myself, my name
and stating that I am the nursing student that will take care of the resident for that shift, addressing the client by the name and title they
prefer (e.g. Judge or Jack) because that is what they feel comfortable to be called with.

Speaking appropriately and concisely with the unit staff to convey messages clearly and precisely to save time and effort.
----------------------------------------------------------------------------------------------------------------------With the Inter-professional health care team, I would speak appropriately and concisely to reduce time wasted. (Client's food intake, I
verbalized to her how much he ate and also gave her the sheet of paper where the food was listed and wrote 100% consumed)

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

Satisfactory

Satisfactory

Protection Act (PHIPA)

L.P.L. : When I took my client's information from his chart, I did not include anything that would distinguish who he was. No name,
address, or anything specific to him. Just the medication, diagnosis, medical history etc.

In addition to that, I keep my password for the computers in the unit to myself and do not share it with anybody. And keep all information of
the residents in the unit and not bringing any confidential paper work home.

When my resident's wrist band broke, I gave the broken wrist band to the admin and she put it in the shredder.

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

Satisfactory

Satisfactory

L.P.L. : I use the computer in the unit in the 4 quads or in the conference room to research the client's care plan, diagnosis, medication etc.
to help me with my plan of care. Also when there is a new addition to the medication list on the MAR, I use my cellphone to use the drug
app to help me find information about the new medication.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Consistently communicated and consulted with clinical instructor and staff regarding new skills, medications and patient care. Active
participant in group discussions. Respectfully communicated with all clinical patients.

3. CARING RELATIONAL PRACTICE

3. 1 Utilize effective communication techniques.

Satisfactory

Satisfactory

L.P.L. : Communication techniques from the CNO, Therapeutic Nurse-Client Relationship, (2006), such as announcing myself, my name
and stating that I am the nursing student that will take care of the resident for that shift, addressing the client by the name and title they
prefer (e.g. Judge or Jack) because that is what they feel comfortable to be called with.

Starting with these techniques helps to the client to become more comfortable with a new face that they haven't seen before, and
acknowledging that they are in charge of their care, that they have the right to know who is caring for them and the procedure to be done
for them or to them.

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

Satisfactory

Satisfactory

clients and health care team members.

L.P.L. : One instance, I had a client who was becoming very agitated and I remembered that she liked to sing or to be sang to, we sang
together the "you are my sunshine" song and it brought the biggest smile on her face and after that she was more complaint for her care.

I helped my client with his puzzle, to keep him occupied and to help with his cognition. I then conveyed that to the nurse in charge of him
on how many correct colours he matched together. (therapeutic & compassionate)

3. 3 Apply knowledge of therapeutic use of self and identify its effect on client well-being.

Satisfactory

Satisfactory

L.P.L. : The therapeutic use of self to me that would relate to my client is explaining to my client each step that I would do so that he knew
what was happening with his care. (I will turn you over now, you might feel some bumps under you because of the diaper change, etc.) I
believe that it helped with the client well-being because he knew what was being done for him, and things like giving the client choice of
what to wear also.

Simple things such as letting them have the choices for their clothing, if it was the right timing for the care for them, etc helps have a
positive effect on the client well-being. I would like that treatment even at home for myself so I believe this is a therapeutically positive for
the clients.

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

Satisfactory

Satisfactory

have on relational practice.

L.P.L. : For me, I was aware that if I told the patient what happens during care he was more compliant and willing to help when he can.
Because I know for myself when I go to the doctor's office I am thankful when they tell me what is happening throughout the whole
procedure so that there are no surprises. Explain the procedure and the steps throughout the care, giving client choice and a chance for
their preferences.

Another personal experience I can share is that one resident in a nursing from work always wore her turban on and if a new PSW came in
the morning and did not put it on her, she would become very upset. To be self aware that these things effect the care done for the patient
is very important, everybody has beliefs, values and these things are very important to each individual.

3. 5 Interact with clients and members of the inter-professional health care team; and, consult
appropriately.

Satisfactory

Satisfactory

L.P.L. : When the residents are in the TV room, I always say hello to them and that makes them happy, to be approached and just share a
smile and small talk with them before going into the unit (usually happens after meals). A resident loves to watch the fishes and when I
ask him how many can he count and if it was time to catch the fish, he will always have a smile on his face.

For the staff in the unit like the Nurses (RN, RPN, maintenance, the people in charge of giving the trays for the clients etc.) I have had a
chance to interact with them in the unit, it is always nice to get along with everybody even though there are differences. Some of the tray
service will like me to take the tray, some will say that they will give it to the resident because she doesn't want to get confused etc and I
understand that because she only wants to do her job correctly without making the mistake of giving the tray to a different resident or a
very easy mistake of a caregiver taking the wrong tray (especially most important if the resident had a special diet such as pureed texture
of food because of swallowing issues).

I also had the chance to speak to the OT at the beginning of this rotation regarding a resident's physiotherapy session and how he was
progressing.

3. 6 Apply knowledge of practices and systems that support the diversity of clients and the

Satisfactory

Satisfactory

inter-professional health care team.

L.P.L. : When the residents are in the TV room, I always say hello to them and that makes them happy, to be approached and just share a
smile and small talk with them before going into the unit (usually happens after meals). A resident loves to watch the fishes and when I
ask him how many can he count and if it was time to catch the fish, he will always have a smile on his face.

For the staff in the unit like the Nurses (RN, RPN, maintenance, the people in charge of giving the trays for the clients etc.) I have had a
chance to interact with them in the unit, it is always nice to get along with everybody even though there are differences. Some of the tray
service will like me to take the tray, some will say that they will give it to the resident because she doesn't want to get confused etc and I
understand that because she only wants to do her job correctly without making the mistake of giving the tray to a different resident or a
very easy mistake of a caregiver taking the wrong tray (especially most important if the resident had a special diet such as pureed texture
of food because of swallowing issues).

3. 7 Apply knowledge of clients cultural, religious, and other beliefs and values as these

Satisfactory

Satisfactory

influence clients choices and decisions.

L.P.L. : Another personal experience I can share is that one resident in a nursing from work always wore her turban on and if a new PSW
came in the morning and did not put it on her, she would become very upset. To be self aware that these things effect the care done for the
patient is very important, everybody has beliefs, values and these things are very important to each individual.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

L.P.L. : I gave effective client education when the resident was itching all over and he was saying why I had to put on the "cold" cream on
his back and I educated him about his Urea cream for his back for the excessive dryness and that it will help with the itchiness, after that
he complied and agreed that the cream was important.

Teacher comments for CARING RELATIONAL PRACTICE :

Consistently provides therapeutic communication and care to assigned clients. Professionally interacted with staff on the unit.

4. LEADERSHIP AND ADVOCACY

4. 1 Recognize conflicts and strategies for resolution.

Satisfactory

Satisfactory

L.P.L. : I believe that my conflict at this time was when I realized that the list of medication for the client I had for that week had changed, I
was taken aback and I lost focus for a quick second because the "steps" that I had practiced was interrupted because of that new med,
however I was able to bounce right back and performed medication administration correctly and properly.

My strategies for resolution was to breath at times of unexpected outcomes, and realize that medications do get changed as the client's
status changes and that resources are always available in the unit.

This instance happened right at the beginning of the rotation, that I will never forget. Since then I was able to remain calm and just relax.
Realize that client status changes, medications change, and that resources. I noticed that after that situation that I conquered, I enjoy
medication administration more compared to being very nervous.

4. 2 Demonstrate leadership skills that foster group work and a positive learning environment.

Satisfactory

Satisfactory

L.P.L. : I demonstrate leadership skills and foster group work and positive learning environment when I perform a task with a resident
being very difficult at that time because of their Dementia, and succeed, then my peers ask me how I approached the client, or how I did
the fleet enema for one specific client, how I gave a bed bath to a client who had his leg amputated etc, I offer my knowledge to them and
give encouragement and positive feedback that they too can succeed with the task at hand.

4. 3 Identify opportunities to improve health care service and nursing interventions by

Satisfactory

Satisfactory

advocating for client, self, others, and quality practice.

L.P.L. : By doing the self evaluation and self reflection along with the learning plans, this is one way of many to improve health care
service and quality practice and my growth as a person and a nurse.

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

Satisfactory

Satisfactory

professional health care team.

L.P.L. : Provided feedback to peers and accepted feedback from them during the conference and also when the unit nurses give feedback
for the day, I feel happy and accomplished that I was able to help them while I was there to learn.

Also:
During a procedure of giving inhalant medication to a patient, my classmate was uneasy of doing it because it was her first time. I
demonstrated, and to read the instructions on the inhaler after she had discussed the medication with the clinical instructor and I provided
her feedback about her performance.

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

Satisfactory

Satisfactory

L.P.L. : I support client's right for self-determination and choice by giving the resident her baby doll, because it helped her calm down and
whenever she had that doll she was content and happy.

Choice of clothes to wear, choice of programs to attend etc.

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

Satisfactory

Satisfactory

L.P.L. : First week in clinical, I was shadowing a nurse who had 5 clients to take care of. At first we were taking care of a client who was
awake but was bedridden, when we were about to start the care with resident 1, resident 2 who was in the next bed tried to get out of his
bed so she decided that we would do resident #2 first and go back to resident #1 after because resident #2 was calmer on the wheelchair
once he is awake. I followed the nurse who went right to the bed of resident #2 but I went to the bathroom to remove my gloves, did hand
hygiene then put on a new set of gloves. She then also did the same.

I do not know when the nurse was planning to change her gloves and wash her hands but I am glad she did when she did before handling
resident #2.

4. 7 Consult and collaborate when carrying out health care and nursing practices that are in

Satisfactory

Satisfactory

the best interests of the public and protect the public through collaboration and consultation.
L.P.L. : Protecting the public and my family when I remove the scrubs I had on in the unit before going home. To prevent infection and for
bacteria to be passed around on the TTC and I put my uniform in the was right away so that my family is also prevented from contacting
anything that got into my uniform (specially with contact precaution residents that I care for).

Teacher comments for LEADERSHIP AND ADVOCACY :

Improved leadership skills throughout the term, you were a valuable resource to the staff and your peers. Always open to feedback, and
gave feedback to your peers when needed.

5. PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES

5. 1 Incorporate the unique needs and expected outcomes into individual clients plans of

Satisfactory

Satisfactory

care.
L.P.L. : Every week I bring in a new care plan to be filled in as the day goes. I believe that I was uncertain of what to put in that chart at the
beginning of the rotation but as the clinical days progressed I was more confident in filling them out especially after the "formal"
submission of the careplan step 1 and 2 and getting a satisfactory grade.

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

Satisfactory

Satisfactory

articulated competently in writing and orally.

L.P.L. : Theory-based plans of care that are holistic and client centered was articulated and competently completed in written with the final
submission of the care plan (#2) and developing a theory-based plan from the diagnosis of the client and their current status.

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

Satisfactory

Satisfactory

L.P.L. : In regards to morning care, some residents prefer to stay in bed until after breakfast. Some are early risers and like to be up first
thing in the morning. I learned to prioritize first with the careplan of one resident, then it became two, and progressed to three by the end
of the rotation.

Prioritizing and planning out my day was important so that everybody was able to go on break, everything was done on a timely fashion
etc. Was able to plan my day e.g. giving am care then breakfast then wait 30minutes to give a fleet enema, then go on break while waiting
for the enema result, and when I came back I did the bed bath because the enema was successful.

5. 4 Provide information that contributes to the evaluation and refinement of plans of care.

Satisfactory

Satisfactory

L.P.L. : Every week I bring in a new care plan to be filled in as the day goes. I believe that I was uncertain of what to put in that chart at the
beginning of the rotation but as the clinical days progressed I was more confident in filling them out especially after the "formal"
submission of the careplan step 1 and 2 and getting a satisfactory grade.

Also, when evaluating the plans of care with the CI, I realize more and more that the things I wrote on the care plan was on point and that
little tweaks and little refinements would improve the plan of care for the resident.

5. 5 Safely and competently carry out nursing assessments and nursing interventions that are

Satisfactory

Satisfactory

theory-based and within skill abilities.

L.P.L. : After the first half of this rotation, I was not really able to carry out nursing assessments thoroughly, however as I was getting used
to the morning routine, I was able to do more nursing assessments and nursing interventions that were theory-based (stuff we learned in
health assessment and lab) and within my skill abilities. E.g. when providing a bath, I was able to do skin assessment, find the pulses, and
do an overall inspection of the resident. When it was down time e.g. after meals, I was able to do use my stethoscope to listen to their lung
sounds and apex and take a pulse rate from there. Listen to the abdomen and see palpate if it was tender or not.

5. 6 Carry out nursing care that reflects the practice decision-making framework.

Satisfactory

Satisfactory

L.P.L. : Using the Step 1 and Step 2 of the care plan (written) and explaining it to the clinical instructor (orally). Deciding what was
important at that time, e.g. changing the client's coccyx dressing while he was in bed (after the fleet enema) so that he would have a clean
and new dressing for the day. (His dressing needed to be changed once a day)

Also:
Deciding that doing a task when a resident was agitated would not help the situation and just leave them on the bed, on the lowest level
possible and make sure they were safe before leaving to let them settle and calm down.

5. 7 Complete nursing care responsibilities and nursing interventions in an organized and

Satisfactory

Satisfactory

timely manner.
L.P.L. : Using the care plan, and scheduling a time frame for the day helped me complete my nursing care responsibilities and nursing
interventions in an organized and timely manner. Being able to go on break on time because I had planned out the day so that things were
in order. Being on time for the resident's meals so that they were able to eat on time etc.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Showed improvement and understanding with completing patient assessments and care plans. Developed confidence in skills that allowed
for timely and thorough completion of patient care.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

6. 1 Work 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.
L.P.L. : I Always communicate with the nurse in charge of my resident to mutually agree to expected outcomes of care for that day. Explain
to them my plan of care and go from there.

6. 2 Contribute as a member of the inter-professional health care team to respond to the

changing needs and expected outcomes of clients.

Satisfactory

Satisfactory

L.P.L. : While reading the care plan for a resident, I read that she was given PRN medication when her wound care (epsom salt soak) was
to be done. So we gave it 30 minutes prior to the care and she was very compliant with the task. The expected outcome was a positive one
because we were able to do the soak and she let us open her hand a little bit so that I could irrigate inside her palm.

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

Satisfactory

Satisfactory

L.P.L. : When doing transfers with the ceiling lifts I would seek out assistance with the unit staff.

Also how to approach a specific resident when she would refuse her medication because of her dementia. In the morning I was advised to
crush it and put it in her scrambled eggs and in the afternoon I was very amazed that she was able to take them whole but at a very specific
time, just before dinner before she entered the dining room. (these little hints help ease providing care to residents who are very resistive).

6. 4 Use teamwork, consensus building, and conflict resolution skills.

Satisfactory

Satisfactory

L.P.L. : I help my peers with what they needed when I was able to for teamwork and concensus building and to avoid conflict (e.g. when I
need help they would be willing to help me out as well because I helped them when they needed someone). When giving a bed bath with a
heavy resident, I would ask if they needed an extra set of hands and hope that vice versa they would do the same. (Common courtesy)

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

Satisfactory

Satisfactory

a changing environment.
L.P.L. : One time my client was getting very agitated, his health status was changing, the nurse said he was getting stronger. I observed
him and told her how he was for the day while I was watching him. And the nurse was there to check every hour, and also with the sitter
and that was the time the nurse decided to give him his prn for agitation. (she had given it when I went on lunch, and she just relayed that
to me when I came back on the unit) -Client's status was changing so the effective and collaborative teamwork of observing the client
helped to treat him and meet his needs at the time.

Within two weeks, indeed the resident got stronger and his plan of care changed and also he was moved to a different unit where he was
going to be observed and cared for more closely.

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

Satisfactory

Satisfactory

competencies.
L.P.L. : I note to myself who is who (rpn or rn, administrator etc.). Also interact with the activity facilitator because she is the one who
takes the residents to the activities downstairs and she is the one who gives them their nourishment. The tray deliverers, the maintenance
all help to provide a holistic health care approach to the residents.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Collaborated well with staff and peers and was a valuable team member of the interprofessional team. Maintained consistent
communication with staff regarding patient care.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

7. 1 Act in the best interests of clients and protect clients from harm through collaboration
and consultation with members of the inter-professional health care team and through
competent and safe practice.

Satisfactory

Satisfactory

L.P.L. : This was done when I had my first client, he was very agitated and was prone to falls. Right in the morning when it was change of
shift I noticed that he had a fresh skin tear on his left knee, it was dressed already by the nurse from the evening shift. I consulted with the
nurse who was assigned to him and also with my clinical instructor regarding the client throughout the day, however I was on watch for
him for the whole shift so that he was safe and did not fall off his wheelchair. The following week, I noticed that he had an evening sitter,
and that someone was with him at all times. Also, they had changed his wheelchair to prevent or to lessen him to be able to climb out of it.

Also:
Same with another resident who was prone to falls, I made sure that he had his side rails always up and his seat belt always on when he
was on his wheel chair. Also tilted back.

7. 2 Participate in self-reflection to identify strengths, areas for improvement.

Satisfactory

Satisfactory

L.P.L. : I used the self-reflection to identify my strengths and areas for improvement twice this rotation. (To be filed in my nursing
portfolio).

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

Satisfactory

Satisfactory

program (CNO).
L.P.L. : Used the Quality Assurance Program (CNO) template to create, implement and evaluate my learning plan starting from last
semester and also did one for the end of this rotation.

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

Satisfactory

Satisfactory

integrate these into practice.

L.P.L. : By going to the Sickle Cell conference at school, I was able to seek out learning opportunities. I am now more aware of the said
disease and to know within myself to avoid the stigma and stereotype of their symptoms

7. 5 Utilize nursing, health and other theory and literature to improve nursing practice.

Satisfactory

Satisfactory

L.P.L. : I was able to utilize nursing, theory and literature to improve my nursing practice when I did my scholarly paper about family
preparedness to end-of-life care.

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

Satisfactory

Satisfactory

L.P.L. : I was able to utilize nursing, theory and literature to improve my nursing practice when I did my scholarly paper about family
preparedness to end-of-life care. (Also using evidence based practice from scholarly articles)

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Consistently seeked out and participated in new learning opportunities and new skill practice when available. Good learning plan and selfassessment completed at the end of the term. Understood own strengths and areas for improvement.

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

8. 1 Utilize problem-solving skills to inform decision making in all aspects of nursing care.

Satisfactory

Satisfactory

L.P.L. : Using the care plan, helped me complete my nursing care responsibilities and nursing interventions in an organized manner. It
helped me utilize my problem-solving skills to inform decision making in all aspects of nursing care by helping me to point out the
ineffective or maladaptive aspect of the client's progress.

E.g. the importance of having a no sugar added diet because the resident is diabetic, knowing that he was not able to have any juice when
he asked for something to drink, instead I gave him the thickened water from the fridge because he was thirsty.

8. 2 Use problem-solving and decision-making skills to assess clients and to determine

Satisfactory

Satisfactory

nursing diagnoses, expected outcomes, nursing interventions, and evaluative criteria.

L.P.L. : Using the care plan, helped me complete my nursing care responsibilities and nursing interventions in an organized manner. It
helped me utilize my problem-solving skills to inform decision making in all aspects of nursing care by helping me to point out the
ineffective or maladaptive aspect of the client's progress.

E.g. the importance of having a no sugar added diet because the resident is diabetic, knowing that he was not able to have any juice when
he asked for something to drink, instead I gave him the thickened water from the fridge because he was thirsty.

I then evaluated that knowing the diagnosis helped me make a positive expected outcome (knowing he was not able to drink juice) and in
doing so I was able to provide proper nursing intervention of giving the thickened water because the resident had swallowing issues.
Evaluated that that was a good plan of care.

8. 3 Use self-reflection to design a plan to improve problem-solving and decision-making

Satisfactory

Satisfactory

skills.
L.P.L. : Used the Quality Assurance Program (CNO) template to create, implement and evaluate my learning plan starting from last
semester and also did one for the end of this rotation.

And

I used the self-reflection to identify my strengths and areas for improvement twice this rotation. (To be filed in my nursing portfolio).

8. 4 Utilize knowledge from variety of nursing, health, and other theory into nursing practice

Satisfactory

Satisfactory

to provide safe and competent care.

L.P.L. : Besides from the nursing textbooks, from the classes that I attend there are information regarding safe and competent care (e.g.
prevention of falls, safe medication administration etc.) Also the sickle cell day presentation and other informative and important
conferences that I had joined such as the ASSIST training.

8. 5 Use prioritization strategies for client care.

Satisfactory

Satisfactory

L.P.L. : When using my care plan and being able to change and modify it throughout the day to accommodate the client and their needs

8. 6 Demonstrate professionalism and accountability.

Satisfactory

Satisfactory

L.P.L. : I am on time for each of my lab classes, sims lab and especially clinical placement because that shows professionalism and
accountability.

8. 6 Recognize strengths and limitations and seek appropriate assistance and support.

Satisfactory

Satisfactory

L.P.L. : When I need clarification, I do not hesitate to ask my clinical instructor or the nurses in the unit for assistance and support.

Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING EFFECTIVELY :
Improved prioritization, problem solving and decision-making skills throughout the term. Able to care for 2-3 patients with confidence.
Consistently was professional and accountable for own learning and completing assigned work on time.

Student Final Summary with Strategies for Continued Growth

I will continue to develop my skills in lab, in the clinical placement and now during SIM lab.
I will continue to properly complete my care plan and use the Step 1 and Step two templates as guide.
I will continue to seek out more learning opportunities that are provided in school, at work or elsewhere for continued growth.
Do more reading during the break and review whatever was covered during semester 1 and 2 to prepare for the coming 2nd year.

Teacher Final Summary with Strategies for Continued Growth

Very pleasant and positive student. Was a good and trusted resource to staff and peers with helping completing patient care. Showed good
accountability and responsibility with own learning and growth as a PN student. Received positive feedback from staff regarding student's work and
skills. Continue to seek out learning opportunities to develop and apply your skills and knowledge in lab and clinical. I have no hesitations you will be
successful as you continue in your nursing career.

Student's References
CNO, Culturally Sensitive Care, 2009 (https://www.cno.org/Global/docs/prac/41040_CulturallySens.pdf)
CNO, Therapeutic Nurse-Client Relationship, Revised 2006 (http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf)

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