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Date: 4/18/15

NURS 220 Weekly Self-Evaluation

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
Both of my patients this week always had family members present in the room. Establishing
a professional relationship with the daughter of a patient with dementia proved to be very
helpful in providing care to the patient. The daughter explained a lot about her mother, and I
got the answers to many questions I had concerning her care. At the same time, however,
there are times when it is necessary to correct educate the patients family members about
certain aspects as well.

2. Describe one assessment skill you performed well and another you need to improve. Include
your plan for improvement.
I am still having difficulty in assessing abnormal heart sounds. One of my patients this week
was an older patient, and I did not catch that she had a murmur when I listened with my
stethoscope. This week I was fortunate to have a very helpful nurse, who was able to verify
that the patient had a murmur when she went into the patients room. She pointed out the
whooshing sound upon auscultation and explained to me that anytime you hear that sound,
it is a murmur. I will need a lot more practice to continue to improve this assessment skill.

3. Describe a new skill you implemented this week and evaluate your performance in
completing it.
It was my third time giving a Lovenox injection, but my first time giving a subcutaneous
injection in the arm. After selecting the appropriate site, I remembered all the steps of
cleaning the area, making sure the air bubble is at the top of the syringe, pinching an inch,
and injecting. I was very pleased that the patient said he didnt feel any pain during the

4. Identify time management strategies that were and were not effective.
Juggling two patients this week made me learn how important it is to better prioritize my
tasks. After making my list of tasks for the day, it might help to prioritize each one, giving
them a number according to how urgent they are. This will better help in planning my day
and making sure I get all the essential tasks done first.

5. Were you involved in using interdisciplinary resources for your client? What resources could
your client have benefitted from?
A case manager would be useful for the patient with dementia before discharge to discuss
with the family options outside of the hospital to help care for their family member. This
patient requires extensive, around-the-clock care, which will probably be difficult for her
adult children to manage. If not already done, the case manager would discuss options with
the family members, such as the possibility of transferring her to a nursing home, or utilizing
a home health aide in assisting with her care.

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?
A family friend was present in the patients room. I had to remember to be mindful about the
possibility that the patient does not want certain information known to this friend. This is
especially true for teenage patients who tend to be more private. Sometimes its easy to forget
that some patients dont want information released and that consent should be given before
releasing that information to family and friends.

7. Identify a safety risk for your client (using the safety rubric) and describe how you reduced
the clients risk for injury.
I had a patients with an aspiration risks, so made sure to keep the head of the bed elevated as
much as was tolerable for the patient when administering oral medications. I informed the
patients family member to provide oral care after meals to remove residuals reduce
pocketing of food that can be later aspirated. However, I did not realize how important it was
to know whether certain medications could be crushed until this week. I will make a mental
note to always know when a PO medication can be crushed, especially when I have a patient
who has an aspiration risk, so that I can assist someone who has difficultly in swallowing by
mixing it into a pudding or applesauce. If I am unsure, it would be appropriate to call
pharmacy before the start of my care of that patient to ask.

8. Reflect on your professional growth (using the professionalism rubric). What can you do to
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?
I have demonstrated a commitment to develop professionalism during this clinical rotation by
by getting past my fears and consistently challenging myself by doing things that were new

and scary to me at first. Many skills I was petrified of doing in the beginning (such as giving
injections) has become almost second nature to me now. During the summer break, I plan to
continue my commitment to professional development by practicing all the skills I have
learned thus far at least once every week. Though I know it is not the same as practicing on a
real patient, it will help me keep the steps of each skill fresh in my mind for the upcoming
semesters and even into my professional career.