Self Assessment

2016 - 2016 - NURS 151 Practical Nursing Practice 2 Final (201508)

NURS 151 Practical Nursing Practice 2 (PN, 12-Jan-2016 - 07-May-2016)
Student : Chet Raj Bhatt
Clinical Teacher/Preceptor : Agnes Majda
Program Coordinator : Wendy Chow
Location : Lakeside Long Term Care Centre
Placement Setting : Agency
Unit/Office/Clinic : LTC
Period : 12-Jan-2016 To 07-May-2016
Student hours : 168
Required Hours : 168
Validated hours : 156
Teacher comment for validated hours:
Chat was absent from the clinical in week 11. He informed the teacher of his absence in a timely manner.

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

Satisfactory Satisfactory
1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies and

procedures.

C.R.B. : During clinical practice, I did not discuss the resident's personal information with anyone else by keeping it confidential. I followed the

CNO'standard guideline while administering medication.

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

C.R.B. : I was always on time, with proper student nursing uniform and student ID for clinical practice.

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

professionals.

C.R.B. : I was not allowed for wound care and dressing at the facility, therefore I asked to RPN to change the wound dressing of one of the resident

for whom I was assigned to take care.

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

C.R.B. : I studied about gerentology, and some common diseases of old age like diabetes, arthritis, dementia, alziemer, and I used the knowledge

during the care of older resident who are suffered from the same diseases.

Satisfactory Satisfactory
1. 5 Ensure client safety and a safe environment.

C.R.B. : I always ensured resident's safety and maintained a safe environment by practicing safe behaviour and skills developped through lab

practice. For example, keeping the call bell within the access of resident, side rail up for the resident with risk of fall, helping resident to put on non

slippary shoes.
 Satisfactory Satisfactory
1. 6 Ask relevant questions to clarify understanding of the plan of care and whenever uncertain.

C.R.B. : I asked to the patient about their feeling of dizziness when they get up from the bed, also asked about the pain that they are feeling, and

informed to RPN so that they change the plan of care.

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

C.R.B. : I found that one of the PSW brought alzheimer resident of locked down floor to the staff lunch room of the fourth floor, which was unsafe

practice. We discussed this issue with our clinical teacher.

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

C.R.B. : I played an effective role of student nurse and folloed the facility's policy of not administering medication, respecting all residents, feeding to

residents, helping in using washroom, taking shower, ambulating etc.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :

You have shown efforts at clinical preparation that demonstrated commitment to your clients wellbeing. You have acted with integrity in all
situations. You have maintained confidentiality of resident information. I would encourage you to remember that ethics is a part of nursing
practice and that you continue to recognize that all interactions with the client and ethics is entwined throughout our practice as a nursing
student and as a nurse.

2. ACCURATE AND RELEVANT COMMUNICATION

Satisfactory Satisfactory
2. 1 Participate in team sharing and discussions.

C.R.B. : At the end of the clinical hours, we had a post conference meeting to discuss and share the knowledge, issues, learing with eachother. I

shared my experience with peers and clinical teacher.

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

C.R.B. : I documented the all caring activities of my residents in a flow chart that includes feeding, record of urination and fecal elimination, shower,

skin assessment, dependency or independency to perform ADLs etc.

Satisfactory Satisfactory
2. 3 Report relevant information to the appropriate personnel.

C.R.B. : I reported the pain complaint of one resident and need for dressing change for sacral ulcer of another resident to the RPN immediately.

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

C.R.B. : I tried to aply proper strategies of communication during clinical practice. There were mostly very old resident at the facility. Therefore, I used

simple sentences, drawn attention of the residents before speak, one question (yes/no) at a time techinques for communication.

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

(PHIPA)

C.R.B. : I closed the door during the care of the resident in the room, and I never disclosed the personal infromation of the residents with others.

Satisfactory Satisfactory
2. 6 Use technology to retrieve information including research, data and other information.
C.R.B. : I used the computer program available at the facility to explore the detailed history and information on current health status from the profile of

the resident.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

You were able to begin to form nurse-resident relationship by asking questions with kindness and provide information in a way that
demonstrated interest, created feelings of acceptance, especially in modern multicultural society. You provided privacy and comfort of
space for communication to take place.

3. CARING RELATIONAL PRACTICE

Satisfactory Satisfactory
3. 1 Utilize effective communication techniques.

C.R.B. : My residents had the aphasia and dysphasia probelm at the facility, so I used to ask the closed ended or yes/no answer question. Similarly, I

provided enough time to the residents to understand and respond to a quesion.

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

and health care team members.

C.R.B. : I spent some time with the resident after lunch and participated in drawing, talking to them about their interest, passing a ball game, walking

with them in a hallway. These activities helped me to develop a good nurse-client relationship and care for them therapeutically.

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

C.R.B. : I used some of my time spending in recreational activities with the residents such as art, coloring, ball pass, talking about their past, and it

helps to feel good and entertain themselves.

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

relational practice.

C.R.B. : I was awared not to use elderly speak with the residents. Therefore, I treated all the residents as adult and matured human by adressing

their name not by the word like honey, grandpa, grandma etc, and it made the residents' attitude positive towards me. I respected them and I received

love and respect from the resident too.

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

appropriately.

C.R.B. : I talked to residents on thier food choice and satisfaction, need to use washroom and help them accordingly. Similarly, I discussed about the

residents' issues such as pain complaint, wound care and dressing change to the PSW and RPN in time.

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

professional health care team.

C.R.B. : I was involved in care of residents with different disease and health condition such as arthritis, diabetes, pneumonia, acute myocardial

infarction, hypertension, dysphasia and aphasia, dementia and alzheimer etc. I practiced the knowledge and skill of care that I had learnt in lab of

college, with these diversity of residents in the clinical practice. Moreover, I used the knowledge of creating concept map and cared the residents

according to plan.

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

clients choices and decisions.

C.R.B. : I called the residents by their name but not by any relational word like grandpa, grandma, honey, sweety etc. because it was clients' culture

to be called by their name.

Satisfactory Satisfactory
3. 8 Provide effective client education.

C.R.B. : I provided effeective health education especially on safey because most of the residents were in risk for fall. For example, residents were

advised to use call bell whenever they need anything, use walker and nonslippary shoes when they go for walk etc.

Teacher comments for CARING RELATIONAL PRACTICE :

Your approach to patients is respectful and caring. You have demonstrated respect for the wishes of the residents. Your focus has
remained on the nurse-client relationship and most of your behaviours have been consistently professional and therapeutic.

4. LEADERSHIP AND ADVOCACY

Satisfactory Satisfactory
4. 1 Recognize conflicts and strategies for resolution.

C.R.B. : I eperienced a conflict between two clients in the activity room of the facility, and then I take one of them out of the activity room and talked

and distracted her from the previous conflict.

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

C.R.B. : When I involved in after lunch acitivities of residents, I encourage some of them to through the ball, motivate them to colour the paper, and

solve the puzzle.

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

client, self, others, and quality practice.

C.R.B. : I identified that PSWs need to find out what the residents (who can not talk) trying to express through their expression so that their needs

can be met.

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

professional health care team.

C.R.B. : I got constructive feedback from Clinical teacher, peers and Health care staff at the facility to improve my skills and performance, and so I

did for peers too.

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

C.R.B. : I always asked the resident for thier choice whether they wanted to get rest or go for a walk, wanted to eat more or no more eating etc. I did

respect for their choice and self deterimination.

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

C.R.B. : I discussed with the PSW and RPN about sling left on the wheelchair which was uncomfortable for the resident. Similarly, I discussed about

wound care and dressing chane without using non-sterile method, which was unsafe and unprofessional.

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

interests of the public and protect the public through collaboration and consultation.
C.R.B. : I consult with PSWs and peers for frequent use of gloves, hand sanitizer, use of call bell within the resident's reach, use of mat on the floor

to prevent fro fall and other infectious diseases from one resident to other resident.

Teacher comments for LEADERSHIP AND ADVOCACY :

You have demonstrated professionalism in your behaviours of consistent attendance (with one day missed) and punctuality and complete
preparation for all clinical activities. You appearance has been consistently professional in dress and comportment. You still need to work
on being more of an active participant in asking questions during clinal, lab, and in conference discussions and taking on a role of a leader.

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

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

C.R.B. : The individual client that I was caring for, had risk for fall. Therefore, I planned to assist the client for ambulating with walker to go for

breakfast and lunch as well as for toilet activities.

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

competently in writing and orally.

C.R.B. : I developed the concept map with appropriane nursing diagnosis and interventions, and then carried out the care activities according to

concept map.

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

C.R.B. : I used the nursing knowledge and skill to care the resident during clinicak placement. For example, while I asked resident to sit up from lying

position on bed, I assessed the dizziness of the resident, and then only assisted ambulating with help of walker.

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

C.R.B. : I was assigned to care the resident who had arthritis, and she complained the pain when I woke her up in the morning. Her complaint of pain

made a change in her care plan on that day. I reported the pain to RPN.

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

based and within skill abilities.

C.R.B. : I developed the concept map for the care of diabetes type 2 and arthritis, in which I used the nursing knowledge and skills for assessment

and appropriate interventions to care the resident.

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

C.R.B. : In a concept map to plan a care for the resident, there were nursing interventions to protect from fall, improve their wellbeing etc. which are

the part of decision making practice.

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

manner.

C.R.B. : I went through the concept map plan to care the patient. I implement the appropriate interventions mettioned in concept map to care the

patient. For example, I placed the call bell within the reach of resident.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
You demonstrated satisfactory organization and priority setting including completing client care in a reasonable period of time. You
completed all skills (simple wound dressing, indwelling catheter insertion) during the lab hours at at satisfactory level. Please continue
practice to improve in areas.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

Satisfactory Satisfactory
6. 1 Work with clients and members of the inter-professional health care team to assess clients,

determine health needs, and to achieve mutually agreed expected outcomes.

C.R.B. : I worked with inter-professional team of nurse, personal support worker to assess the resident in a clinical placement. We assessed the

pressure ulcer of the resident which was of stage 2, and then made a plan of care to keep pilow to prevent it.

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

needs and expected outcomes of clients.

C.R.B. : As a member of the inter-professional health care team, I reported the need of pain reducing medicaion for the resident to RPN, and resident

felt relief from the pain after administering medication by RPN.

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

C.R.B. : I asked for the help from the PSW to tansfer the resident from the bed to the wheelchair and while showering the residents. We discussed on

skin assessment of the resident while taking shower.

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

C.R.B. : I did not experience any serious conflict with the client but while taking care if them I and the PSW had to convince the resident for doing

certaing activities. For example, we made an agreement to take shower, feeding etc. with the resident.

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

changing environment.

C.R.B. : There were effective strategies of the facility t meet the residents' need in completely different environment than their home. For example,

residents have family pictures, TV, thier favourite music turned on etc. I used to ensure music turned on and I also provided their tooys to feel to be

with thier loved one while the residents were on their bed.

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

C.R.B. : I interacted regularly with PSW, RPN, clinical teacher about my role of nursing in a clinical setting to provide a competent care to the

residents. For example, I discussed about medication administration with clinical teacher and RPN as well.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Please keep in mind that the importance of interdisciplinary involvement by the total health care team is central to effective resident care.
This means that you as a nursing student play a critical part in how effective the resident care is. I strongly suggest that you look into
understanding the significant contributions that other health care professionals can make to patient care, as this is an important part of the
nurses knowledge base. To do this, you need to continue to develop an accurate understanding of the expertise of each member of the
team i.e. RNs, PSWs, Dieticians, Activation Team, and Physicians.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

 Satisfactory Satisfactory
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.

C.R.B. : I assisted the residents by consultating with members of interprofessional team to protect them from harm while transfering from bed to the

wheelchair, ambulating, feeding etc.

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

C.R.B. : I shared with peers and clinical teacher in post conference about my strength of taking shower and feeding well to the residents. Likewise, I

found that I need to improve the communication strategies because I did not get enough opportunity to communicate with the resident as most of

them were the patient of dysphasia and aphasia.

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

(CNO).

C.R.B. : I created learnig plan with 3 major goals to achieve. In a learning plan, I mentioned the CNO's documents ot study related to my goals, and

also activities to acieve those goals.

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

integrate these into practice.

C.R.B. : l took advantages of each and every learning opportunities during clinical practice. I asked many questions to members of health care

professional at the facility. Moreover, I discussed the care methods with peers, and implement them into practice. For example, I learned to transfer

resident using lifter and sling with the help of PSW.

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

C.R.B. : I utilized the the knowledge and skill of wound care and dressing change gained through reading textbook and watching videos which helped

me to improve my nursing skills of wound care.

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

C.R.B. : I checked the 6 rights of medication adminsitration at the facility while I got the opportunity to administer a drug to the resident.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

You have completed your work in a timely fashion with satisfactory Patient Care Plans and good Learning Plan. You have responded well
to suggestions for improvement and you took the opportunity to seek out additional information to support you knowledge. You worked
with others on the unit to promote safe care to your clients.

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

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

C.R.B. : During clinical practice, I found the conflict between two residents in the activity room. At that time, I contributed to solve the problem by

requesting one of the resident to leave that place and I went for a walk with her, and drop her to her own room.

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

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

C.R.B. : I developed the concept map on diabetes type 2 and arthritis using the probling solving and decision making skills and determined the

nursing diagnosis, expected outcomes and interventions of the resident.

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

C.R.B. : I reflected myself in post conference and shared the activities that I performed as a student nurse on that day which helped me to improve

the problem solving and decision making skills after getting feedback from peers and clinical teacher.

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

provide safe and competent care.

C.R.B. : I gained the nursing knowledge and skills from reading textbook, wathcing nursing care videos, practicing in college lab, and I utilize that

knowledge and skills in clinical practice. For example, I utilize the knowledge of bed making, wound care, medication administration (one time only)

during clinical practice at the facility.

Satisfactory Satisfactory
8. 5 Use prioritization strategies for client care.

C.R.B. : Priority need should always be addressed first during nursing care. I addressed the need of resident to use washroom first for elimination

before going for breakfast and lunch.

Satisfactory Satisfactory
8. 6 Demonstrate professionalism and accountability.

C.R.B. : As a student nurse, I was assigned to care certain residents, and I was fully responsible for the care that I provided them such as wake up

them in the morning, help them in washroom activities, feeding breakfast and lunch, safety care etc. I I demonstrated the professional quality by not

disclosing their personal information except health care team.

Satisfactory Satisfactory
8. 7 Recognize strengths and limitations and seek appropriate assistance and support.

C.R.B. : I was good to care of the residents on feeding, ensuring safety, taking shower, bed making etc. I asked for the help from PSWs to transfer

the immobile residents from bed to wheelchair using lifter, and also called the RPN to change wound dressing. I found ineffective communication as

one of the major weakness during clinical practice.

Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING EFFECTIVELY :

Your satisfactory preparation for clinical practice demonstrated your ability to search and access appropriate sources. You demonstrated
adequate level of preparation and knowledge to be able to establish connections between medical conditions, medications and
assessment findings on weekly bases.

9. SIM number of hours

9. 1 SIM number of hours

C.R.B. : 6

A.M. : 4

Teacher comments for SIM number of hours :

Chet accumulated 4 hours of SIM lab.

Student Final Summary with Strategies for Continued Growth

The clinical placement in this semester helped to have real experience on nursing skill practice, and it bult up my confidence to do better in future. I
am planning to be well prepared with deep study and research on nursing skills for the care of diverse group of the clients in next semester. I am
going to have detailed knowledge on client's medical history, developing concept map and nursing plan of care, effective communication techniques
to better understand the client and to provide therapeutic care in next semester.

Teacher Final Summary with Strategies for Continued Growth

You have consistently demonstrated a mature and efficient manner this term towards your clients, the staff on the unit, and your peers. I have seen
tremendous growth and development in your work with clients and in your nursing care. You have maintained a calm approach towards your clients
and demonstrated a satisfactory understanding of their needs. However, you still need to work on your confidence level. Please ask more questions!
If you seek reassurance that you are achieving the best patient outcomes, then evidence-based practice is the key. Asking for the evidence helps
build a sound framework of knowledge and ultimately will increase your confidence level. Also, practice the skills, procedures and protocols. The
more you practise, the better you will perform and the more confident you will become!
Congratulations on a successful semester!
Best,
Agnes

Grade Satisfactory Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

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