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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 : Pritima Heerah
Clinical Teacher/Preceptor : Janet Jeffery
Program Coordinator : Wendy Chow
Location : William Osler Health Centre/Etobicoke General
Hospital
Placement Setting : Agency
Unit/Office/Clinic : 9CCC
Period : 12-Jan-2016 To 07-May-2016
Student hours : 126
Required Hours : 168
Validated hours : 138
Teacher comment for validated hours:
Student missed 30 clinical hours due to family emergency

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.

P.H. : I do comply with regulatory standards,relevant legislation by referring to my theory when providing care as a nursing student.

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

P.H. : I continuously act responsibly,ethically and shows accountability when caring for my client.For example I always measure blood pressure

before giving anti-hypertensive drugs and follow up my client blood pressure after administration of anti-hypertensive.

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

professionals.

P.H. : Whenever I am unsure,I consult my clinical teacher and assigned nurse or PSW to help me out.When I feel comfortable in providing care,I

helped out my peers.For example I always help my peers when they are in need for wound dressing.

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

P.H. : I use evidence informed practice and always prepare myself by researching my client diagnosis and medications before my clinical day.

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

P.H. : Client safety with safe environment is always main priority for example when my client walks to the washroom, I always walked beside and

remove any hazards from their way to prevent fall.

Satisfactory Satisfactory
1. 6 Ask relevant questions to clarify understanding of the plan of care and whenever uncertain.
P.H. : I do ask the assigned nurse about the plan of care especially when I am administering medications, if I need any clarification.

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

P.H. : I didn't encounter any unsafe situation yet.

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

P.H. : I show understanding of the role of a student nurse as I always confirm my plan of care with the experience assigned nurse or my clinical

teacher.

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

Pritima has consistently demonstrated accountability throughout the semester by ensuring that her practice and conduct depict respect
and professionalism. She has adhered to the policies of Humber College, School of Health Sciences, and the William Osler;EGH. She has
met the standard of accountability by being present, punctual and prepared for clinicals/labs. Pritima missed clinical hours due to family
emergency. She has demonstrated client safety by ensuring call bell in place, brakes are on, bed in lowest position and she knowings her
limitations when to seek for necessary help.

2. ACCURATE AND RELEVANT COMMUNICATION

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

P.H. : During our meeting after every clinical day, I participate confidently in discussion with my clinical teacher and peers

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

P.H. : I do document clearly,accurately and concisely when writing my patient note and on meditech about my client.

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

P.H. : Any important information, I do say to the concern person for example my client was having loose stools,so I informed the nurse so as to avoid

administering stool softener.

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

P.H. : I use effective communication skills with my client, teacher,peers and inter personal team to be efficient.

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

(PHIPA)

P.H. : I always keep any patient privacy as well as confidentiality for example I never reveal my client names outside of the unit.

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

P.H. : I always use my laptop,phone or Humber computers to research and collect data to help me gain knowledge and to be successful.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :


Pritima has consistently participated in retrieving and sharing information in the clinical setting each shift.She independently collected
information from client's chart (including electronic); shared information information throughout the shift with nurse and PSW (including
breaks and end of shift) and documented Shift Report, Vital Signs, ADL flow Sheet, Diabetic Record, Wound Care (including suture
removal, Output adequately using MediTech each shift. Her patient care narrative notes were done well.

3. CARING RELATIONAL PRACTICE

Satisfactory Satisfactory
3. 1 Utilize effective communication techniques.

P.H. : when delivering care, I always use effective communication for example I talk patiently with my client so as they understand my instructions

when I do assessment with them.

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

and health care team members.

P.H. : I consider safe,therapeutic and culturally care as taught mainly in my theory and clinical classes.

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

P.H. : I do apply knowledge of therapeutic use of self and recognise that my well-being will impact and benefit my client well being as I will be able to

deliver the best care to my client for example I make sure I have a good sleep before clinical day to perform efficiently.

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

relational practice.

P.H. : I am conscious about identifying my own beliefs,values and personal experiences have when I provide care.

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

appropriately.

P.H. : I interact with my client,physiotherapist,recreational therapist team,nurses and PSW appropriately for example when the assistant

physiotherapist applied hot compress to alleviate for my client,I remind the therapist when the compress has to be off .

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

professional health care team.

P.H. : I use my knowledge base to practice and understand different cultures of my client and the health care team so as to provide holistic care.

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

clients choices and decisions.

P.H. : I recognise and show understanding of my client's culture,religion,belief which impact their choice especially for choosing their meal.

Satisfactory Satisfactory
3. 8 Provide effective client education.

P.H. : I educate my client about the importance of mobility so as to get back to their activities of daily living and about eating their meal as well as

enough fluid.

Teacher comments for CARING RELATIONAL PRACTICE :


Pritima established and maintained respectful and therapeutic relationships with her clients and their family members. She is a caring
practitioner and her conduct is guided by respect for cultural diversity and she promotes the well-being of his clients.

4. LEADERSHIP AND ADVOCACY

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

P.H. : I didn't encounter any conflicts yet.

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

P.H. : I help my peers in doing different nursing procedures in a positive learning environment for example I demonstrated my peer how to give

nebulization using the face mask.

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

client, self, others, and quality practice.

P.H. : I do advocate for my client, self, others so as to deliver quality safe care.

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

professional health care team.

P.H. : I always accept and provide feedback to my peers to improve my standard of practicing efficiently.

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

P.H. : I respect my client's right for self-determination and choice for example my client prefer to shower in the afternoon time,so I respected her

choice.

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

P.H. : I did not encounter yet.

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.

P.H. : I do consult and collaborate when practising as a nursing student but I didn't work with the public yet such as the emergency unit.

Teacher comments for LEADERSHIP AND ADVOCACY :

Pritima has demonstrated strong leadership skills among her peers in the clinical setting. Pritima has previous nursing knowledge and
skills and she willingly shared information and demonstrated nursing skills with her peers. She was able to demonstrate wound packing for
her colleagues on the first clinical day. She role-models professionalism among her peers and she used her clinical time to seek out new
learning opportunities. Pritima worked closely with her clients and their families and often practiced advocacy. In one situation, her client
had not had a shower since admission and was requesting a shower in the afternoon. Although, the PSW's were suggesting a shower the
following morning, Pritima advocated for her client and was successful in having her client get a shower that afternoon.
4.7 Pritima, who do you consider as the public?

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.
P.H. : I always incorporate my client needs and expected outcomes into personal plan of care for example my client was impatiently waiting for her

husband and when he came,I made him sit comfortably beside my client and she became very happy to have her life partner accompanying her.

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

competently in writing and orally.

P.H. : Before my clinical day,I research about my client's holistic care , take notes, plan care and verbalizes it to my teacher before the shift starts.

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

P.H. : I do use my knowledge,skill and judgment to assess my client and prioritize needs and care for best outcomes for example my client was on

oxygen therapy,so I made sure to keep her nasal prongs in place and carefully perform bed bath as to my client tolerance as she felt tired very easily.

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

P.H. : I do provide nursing interventions and evaluation to assess my client for example my client was given an opioid drug,dilaudid,for low back pain

as his pain level was 7/10 ,so I assessed the pain in an hour which decreases to 4/10.

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

based and within skill abilities.

P.H. : I skillfully perform nursing assessment and implement nursing interventions referring to my research,class notes and books.

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

P.H. : I decide the priority of care by assessing my client first as my client was extremely tired and sleepy due to the lack of sleep.So,I allow her to

rest,have her breakfast before giving her bedside bath.

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

manner.

P.H. : I organize and manage my care and nursing procedures efficiently to be able to deliver the best care.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :

Pritima has demonstrated the ability to create a concept map by selection of priority diagnoses and showing connections between clinical
manifestations, priority assessments and interventions.
She has demonstrated great confidence in her ability to plan and deliver care for two clients independently. She performs vital signs and
other assessments and can distinguish abnormal values. She provides hygiene care including partial bath/total bath /showers. She
administers medications orally, subcutaneously and via nebulizers. She has provided provides wound care and removed staples.

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.

P.H. : I continually collaborate with the assigned nurse,PSW,physiotherapist and recreational therapist for providing care to my client.For example I

encouraged my client to go for recreational therapy so as she can interact with people with her same age group.

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.


P.H. : Whenever there is a situation of changing need,I informed the assigned nurse,PSW and my clinical teacher.For example my client was having

loose stool so I informed the nurse so as to with hold stool softeners for the client well-being.

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

P.H. : I always seek out assistance whenever needed with the nurse,PSW,my clinical teacher and my peers when delivering care.

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

P.H. : I always work in collaboration with my assigned partner during my clinical for example to lift my client on bed,I asked my partner help and I

have not encounter any conflicts yet.

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

changing environment.

P.H. : I work competently in collaboration with the health care team to make client comfortable and deliver quality care for example a client who

moved in from Brampton hospital was asking for food when diner was being served. So,I clarify with the nurse who told me his diner will be coming a

bit late as the order was placed in the afternoon.

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

P.H. : I continuously pay respect to any health care team member .

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Pritima has promoted colloborative practice. Pritima has attended patient care rounds where she noted the interactions of the
interdisciplinary team. At the beginning of the semester, she attended a workshop held by the recreational therapist and and has a full
understanding of the roles of members of the interdisciplinary team on a Rehabilitation unit.She collaborated well the intraprofessional
(nurse and PSW) team each shift. She provided care to her clients in a timely manner to facilitate their participation in their therapy
sessions.

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.

P.H. : I always act in best interests of clients and protect clients from harm for example walk beside my client when going for shower and remove any

hazards from the way to prevent fall.Thus providing safe practice.

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

P.H. : I do self reflection after every clinical day to improve my strengths and areas of limitations.

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

(CNO).

P.H. : N/A

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

integrate these into practice.


P.H. : N/A

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

P.H. : I use my nursing,lab and health theory, other acquired knowledge to practice efficiently.

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

P.H. : I use my theory base learning, approach and evidence -informed practice to nurse my client for example I always review my nursing

procedures beforehand if I have to perform a nursing procedure.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Pritima has consistently demonstrated responsibility for his learning in the clinical setting. At the beginning of each shift, she has very
good level of preparedness, she responds well to feedback and sought out learning opportunities in the clinical setting. She has
completed the Quality Assurance requirements.
Please review 7.3, 7.4

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.

P.H. : I use problem solving skill to make a decision about my client well-being.For example I covered the air vent to protect my client who was

feeling very cold.

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.

P.H. : I continually use problem and decision solving skills to assess clients in relation to nursing diagnoses,expected outcomes,nursing interventions

and evaluative criteria for example as my client had a pain level of 6/10 before physiotherapy,I recognise that the pain medication should be

administered to prevent increasing the pain and hence the client will be more comfortable in doing the exercises.

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

P.H. : I use self reflection to plan my areas of improvement in problem-solving and decision-making.

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

provide safe and competent care.

P.H. : I am aware where to research and collect data in order to get knowledge about performing my nursing procedures safely as well as efficiently.

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

P.H. : I always focus in priority when proceeding my client care as I recognise its crucial to give analgesics before I perform wound dressing.

Satisfactory Satisfactory
8. 6 Demonstrate professionalism and accountability.

P.H. : I demonstrate professionalism and accountability when providing care. I keep myself up to date about my research and learning process to

practice efficiently.

Satisfactory Satisfactory
8. 7 Recognize strengths and limitations and seek appropriate assistance and support.
P.H. : I recognise my strengths and weaknesses and I usually ask help from my peers and clarify any misunderstanding with the nurse or my teacher.

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

Pritima has demonstrated clinical reasoning throughout the semester. She recognizes abnormal values and how to respond
appropriately; she knows rationales for her actions and overall she can make connections between diagnoses, clinical manifestations
(including lab values),nursing assessments and interventions. Her prioritization and time-management skills are improving.

9. SIM number of hours

9. 1 SIM number of hours

P.H. : 4

J.J. : 4

Teacher comments for SIM number of hours :

Confirmed by student

Student Final Summary with Strategies for Continued Growth

Overall during semester I have been knowledgeable through theory as well as practice.The clinical experience in the real setting made me more
confident to provide quality holistic care. I am still growing my learning in different aspects and I am happy to be able to continue my clinical
experience next semester.Thank you Janet for the support.You are great teacher.

Teacher Final Summary with Strategies for Continued Growth

Overall, Pritima has performed very well this semester! She has modeled the way of professionalism for her peers! She has demonstrated the
ability to plan and deliver care for two clients efficiently.
She needs to continue her growth by remaining very caring and compassionate, maintaining a high level of preparedness,practice priority
assessments, continue to use organizational plan to provide timely care, value each clinical day as a precious opportunity to learn and continue with
an inquiring mind! Good Luck!

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

Student Comment

I missed 30 clinical hours due to my mum who is critically ill.The clinical experience at Etobicoke General Hospital was a great learning opportunity
with the support and guidance of Janet and the nurses all the way.Thank you.