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NURS 2021H Clinical Course Evaluation

Final Evaluation

Student: ____________________________________

Clinical Instructor: ____________________________

Placement: __________________________________

Satisfactory Unsatisfactory
Please circle the appropriate outcome

*Please note: the student must receive a satisfactory in labs, simulation, enhanced learning activities, and clinical
practice in order to receive a passing or satisfactory grade for this course.
NURS 2021H Clinical Course Final Evaluation

Progress
Course Objective Evidence/Indicators Satisfactory Unsatisfactory
Recognize and begin to navigate Week 2: Realized with two patients that although breastfeeding is
the complexities of family what is technically best for the baby, some moms decide not to do
this. As both the mom and baby are the patient, you as a nurse need
nursing. to support the mom in the decision to not breastfeed but also
advocate for the babys optimal nutrition. This is because the optimal
choice for the baby is breast milk as it provides the most nutrients, as
well as antibodies from mom to baby.
Week 2: Experienced how the delivery of a baby is very much a
familial experience, and that many family members would like
to/need to be informed about certain things regarding mom and
baby.
Week 3: When I went into a patients room to remove an IV, many of
her family members had just arrived to meet her new baby. I debated
whether or not this was the best time to do this procedure, but I
realized that this patient most likely would like to have her IV
removed as soon as possible. As the IV was difficult to take out, my
clinical instructor did this for me. This situation relates to family
nursing as it helped me to decipher what procedures are too invasive
to do in front of other family members, and which procures take
precedence over this.
Week 4: When taking the vitals of a child recovering from surgery, the
mother was very curious about knowing what each vital was. I
realized the importance of telling the mom about her sons vitals as
she as the parent must have been very worried that he might develop
a fever post-operative. From this I understand the importance of
communicating with all family members in family nursing.
Week 5: When doing a discharge with a nurse, I realized the
importance of educating both the mom and the dad/other primary
caregiver instead of just the mom. They will both be raising the baby
and both need to be educated. I have caught myself focusing most of
my attention on the mom when providing care, but through this
experience I realized that is important to care for all caregivers so
that the baby is provided with optimal care and all caregivers feel
capable to parent.
Week 8: When assisting in a vaginal birth, the father was
able to help the mother as she pushed. This shows the
complexities of family nursing as the father was able to
assist in delivering his own child. I realized that although
in this moment the patients are the mother and the baby,
it is important that the father is also cared for as he, too,
is expecting a child. It is important to involve family in
care when it is possible to do so.
Week 8: When a mother was experiencing a postpartum
hemorrhage, her own mother was waiting in the hallway.
After I finished assisting the medical staff in treating the
hemorrhage, I went out to speak with the mother of the
patient. I asked her how she was doing and if I could do
anything for her, as I understood she must have been
overwhelmed and worried about her daughter. From this,
I understand how important it is in family nursing to keep
other family members informed.
Week 8: When a mother was hemorrhaging, her husband
was allowed to stay in the room with her. This
demonstrates the complexities of family nursing as
usually in a situation such as this one everyone would be
asked to leave the room. Since the mother had just
delivered a baby, the father was allowed to stay to
comfort her while going through this.

Integrate knowledge from Week 2: Used communication skills I learned from NURS2001 to
previous courses to support facilitate some conversations between myself and the families.
diverse populations. Week 2: Used skills Ive recently learned in NURS2001 about
relational practice when facilitating communication with patients and
their families to focus more on their life other than the reason that
they are in the hospital.
Week 3: Used knowledge from NURS 1000 regarding proper body
mechanics when I raised the patients bed to my waist level to avoid
back problems as I advance in my career.
Week 4: Used knowledge from all of my nursing courses regarding
hand hygiene. I performed hand hygiene before entering a room and
upon exiting in order to prevent the spread of infection.
Week 4: Used knowledge regarding infection control from all
previous and current nursing courses when I wiped down my
stethoscope with an antibacterial wipe in order to prevent the spread
of infection from person to person.
Week 5: Used my knowledge from BIOL 1050 (human anatomy and
physiology) when assessing a patient with a laparoscopic
hysterectomy. I was able to see each incision and visualize where the
ovary, uterus, and tubes would have been internally.
Week 8: Used knowledge from BIOL 1050 (Human
anatomy and physiology) when I recognized that oxytocin
was being administered to the mother. Oxytocin
promotes contraction of the uterus as well as production
of breast milk, and in this scenario it was used to increase
the mothers contractions so she would get closer to
delivery.
Week 8: Used knowledge from BIOL 1550 in
pathophysiology and pharmacology when I saw that a
patient was administered penicillin during labour. This
was done to kill the group B strep bacteria so that her
baby would not develop an infection after birth.
Week 8: Used knowledge from NURS 1001 and relational
practice to use therapeutic communication with a patient
while she was hemorrhaging, as well as with her mother
waiting in the hallway during her hemorrhage.
Week 8: When a doctor was delivering a baby, I watched
a nurse tell her to raise the bed to her hip level to save
her back. This is something I learned in NURS 1000 and
have done myself before, but it was interesting to see an
older nurse correct the young doctors habit of bending
down.
Week 8: Used knowledge from BIOL 1050 to understand
how a newborn develops jaundice. It develops in
newborns because they have more bilirubin than they can
get rid of. Their organs are not very good at getting rid of
excess bilirubin yet, so they are at a higher risk of
developing hyperbilirubinemia (jaundice). Eventually,
these levels go down because bilirubin is excreted
through urine and stool, but if levels remain high and are
not treated, newborns can develop brain damage and
kernicterus. Jaunice is treated by phototherapy.
Critically appraise relational Week 2: Each time I went into the room to assess a mom/baby, I
inquiry processes and begin to developed a stronger bond with them, talking about things other
develop meaningful than their pain, meds, etc. I witnessed by clinical instructor chatting
about baby names and her kids names and realized the importance
relationships with health care of conversation between nurse and patient.
providers and family members. Week 3: Took a mom who was 32 weeks pregnant whose water had
broken to the ultrasound clinic. She was very worried about her baby
and what the outcome of this pregnancy was going to be. With my
knowledge regarding relational inquiry, I tried to console her without
promising that everything would be okay. I asked her about her
other son, and we talked about thanksgiving and other topics in
attempt to take her mind off of the situation and ease her worries.
Week 4: Consistently communicated with the nurse that I was
working with in order to provide the best care for my patient. Proper
communication makes the patient experience better. In my case, a
lack of communication would have possibly resulted in my patient
having their vitals taken every 2 hours, and they may have been asked
the same question more than it is needed. This would become
annoying to the patient and is totally avoidable with proper
communication.
Week 8: Listened in on and helped give report from
myself and the labour and delivery nurse to the nurse on
A6. I understand the importance of communication
between health care staff so that the all staff involved
know the whole story when it comes to the patient. This
ensures that the patient is given the care they need.
Week 8: A mother decided to tell me she was
encapsulating her placenta. She told me that this was
something she has not yet told any of her
friends/extended family yet. Using relational inquiry, I
discussed this topic with her. I told her that she was not
obligated to tell anyone anything about her birth and
parenting plans. I explained to her how everyone has an
opinion on something and should be able to act on this
opinion however they like. I explained to her that if she
wanted to encapsulate her placenta then she should, and
she does not need to tell anyone about it. I told her that if
she felt it was right, then she should do it. I believe that
speaking to her this way through relational inquiry
allowed us to build a better relationship, and it allowed
her to have more trust in me.
Week 8: When a mother was about to give birth, I
introduced myself as soon as I entered the room. I then
asked the parents if they knew what they were having,
and they talked to me about their gender reveal party. By
just asking questions and using relational inquiry, I was
able to develop somewhat of a relationship with both
these parents before the mother was about to be very
exposed in front of a complete stranger. I think this
allowed her to be more comfortable with me and
watching her birth.
Collaboratively formulate a plan **ALL WEEKS**
of care based on knowledge of - When I arrive in the morning, I check my patients chart to see if
family nursing, related theories they are GBS positive. If they are, I perform vitals on the baby q4h to
ensure that they are not developing an infection and that if they are it
and scholarly literature. can be controlled quickly.
- Although I have not experienced this yet, if a baby is admitted who
has been delivered with the use of forceps/vacuum, I understand the
importance of the head circumference protocol. The circumference
of the babys head is measured so that if hemorrhaging occurs it
could be dealt with promptly.
- When I arrive in the morning, check my patients charts to see the
date and time the baby was delivered. From this, I am able to
calculate at what time I need to perform vitals, and if any other tests
need to be done, such as a bilirubin scan. This is important so that the
baby is properly monitored and cared for, and so that the health care
team knows if and when it is safe for the mom and the baby to go
home.
Week 8: The patient I had was GBS positive and RH
negative, had a high BMI and was delivering her first baby
at age 39. From these factors, it was already known that
she was at a higher risk for hemorrhage (which she did).
Being GBS positive, she was on antibiotics during her
labour to prevent her baby from developing an infection.
After birth, this baby would be need to be monitored
every four hours in order to catch an infection early if it
were to develop. The mother was also given a shot of
rhogam before and after birth (after determining the
babys blood type) as she was Rh negative and this is to
prevent the mother from reacting to her childs blood
type.
Week 8: I watched a baby be delivered with forceps. I
understand that the babys head will need to be
continuously measured after birth to make sure the head
circumference does not increase. Forceps cause the baby
to have a higher risk of having a hemorrhage in/under
their skull, and the head circumference protocol attempts
to catch any swelling as soon as possible.
Week 8: Something new I learned this week was how to
push during a vaginal delivery. This is three 10-second
pushes during each contraction with a breath in between.
Contractions should be around 60 seconds apart to give
the fetus time to recover (as well as mom) between
pushes. When the fetuss head is almost out, the mother
is encouraged to do quick, successive pushes to reduce
the risk of tearing.
Develop, implement and evaluate Week 2: When a mom was having trouble with the baby latching, my
the effectiveness of health- clinical instructor guided her into how to do it the right way.
promoting, evidence-based Although the patient did not keep up with this advice, she did get her
baby to breastfeed sufficiently for several minutes. It is important to
practice, reflecting principles of
at least show how to do something right so that the patient has the
family nursing as relational ability to practice this action if they choose to.
**ALL WEEKS**
practice. - When bathing babies for the first time, I educate parents on the
importance of bathing cleanest to dirtiest. I teach them to start
with the eyes, using a different part of the cloth to wipe each eye,
progressing all the way through the bath until the genitals are washed
last. This is important for the well-being of the baby, so they do not
have infections spreading from body part to body part
- Educate moms on why breastfeeding is the best option, as it
contains nutrients and antibodies that cannot be found/produced in
formula. This is important so the baby can thrive and be as healthy as
possible.
- Educate parents on the back to sleep method. This is important so
that babies do not suffocate in their sleep.
- I understand the importance of administering Vitamin K to assist in
blood clotting and in the administration of erythromycin to prevent
eye infections. I also understand that it is important to teach the
parents the importance of each if they chose to decline these
procedures.
- I understand that there is no specific cause of SIDS
(sudden infant death syndrome) but it is important that
steps are taken to avoid it. I am able to educate parents
that in order to avoid SIDS it is important that the back to
sleep protocol is implemented. This is when the baby is
placed on their back when put in the crib so that there is
little risk of suffocation. Babies who are put to sleep on
their back are also at a lesser risk of overheating, which
may cause a sudden death. It is important to educate
parents on back to sleep to avoid SIDS.
- It is important to educate parents to reposition their
baby differently in their crib each time they sleep (feet
toward one end one night and toward the other end the
next) to avoid plagiocephaly. Plagiocephaly is the
flattening of the head from the newborn remaining in the
same position for too long. If they are continuously
moved, they are less likely to develop this.
- I make sure my patients know the importance of skin to
skin. It allows for the newborn to bond with the mother
and father, and helps regulate the babys internal
temperature. It can also help the newborn with
breastfeeding in achieving a latch. This all helps the
newborn adapt to their new environment.
Demonstrate increasing Week 2: After I gave my first baby bath, I felt incredibly more
competence and confidence in competent to do so again on my own, adding to my nursing skills set.
the application of psychomotor Week 2: After performing vitals on infants several times, I now feel
much better about getting accurate results each time.
skills in practice settings. Week 3: My instructor asked me to help other students with baby
baths as she was confident in my abilities to do so on my own. This
shows my progress in my psychomotor skills.
Week 4: This week I went with a nurse and took out an IV on my own
with her verbal guidance. I feel competent to do this skill on my own
now, which demonstrates my progress.
Week 4: As small as this skill is, I feel much more comfortable holding
newborn babies now than I did in week 2. I know now how to
properly support the head, and I am far less nervous when picking
babies up out of bed and putting babies back in their beds.
Week 5: Practiced taking out IVs on diapers. In addition to this, we
practiced drawing up water in a syringe and administering it into
either a diaper or a skin cube. We also reviewed how to administer
an IV on a diaper, so I feel more educated on how to do so when I
attempt it for the first time.
Week 5: After 4 weeks of performing vitals I feel very competent in
my abilities in taking vitals from a diverse range of patients.
Week 8: I was in labour and delivery this week, and did
not perform many psychomotor skills; I mainly observed. I
did a temperature, respiration, and heart rate on a
newborn successfully and took the temperature of a
mother twice. Although I did not get to practice my
psychomotor skills, I had a comprehensive six weeks of
practicing these psychomotor skills up until midterm and I
feel confident in all of the tasks I learned how to do this
semester.
Demonstrate accountability and Week 2: When asked to do things from nurses on the floor that were
professionalism that is consistent out of my scope of practice, I said that I would love to watch but not
with a nurse entering a self- necessarily perform these actions/procedures myself.
Week 2: When learning to chart, I triple checked my charting with my
regulating profession. clinical instructor as this is a legal document.
Week 3: Did not make promises to patients while proving care,
although I made sure to follow through with the statements that I
said I would do.
Week 4: Only opened and reviewed charts that I had reason to look
into. This demonstrates professionalism and not breaching
confidentiality.
Week 5: When I took the vitals of a baby and got an odd number for
temperature and respirations I checked these vitals again. The second
time the numbers made more sense. I did this because I am held
accountable for this patients well-being, and I showed
professionalism by not ignoring the weird numbers I got and took
them again.
Week 8: When my patient was hemorrhaging, my gut
feeling was to tell her she was going to be okay. Instead of
doing this, I remained professional and accountable by
reminding her she was doing great, and encouraging her
to keep breathing. Since there was no way I could ensure
that she would actually be okay, I could not promise her
she was going to be okay. Instead I used other methods to
soothe her instead of promising anything.
Week 8: I remained professional and accountable when a
nurse asked me to mix medications into the IV. Since this
is out of my scope of practice I told her I would be happy
to watch and learn, but that I was not allowed to mix
medications in this point of my schooling.
Select appropriate community Week 2: When tagging along in discharging patients, I was able to tell
support services for families the difference between the information given to a first time moms vs.
needing referral to enhance a mom whos just delivered her second or third baby. The same
crucial info is given, but new moms may be told about extra
coping with diverse transitional resources and services in order to help ease the transition into
experiences. motherhood.
Week 3: My 19-year-old patient was given a social worker and was
provided with resources to help her raise her baby in a difficult living
situation at such a young age. This is important to help her cope with
her transition into motherhood at a young age with poor social
supports.
Week 5: The nurse I was shadowing in a discharge told a mom about
a hotline she could call if she was ever having trouble with
breastfeeding. This was important to tell her as it comforted her
worries regarding her baby not getting sufficient food.
Week 8: Although I was not there for discharge and do
not know what this patient was linked to, I have an idea of
what I would have done as a nurse. Since this patient had
a history of anxiety and depression and she had a pretty
traumatic birth and postpartum experience, I believe it
would be very beneficial to link her to a therapist or some
sort of mental health counselor to monitor her mental
health status. Because of her history and her birth
experience, she is at a high risk for postpartum depression
and should be carefully monitored so that she can get the
help she needs if she were to begin to develop symptoms
of postpartum depression. In addition to this, this was her
first child and she was concerned about breast feeding. I
would have linked her to the lactation consultant at PRHC
so she would be able to get help if she needed it.

To be completed by student:

Student Areas of Strength

1. I am able to accurately obtain vitals from mothers and babies.

2. I am able to perform a baby bath very well, while being able to educate parents on how to do so.

3. I am good at feeling out a situation. I am very analytical and I am good at sensing out the .
.family/relationship dynamics in many situations.

Student Areas for Future Development

1. Therapeutic communication with patients in a crisis.


2. Charting: I need to work on being more precise, accurate, and detailed in my charting.

3. I need to be more confident in myself when trying new psychomotor tasks.

Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)

Attendance

Hrs. Hrs.
Week 1 Week 5
Week 2 Week 6
Week 3 Week 7
Week 4 Week 8

Total number of clinical hours completed_____________


1. Clinical Component

Satisfactory Unsatisfactory
Please circle the appropriate outcome

2. Clinical Learning Center- labs and simulations

Satisfactory Unsatisfactory
Please circle the appropriate outcome

3. Enhanced Learning Days


Mental Health Day ___________
NVCI ____________

Satisfactory Unsatisfactory
Please circle the appropriate outcome

Signature of Instructor____________________________________
Date_______________________________

Signature of Student______________________________________
Date________________________________