Self Assessment

2017 - 2018 - NURS 208 Course Learning Outcomes Final (201708)

NUR 208 Practical Nursing Practice 4 (PN, 05-Sep-2017 - 31-Jan-2018)
Student : Cathy Phong
Clinical Teacher/Preceptor : Martha Lalor
Program Coordinator : Judy Martin
Location : William Osler Health Centre/Etobicoke General
Hospital
Placement Setting : Agency
Unit/Office/Clinic : 8E Orthopedics
Period : 05-Sep-2017 To 31-Jan-2018
Student hours : 196
Required Hours : 196
Validated hours : 168
Teacher comment for validated hours:
Actual clinical hours completed

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: Consistently practice safely,
competently, and ethically within legal and regulatory frameworks and the policies and procedures of the practice setting.

Satisfactory Satisfactory
1. 1 Comply with regulatory standards, relevant legislation and the practice setting’s policies and

procedures.

C.P. : I was able to adhere to the standards, legislation and the hospital's policies and procedures by performing proper hand hygiene, putting on

PPE whenever needed, and so on.

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

C.P. : Whenever I am on the floor, I was able to act in a responsible, ethical, and accountable manner by following the policies and ensuring that I

take, if any, consequences for my actions.

Satisfactory Satisfactory
1. 3 Determine how the three factor and practice decision-making frameworks influence client care.
C.P. : I have been able to show how the three factor and practice decision-making frameworks influence caring for patients through my scope of

practice and experiences on the floor. The three factor frameworks include: the client, nurse, and environment. In order to make appropriate decisions

based on a clients needs, it must include the three factors listed above (CNO, RN and RPN Practice). In terms of the client factor, the decisions are

based on the client's wellbeing. Nurses need to determine what to do depending on their condition and according to the decisions the nurse made, the

good and/or bad outcomes will be predictable, which is a part of the nursing process/care plan. The attributes the nurse must have to provide safe

care are "leadership, decision-making and critical thinking skills." Another factor that also contributes is the application of knowledge; nurses need to

know when and how to apply it. Nurses must continuously develop their skills and competence through ongoing learning, experience, and education

in activities. They also consult with other health care professionals in a situation where it is beyond their scope of practice. Nurses must be able to

know the reason why they are asking for consultation for the patient in order to figure out a safe and appropriate course of action. Last but not least,

the environment plays a role to influence safe client care by having more staff, consultation resources, staff who are familiar with the environment, and

ensuring that it is harm free for the patients. In terms of the practice decision making framework, the nurses must know what the problem is, assess it,

list out all of the possible options, the benefits and consequences, then make the final decision that best matches for the patient's condition and what

is the safest.

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

C.P. : Evidence informed practice is a form of informative research with proof from clinical practice, the patients' preferences, and professional clinical

judgement to provide safe and effective care for the patients. I was able to utilize evidence informed practice on the unit by witnessing other nurses

providing care for their patients, used their clinical judgement to provide care and doing what they did.

Satisfactory Satisfactory
1. 5 Carry out safety-based practices and risk management principles to ensure client safety and a

safe environment.

C.P. : I ensured that the patients I have had were safe by doing my best to keep their environment harm-free and managed the risks. Safety is one of

the biggest priorities when it comes to caring for patients.

Satisfactory Satisfactory
1. 6 Ask questions and clarify the plan of care, unclear orders or directions, and whenever uncertain.

C.P. : Whenever I came to a situation in which I was unsure of what to do, I made sure that I went to the instructor or nurses on the floor to ask

questions in order to clarify the plan of care. I did not want to do anything wrong, before I started to do a procedure I also made sure that it was okay

with both the patient and the nurses. Most of the time I did the procedures with the guidance of my nurses and instructor.

Satisfactory Satisfactory
1. 7 Demonstrate professional behavior by seeking assistance in situations in which there is unsafe,

unacceptable and/or unprofessional behavior.

C.P. : I have been in a situation at the placement when the physiotherapists came in one time and before they moved my patient, I informed them

that I had put in a bedpan. The physiotherapy team was so furious and raised their voices at me so I removed myself from the situation. When I came

back to check on my patient, they left them on the commode. The nurse was there to witness it all and helped my patient back into bed. I came in after

and was told that the physiotherapy team took off their wound dressing and just left it there hanging. My patient was crying in pain and the nurse and I

were able to ease it. I was also able to change their wound dressing without any assistance, but the nurse told me what I had to do, and the steps

were very simple and I changed it quickly and efficiently.

Satisfactory Satisfactory
1. 8 Demonstrate understanding about the role of the nurse within health care.

C.P. : I have been able to comprehend the role of a nurse in the health care field. Being at this placement has allowed me to further my knowledge,

develop the vital skills that are needed, and gain experience in the field so I know what it will be like in the real world. I also got to follow my nurses'

footsteps and witness what they do as licensed practitioners and I will be able to do the same. I have always aspired to be a nurse and giving care to

people who need it makes me feel amazing.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK: Consistently
practice safely, competently, and ethically within legal and regulatory frameworks and the policies and procedures of the practice setting. :

Cathy exhibits professionalism by adhering to the Humber College uniform code. She also practices within her scope has a Practical
nursing student.

2. ACCURATE AND RELEVANT COMMUNICATION: Communicate using strategies and technology to affect accurate and timely documentation,
reporting, and information sharing.

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

C.P. : By the end of the day, the group comes together into a conference room to discuss how our day goes, or our instructor would give us a case

study. I was able to participate in sharing my day and ideas to the case study to figure out what the nursing priorities are and what our actions would

be.

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

C.P. : At first, Meditech was a bit difficult to get used to given that we couldn't use the mouse and in order to function it, it was buttons on the

keyboard. After the 12 weeks I have been there on the floor, I have become very familiar with how to use it and know all of the functions of the buttons

on the keyboard. Even after when I finished administering my medications, I had to sign it off in a paper version of the MAR. I was able to do this with

my nurse and teacher efficiently in a timely manner.

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

C.P. : There have been many times where patients on the floor have asked for my help but because I am not licensed to carry out specific tasks, I

told them that I would go get their nurse, checked who the patient's nurse was and reported to the nurse what they needed and the nurse went to

address the client.

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

C.P. : I have been able to communicate effectively with my patients and the health care team on the unit by asking open and close ended questions,

putting all of my findings when documenting, getting shift/bedside reports from the nurses, using hand motions and gestures, listening to what the

patient wants to say; allowing them to express how they feel, then empathize and sympathize what they are going through, motivating them and

making them feel better, being honest with the patient and the health care team.

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

(PHIPA).

C.P. : I have ensured privacy and confidentiality of my patients by reporting to the nurse(s) what room number and bed the patient is rather than

stating their name, making sure that their MAR and cardex is not left out in the open, when I share how my day went during post-conference, I do not

say their name, and I do not talk about my patients out in public. Even in the K4Y assessments, I don't even use the initials of my patients. I just use

pronouns such as "they," or "their." Privacy and confidentiality is a very significant principle in nursing.

Satisfactory Satisfactory
2. 6 Use technology to retrieve and share information including research, evidence based data, and

other health information.

C.P. : I was able to do medications the past few weeks, so I had to do some research on the different types of drugs; what they are for, the adverse

effects, nursing considerations, and what the mechanism of actions are. I was also able to look up some abbreviations and words that I was unsure of.
Teacher comments for ACCURATE AND RELEVANT COMMUNICATION: Communicate using strategies and technology to affect accurate and
timely documentation, reporting, and information sharing. :

She communicate relevant information about her assigned patient and documented clearly, concisely and accurately using the hospital
electronic Meditech system.

3. CARING RELATIONAL PRACTICE: Establish and evaluate relationships that are caring, compassionate, and respectful of clients and others.

Satisfactory Satisfactory
3. 1 Use effective communication techniques.

C.P. : I have been able to communicate effectively with my patients and the health care team on the unit by asking open and close ended questions,

putting all of my findings when documenting, getting shift/bedside reports from the nurses, using hand motions and gestures, listening to what the

patient wants to say; allowing them to express how they feel, then empathize and sympathize what they are going through, motivating them and

making them feel better, being honest with the patient and the health care team.

Satisfactory Satisfactory
3. 2 Establish and evaluate therapeutic caring, compassionate, and culturally safe relationships with

clients and health care team members.

C.P. : I have been able to establish great therapeutic relationships with my patients by building a rapport with them. I took their feelings and concerns

into consideration, giving them the benefit of the doubt and helped them with whatever they needed. I was also able to do the same for the nurses,

just helping them out with whatever they needed, grabbed equipment for them, helped them with the other patients they had, doing ADLs, and so on.

Satisfactory Satisfactory
3. 3 Demonstrate therapeutic use of self to foster client well-being.

C.P. : I was able to follow my patients wishes, doing what they wanted to do and what they could do, and if they needed assistance, then I was there

for them. For example, one of the patients I had called me to help them get out of bed and use their walker to go to the bathroom. Another time,

another one of my patients asked if I could put in the bedpan for them so I did that as well.

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

relational practice.

C.P. : I did not put my personal experiences and life in the way of giving care to the patient, or when they make decisions about what they wanted to

do. I followed the way my patient wanted their daily care done. However, if there was a procedure that needed to be done that was beyond my scope

of practice, I was able to consult with my peers, nurses, or instructor.

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

appropriately.

C.P. : I am able to cooperate with patients, their families, and the inter-professional health care team effectively. I am continually developing my

teamwork skills and working with others is very important in order to give appropriate collaborative care. I approached the patients and nurse about

the plan of care, what to do and how to move forward with something.

Satisfactory Satisfactory
3. 6 Support the diversity of clients and the inter-professional health care team.

C.P. : Canada is known for its multiculturalism, therefore there are millions of people from hundreds of different backgrounds and ethnicities. Being a

nurse means giving care to everyone, no matter who they are, what their skin colour, background, religion, or ethnicity is. I can be a very strong

advocate for others when it comes to diversity because we should not let our personal judgements get in the way of providing care. I was able to

adjust my practice depending on what the patient wanted, respecting their wishes. In addition, working with the health care team means working

together to provide effective care for the patients.

 Satisfactory Satisfactory
3. 7 Display sensitivity and respect for clients’ cultural, religious, and other beliefs and values

influencing their choices and decisions.

C.P. : As stated above, Canada is a very multicultural country. That means that we should not put our personal judgements in the way of giving care

to others and respecting the patient for what they believe in, who they are, and what they think is best for them. Being non-judgemental is one of the

most important aspects to nursing.

Satisfactory Satisfactory
3. 8 Provide client education and evaluate effectiveness.

C.P. : I was able to see some of the nurses discharge patients. Since it is a surgical floor, they told the patients what to do if they experience any of

the symptoms, making sure to see their family doctor, not do any heavy lifting activities, avoid smoking and alcohol, and so on. From what I

experienced with client education and evaluating the results, I did a pain assessment on a patient and was able to administer medication for the pain

that they were feeling. After a while, I came back to check on them and their pain has lowered significantly.

Teacher comments for CARING RELATIONAL PRACTICE: Establish and evaluate relationships that are caring, compassionate, and respectful of
clients and others. :

She accepts and utilized constructive feedbacks to optimize her nursing care when assisting her patients with ADL.

4. LEADERSHIP AND ADVOCACY: Use leadership skills to promote quality practice.

Satisfactory Satisfactory
4. 1 Apply appropriate conflict resolution skills in therapeutic client and other interactions.

C.P. : I have been able to apply appropriate conflict resolution skills by solving problems using the conflict resolution strategies. The steps to conflict

resolution includes clarifying what the source of the problem is, suggest some solutions, techniques to meet the goal, what are the benefits and

consequences regarding the solution, the best way to reach it, then follow through with the plan.

Satisfactory Satisfactory
4. 2 Evaluate and refine leadership skills to develop solutions and create a positive work

environment.

C.P. : I demonstrated leadership with due diligence to develop solutions. For example, sometimes when giving the patient a bed bath, I usually ask

another student to aid me. Since it is my patient I am giving the bed bath to, I was able to take control of the situation in a quality manner and come up

with ideas in order to keep the patient safe and prevent them from experiencing pain.

Satisfactory Satisfactory
4. 3 Provide feedback to peers and accept feedback from peers and members of the inter-

professional health care team.

C.P. : By one of the weeks, all of my classmates and I had to submit a peer feedback as well as a self evaluation. With the feedback I received, I

implemented the comments into my practice as a nursing student.

Satisfactory Satisfactory
4. 4 Advocate for clients, self, others, and quality practice environment.

C.P. : When I experienced the situation that was mentioned above, I was able to advocate for my patient and myself to do what they wanted; for

example, asking them if they wanted to use the commode or bedpan. As well with other patients, I have been able to follow their wishes.

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

C.P. : I always support my patients' rights for self-determination and choice by allowing them to make their own decisions and speak for themselves

because they are human beings too. I would never, in my whole career as a nurse, make my patients feel like they don't have a voice.
 Satisfactory Satisfactory
4. 6 Respond appropriately to unsafe, unacceptable, and unprofessional behaviours.

C.P. : I was able to respond appropriately to unprofessional behaviours to the situation I have experienced and solving it by using the conflict

resolution steps stated above.

Satisfactory Satisfactory
4. 7 Collaborate and consult when implementing health care and nursing practices that are in the

best interests of the public and protect the public through collaboration and consultation.

C.P. : CNO's mission is to protect the public by following the scopes of practice that the nurse is able to do. I have only performed the tasks that are

part of the scopes of practice along with my instructor and nurse in order to protect the public. If it was beyond my scope of practice then I would

consult with my classmates, nurses or instructors.

Satisfactory Satisfactory
4. 8 Contribute to the creation of quality practice solutions and strategies.

C.P. : I have been able to contribute to the production of quality solutions and strategies by following the standards and policies that are set at the

hospital and shared my ideas to reach the goals with the patients and inter-professional health care team.

Teacher comments for LEADERSHIP AND ADVOCACY: Use leadership skills to promote quality practice. :

She takes the initiative to care for her patients with great enthusiasm. She is a great patient advocate and a wonderful team player.

5. PLANS OF CARE: MEET CLIENTS’ NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES: Develop, evaluate, and modify mutually
agreed upon plans of care that maintain, promote, and restore health, prevent illness, support rehabilitation, and provide palliation.

Satisfactory Satisfactory
5. 1 Incorporate the clients’ unique needs and expected outcomes into holistic and client-centred

plans of

care.

C.P. : I was able to do what the client wanted and needed to provide them with the care that they need by respecting their wishes. In order to provide

holistic care, I used the nursing process and created concept care maps.

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.P. : When making the concept care maps, I was able to create plans of care that are theory-based and they are always client centered in order to

meet my patients' unique needs and provide effective and holistic care.

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

C.P. : During my time at the hospital, I have been able to do head to toe assessments and with my knowledge, been able to figure out what is within

range or abnormal. In order to perform this assessment, I needed to prioritize my time to get it done in a timely manner.

Satisfactory Satisfactory
5. 4 Collaborate in the evaluation and modification of plans of care.

C.P. : I have been able to exceed the expectations with positive outcomes when collaborated with my peers and the inter-professional health care

team when examining the care plan. For example, because I am on a surgical floor, in the patients' room, there is a whiteboard that contains a section

on what their goal is for the day. One of the goals I have read is to get up and walk using a walker. The physiotherapy team came to help my patient

get up and used a walker to walk around the room and floor successfully. I have never seen such a big smile on my patients face.
 Satisfactory Satisfactory
5. 5 Safely and competently implement and evaluate nursing assessments and nursing interventions

in a manner that demonstrates knowledge and skill.

C.P. : I was able to perform head to toe assessments safely and competently from what I learned and getting feedback from others after I did them.

With the feedback, I used it in order to perform a better assessment the next time. I could also present interventions, such as when the patient is

experiencing pain, which is very common, I would do a pain assessment and try to figure out what to do to relieve their pain, remove anything that

would trigger it, and try to get them relaxed and as comfortable as possible. Then, I would notify the nurse and they would administer pain medication

by what is in the PRN medication schedule and document what they gave and how much.

Satisfactory Satisfactory
5. 6 Use the Three-Factor and practice decision-making frameworks to guide practice.

C.P. : In order to guide my practice, I used the three factor framework to allow the patient to make their own decisions based on their well-being. As a

student nurse, I was able to determine what to do depending on the patient's condition and predicted the benefits and/or consequences. I am doing

my best to gain a lot of experience and knowledge from my peers and the inter-professional health care team to further my skills. It is very important

for one to learn something new everyday because this allows them to develop their skills and competency as a nurse. I have also communicated with

other nurses and asked them for consultations on their patients; for example, there was a patient's family member who asked to get the IV bag

removed because they thought that they did not need it anymore. I explained to them that I am just a student nurse and I do not have the authority to

do so, so I told them to wait and i will get their nurse for them. I was able to make decisions based on the steps in the framework in order to make the

most appropriate and safest choice based on the patient's condition.

Satisfactory Satisfactory
5. 7 Prioritize nursing care and nursing interventions in order to manage workload, time, and physical

resources.

C.P. : On the unit, it can be a very busy but slow day, given that it is a surgical floor and not much needs to be done. I was able to prioritize what I

needed to do and when. For instance, whenever my patients weren't doing anything, I would go into their rooms and perform a head to toe

assessment. Especially when giving medications, it is very important for a patient to receive their insulin first before eating any breakfast to avoid

having their blood sugar rise up too high. I tried my best to take every opportunity there was to do or see something in order to gain my knowledge

and experience, nursing is the profession where one is constantly learning. I was able to manage my workload, time, and care efficiently and

effectively.

Teacher comments for PLANS OF CARE: MEET CLIENTS’ NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES: Develop, evaluate, and
modify mutually agreed upon plans of care that maintain, promote, and restore health, prevent illness, support rehabilitation, and provide palliation. :

She is confident and comfortable in her ability to carry out interventions such as administering medication and relating it to the diagnosis;
performing ADLs etc.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM: Work effectively as a member of the inter- professional health
care team to develop and carry out holistic plans of care recognizing age-specific changes.

Satisfactory Satisfactory
6. 1 Collaborate 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.P. : I was able to do head to toe assessments with my peers and one of my nurses to determine health needs. For example, several patients will

be constipated and not be able to have a bowel movement because of the anesthesia. The main goals for a post-op patient are to get them up and

moving and having a BM. In that case, the nurse would ask if they had a bowel movement yet or pass any gas. I would also listen for any sounds for

bowel movements in any of the four quadrants, see what they are consuming, and suggest to increase their fibre and water intake. In addition, I had

two patients with catheters and I was able to examine the colour of the urine, smell, amount, and consistency.
 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.P. : To meet the expected outcomes of patients, I have contributed as a good team member to respond to the changing needs. For instance, an

outcome that is expected from all post-op patients is that they are able to get up and ambulate by themselves without any assistance. This may be

difficult for some patients because they are in pain and the anesthesia is just wearing off, but for others I have seen them get up and ambulating with

no problem.

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

C.P. : Since many of the practices were beyond my scope of practice given that I am a student nurse, I always asked for assistance and consulted

with the nurses on the unit to clarify things for me to understand and gain knowledge.

Satisfactory Satisfactory
6. 4 Use teamwork, consensus building, and conflict resolution skills to meet expected client

outcomes.

C.P. : One of the most important skills to have as a nurse is teamwork. Nurses must work with everyone within the health care team (or circle of care)

in order to provide holistic, quality care. As a student nurse, I have been able to consistently develop my teamwork skills by working with others to

determine the best course of action for the patients.

Satisfactory Satisfactory
6. 5 Use effective, collaborative, and consultative strategies to meet client’s needs within a changing

environment.

C.P. : The patient needs to be comfortable with the environment that they are in. Whenever a patient needed something, they would ring their call bell

and i would answer it. If the nurse was needed, I would figure out who the nurse was and I did whatever I could to help them feel comfortable and

keep them safe.

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

C.P. : I was able to communicate with my fellow class mates, the nurses and the physiotherapy team, seeing what they do and respecting their

actions given that they all have a significant role in supporting and helping patients ambulate after surgery.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM: Work effectively as a member of the inter-
professional health care team to develop and carry out holistic plans of care recognizing age-specific changes. :

She consulted and collaborated with peers, teacher and members of the inter-professional team when carrying out health care and nursing
practice that is in the best interest of the patients.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE: Provide safe, competent care by using reflective practice and Quality
Assurance practices.

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.P. : I was able to follow my patients' wishes and supported them in whatever way they needed. I ensured that their environment was safe and

prevented harm by working with the nurses and my classmates, safely and competently. For example, from the situation I have explained above, I

was able to work with my nurse to transfer them into bed after they were left on the commode in the bathroom.
 Satisfactory Satisfactory
7. 2 Engage in ongoing reflective practice to identify strengths, areas for improvement; and, integrate

feedback into practice.

C.P. : I always seek out for feedback from my peers and instructors, as well as the nurses on the unit to take those comments that have been given

to me and use it in my practice the next time. For example, I have been told and I know myself that I need to really develop my critical thinking skills.

This is a vital skill to have as a nurse and I am doing my utmost best to gain it.

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

(CNO).

C.P. : CNO documents are crucial in the nursing profession. Its mission is to protect the public and within the documents are what nurses can do in

order to protect their patients. The documents also have everything that we need to know as nurses and I look back at them whomever I can in order

to create learning plans.

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

integrate these into practice.

C.P. : I always seek out for learning opportunities at the hospital whenever I can. For instance, when it is time to change an IV bag, I was able to

change one with guidance from the nurse. I was also able to witness two very different types of vac dressings and learned a lot as to why the patients

need it and what it was for. I also always seek out for feedback from my peers and instructors, as well as the nurses on the unit to take those

comments that have been given to me and use it in my practice the next time. For example, I have been told and I know myself that I need to really

develop my critical thinking skills. This is a vital skill to have as a nurse and I am doing my utmost best to gain it.

Satisfactory Satisfactory
7. 5 Use nursing research to foster professional development and implement nursing care plans.

C.P. : I always research evidence that is used to support nursing practices, such as the CNO documents, the nursing textbooks I have, and surfing

the net. This will allow me to further my skills as a nurse and implement appropriate care plans for the patient to provide holistic and quality care.

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

C.P. : I am able to use a theory-based approach by organizing the day to day care of patients and implement a care plan proactively. With doing so,

this allows me to be more efficient, communicate with others, and be able to reach the expected outcomes of the patients. In terms of evidence-

informed practice, I have been able to use evidence to determine the plan of care and why it is needed.

Satisfactory Satisfactory
7. 7 Apply knowledge of changes to the health care system, technology, and in society as these

affect nursing practice.

C.P. : Recently technology has really advanced. Almost everything that we do is online and human beings usually rely on it. I can be a technical

person myself, therefore I am pretty knowledgable about technology and how to work it. At first, using meditech, a computerized way of documenting,

it was difficult to use. Now that I have been able to use it more and more, I am used to all of the keys and this will allow me to document things in a

timely manner.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE: Provide safe, competent care by using reflective
practice and Quality Assurance practices. :

She is very receptive to learning new skills and is able to use feedback provided to improve her clinical practice.

8. CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING: Use critical thinking, problem solving, and decision making skills to meet the
health care needs and expected outcomes of clients.
 Satisfactory Satisfactory
8. 1 Use critical thinking and problem-solving skills to inform decision-making in all aspects of nursing

care.

C.P. : I have been able to use my critical thinking skills quite effectively. I am constantly doing my best to improve my critical thinking skills by being

able to think outside the box and determine the right actions and decisions according to the patients condition. I think that my problem solving and

decision making skills are good, but I am continually developing these skills.

Satisfactory Satisfactory
8. 2 Use critical thinking, problem-solving and decision-making skills to assess clients and to

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

C.P. : By creating concept care maps, it has allowed to me to use my critical thinking, problem-solving and decision making skills. Using these skills

allow me to determine what to do based on the client's conditions, and what is to be expected of them. I am constantly doing my best to improve these

skills continually in order to help me become a better nurse.

Satisfactory Satisfactory
8. 3 Evaluate critical thinking, problem-solving, and decision-making skills and design a plan to

improve

these.

C.P. : I have been able to use my critical thinking skills quite effectively. I am constantly doing my best to improve my critical thinking skills by being

able to think outside the box and determine the right actions and decisions according to the patients condition. I think that my problem solving and

decision making skills are good, but I am continually developing these skills.

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

provide safe and competent care.

C.P. : I constantly integrate knowledge from a variety of resources into my nursing practice to provide quality and safe care by researching evidence-

based, evidence-informed, theory-based, the decision making framework, conflict resolution strategies, applying the three factor framework.

Satisfactory Satisfactory
8. 5 Prioritize effectively.

C.P. : I am able to better prioritize my patients' needs and time manage what I need to do throughout the day to provide safe and competent care.

For example, if my patient was complaining of pain, then I would do a pain assessment and then let my nurse know. From there, the nurse would look

into the MAR and see if they have any medications that are PRN. When that is done, they get the medication, then sign it off. Pain is what the

patient's say that it is because they are the ones who are feeling it.

Satisfactory Satisfactory
8. 6 Demonstrate professionalism and accountability.

C.P. : I always hold accountable for my actions and I always act in a professional manner by showing respect to everyone. I always come to clinical

placement prepared and ready to learn.

Satisfactory Satisfactory
8. 7 Use the practice decision-making and the nurse-client-environment frameworks to inform and

guide practice.
C.P. : To guide my practice, I used the three factor framework to allow the patient to make their own decisions based on their well-being. As a student

nurse, I was able to determine what to do depending on the patient's condition and predicted the benefits and/or consequences. I am doing my best to

gain a lot of experience and knowledge from my peers and the inter-professional health care team to further my skills. It is very important for one to

learn something new everyday because this allows them to develop their skills and competency as a nurse. I have also communicated with other

nurses and asked them for consultations on their patients; for example, there was a patient's family member who asked to get the IV bag removed

because they thought that they did not need it anymore. I explained to them that I am just a student nurse and I do not have the authority to do so, so I

told them to wait and i will get their nurse for them. I was able to make decisions based on the steps in the framework in order to make the most

appropriate and safest choice based on the patient's condition.

Teacher comments for CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING: Use critical thinking, problem solving, and decision
making skills to meet the health care needs and expected outcomes of clients. :

Cathy needs more development with critical thinking skills, but continues to show growth each week.

Student Final Summary with Strategies for Continued Growth

I understand the importance of critical thinking and its role in solving clinical problems and making sounds clinical decisions. However, as a nurse, we
must constantly learn from our practice every day, reflect on them, and see what we need to do better next time. I am continually expanding my
learning experiences which allow me to develop critical thinking, problem solving, and decision making skills based on the client. These skills are the
most important skills to have in order to provide effective, safe, and quality care. I am always striving for the best and as many learning opportunities
as I can, as well as doing my utmost best to improve myself as a student nurse.

Teacher Final Summary with Strategies for Continued Growth

Strategies for continued growth will be researching on methods of communicating with patients who are nonverbal and in scenarios where language
barrier exist. With continued exposure to acute care setting and different clinical situations her nursing skills should improve.

Student's References

http://www.cno.org/globalassets/docs/prac/41062.pdf
http://hrdailyadvisor.blr.com/2013/06/24/6-steps-to-conflict-resolution-in-the-workplace/
https://bettermindbodysoul.com/effective-communication-techniques/

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