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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 : Donnamir Duario
Clinical Teacher/Preceptor : Fahim Awadh
Program Coordinator : Judy Martin
Location : William Osler Health Centre/Brampton Civic Hospital
Placement Setting : Agency
Unit/Office/Clinic : N4 Reactivation
Description : Final evaluation
Period : 05-Sep-2017 To 08-Dec-2017
Student hours : 196
Required Hours : 196
Validated hours : 196
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.

D.D. : I am able to comply with regulatory standards, relevant legislation and the practice setting policies and procedures by reading the practice

handbook provided by the hospital at the beginning of clinical and read rules and regulation in the hospital. As well as wearing proper uniform with an

ID on.

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

D.D. : I am able to act in a responsible, ethical and a responsible manner by looking up my patients charts before starting my shift and knowing what

the medication I am giving my patient prior to giving it. I am also able to respect my clients decision if they are refusing medication in a responsible

manner

Satisfactory Satisfactory
1. 3 Determine how the three factor and practice decision-making frameworks influence client care.

D.D. : Nurse, Client and environment influence my client care by making sure that I am competent on what I do as a nurse, make sure my client is

receiving care and ensure that the environment is safe.

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

D.D. : I am able to use evidence informed practice and theory based approach to care for the patient by applying the the materials I learned in class

and apply it to the clinical setting and ensure to know the rationale before doing any nursing care and give medication.

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

safe environment.
D.D. : I am able to ensure client safety by making sure that I give the 10 rights of medication before giving it, by putting the bed rails up and putting

the bed in the lowest position to avoid falls, put the call bell near the patient if ever they need to call for help.

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

D.D. : I ask questions whenever I am uncertain of a certain procedure or how a medication works to ensure patient safety.

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

unacceptable and/or unprofessional behavior.

D.D. : I able to seek for assistance whenever a situation is unsafe. For example, seeking the nurse whenever I am unsure on how to handle a

situation.

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

D.D. : I am able to demonstrate this understanding by constantly asking questions and my carefully observing the role nurses play within the health

care.

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. :

D.D. demonstrate ability to provide safe and competent care to assigned patients. D.D. managed to observe policies regarding transferring
patient from bed to chair safely.

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.

D.D. : I am able to participate in team sharing by sharing my experience with my team during post conference. Also, I share my knowledge to my

colleagues about the new medication I learned.

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

D.D. : I am able to document clearly, accurately, concisely in a timely manner by making time after I do my patient's ADL and giving medication to

document the input and output, vital signs, mental status and bedside reports before I leave the unit.

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

D.D. : I am able to report information to the appropriate personnel by reporting to the nurse i am assigned with the vital signs and status of the

patient.

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

D.D. : I am able to communicate with the staffs regularly. I am able to verbalize my patient's vital signs to the nurse at the beginning of the shift. In

addition, I am able to communicate to the nurse or the PSW if there is a concern with my patient.

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

(PHIPA).

D.D. : I am able to ensure privacy and confidentiality by not disclosing information about the patients outside of the healthcare team.
Satisfactory Satisfactory
2. 6 Use technology to retrieve and share information including research, evidence based data, and

other health information.

D.D. : I am able to use technology to retrieve and share information by using the computer and letting my peers know about what i have learned.

Example is when i told my peers about about what calcitriol was based on the research i found on the internet. In addition, I am able to use technology

to search up

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

D.D. managed to accurately documents assessment and intervention in Medtech in timely manner. D.D. had opportunity to communicate
with pharmacy department regarding missing medication.

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.

D.D. : I am able to use effective communication techniques by communicating daily with the patients and the staffs of the health care team. I am able

to report to the nurse and my clinical teacher whenever I have difficulties or if I am unsure of a procedure.

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

clients and health care team members.

D.D. : I am able to establish and evaluate therapeutic caring, compassionate, and culturally safe relationships with clients and health care team

members by making sure that i'm giving the best care possible with the clients and being respectful to the team members.

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

D.D. : I am able to demonstrate therapeutic use of self to foster client well-being by talking to the clients and addressing their concerns.

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

relational practice.

D.D. : I am able to use self awareness by reflecting on my practice and sharing my experience every clinical day to my peers and instructor. In

addition, I am able to respect the client's values when providing care.

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

appropriately.

D.D. : I am able to collaborate with clients and the health care team by addressing any concerns the clients have (ie. go to the washroom) and help

the health care team with bathing, giving medications and preparing beds. In addition, I am able to assist my colleaguea whenever they have

dressings to do.

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

D.D. : I am able to support the diversity of the clients and the health care team by being respectful to the clients and their values.

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

influencing their choices and decisions.


D.D. : I am able to display sensitivity and respect for clients beliefs by not judging their beliefs and assisting them with what they believe in .

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

D.D. : I am able to provide client education to the patient by always reminding them to stay upright for 30 minutes after they eat their food. Also, I am

able to educate my patient to sit after taking Forsavance.

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

D.D. demonstrate the ability to provide safe, competent, compassionate and respectful care to assigned patients as illustrated when caring
for patient P.

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.

D.D. : I was able to apply appropriate conflict resolution skills in therapeutic client by complying with the patient whenever they refuse medication.

However, I make sure to educate the patient the rationale as to why they are taking the medication.

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

environment.

D.D. : I was able to lead a post conference and ask everyone to share their thoughts that week about clinical. I am also able to create a positive work

environment by encouraging my colleagues to do their best when taking care of a client.

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

professional health care team.

D.D. : I am able to provide feedback to my peers thought post conference at the end of the day. Through that we were able to recap what we did that

day and i am able to accept feedback from my colleagues . In addition, I am able to accept feedback from my clinical teacher and the health care

team and use those feedback to improve my nursing practice. For example, how to make a bed properly and prepare medications beforehand.

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

D.D. : I was able to advocate for my client by asking the nurses to do not give one of my patient laxative as she had diarrhea the night before.

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

D.D. : I was able to support the clients rights by letting them become independent with their actions to promote independence. In addition, when a

client refuse their medication, I am able to adhere to their choice.

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

D.D. : I am able to respond to unsafe environment by cleaning up tripping hazards in the room. Also I am able to respond appropriately to

unacceptable and unprofessional behaviour by letting them know that I do not tolerate those behaviours .

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.
D.D. : I am able to collaborate with the health care team by always offering to help them if ever they need help. Also, I am able to help my peers too

with bathing their clients or helping the PSW by changing the bed sheets.

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

D.D. : I am able to contribute to the creation of quality practice solutions and strategies by making a sign to do BP or blood work for a patient with a

fistula on her left arm. Also, I was able to always let the nurse or PSW know whenever I am transferring a patient that is required to use a hoyer lift.

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

D.D. demonstrate leadership skills during post conference. D.D. advocate for the patients assigned to as illustrated when caring for patine
L.

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.

D.D. : I am able to incorporate client's unique needs by giving them their daily grooming necessities when ask and giving them morning care to start

the day. I also ask them if they want me to do a procedure a certain way. For example, put on clothing at a certain way different from how I put it on

them.

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

competently in writing and orally.

D.D. : I am able to develop theory based plans of care by learning how to care for my patient through the kardex and the signs in the patient's room

on how to transfer them independently with the guidance of PSW and nurses.

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

D.D. : I am able to use my knowledge to asses my clients and their priorities. For example, one of my client had a cast and I have to asses if she

could move her fingers to check if there is blood circulating in that certain part and that the cast is not too tight. Also, I hold a laxative because the

client had regular loose bowel.

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

D.D. : I am able to collaborate in the evaluation and modification of plans of care by always checking the kardex before my shift and assessing the

patient if there needs to be modification with their care.

Satisfactory Satisfactory
5. 5 Safely and competently implement and evaluate nursing assessments and nursing interventions

in a manner that demonstrates knowledge and skill.

D.D. : i am able to safely and competently implement and evaluate nursing assessments and nursing interventions by making sure that my practice

includes rationale behind them. For example, I search up my client's condition and medication before providing care to them.

Satisfactory Satisfactory
5. 6 Use the Three-Factor and practice decision-making frameworks to guide practice.
D.D. : I am able to use the three-factor framework, nurse, client and environment by checking the complexity of my patient and making sure that the

environment around me and the patient is safe.

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

resources.

D.D. : I am able to prioritize nursing care and intervention in a timely manner by doing vital signs beforehand,assisting the patient with their ADLs

before meal time and preparing medications on time. An example of this is my patient who has an anti-parkinson medicine that needed to be

administered 15 minutes before or after the time it is due.

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. :

D.D. managed to provide safe, competent care that meet clients' needs as demonstrated when caring for a patient with Parkinson diseases.
D.D. also ensure the assigned patients are ready for their Physiotherapy session on time.

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.

D.D. : I am able to collaborate with clients and the members of the health care team by regularly asking the health care team questions about the

patients to give them quality care (ie. transfer , diet). As well as observe on how they do their job to keep in mind on how i should be doing mine in the

future.

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.

D.D. : i was able to contribute a member of the inter-professional health care team to respond to the changing needs and expected outcomes of

clients by assisting in the discharge process of a patient one day before the intended date because of the family’s request.

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

D.D. : I able to seek for assistance whenever a situation is unsafe. For example, seeking the nurse whenever I am unsure on how to handle a

situation and ask for tips on how to improve my practice.

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

outcomes.

D.D. : I am able to use teamwork by collaborating with my peers and the health care team to give the patient quality care. I am able to use my conflict

resolution if ever the patient refuses their medication, I make sure that I tell the patient what the medication is for before giving up.

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

environment.

D.D. : I am able to use effective, collaborative, and consultative strategies to meet client’s needs by collaborating with my peers to care for my patient

thru changing briefs, or giving a bed bath. In addition, I help my peers on how to administer IV medications.

Satisfactory Satisfactory
6. 6 Interact with members of the health care team respecting their unique role and competencies.
D.D. : I am able to interact with the healthcare team through asking them questions and also through respecting their work and role in the hospital.

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. :

D.D. managed to effectively collaborate with other health care team members while caring for assigned 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.

D.D. : I am able to protect clients from harm through collaboration by making sure that the railways up and the bed in lowest position and reminding

my peers if ever they forget about it.I also make sure to document everything I did on my shift accurately.

Satisfactory Satisfactory
7. 2 Engage in ongoing reflective practice to identify strengths, areas for improvement; and, integrate

feedback into practice.

D.D. : I am able to engage in reflective practice by reflecting on my practice during post conference and looking back on what I did by doing the

weekly evaluations. Also, I ask my peers and the health care team if ever there is an area i need to improve on.

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

(CNO).

D.D. : I am able to create, implement, and evaluate a learning plan with the Quality Assurance program by planning my nursing practice and doing a

SMART goal.

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

integrate these into practice.

D.D. : I am able to seek out learning opportunities by being involve whenever a procedure is done (IV) or through observing the nurse if they do a

certain procedure (dressing change, blood work). Also, I take advantage whenever I am given the opportunity to change a dressing, do IV

medications, observe how Pyxis works, and transfer a patient.

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

D.D. : I am able to research to foster professional development by looking up medication and knowing what they are before giving them on the

internet and/or drug book. Also, looking up the patient's health history using Meditech.

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

D.D. : I am able to use theory based and evidence informed approach to my practice by using my nursing skills and pharmaceutical knowledge when

caring for the patient.

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

affect nursing practice.

D.D. : I am able to apply knowledge of changes to the health care system and technology by
F.A. : D.D. managed to use Tubing system to send blood sample to LAB, sending MCF to Pharmacy department requesting them to send missing

medication for patient R.

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

D.D. managed to improve in competence as illustrated by the ability to provide safe and competent care to two assigned patients.

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.

D.D. : I am able to use critical thinking and problem solving skills by being aware of certain medications critically think on why they need to take that

certain medication (ie. calcitrol needed for renal patient as they are not normally absorbing calcium). Also I am able to critical think if I should give

laxatives to my patient depending on their stool.

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.

D.D. : I am able to use critically thinking to assess clients and to determine nursing diagnoses, expected outcomes, nursing interventions, and

evaluative criteria by looking at their clinical history, and from that, think about nursing diagnoses and interventions that are seen fit in their situation.

(ie. CVA can have a nursing diagnosis of skin breakdown therefore need to be moved every 2 hrs).

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

improve

these.

D.D. : I am able to evaluate critical thinking, problem-solving, and decision-making skills by managing my time in giving ADLs and medications by

having enough time to search up what the medications mean prior to giving it.

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

provide safe and competent care.

D.D. : I am able to integrate knowledge from a variety of nursing, health, and other theory into nursing practice to provide safe and competent care

by paying attention and observing what a nurse's role is in the health care setting and how they deliver their skills to the patient to ensure they give the

best care.

Satisfactory Satisfactory
8. 5 Prioritize effectively.

D.D. : I am able to prioritize effectively by managing my time. I make sure to give ADLs and give the medication during its designated time. This is

important to one of the patient who takes a medication that needs to be given in time.

Satisfactory Satisfactory
8. 6 Demonstrate professionalism and accountability.

D.D. : I am able to demonstrate professionalism and accountability through doing my work, being respectful to the health care team and wearing my

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

guide practice.

D.D. : I am able to use the practice decision-making and the nurse-client-environment frameworks to inform and guide practice by knowing my role as

an RPN in the clinical setting. Know the complexity of my patient and their risk for negative outcome. Also, make sure that the environment is safe and

clear from tripping hazards materials.

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. :

D.D. managed to use critical thinking as demonstrated by the ability to make connection of the patient's medications, test and diagnosis.
D.D. able to make connection of INR level for patient on Warfarin therapy.

Student Final Summary with Strategies for Continued Growth

I am able to notice that I improved greatly since the first week of clinical. Before I was not confidence in doing several nursing skills, but now I am
confident to do many nursing skills thanks to the support of my peers, clinical teacher and self-determination. I am regularly reflecting on my nursing
care and will wish to develop further on my confidence and nursing skills in the future.

Teacher Final Summary with Strategies for Continued Growth

D.D. managed to demonstrate the ability to provide safe and competent care. Able to accurately document assessment and intervention in timely
manner. Demonstrate the ability to collaborate effectively with other members of health care team. Hope the knowledge you gained in this clinical will
help you in you future placement and your nursing career in general. Good job D.D.

Student's References

Nursing textbooks, clinical instruction, classmates and self-reflection.

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

It was a great experience to be able to do clinical at Brampton Civic Reactivation unit as it allowed me to improve on my nursing practice. Clinical
teacher was very helpful throughout the whole clinical to ensure that I am becoming more confident in becoming a nurse and that I am reaching all the
required criterias.