Self Assessment

2015 - 2015 - Final NURS-151 Course Learning Outcomes

NURS 151 Practical Nursing Practice 2 (PN, 13-Jan-2015 - 30-Jun-2015)
Student :
Clinical Teacher/Preceptor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Valentina Ramirez
Marilyn Daniel-Awong
John Stone
Trillium Health Partners/Mississauga Hospital
Agency
3C rehab
24-Mar-2015 To 24-Apr-2015
168
168
156

Teacher comment for validated hours:

Instructor was absent for 12 hours
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

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

Satisfactory

Satisfactory

and procedures.
V.R. : I comply with regulatory standards, relevant legislation and the practice settings policies and procedures every time I fill out a bowel
protocol form for patients who haven't had a bowel movement in 3 days.

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

Satisfactory

Satisfactory

V.R. : I act in a responsible ethical and accountable manner each time I administer patients medications at the right time. I also arrive early
and on time for each clinical day.

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

Satisfactory

Satisfactory

professionals.
V.R. : I am good at identifying my strengths and limitations and I seek help from other care professionals when helping a patient out of bed
for the first time who requires assistance.

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

Satisfactory

Satisfactory

V.R. : I use evidence informed practice and theory-based approach to care every time I raise the head of the bed to a 30 degree angle when
a patient has trouble breathing.

1. 5 Ensure client safety and a safe environment.

Satisfactory

Satisfactory

V.R. : I ensure client safety every time I lower the bed before I leave their side. I make sure the call bell is within reach and in sight. I keep
their environment safe every time I'm removing any tripping hazards (i.e. Shoes, garbage bin).

1. 6 Ask relevant questions to clarify understanding of the plan of care and whenever

Satisfactory

Satisfactory

uncertain.
V.R. : I ask relevant questions to clarify understanding of the plan of care whenever uncertain; such as asking if a patient has any set
appointments for the day (I.e. X-Ray, or other lab tests) so I know when to have the patient dressed and ready by.

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

Satisfactory

Satisfactory

V.R. : I have been able to identify ethical and unsafe situations and seek appropriate assisstance to resolve these. For example, when a
confused patient is yelling out for help and I notice that they are lying on their side and yelling because they had soiled their briefs I go and
get the nurse that is supposed to be looking after that patient to help comfort them.

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

Satisfactory

Satisfactory

V.R. : I demonstrate understanding about the role of the student nurse every time I introduce myself to the patient as a student. I also write
on their bedside whiteboard my name and indicate I am a student nurse next to it. I underestand and follow the rule that I cannot administer
medications without my clinical teacher present.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Student practices within safe and ethical framework. Makes every effort to seek out assistance when needed, to ensure safe patient
centered care.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

V.R. : I am able to participate in team sharing and discussions during every clinical conference. I am able to share my experiences about
severely ill patients that no other teammate has had the benefit of experiencing yet. For example, handling a patient suffering from severe
dementia who fails to fall within the normal limits of level of consciousness. I discussed the nursing care that I delivered to the patient
when they had refused to take their medication, and when they weren't sure about their surroundings and where they were.

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

Satisfactory

Satisfactory

methods.
V.R. : I always document clearly, accurately, concisely in a timely manner using written and electronic methods. As soon as I am done
administering a patient's medication, I initial my name in the MAR next to the right medication using a black pen. Throughout the day, I am
periodically documenting the patients vitals, findings from the head to toe assessment, and other important events in the electronic source
(sunrise records).

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

V.R. : I report relevant information to the appropriate personnel every time I go for break. I inform my patient and the nurse assigned to
that patient that I will be going for my break. I always make sure that there is a nurse on duty that can care for my patient incase the one
assigned to my patient is not available.

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

Satisfactory

Satisfactory

V.R. : I utilize communication techniques with the client and inter-professional healthcare team as I see fit. For example, after
administering prn medications to a client in pain I check to validate if they are feeling any better. This tells me whether or not their needs
have been met. I use clarification when speaking with my healthcare team. If I do not understand their request the first time I repeat it again
in my own words to make sure I do the right thing.

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

Satisfactory

Satisfactory

Protection Act (PHIPA)

V.R. : I maintain privacy and confidentiality according to the standards of the Personal Health Information Protection Act every time I place
the patients MAR back on the correct shelf. When I bring the MAR into the patients room I never leave it unattended or open for other
patients or visitors to see.

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

Satisfactory

Satisfactory

V.R. : I use technology to retrieve information including research, data and information. I've been able to use sunrise records to view data
on a patients lab results, this helps me better understand their condition. i also use the app called bookshelf to help me find information
on medications that had been newly added to my patients MAR.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Student document accurately and concisely in hospital sunrise program, and uses therapeutic techniques to enhance patient care.

3. CARING RELATIONAL PRACTICE

3. 1 Utilize effective communication techniques.

Satisfactory

Satisfactory

V.R. : I utilize effective communication technique with everyone. When it comes to patients, I am a good listener and I listen to anything
they would like to talk about whether it is about their pain or their life. When it comes to my teammates, I offer my support especially when
they are nervous in performimg a task (I.e. injecting a needle).

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

Satisfactory

Satisfactory

clients and health care team members.

V.R. : I demonstrate therapeutic caring, compassion, and culturally safe relationships with clients and healthcare team members when I
smile. It is a simple act but it shows I care. I also avoid interrupting a patient or team member while they are talking. I let the patient know
when and where I am going to touch them (i.e. When placing my stethoscope on the patients chest) so i can keep a culturally safe
relationship.

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

Satisfactory

Satisfactory

V.R. : I applied knowledge of therapeutic use of self and identified its effect on client well-being when I gave a patient a genuine response
to something. For example, when my patient was talking about owning a dog, I then mentioned how much I love dogs and that helped my
patient open up and speak more about how much they missed their dog. My patient knew I could relate to what they were feeling, since I
had my own experience with owning a dog aswell.

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

Satisfactory

Satisfactory

V.R. : I use self awareness to identify the effects that beliefs, values, and personal experiences have on relational practice by being open to
new perspectives. I know where my strengths are and where my weaknesses are, so when I notice another person giving AM care to a
patient in the washroom instead of in the bed I find out why they prefer to approach the task in that way. I've now gained some perspective
on doing a task in a new way that encourages the client to get up and help assist in their own care.

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

Satisfactory

Satisfactory

appropriately.
V.R. : I interact with clients and members of the inter-professional healthcare team; and, consult appropriately whenever I check on my
patients or see if one of my healthcare team members needs assistance. For example, when I notice my patient just came back from their
physio appointment I ask how the session went and if they're feeling fatigued and want to rest for a little bit. When the patient wants to rest,
I assist them back to their bed safely. When I notice a team member in need of some assistance while changing a soiled brief on their
patient I will lend a hand and ask what essential materials to help gather to perform the task.

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

Satisfactory

Satisfactory

inter-professional health care team.

V.R. : I apply knowledge of practices and systems that support the diversity of clients and the inter professional healthcare team every
time I show cooperative behaviour. I negotiate with others to make sure certain tasks are completed within the time limit. For example,
while I was performing a.m. care on one of my patients, they wanted to wear a hospital gown, but I informed them that they were set to be
discharged very shorty. I gave them a choice to be put in a hospital gown like they wanted and be re-dressed before they left or change
straight into their regular clothes in that moment. The client thought that dressing in their regular clothes would be more practical. When I
go for my break I make sure all necessary care for my patient has been finished so that they can be handed off to the next nurse. I try not to
leave for my break at the time a patient needs their medication.

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

Satisfactory

Satisfactory

influence clients choices and decisions.

V.R. : I applied knowledge of clients cultural, religious, and other beliefs and values as these influence clients choices and decisions by
talking to them. I engage in conversation with my patients. I had a patient who said they were Catholic and they discussed how they could
get through their pain by praying to God. This patient was spiritually content. This meant that their pain could be managed through their
faith in God. It is important for me to support their religious beliefs and values to help with their recovery.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

V.R. : I provide effective client education when I tallk to patients about the precautions of their surgery. When I am assigned patients who
just had hip surgery, I remind them not to cross their legs at any point in time. Using a pillow placed between their legs helps them refrain
from crossing their legs.

Teacher comments for CARING RELATIONAL PRACTICE :

Student demonstrate understanding of providing culturally sensitive care.
Advocates for and supports patient's decision of care.

4. LEADERSHIP AND ADVOCACY

4. 1 Recognize conflicts and strategies for resolution.

Satisfactory

Satisfactory

V.R. : I am able to recognize conflicts and strategies for resolution when patients are fatigued and overstimulated. For example, at the
begginning of my shift I took vital signs for my patient; however, they were still tired and since taking the vital signs seemed like too much
for them at that moment I was able to relax them by placing the lights to a more dim setting.

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

Satisfactory

Satisfactory

V.R. : I demonstrate leadership skills that foster group work and a positive learning environment when helping a team member who needs
assistance with their patient. While repositioning a heavy patient who needed to be placed more towards the head of the bed I asked
another one of my team members to help move the pillow up on the count of 3. This was to ensure the patients head was kept elevated
because they were having trouble breathing. As well as providing comfort during the shift.

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

Satisfactory

Satisfactory

advocating for client, self, others, and quality practice.

V.R. : I am able to identify opportunities to improve healthcare service and nursing interventions by advocating for client, self, others, and
quality practice when I bring the patient to the bathroom. Many of the bathrooms in patients rooms are tightly spaced and leave little room
for maneuvering wheelchairs or commodes. When I transfer my patient to their commode from a wheelchair I make sure to back the
wheelchair in through the doorway. This helps to avoid banging their legs or feet on any walls or surfaces. When I'm helping out a team
member and I notice they enter the patients commode or wheelchair forward through the doorway then try turning the patient around in the
tight spaced bathroom, I talk to them about the benifits of entering backwards instead. It makes the job easier for my team members as well
as provides safety to the patient.

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

Satisfactory

Satisfactory

professional health care team.

V.R. : I am able to provide feedback to peers feedback from peers and members of the interprofessional healthcare team. I have completed
the peer feedback evaluation and in return I have also received feedback from from my peers. I noticed one of my peers needed to work
more on subcutaneous injections, and ever since mentioning what they need to work on, things have improved. They are more confident
with injection administration and can asses the skin for previous injection sites correctly. The feedback I received from one of my peers
was that I should condense the information I gather about my patient so that it looks more organized and can be referred to quickly. I have
been successful in using this feedback to condense my notes and prepare them in point form. I write only the necessary information about
my clients medications and diagnosis.

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

Satisfactory

Satisfactory

V.R. : I support clients rights for self determination and choice when I assist patients with their ADL's. For example, I was assisting my
patient with putting on their clothes and their blouse had buttons, my client focused their attention on trying to button up the blouse, so I
gave them the time to finish performing this task; while, I made sure the buttons had all lined up accordingly. My client was able to assist in
their own dressing and it was important for me to allow time for them to finish buttoning all their buttons independently.

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

Satisfactory

Satisfactory

V.R. : I respond appropriately to unsafe, unacceptable, and unprofessional behaviours by giving myself some space to recollect my
thoughts. For example, when one of my patients got agitated after I asked about their pain level I moved on to letting them know I would
come back. I decided to wait and ask about their pain once they've had a bite to eat.

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.

Satisfactory

Satisfactory

V.R. : I consult and collaborate when carrying out healthcare and nursing practices that are in the best interest of the public and protect
the public through collaboration and consultation when a patient is carrying a disease that can be transmitted to others. For example, I saw
a patient, who was infected with MRSA, sitting in their wheelchair between their doorway. They were talking to another patient out in the
hallway. I contacted the nurse that was caring for this patient. I was told to keep an eye out for the two and make sure there was no contact
between them. No contact was made between the two and the infected patient receded back into their room. As a precaution, the nurse
went to the uninfected patient to make sure they performed hand hygiene.

Teacher comments for LEADERSHIP AND ADVOCACY :

Student demonstrate positive leadership role with peers, and collaborates with health care team to maintain and advocate for patient's
rights to care.

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

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

Satisfactory

Satisfactory

care.
V.R. : I incorporate the unique needs and expected outcomes into individual clients plan of care when they have special requirements for
the way they take their pills. I had a client who needed to have their pills crushed. They preferred to have the crushed pills placed into an
applesauce rather than in a liquid. I made sure to have the applesauce at hand to mix the medications in.

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

Satisfactory

Satisfactory

articulated competently in writing and orally.

V.R. : I develop theory based plans of care that are holistic and client centered and are articulated competently in writing and orally every
time I write their name down and use it. Soon after, I learn my patients name and I smile as I say it.

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

Satisfactory

Satisfactory

V.R. : I use knowledge, skill and judgment to assess clients, prioritize needs and outcomes at the begginning of my shift. For example, I
have worked with diabetic patients that needed to have their glucose reading done half an hour before breakfast, so I would check to make
sure it was taken. The glusose reading helps me establish how much insulin to give according to the sliding scale the physician writes for
them. I assess their appetite to make sure they want to eat something before I give them their dose of insulin.

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

Satisfactory

Satisfactory

V.R. : I provide information that contributes to the evaluation and refinement of plans of care as I keep track of my patients bowel
movements. I record and I report to the caring nurse about my patients latest bowel movement. I have had some patients that haven't had a
bowel movement the entire shift. When I provide information that the patient has not had a bowel movement in 3 days, it is time for a bowel
protocol. A laxative is given to my patient to assist with their bowel movement.

5. 5 Safely and competently carry out nursing assessments and nursing interventions that are
theory-based and within skill abilities.

Satisfactory

Satisfactory

V.R. : I safely and competently carry out nursing assessments and nursing interventions that are theory-based and within skill abilities
every time I am checking for vitals. For example, I was asked to monitor the oxygen saturation for a patient who was administered 1 litre
oxygen via nasal prongs; however, the machine was having troubles reading this patient's oxygen saturation, so we double checked to see
if the machine was functioning by testing the finger probe on ourselves to see if we would get a reading; we did. The patients hands were
cold to the touch, indicating low circulation. The next step I took was to warm up the patient's hands using my hands, so that the machine
could have a better chance at reading their vitals. This technique worked and I repeated this process every five minutes or so, until the
patient reached a satisfactory oxygen saturation level.

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

Satisfactory

Satisfactory

V.R. : I carry out nursing care that reflects the practice decision-making framework every time I need to administer certain medications that
connot be taken with other medications. For example, I have cared for several patients who were prescribed a calcium supplement at
1000hrs and their iron supplement at 0800hrs; however, breakfast comes at 0800hrs and I know that iron absorbs best on an empty
stomach and that if taken with calcium it would interfere with iron absorption in the body. In this case, I give the calcium supplement at
breakfast and wait 2 hours until I can administer their iron supplement.

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

Satisfactory

Satisfactory

timely manner.
V.R. : I complete nursing care responsibilities and nursing interventions in an organized and timely manner every morning before
breakfast. For example, I make sure to check on my patient and introduce myself. The patient is still in bed and this gives me a good
opportunity to check all their vital signs. After I'm done checking ther vital signs, I assist them with their toileting. Breakfast should be
arriving any minute now, so I leave myself time to prepare the 0800hrs medications, especially the ones that need to be taken with food.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Student seeks out opportunity for learning, collaborates with clinical instructor to evaluate care planning for patients to ensure safe and
competent practice within a timely manner.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

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

Satisfactory

Satisfactory

clients, determine health needs, and to achieve mutually agreed expected outcomes.
V.R. : I am able to work with clients and members of the inter-professional healthcare team to assess clients, determine health needs, and
to achieve mutually agreed expected outcomes. For example, I was assisting a nurse with a patient who developed edema in their lower
extremities. We moved the patient from their wheelchair into the bed so that we could elevate their legs and prevent further swelling. We
placed a pillow under the feet of the patient to help with draining the fluid back towards the upper body. At first, the patient shook their
head, indicating that they didn't want the pillow, but after the nurse and I explained how it would help reduce the swelling they agreed to
leave it.

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

Satisfactory

Satisfactory

changing needs and expected outcomes of clients.

V.R. : I contribute as a member of the inter-professional health care team to respond to the changing needs and expected outcomes of
clients who are slowly recovering. For example, I had a patient who was deemed incontinent in their charts, but when I started my shift I
noticed they were fully independent when going to the washroom. The occupational therapist came in that morning to assess the patients
performance on ADL's. The OT informed me to encourage the use of the patients new assistive devices throughout the day. I made sure
they were kept in arms reach for the patient at all times.

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

Satisfactory

Satisfactory

V.R. : I seek out assistance and consult with members of the inter-professional health care team when administering prn medications. For
example, I had a patient who had severe pain in their leg, so I proceeded with a plan for pain intervention. I checked their MAR for any prn
medications prescribed by the physician. I noticed one opiod prn medication that would increase the pain thresh hold for the patient, so I
confirmed my results with another nurse and made sure it was the best suited form of pain relief for this patient.

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

Satisfactory

Satisfactory

V.R. : I use teamwork, consensus building, and conflict resolution skills when dressing a wound on a patient. For example, I was working
with a patient who suffered a stroke on their left side. I was preparing to do a wound dressing change to an area on their affected side. It
started bleeding because they accidentally banged it. The patient then asked if they could receive a different type of dressing, rather than
the clear tegaderm dressing because they felt the wound would be better protected with something thicker. They also diddn't like how the
tegaderm dressing was so adhesive upon removal; they were worried the wound would bleed more. I told the patient the reason for the use
of the tegaderm and that it was beneficial to see the wound if it ever started to bleed again. To satisfy the patients inquiry even further I
asked my clinical teacher if there was another dressing that could be used. As my clinical teacher assessed the wound she was able to
further help the patient understand that a thicker dressing was not necessary. The patient became content with me using the tegaderm
dressing as protection for their wound.

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

Satisfactory

Satisfactory

a changing environment.
V.R. : I describe effective, collaborative, and consultative strategies to meet clients needs within a changing environment when a patient is
drinking water in bed. For example, I assisted a client with their water by holding the straw up to their lips. The patient started to cough, so
I informed my peer to elevate the head of the bed from a semi fowlers postion into a high fowlers postion. The patient quickly regained their
composure and was able to continue drinking.

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

Satisfactory

Satisfactory

competencies.
V.R. : I interact with members of the health care team respecting their unique role and competencies. For example, I had the pleasure of
meeting one of the housekeepers who was on duty during my shift. They were about to make a patients bed, and I asked if I could assist.
They taught me how to make the bed according to the hospitals requests. I learned how to make the bed look inviting to a patient by neatly
folding the blankets in a specific way.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Student demonstrated understanding of the importance of team work and working with inter-professional team to enhance patient centered
care.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

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.

Satisfactory

Satisfactory

V.R. : I act in the best interests of clients and protect clients from harm through collaboration and consultation with members of the inter
professional healthcare team and through competent and safe practice every time I get help for patient transfer. For example, I had a
patient who needed to be transferred to the commode so they could use the bathroom. It was a 2 person assist, so I told them to wait so I
could get another colleague of mine to assist. Together we transferred the patient safely and got them to the bathroom in a timely manner.

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

Satisfactory

Satisfactory

V.R. : I participate in self reflection to identify strengths, area for improvement every semester when I fill out my goals in my QA program
learning plan form. I also had been identifying areas of improvement. For example, being more efficient at changing a patients incontinent
brief.

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

Satisfactory

Satisfactory

program (CNO).
V.R. : I create, implement, and evaluate a learning plan consistent with the Quality Assurance program (CNO) for each semester. I have
been able to improve my practice through the important feedback of my peers. I strengthen my weaknesses as I practice on family
members and re-read modules or chapters on evolve.

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

Satisfactory

Satisfactory

integrate these into practice.

V.R. : I seek out learning opportunities and feedback that foster professional development; and, integrate these into practice. For example,
I wanted to do well in charting electronically, so I asked a nurse if I could see how they entered in their data. I received a better
understanding on how they worded their clinical notes. I was able to learn how to word the events that took place with my patient.

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

Satisfactory

Satisfactory

V.R. : I utilize nursing, health and other theory and literature to improve nursing practice every time I review my e-books. I incorporate my
simulation modules in my learning to review videos, such as performing a wound dressing change, when I know I am going to perform that
task on a patient the following day. I make sure I do my best to come prepared for my patient.

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

Satisfactory

Satisfactory

V.R. : I use a theory-based approach and evidence-informed practice with patient transfers. For example, when transferring a patient into
their wheelchair I make sure I bend my legs instead of using my back to lift the patient from the bed. This will prevent me having any
musculoskeletal injuries.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Student utilize self reflective practice to enhance care, seek out new learning opportunities, and inform best practices.

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

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

Satisfactory

Satisfactory

V.R. : I utilize problem solving skills to inform decision making in all aspects of nursing care. For example, I had a patient who was
complaining of itchy skin on one of their lower legs, so I asked another nurse if there was a specific cream I could apply that would relieve
my patients itchiness. I was directed to the cream and I applied it to my patients lower leg using gloves. After the cream was applied, the
patient felt a lot more comfortable and was able to rest without the sensation of wanting to itch.

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

Satisfactory

Satisfactory

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

V.R. : I use problem solving and decision making skills to assess clients and to determine nursing diagnosis, expected outcomes, nursing
interventions, and evaluative criteria. For example, I have been assigned many patients who have suffered hip fractures and I expect for
that patient to have weakness on the affected side. I make sure to move the patient according to hip precautions during an incontinent brief
change. I roll the patient onto their unaffected side and support the weakened leg during the shift, to avoid any pulling on the staples of the
surgical incision.

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

Satisfactory

Satisfactory

skills.
V.R. : I use self reflection to design a plan to improve problem solving and decision making skills especially with diabetic patients. For
example, when I am caring for a diabetic patient I make sure I organize myself according to their diabetic needs (I.e. Insulin taken on time
and 15 minutes before meals). There had been a time when the food should have arrived in the patients room, but the service ended up
coming late. I made sure not to administer the insulin until I was sure their food tray was coming.

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

Satisfactory

Satisfactory

to provide safe and competent care.

V.R. : I utilize knowledge from variety of nursing, health, and other theory into nursing practice to provide safe and competent care every
time I assist in a bed bath for a diabetic patient. For example, after I have finished washing both feet on my diabetic patient, I make sure I
dry them thoroughly to decrease the risk for any fungal infection. This risk is especially higher for diabetic patients because they are prone
to nerve damage and peripheral vascular disease which will interfere with the healing process to any skin breakdown on the foot and cause
infection; therefore, attention is needed.

8. 5 Use prioritization strategies for client care.

Satisfactory

Satisfactory

V.R. : I use prioritization strategies for client care as I prepare my organizational daily plan for the day. I make sure to write down all of the
patients medications for that day, as well as the times they will be given at. For hypertensive medications I am sure to check the patients
blood pressure prior to administration of the drug.

8. 6 Demonstrate professionalism and accountability.

Satisfactory

Satisfactory

V.R. : I demonstrate professionalism and accountability the moment I arrive on the hospital grounds. For example, I always wear my
outside shoes on my way to work, then change into my scrub shoes at the hospital. I am reducing the amount of outside bacteria trekking
into my unit, and vice versa. I always greet the nursing staff as I arrive onto the unit and I have been punctual for every shift.

8. 6 Recognize strengths and limitations and seek appropriate assistance and support.

Satisfactory

Satisfactory

V.R. : I recognize strengths and limitations and seek appropriate assistance and support. For example, I feel that I need to work on getting
to know my patients by being confident in starting conversations. I had asked a few of my peers if I could listen to how they conversed with
their patients. I later found myself merged in their conversation. It was therapeutic for all of us to be talking, even if it was a topic as minor
as the weather or schooling. I was able to initiate conversations with my clients after reviewing my peers techniques. I had one patient who
opened up to me about their religion. It played a big role in their recovery. They had relied on their prayers to ease their pain and get them
through this time in their life.

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

Student demonstrate understanding of critical thinking when organizing and evaluating care provided to patients.

Student Final Summary with Strategies for Continued Growth

I will continue to read my nursing books, and go over learned materials so that I can practice my technique. There are a few things I would like to
strengthen this semester including being more efficient at changing a patients incontinent brief and building my nurse- client relationship by listening
and talking. I will continue to deliver care safely and within a reasonable time frame by keeping up with my readings and preparing organizational daily
plans. If I do become unsure of a task or situation I will not be hesitant to seek help.

Teacher Final Summary with Strategies for Continued Growth

Student has demonstrated significant professional growth during this semester, however, need to continue connecting theory to practice as she
progresses to next semester.

Grade

Satisfactory

Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

Grade

Satisfactory

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 have learned from this experience and I will continue to improve my practice and come prepared for clinicals.