NURSING 3020 Clinical Evaluation

NURS 3020H

Clinical Evaluation

Midterm

Student Name: Alicia Jeffery

Clinical Instructor: Holly Grieder

Missed Clinical Hours: 0 Missed Lab Hours: 0

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Program Goals
Graduates are generalists entering a self-regulating profession in situations of health and illness.

Graduates are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a
variety of settings.
Graduates continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their
practice.
Graduates will demonstrate leadership in professional nursing practice in diverse health care contexts.

Graduates will contribute to a culture of safety by demonstrating safety in their own practice, and by identifying, and mitigating risk for
patients and other health care providers
Graduates will establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based
upon relational boundaries and respect.
Graduates will be able to enact advocacy in their work based on the philosophy of social justice.

Graduates will effectively utilize communications and informational technologies to improve client outcomes.

Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed
interventions and outcome measures.

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Progress
Objectives Developing Needs Does not meet
Indicators/Evidence as expected Improvement expectations
1 Prepared to provide - I completed my preclinical tools thoroughly so
nursing care that includes that I knew what each patient would need and
comprehensive,
so that I could be prepared to demonstrate new
collaborative assessment,
evidence-informed skills if needed. I used my textbooks and the
interventions and internet to look for this information. Ex. My
outcome measures. assigned patient had a tracheostomy and a G-
tube so I researched how to do tracheostomy
care and how to flush a G-tube before clinical. I
did this so that I would have some prior
knowledge before observing it being done, or so
that I could do it supervised.
- Identified that I needed to practice my head-to-
toe assessments (due to not having ever done
one on a patient before and not being fully
comfortable doing one). I took initiative to make
this a goal of mine and read over sample head-
to-toe checklists, watch videos of nurses doing
them and practice on friends to improve this
skill.
- Researched different characteristics of wounds.
Including types of exudate (purulent,
sanguineous, serosanguineous, fibrinous), stages
of pressure ulcers and what maceration means.
Maceration is the softening and breakdown of
the skin surrounding a wound which occurs from
prolonged exposure to moisture.
- Researched what needles to use when. The

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gauge of a needle tells you the diameter of the

hole where the medication comes out. Smaller
guage indicates a larger diameter. For IM
injections, it is recommended that you use a 21
or 23 gauge needle that is 1-1.5inches long. For
subcutaneous injections, it is recommended that
you use a 25 or 27 gauge needle that is 3/8-5/8
inches long.

2 Establishes and maintains - Learned alternative ways of communicating with

therapeutic, caring and patients when there are certain barriers to
culturally safe
communication. Ex. One patient had vocal cord
relationships through
effective communication. paralysis, so I tried using mostly yes or no
questions (so they could nod yes or no) and
adapting to his chosen method of using a
whiteboard to communicate longer sentences.
- Communicates with peers, clinical instructor and
nurses on the unit effectively. Asks for help
whenever necessary (ex. If I need an extra assist
or help with a bath or help with a new skill).
- Asks nurses if they need any help whenever I
have free time. This enables me to
experience/see more things each clinical shift
and can enable nurses to have time to do other
things (ex. Charting, giving meds).
- I give and receive report to/from the nursing
student who is assigned my patient. I ask the
other student questions to clarify whenever I’m
unsure about something they have said and ask
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questions whenever I feel that I need more

information (ex. If they forget to include if the
patient gets up independently to go to the
bathroom, etc.). After giving bedside report, I
always ask the next student if they have any
other questions before I go and I make sure that
I have introduced them to the patient. I also
make sure that the patient has everything they
need before I leave the unit at the end of my
shift and I tell the nurse that I’m leaving.
- Reassured patient by holding her hand and
talking to her while another student
administered an IM injection.

3 Applies the four ways of - Used personal knowing to set goals for myself
knowing and during this clinical experience this term. I have
informational
also thought about ways to reach these goals.
technologies to
effectively care for Once I have met goals, I have come up with new
diverse, acutely ill goals to replace these met goals.
patients. - I engaged in reflection to write my first journal.
This enabled me to think about what I had done,
think about why I felt the way I felt in the
situation and enabled me to come up with ways
to improve. This can improve the patient’s
experience.
- I have used personal and aesthetic ways to
knowing and I have acknowledged that I have
misconceptions about how patients feel about
being in the hospital. I used to think that most

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patients would want to leave the hospital as

soon as they could but I have come to realize
that some patients do not want to go home.
- I use technology to research new skills. I use the
internet to look up how to do these skills and I
use Youtube to watch videos about how to do
skills.
- I ask my clinical instructor, peers and nurses
questions when I don’t understand things. I have
also asked my clinical instructor to teach about
proper needle/IV selection during a post-clinical.
- During one clinical shift, there was a patient who
fell. I remembered that other students had
talked about there being a lot of paper work that
needed to be filled out when a patient falls in
the hospital. When I told this patient’s nurse
about the fall, she was busy and it seemed like
the nurse thought that the paper work was not
the most important thing for her to do. Using an
ethical way of knowing, I realized that it would
be unethical to not fill out the paper work. It can
be difficult as a nursing student to say something
to nurses when you disagree with them, but I
knew this needed to be done so I reminded her
multiple times during the shift and asked to look
over the paperwork when she had completed it
so that I would know what the paper work
entails in the future.

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4 Adheres to professional - I submitted all pre- and post-clinical tools on

practice standards and time each week. The forms were complete and I
organizational polices to
used resources (our textbooks and the internet)
contribute to a culture of
safety. to engage in new learning when a patient had a
diagnosis, test, etc. that I had never encountered
before.
- I always was ready on time, in uniform and
prepared for all labs and clinical shifts.
- Always lowers patients’ beds and ensures the
call bell is within reach before leaving their
room. Tidies rooms and removes trip hazards.
Ensures assistive devices (such as walkers and
canes) are within reach.
- Disposes of sharps into sharp containers in both
the clinical setting and in labs.
- Maintains confidentiality and disposes of any
papers with patient information into the
shredder box before leaving the unit.
- Always gets help from peers when a patient
needs more than one assist for ambulation.
- Uses proper ergonomics when demonstrating
tasks to ensure my own safety.
- Used proper landmarking and technique when
administering an IM injection in the deltoid
muscle. 2 fingers down from the bone at the top
of the arm, without squeezing the skin.
- Uses correct isolation precautions and correct
donning and doffing. Contact precautions: gown
and gloves, droplet precautions: gown, gloves

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and mask with goggles. Correct donning order:

gown, mask, goggles, gloves. Correct doffing
order: gloves, goggles, gown, mask.
- Washes hands at the four moments for hand
hygiene (before entering the room, before an
aseptic procedure, after bodily fluid exposure,
and when leaving the patient’s room).
5 Exercises leadership to - Asks peers how I can help them, especially when
enhance patient care, they look busy and I am not. I support peers and
and support
offer suggestions whenever they ask for ways to
professionalism in
practice. improve/do things differently. For example,
when doing bed baths with peers, I try partner
with a peer who has not worked as a PSW
before. I try to support them and help lead them
through it so that in the future, they will
hopefully be more comfortable. I also try to
show them little things that I like doing (like
using the soapy water to get the EKG stickers off
patient’s skin without hurting them).
- I make myself available to help my peers and
other staff with AM care once my patient’s care
has been completed.
- When my patient was discharged, I found a new
patient for the next nursing student. I
researched his diagnoses, medical history and
drains, IVs and medications so that I could give
bedside handoff to her. This also helped the next
student to have a new assignment when arriving
at the unit and since I had done the extra work,

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she did not have to research things once she

arrived.
- During one shift, I was present with another
nursing student when a patient had a fall. I took
the lead by calling a nurse for help and by
reassuring and checking on the patient. I also
made sure that the nurse had enough
information to fill out documentation as per
hospital policy about the fall.

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

Alicia always shows up for clinical early and prepared. Her assignments are always well done and on time. Alicia remains
professional while interacting with the patients and her co-workers. She completed a thorough head to toe assessment on a
patient not missing any parts of the assessment. Before completing any tasks, Alicia will research the skill and the related risks.
While at clinical Alicia works well as part of the team supporting the other students when they require assistance. Alicia has
show professionalism and leadership many times. For example sharing the nursing skills that occur with the other students.
I have received a great deal of positive feedback from the staff regarding Alicia’s care and eagerness to help. Great work!

Signature of Instructor___________________________________________________ Date _____________________________

Signature of Student_____________________________________________________ Date ______________________________