Student Name:

Micah Finney

Southwestern Oregon Community College Nursing Program

Nursing 222
Foundations of Nursing: Acute Care II

Clinical Evaluation Tool

The purpose of the weekly clinical performance evaluation tool is to provide feedback about achievement of the course outcomes and
competencies and to assist the student to meet the standards of care for nurses in Oregon as outlined in the Nurse Practice Act.
Explanation of Rating Scale:
(S) Satisfactory = Clinical performance is safe and student adequately demonstrates application of the nursing process/clinical judgment,
required skills, and expected synthesis of learning appropriate to level in the program. Verified by direct instructor observation.
(NI) Needs Improvement = Indicates that additional learning and attention to detail is required for a particular item or that the overall
performance for the week is at a minimum level. The instructor will write an explanation of the rating on the comments page.
(U) Unsatisfactory = Clinical performance is unsafe and inadequately demonstrates application of the nursing process/clinical judgment model,
required skills, and expected synthesis of learning appropriate to level in the program. The instructor will write an explanation of the rating on
the comments page.
(NA) Not applicable = Particular item does not apply to the clinical performance.
(NO) Not observed = Instructor did not observe or has no knowledge of the students performance of the activity.
Students with a grade of NI or U will be required to meet with their advisor and clinical instructor and discuss a plan for change in their behavior
before their next clinical experience.
Safety and legal/ethical concepts are considered critical to the profession and will be graded as NI or U if any violation occurs.
If a student is assigned a U or NI for two weeks, the faculty will review the students clinical performance and consider the options of either
placing the student on probation or dismissing from the program.
In cases of potential failure, notification of the student by the instructor that she/he has been assigned a grade of U or NI for one week
constitutes proper warning of the grade status.
If a student is placed on probation and then receives a grade of U, the faculty will review the students performance and determine whether or
not the student will be dismissed from the program.

Nursing 222 Clinical Evaluation Tool

Student Name:

Competency
(C)
Course
Outcomes
(CO)

Clinical Week
1

Dates

10/9

10/
16

10/
23

10/
30

11/3
6

11/
13

11/
20

Attendance: P=Present, A=Absent, T=Tardy

ED

MCU

ICU

Facility/Unit
C9
CO1,2, 5

IMC APU REU PSU

HOL 12/4

Applies concepts and theory to clinical practice in client care and

written assignments:
1. Conducts evidence-based assessment, using age, developmental
and culturally appropriate communication skills

1. Collects and monitors a variety of data

1. Analyzes and interprets the data/assessment findings in

increasing complex acute conditions.

1. Recognizes pathophysiological changes and symptoms

1. Regularly monitors clients level of comfort and ability to

manage symptoms and symptom distress

1. Prioritizes health problems.

1. Develops and uses evidence-based individualized interventions

Make-up

CO4
C8

1. Develops a plan of care that considers the individual, family, age

of client, developmental stage, psycho-socio-cultural issues,
and/or learning needs.

1. Evaluates and reflects on plan of care for clients with acute

conditions.

Develops discharge plans in collaboration with client, family, and

other members of the health care community.

Uses therapeutic communication with patients and agency staff.

NA

C 6,7,8
CO1

Recognize cultural issues and interact with clients in culturally

sensitive ways.

C5
CO3

Collaborates with other members of the health care team to provide

comfort and symptom management.

Uses research and evidence to support clinical decision making.

Utilizes resources as needed.

Able to identify/define leadership skills for nurse's role

Exhibits critical thinking skills when prioritizing and delegating

patient care.

C10, CO2
C6, CO
C4
C9
CO1

Make-up

C9, CO1

Demonstrate responsibility and accountability for professional

behavior:
1. Performs safely in clinical.

C3

1. Prepared for clinical (Appropriate attire, appropriate tools such

as stethoscope, skills list, evaluation tool, assessment tools).

C4

1. Takes initiative in making decisions and assuming responsibility

for decisions.

C3

1. Looks for opportunities for continued learning and selfdevelopment.

C4

1. Identifies behaviors and attitudes influencing professional

behavior.

C1, 2

1. Demonstrates growth in coping with stressful situations in a calm

and dependable manner.

1. Maintains patient confidentiality.

1. Documentation of client care is accurate and relevant and

consistent with agency policy

1. Completes and submits assignments on time.

1. Organizes and manages time effectively.

1. Attends and participates at post-conference.

JT

JT

JT

JT

JT

JT

JT

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C1
C8
C3
C2
C4

Instructor Initials
Student Initials

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Key: C=Competency, CO=Course Outcome

Week

Instructor include comments that are positive, areas that need improvement or are unsatisfactory. Reference the course
outcomes listed in the syllabus and/or the OCNE Competencies from the Nursing Student Handbook (Date/Sign all entries)

Student Initials

mf
Micah, it is nice to have you back in clinicals. Working as a CNA at BAY has definitely increased your confidence
level. I appreciated your input on your nursing diagnoses. I watched you help other staff on the floor and answer
call lights thus collaborating with the health care team (competency 5). You may find it difficult to be in the nursing
student roll with staff, as they know you as a co-worker. Just a suggestion, do not let them use you as a tech and try
to remain in the roll of a nursing student. Nice job this week, you did well.
Jenny Tausch RN MSN PCCN

mf
Being in the acute psych unit is defiantly a change from the other nursing units. When I came onto the unit, you
were visiting with your patient in a very relaxed therapeutic manner (competency 7). The nursing staff stated that
you did well and that they enjoyed having you on the unit. I noticed in your reflection that it sounded as if you were
feeling a little less than fully confident, you can do this and you can increase your confidence level. Micah, you do
well in the clinical setting and are growing as a student.
Jenny Tausch RN MSN PCCN

Micah, you did such a good job at starting that IV! I felt that you were apprehensive at first, and a bit nervous, but you got it
mf
the first attempt. I hope this was a confidence booster for you. Whenever I rounded on the unit, I found you helping the other

staff, answering call lights, and looking for things to do (competency 3). While this is wonderful, ensure that you are caring for
your assignment and getting your tasks completed. Your interventions were appropriate and your care plan was complete, I
had very few comments. You had a nice experience this clinical rotation; I hope that you continue to have great times.

Jenny Tausch RN MSN PCCN

mf
Micah, I feel that you had a good clinical experience this week. I noticed that you were looking for things to do and
new skills to practice, this demonstrates competency 3, intentional learning. Be cautions here, that you do not
overlook the things that you need to do, check offs and practicing skills are great, just ensure that your responsibilities
are met. I also noticed that you were making the patient feel comfortable and developing a rapport with her easily.

Jenny Tausch RN MSN PCCN

Micah, I truly enjoyed reading your reflection from the ED. I noticed that you looked back on your own practice and mf
put some thought into why the patient responded how he did (competency 2). It sounds like you had a wonderful
learning experience and got to be part of the ED trauma team. I feel that rotating through the ED does provide
students with a bigger picture of how the hospital runs. I am pleased that you had a good time. The debriefing would
be a wonderful opportunity for you to experience. This week I really didn't see any particular area that you needed to
work on, so continue looking for ways to improve your practice and your skills.
Jenny Tausch RN MSN PCCN

Micah, it sounds like you had a couple of complicated patients, and that you were able to care for both of them. I did
notice that you were providing assistance and input to another student demonstrating again your ability to meet
competency 5. It seems like you are having some trouble with your electronic equipment, and being able to send me
your assignments, try to work on that You are doing very well in clinical, and I hope to see more out of you.
Jenny Tausch RN MSN PCCN

Instructor out

Holiday

Micah, I have really enjoyed watching you grow as a student over the last couple of years. You are always willing to

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practice skills and help on the floor. This week in ICU, you cared for a fairly sick patient and was able to work with
the other ICU nurses well. This demonstrates competency 5. I hope that you feel like you learned a lot this term, and
that you enjoyed it as much as I did. Good luck next term, I know you will do great.
Jenny Tausch RN MSN PCCN
Clinical
Make-up

9/2/09: revised 5/06/11 sw