NURSING 3020 Clinical Evaluation

NURS 3020H
Clinical Evaluation
(Check one) Midterm ________ Final _____x_______
Student Name: __Emma Cumming__________
Clinical Instructor: _Ashley Finnegan_________
Missed Clinical Hours: ___0___

Missed Lab Hours: ___0___

NURSING 3020 Clinical Evaluation

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.

Objectives

NURSING 3020 Clinical Evaluation

1 Explain the experience of acute illness in individuals
receiving care in acute setting

2 Interpret critical aspects of the persons experience of acute

illness in relation to common signs and symptoms,
responses to treatment, patterns of coping, and impact on
individual and family relationships

3 Identify common medical treatments and potential

consequences/complications of selected acute illnesses

Progress
Indicators/Evidence
One of the most important things I found through the clinical experience, is how different
the hospital experience is for many patients compared to living and dealing with illness at
home. Being in the hospital completely disrupts the patients normal routine of daily
living, ultimately making it harder for them to transition through their stages of illness.
Many of my patients simply want to return home to comfortable surroundings, where they
can be with loved ones, and have the comforts of home easily accessible, such as their
own bed, showers, soaps and hygiene products, and to simply just be in familiar
surroundings. Having to adjust to new smells, sounds, sites, and situations such as sharing
a room with a stranger, having vitals being taken every few hours, and having pain from
surgery can be overwhelming for patients, especially for patients who may have lessdeveloped coping mechanisms. As a nursing student, I am able to provide care to patients
to enhance their comfort, ultimately allowing them to focus on their recovery process. I
also try to relieve the stress and anxiety around being in a new environment, by explaining
procedures, expectations, and expected outcomes, as well as by ensuring my patients that
they will be ok, and that they are in good hands with the staff at the hospital.
Common signs and symptoms associated with acute illness include: pain, swelling,
inflammation, immobility due to injury, confusion and disorientation due to medication,
irregular vital signs, edema, fever, and the onset of secondary conditions (such as hospitalborn issues like C. difficile and pneumonia). Lab tests, vital sign checks, and head-to-toe
assessments are common aspects of care for these patients, along with basic care, such as
feeding, helping to ambulate, and am/hs care. If you tell the patient why they are getting
the treatment, why it is important, and how it will benefit them in the future, generally
they tend to be more welcoming to experiencing the treatment. For example, many
patients do not want to be mobile after their surgeries, however, if you explain to them that
they are allowing their muscles to not catabolize, preventing DVT, and potentially
allowing themselves to return home faster, many are more motivated to make the behavior
change to mobilize their sore joint. There are many coping mechanisms that patients tend
to do, often using pharmacological interventions such as pain medications and anti-emetic
medications post-operatively, as well as non-pharmacological coping mechanisms such as
warm blankets, ice packs, and deep breathing. Patients seem to cope better in a supportive,
caring environment, with multiple levels of support, including nurses, family members,
doctors, and physiotherapists working together to care for them. The acute experience has
an impact on the individual themselves, through the pain/discomfort/loss of independence
they experience, and their family relationship, as they may depend on family more than
ever to help with their basic needs (mobility, hygiene, daily tasks).
Lab tests are usually conducted to assess the patient, and how their body is responding to
the acute trauma. Numerous lab tests are done when patients come in, especially unexpectantly for surgery, such as testing for CPK and Troponin levels, to see if they have
damaged cardiac or other cellular tissue after car accidents or falls (often to determine the
cause). Other lab tests include testing blood cell levels to determine
infection/thrombocytopenia (CBC), liver function, kidney function (for medication
administration), and electrolyte levels, to see how the body is responding to the fluid (if
the person needs more fluids via IV or oral consumption). Common medical treatments
given to patients post-surgery include: inserting a catheter to void urine post-surgery, IV
fluid administration, PCAs, hemovac drainage, oral medications for pain once the PCA is
discontinued, wound care, NG tube care, oral care, and physiotherapy. These treatments
and interventions help the patient to recover as quickly and comfortably as possible. Some
complications or consequences associated with post-surgery patients include: infection,
pneumonia (associated with fluid accumulation in the lungs, because of immobility or
prone to infection individuals), DVTs (due to clotting generally in the lower legs), loss of

S U
x

NURSING 3020 Clinical Evaluation

Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)
Emma has progressed very well throughout her acute illness placement. Emma is able to assess, provide care and document for two or more acutely ill
patients. Emma has a background of knowledge and skill in working with families and children with disabilities. Her experience also allowed her to
have ease with developing therapeutic relationships with her patients and family members.
Emma always came to clinical prepared, on-time and was never absent. Emma completed pre-clinical work which allowed her to research and
demonstrate understanding and plan care for her patients ensuring safety and proper care of her patients. If Emma came across anything in pre clinical
work or while in clinical she was always sure to seek clarification from myself, staff or peers. This demonstrates her commitment to learning as well as
working within her scope. During assessments Emma was always sure to inform myself and staff of concerns over abnormal vitals or assessments of
pain or level of consciousness, demonstrating her ability to work within her scope and notify of concerns demonstrating her understanding of the
acutely ill patient.
Post clinical work is completed in timely manner. Post clinical work demonstrates ability to reflect on shifts and care provided. Post clinical work
demonstrates understanding of acutely ill patient and how to incorporate theory into care practices. Although sometimes post clinical assignment may
not pertain to her patient Emma was able to utilize information and experience as a means to further understand lab values and diagnostic tests.
Emma has been able to complete several tasks this semester including simple dressing changes, catheter insertion, removal of IVs, pre and post
operative care, IV therapy maintenance and medication administration, maintenance of patient with catheter and discontinuation of catheter. Emma was
able to complete a med pass safely utilizing 3 checks and 8 rights. Emma was able to assess for nausea/pain and provide appropriate medications and
documentations for her interventions related to medication therapy.
Emma maintains a safe work environment for her patients, peers and staff by ensuring to follow infection control measures ie. Proper disposal of bodily
fluids, performing hand hygiene ensuring to utilize proper PPE and adhering to personalized equipment for patients and cleaning equipment between
patients.
Emma is able to self reflect and note areas of improvement in her care. She receives feedback in a positive manner and is able to incorporate feedback
into her care. Emma seeks feedback and receives it in a positive manner ie. Sterile technique with catheter insertion.
Emma is a great team member and always willing to assist others. She portrays and maintains a positive manner and demeanor at all times at clinical.
Even with faced with uncomfortable situations Emma maintained professionalism. Staff commented on Emmas get the job done and positive
mannerisms at clinical.
I wish Emma all the best in her future nursing practice.
Ashley Finnegan

Student Areas of Strength

4

NURSING 3020 Clinical Evaluation

1. Patient- Nurse Therapeutic Relationships- I believe a strength of mine was being able to develop
mutually therapeutic bonds with my patients, allowing for more holistic, therapeutic care,
ultimately enhancing their recovery process. I believe that I made all of my patients feel
comfortable, and that I was able to brighten their days, even when they were in not-so-good
moods.
2. Head-To-Toe Assessments- Throughout this clinical placement, I performed many head-to-toe
assessments, which I think are now a strength of mine. I feel completely confident entering into a
patients room, and performing a competent, complete head-to-toe assessment, to gather
information needed for care.
3. Documentation/ Charting- This placement was my first time actually charting on patients,
however I feel as though my documentation and charting skills flourished throughout the
semester. I feel confident in my abilities to chart accurate, detailed information, that will benefit
the other staff on the floor.
Student Areas for Future Development
1. Medication Administration/Knowledge- I struggle to remember the different names of the
medications, and often mix up what medications are responsible for what action (when I do not
check them with a reference). I need to work on knowing my medications, especially entering
into my chronic and pre-consolidation placements.
2. Sterile Field Wound Changes- I am slow still at sterile field wound care changes, and I believe with
more practice in the future that I can become proficient in this skill.
3. Catheter Insertion- I was only able to do one catheter insertion and three removals during this
clinical placement. I still do not feel 100% confident inserting a catheter (especially on a female
patient since I only ever did one on a male). This is a skill that I need to become proficient in, to
excel in my nursing practice.
5

NURSING 3020 Clinical Evaluation

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

Attendance
Week
Week
Week
Week
Week

1
2
3
4
5

Thurs
x
x
x
x
x

Fri
x
x
x
x
x

Week
Week
Week
Week
Week

Thurs
x
x
x
x
x

6
7
8
9
10

Fri
x
x
x
x
x

Total number of clinical hours completed____160_______

Clinical Component
Clinical Learning Center

Satisfactory
Completed

Unsatisfactory
Not completed

Signature of Instructor____________________________________

Date_______________________________

Signature of Student______________________________________

Date________________________________