Self Assessment

2015 - 2015 - Final NURS - 208 Course Learning Outcomes (201509)

NUR 208 Practical Nursing Practice 4 (PN, 06-Sep-2015 - 31-Dec-2015)
Student :
Clinical Teacher/Preceptor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Maria Christina C. Carnay

Vertel Spence
Judy Martin
William Osler Health Centre/Brampton Civic Hospital
Agency
N4 PC
06-Sep-2015 To 31-Dec-2015
168
168
168

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.
M.C.C.C. : I believe that I followed all the policies and procedures in the clinical setting by for example making sure any information about
my patients stays in the hospital and will be kept confidential; by documenting truthfully and accurately and by practicing safely. Also, I
always come to the clinical setting with the proper uniform along with my i.d. and hand hygiene is always done before giving care to my
patient.

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

Satisfactory

Satisfactory

M.C.C.C. : I acted in a responsible, ethical and accountable manner by making sure that I take the right action to provide proper care that
my patients need without causing any harm. I understand that I am accountable for my actions therefore whenever I am administering
medications, I make sure that I did my checks and I am giving the right medications and important assessments were done for my patients.
These would all then be documented and signed off that the medication was given and the care was provided.

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

Satisfactory

Satisfactory

care.
M.C.C.C. : I believe that I've practiced according to the standards of practice outlined by the CNO and that I adhered to the rules and
regulations in the clinical setting. I always try to come prepared every clinical and practice safely.

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

Satisfactory

Satisfactory

M.C.C.C. : I believe that I've used evidence informed practice and a theory-base approach to care by researching my medications before I
give them to my patients in order to understand what it does and how it will affect my patients. I've also researched their diagnosis in order
to make a better care plan and prioritize care effectively. Also, I make sure that I am applying the things I am learning in my class in the
clinical setting in order to improve my practice.

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

Satisfactory

Satisfactory

and a safe environment.

M.C.C.C. : Most of the patients I had were at risk for fall, therefore I make sure that I am there beside them when they get up to walk in the
bathroom (either slowly or with a walker) to ensure that that my patient made it safely. I also make sure that their pathway is clear in order
to prevent slipping or tripping on an IV line and that their shoes are fit properly to ensure client safety.

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

Satisfactory

Satisfactory

uncertain.
M.C.C.C. : Whenever I need clarification about a plan of care, unclear orders or directions and whenever I am uncertain, I usually always
ask my instructor to learn and understand better. For example, I asked the instructor how would I know the infusion rate for the IV
medication if it's not in the order or in the IV manual, I wanted to know how to be fully ascertain that I have the right rate of infusion (what if
my calculations were wrong). Also, I once asked if I can hold an antihypertensive medication because the patient's blood pressure was low
but there were no parameters therefore I asked for clarification. With the new skills I learned this semester such as administering IV
medications, using a nebulizer and administering medications via subcutaneous injection, I first sought with my instructor for supervision
and assistance.

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

Satisfactory

Satisfactory

unsafe,
unacceptable and/or unprofessional behavior.
M.C.C.C. : When lifting my patients up in the bed, I make sure that I have a partner who can help me, in order to move up the patient safely.
Also, whenever I am uncertain of a specific skill for example using the nebulizer or using the IV machine, I would ask questions and ask for
assistance. On the other hand, I did not witness any unacceptable or unprofessional behaviour in the clinical setting, but if I did, I will make
sure to report this.

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

Satisfactory

Satisfactory

M.C.C.C. : I understand that the role of the nurse within health care is to maintain competence and make sure that care is being given
safely and effectively for patients. All the rules and policies in the clinical setting were obeyed by making sure any abuse or harm was not
done to any of the patients; documentations were done truthfully and care was provided safely and ethically.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Maria maintained attendance over the course of the 14 weeks of clinical. She demonstrated accountability by arriving on time and was
always dressed in full uniform with her name badge visible to identify herself as a student. She demonstrated the ability to maintain
competence by utilizing her knowledge to provide safe competent and compassionate care. As well, she consistently demonstrated
responsibility for her actions by ensuring that she sought assistance when necessary. She maintained confidentiality by ensuring that her
personal values did not conflict with her practice and provided privacy by pulling the curtains or closing the doors during immediate
nursing care. In addition, she demonstrated regards for commitment for self, peers and patients.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Unsatisfactory

Satisfactory

M.C.C.C. : Participation in team sharing and discussions still need improvement because this is only done when called upon or when
asked to do a presentation.

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

Satisfactory

Satisfactory

methods.
M.C.C.C. : I believe that I've documented clearly, accurately and concisely in a timely manner using written and electronic methods. For
example, I would do my vitals signs right away in the morning, report it to my primary nurse and document since it has to be documented
by 0800. Then, I would do my care and assessments (GI, neurological, cardio, mental status, respiratory etc.) and document before noon.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

M.C.C.C. : I believe that I've reported relevant information to the appropriate personnel such as reporting the vital signs I took on my
patients, reporting when I am going for break so that someone will be there to watch my patient while I'm not there. I also reported to my
primary nurse while she was on break that the doctor had ordered for a patient to try to get up and sit on chair to prevent pressure sores.
The primary nurse and I then helped the patient get on the chair by using the Hoyer lift and was able to safely move the patient.

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

Satisfactory

Satisfactory

team.
M.C.C.C. : I've used communication techniques with my patients for example when I am assessing for their pain, I would ask them to rate
the pain for me from 0 to 10 (0 being no pain and 10 being the worst pain). I would listen to them about what they need or when they are
telling me how they feel in order to understand the patient better and provide care appropriately. I also document and sign the medications
I've given therefore my primary nurse and next nurses who will work after will know what was done during my shift. Other than that, I
always interact with my patients and the inter-professional health care team with respect.

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

Satisfactory

Satisfactory

Protection Act (PHIPA).

M.C.C.C. : I understand the importance of confidentiality therefore I never share or mention any information about my patients to anyone
or outside the clinical setting.Therefore, I ensured privacy and confidentiality according to the Personal Health Information Protection Act.

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

Satisfactory

Satisfactory

information.
M.C.C.C. : I've used technology to retrieve information to research for my patients' diagnosis and their medications in order to understand
their condition better. Such research help me learn what certain medications does and why my patients are getting them. I've also used
technology to retrieve information from my textbooks (E-book) in order to create my concept map and a care plan for my patients by
researching nursing interventions that would be effective and safe.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Over the course of the semester, Maria learnt to communicate effectively with her patients and with the inter-professional team. For
example, she ensured that she received a report of her patient's status every morning and learnt to explain to the patients the care she was
about to provide prior to initiating the actual care. Initially, she struggled with documentation but by week 8 she was documenting
accurately and concisely and in a timely manner. In addition, she developed the habit of maintaining eye contact with her patients during
conversations. Good job!

3. CARING RELATIONAL PRACTICE

3. 1 Use effective communication techniques.

Satisfactory

Satisfactory

M.C.C.C. : I believe that I have used effective communication techniques by always introducing myself to my patient when I first come in
contact with them. Also, I tell them what is going to happen or what I am going to do for example, I inform my patient before I take their vital
signs; I ask them if they would like to get washed and I tell them beforehand that I am going to give their medications. I believe that telling
my patients about what is going to happen beforehand helps create a trusting relationship and help the patient be less anxious which
enables me to give them care safely and effectively.

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

Satisfactory

Satisfactory

and health care team members.

M.C.C.C. : I believe that I've demonstrated therapeutic caring and compassionate and culturally safe relationships with clients and the
health care team members by showing respect and by being non-judgmental. I treat my patients the way I would want to be treated
therefore I do my best when giving care for them and I make sure that I do not offend or upset them in any way. Ruining the nurse-client
relationship would definitely affect the nursing care being given therefore I always try to meet their needs and be respectful no matter who
they are, what they do in life, what their nationality or gender is.

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

Satisfactory

Satisfactory

M.C.C.C. : I am aware of myself with regards to my beliefs and values and my practice. I know that I cannot impose my own beliefs and
values to my patients therefore I have to be respectful and be non-judgmental of them. I also understand what my weaknesses and
strengths are therefore I make sure that I focus on what I need to work on more to improve my practice.

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

Satisfactory

Satisfactory

have on relational practice.

M.C.C.C. : I have used self-awareness to identify the effects that beliefs, values and personal experiences have on relational practice. I
believe that it is important to understand the meaning of health and what I think about nursing is all about. For example, I think that nursing
is all about providing a safe, an ethical and effective care and hence this would have an effect on my practice by having this mindset every
time I come to the health care setting. I know my own views and I understand that I cannot impose these views to anyone else because
everyone is different and that is why different approaches are done to clients.

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

Satisfactory

Satisfactory

consult appropriately.
M.C.C.C. : I have learned to collaborate better with the members of the inter-professional health care team compare to my first few weeks
in clinical. My partner and I would work together to give a patient a bed bath and even work together with giving IV medications. I've also
collaborated with my patients by creating a trusting relationship with them therefore I would be able to assess them accurately and meet
their needs. Before I leave my patient's room, I make sure that they know me as their student nurse, tell them I will be there when they need
me and the call bell will be placed near them.

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

Satisfactory

Satisfactory

M.C.C.C. : I support and respect how diverse and different the clients that I encounter with every week during clinical. I did not have any
problems taking care of a patient because of how old they are or what their nationality is. I also support the diversity with the interprofessional health care team by being respectful of the nurses and the other students that were there in the unit.

3. 7 Display sensitivity and respect for clients cultural, religious, and other beliefs and values
influencing their choices and decisions.

Satisfactory

Satisfactory

M.C.C.C. : I believe that I've displayed sensitivity and respect for clients' cultural, religious and other beliefs and values influencing their
choices and decisions by being respectful and non-judgmental. Some of my patients would refuse a bed bath because they want the family
to do it and I would respect that or some of them would refuse a certain medication. Also, one of the patient I had, refused to eat the
hospital food during lunch time because the patient preferred the food that her daughter will bring. In other words, the patients were not
forced to do anything against their will by understanding and respecting their decision.

3. 8 Provide effective client education.

Unsatisfactory

Satisfactory

M.C.C.C. : A client education that was only done was when I told a patient to ask for assistance whenever they needed to get up in order to
prevent a fall and injury. When I had a patient who was about to be discharged most of the education was given to the doctors and the
occupational therapist and all the information that the patient needed was all there therefore I did not know what else I could add on.

Teacher comments for CARING RELATIONAL PRACTICE :

Maria appropriately communicated with her peers, instructor and inter-professional team to function cooperatively. She developed
collaborative partnerships with patients including families and demonstrated respect and empathy.

4. LEADERSHIP AND ADVOCACY

4. 1 Apply appropriate conflict resolution skills in therapeutic client and other interactions.

Unsatisfactory

Satisfactory

M.C.C.C. : I believe that my conflict resolution skills in therapeutic client and other interactions could still be improved more. Asking
questions and consultation is always done in the clinical setting however I should learn in some situations how to solve problems by
critical thinking.

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

Unsatisfactory

Satisfactory

environment.
M.C.C.C. : I did not have a chance to be a facilitator during clinical therefore I was not able to evaluate myself on how I did as a leader or
were not given any feedback. Leadership skills could definitely be improved to develop solutions and create a positive work environment.

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

Satisfactory

Satisfactory

professional health care team.

M.C.C.C. : I've provided feedback to my peers and accepted feedback from my peers and the instructor. This helped my group and I to
know and understand the things we need to work more on. For example, the instructor told me I was lacking in teamwork, therefore I
focused on how I can work better as a team.

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

Satisfactory

Satisfactory

M.C.C.C. : I support my clients' decisions with regards to different kinds of care they prefer. I also support a non-judgmental and an
unbiased approach to care in order to prevent offending the patient or removing their rights. A good quality practice and a positive
environment is what it should always be in the clinical setting therefore any conflict with the staff or peers did not occur.

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

Satisfactory

Satisfactory

M.C.C.C. : I believe that I've supported my patients' rights for self-determination and choice because for example when one of my patient
refused to wait and eat the food that the patient's daughter will bring, I respected that decision and did not force the patient to eat the
hospital food. There was also a patient who refused a bed bath because the patient wanted the family to do it therefore the patient's wishes
were followed.

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

Satisfactory

Satisfactory

M.C.C.C. : Any unprofessional or unacceptable behaviour were not witnessed in the clinical setting however this will be reported if seen
one.

4. 7 Collaborate and consult when implementing health care and nursing practices that are in

Satisfactory

Satisfactory

the best interests of the public and protect the public through collaboration and consultation.
M.C.C.C. : I've consulted and collaborated with my instructor whenever I was uncertain of something or I am doing a specific skill for the
first time. For example, when I had to give a subcutaneous injection for the first time, I consulted and collaborated with my instructor first
in order to ensure patient's safety. When administering medications, I also consulted the instructor by asking how would I know for certain
if I am putting the right rate of infusion for the IV medication. In other words, I would always consult and ask for supervision and assistance
with my instructor before I do a care/skill I've never done before.

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

Satisfactory

Satisfactory

M.C.C.C. : I believe the I've contributed to the creation of quality practice solutions and strategies in the clinical setting. For example, my
partner and I would figure out the time of when we should go for break in order to manage our time wisely with regards to giving care for
our patients. When my partner and I are doing a bed bath on his/her patient, I would be there to assist and when she/he left a certain
material for example some wipes or cloth I would be the one to get it quickly.

Teacher comments for LEADERSHIP AND ADVOCACY :

Maria demonstrated the basic values and beliefs of the profession through example and behavior. She collaborated with her patients' staff
and instructor to provide respectful, professional nursing care. She demonstrated initiative and eagerness as well, to learn by voicing a
desire to perform certain skills when available. Initially, her team work skills were poor but by week 14 she was very involved in team work
both with her peers and with the inter-professional team.

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

5. 1 Incorporate the clients unique needs and expected outcomes into holistic and client-

Satisfactory

Satisfactory

centred plans of
care.
M.C.C.C. : I have incorporated the clients' unique needs and expected outcomes by creating a client-centred plans of care. After I've
researched my patients' diagnosis and medications being given, I try to understand the patient better and prioritize what I need to assess
first in order to give a proper care. For example, one of my patients were complaining of pain due to a recent fall therefore pain assessment
and plans to relieve the pain were done such as giving prn medications at an appropriate time or suggesting some relaxation techniques.

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

Satisfactory

Satisfactory

articulated competently in writing and orally.

M.C.C.C. : Theory-based plans of care were developed and were holistic and client centred when the concept map was done for example.
Nursing interventions were researched and made sure that it would be an effective and safe care plan.

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

Satisfactory

Satisfactory

M.C.C.C. : I believe that use of my knowledge, skill and judgment to assess clients, prioritize needs and outcomes were done better
compare to the first few weeks of clinical. After obtaining feedback, I was able to prioritize effectively with my patients and understand what
I need to do first. For example, I had a patient who had pain and I needed to do a bed bath on that patient. Therefore, I gave the scheduled
pain medication first in order to relieve the patient's pain and not worsen it while doing the bed bath. I also had a patient who has
pneumonia therefore vital signs and respiratory assessment were done and I made sure that the bed was elevated.

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

Satisfactory

Satisfactory

M.C.C.C. : The instructor gave feedback on the plan of care done for my patient which shows collaboration in order to evaluate and make
sure that the plan of care is proper and will be effective.

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

Satisfactory

Satisfactory

interventions in a manner that demonstrates knowledge and skill.

M.C.C.C. : When doing a bed bath for my patients, I try to do an integumentary system assessment along the way in order to clearly
examine if there's any pressure sores/ulcers. This assessment would be bothersome for the patient if it is done during the day when they
are resting or busy with something else. I always assess my patients from head to toe in order to see if there are any worsening conditions
and any significant findings are all documented after.

5. 6 Use the Three-Factor and practice decision-making frameworks to guide practice.

Unsatisfactory

Satisfactory

M.C.C.C. : The use of the three factor and practice decision-making frameworks to guide practice might need some more practice in the
clinical setting.

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

Satisfactory

Satisfactory

physical
resources.
M.C.C.C. : I believe that I was able to handle and give care properly when I had two patients. I managed my time wisely by figuring out
when I am going to take vitals signs; give medications; wash both my patients and assess; have time for my research and documentation
and a time for my break as well. I did not make any medication error, I was able to assess both my patients from head to toe and document
at the right time and I also had time for my break.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Maria utilized her theoretical knowledge to prioritize care. Initially, she was very unorganized but by week 14 her prioritizing and organizing
skills were developed even though there was still room for improvement. She prepared two concept mapping satisfactorily to include
interventions necessary to provide optimal health for her patients. Good Job!

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

6. 1 Collaborate 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.
M.C.C.C. : I have learned the importance of collaboration and teamwork therefore this is now always done in the clinical setting. I always
work with the partners I have by helping each other do a bed bath on our patients; figuring out who will go on break first to manage our
time wisely and even help each other with IV administration.

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.

M.C.C.C. : I believe that I have contributed as a member of the inter-professional health care team by helping out other nurses take vital
signs or help give a bed bath for other patients. Also, I always report to my primary nurse any significant information about my patient
such as vital signs (especially when there is an abnormal value); any prn medications or care I've given, as well as reporting before I go on
break and before I leave the clinical setting.

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

Satisfactory

Satisfactory

M.C.C.C. : I always seek out assistance and consult with the members of the inter-professional health care team whenever I am uncertain
of a specific skill or a type of care. For example, I consulted with the instructor by asking how would I know for certain what is the right
infusion rate for the IV medication I am going to give if it is not mentioned in the IV manual or the order. Also, i asked for assistance and
consultation when I first gave a subcutaneous injection, when I first used a nebulizer and when i first used the IV pump machine.

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

Satisfactory

Satisfactory

outcomes.
M.C.C.C. : I believe that i was lacking in teamwork with the first few week of clinical, however the instructor have given me feedback that I
was lacking on it therefore I focused on how I can be better with working with others as a team. I believe that I have improved now compare
to before.

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

Satisfactory

Satisfactory

changing
environment.
M.C.C.C. : I have done collaboration with my partner when doing bed bath and even when administering medications. A partner or the
team leader for the week would be with me and make sure that I am giving oral medications correctly to my patients. I have collaborated
with my nurse when we had to move a patient from the bed to the chair by using the Hoyer lift. Moving the patient together with the nurse
helped prevent any fall and injury of the patient. Also, I collaborated and consulted with my instructor whenever I am uncertain or when I
had to do a subcutaneous injection for the first time for example. In other words, these collaborative and consultative strategies in the
clinical setting which promoted client safety.

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

Satisfactory

Satisfactory

competencies.
M.C.C.C. : I've interacted with the members of the health care team by introducing myself to my primary nurse and making sure they know
who the patients I was assigned to. I report to them the vitals signs I took; the care and prn medications I've given and the skills or
medications I cannot give for example, letting them know that we're not going to handle any of the PCA pumps. I have also interacted with
the physiotherapists for example one of the physiotherapists told me that she believed that the patient was having some shortness of
breath after ambulation, therefore I assessed for respiratory and make sure the patient breathing fine.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Maria consistently collaborated with her instructor and with the inter-professional team to provide safe compassionate care for her
patients. She interacted with the team with much respect and ensured that she kept the team well informed about her patient's status

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

7. 1 Act in the best interests of clients and protect clients from harm through collaboration

Satisfactory

Satisfactory

and consultation with members of the inter-professional health care team and through
competent and safe practice.
M.C.C.C. : I have acted in the best interest of clients and protect clients from harm by maintaining hand hygiene all the time before I
perform any task or care to any patient. I made sure that I am doing my checks right before I administer any medication to a patient. I've
worked together with the primary nurse to move the patient safely from the bed to chair by using the Hoyer lift. Also, I always go to my
instructor whenever I am uncertain or I need some clarification on a specific skill.

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

Satisfactory

Satisfactory

integrate feedback into practice.

M.C.C.C. : After clinical, I have a notebook that I always write on to reflect on my practice and see if there is anything I did wrong during
clinical or anything I need to change or anything I need to continue and improve on. I also keep in mind my instructor's or peers' feedback
on me which helped me identify my strengths's and weaknesses. For example, I was having some mistakes with doing my checks during
medication administration at first and lacked in teamwork. Therefore, I tried to work on these things and made sure I am doing better and
doing things right in order to improve my practice.

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

Satisfactory

Satisfactory

program (CNO).
M.C.C.C. : I have created a learning plan which identifies the areas I need to improve or work on. I've set up a goal and a time line on when I
should be able to achieve that goal. For example, one of my goals was to administer an IV medication safely therefore I made strategies
and found resources that would help me achieve this goal.

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

Satisfactory

Satisfactory

integrate these into practice.

M.C.C.C. : I lacked on this part during my first few weeks of clinical and I learned this through feedback. Therefore, whenever there is an
opportunity for learning I would not hesitate and do it. For example, the instructor asked if I wanted two patients for the day and I
responded yes, which helped me learn how to handle two patients by the end of clinical. I was able to help a nurse move a patient from the
bed to the chair as well using the Hoyer lift. I did not operate the machine but I was able to see how this was done and I was able to assist. I
also witnessed a peer insert a suppository to a patient which was the first time I've seen.

7. 5 Use nursing research to foster professional development.

Satisfactory

Satisfactory

M.C.C.C. : With the learning plan, I had to think of strategies and find resources that would help me achieve my goal of improving my
practice. I used research in order to find ways to help me achieve this by searching up nursing videos, textbooks and notebooks which aid
in my learning.

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

Satisfactory

Satisfactory

M.C.C.C. : I always try to practice safely during clinical in order to prevent any harm or injury to any of my patients. Therefore, I research
every medication that I am giving in order to understand what it does and how it might affect my patient. For example, if there is a
scheduled antihypertensive medication for a patient and it has a parameter that says "hold if sbp is <90", I would of course the patient's
blood pressure first. If I did not know that a drug is an anithypertensive and I did not check the blood pressure of the patient, I would have
harmed the patient and made the patient's condition worst. Therefore, I always use a theory-base approach and evidence-informed practice
in order to provide care for my patients safely.

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

Satisfactory

Satisfactory

these affect nursing practice.

M.C.C.C. : There were a lot of changes that occurred when the palliative unit was moved with the oncology unit. There were a lot of
students from other schools and most of the time the floor is packed therefore I make sure that the MAR or the patient's book is not all over
the place and it is where it is supposed to be. Also, I only go to the computer to document when it is free and I leave whenever a doctor or
the staff needs it. In other words I try to manage my time wisely with regards to getting information about my patient and documenting
while preventing any conflicts that might occur in the unit.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Maria demonstrated this outcome by participating in peer review and by preparing a learning plan and self evaluation indicating her
strengths and areas of development. As well, she prepared two concept mappings according to her patients' assessments with the
necessary interventions to provide optimal health

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

8. 1 Use critical thinking and problem-solving skills to inform decision-making in all aspects

Unsatisfactory

Satisfactory

of nursing care.
M.C.C.C. : I believe that critical thinking and problem-solving skills to inform decision-making in all aspects of nursing care might still need
some work for improvement and a better practice int he future.

8. 2 Use critical thinking, problem-solving and decision-making skills to assess clients and to

Satisfactory

Satisfactory

determine nursing diagnoses, expected outcomes, nursing interventions, and evaluative

criteria.
M.C.C.C. : I gave a lot of time creating my care plan to determine nursing diagnoses, expected outcomes, nursing interventions and
evaluate criteria. I made sure that I had a theory-based and effective care that I would be implementing for my patient. I researched their
diagnosis and assessed my patient in order to determine the most important care they need.

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

Satisfactory

Satisfactory

to improve
these.
M.C.C.C. : I did a self evaluation of my practice in order to identify what I need to work on or what I need to change. This would help me
improve and be a better and competent nurse in the future and help provide care safely, ethically and effectively to my patients. 0

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

Satisfactory

Satisfactory

practice to provide safe and competent care.

M.C.C.C. : I believe that I've integrated knowledge from a variety of nursing, health and other theory such as for example I would listen to
the doctors, dietitians or physiotherapists whenever they are talking to my patients. I would apply the lessons and teaching I've received
during my pharmacology and theory class for example and use this to help with my practice.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

M.C.C.C. : I believe that I've prioritized effectively during clinical by identifying what my patient needs the most. For example, when a
patient needs his/her pain medication I will not be late and give this right away. Also, I had a patient who was incontinent and left some
stool on the floor, therefore I cleaned my patient right away and cleaned the floor. The patient had done this twice and tried to cover the
stain on the chair. Therefore, I told the patient not to remove her diaper or call me whenever she wants to go the bathroom.

Satisfactory

8. 6 Demonstrate professionalism and accountability.

Satisfactory

M.C.C.C. : I demonstrated professionalism by coming to clinical with the proper uniform; by accepting my peers' and instructors' feedback
for improvement and by continuously practicing safely. I also understand that I am accountable for my actions therefore I always ensure
the safety of my clients and that I am documenting and signing the medications I have given. I have also done some self evaluation in order
to improve my practice for example, if I made a mistake I would accept and learn from this so that the mistake will not happen again int eh
future.

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

Unsatisfactory

Satisfactory

and guide practice.

M.C.C.C. : The use of practice decision-making and the nurse-client-environment frameworks to inform and guide practice might need
some more development for improvement in the future.

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

Maria's critical thinking skills have increased over the course of the semester as she has demonstrated an increased depth of
understanding and knowledge in all outcomes. By week 14 she was making conscious decisions about her patient's care while asking
questions when necessary.

Student Final Summary with Strategies for Continued Growth

Continuous competence is important in nursing therefore I would continue to learn more about my medications and theory to apply those knowledge
into my practice. Critical thinking and leadership skills still need some improvement and will work more on this for the future. More practice with certain
skills such as wound care, for example is still needed to do. However, I learned a lot of new thigns and was able to do certain skills for the first time. I
learned how to administer medications through a nebulizer, subcutaneous injection and via intravenous. I think that I work better as a team now and
will continue to do so in the future. I also need to be more confident with my practice and to always come prepared before clinical. Other than that, I
always try to practice safely by always doing my checks before giving medications and ensuring client safety for example when they are risk for fall.
Overall, I think that I've improved with my practice compare to my first few weeks in clinical. I learned a lot of things that helped me improve my
practice because of my instructor's feedback and teachings.

Teacher Final Summary with Strategies for Continued Growth

Maria demonstrated the ability to provide safe competent nursing care by week 14. Initially, she was poor in all clinical skills but over the course of the
semester she has developed and enhanced her knowledge and skills by making herself available for new skills and by working close to her peers.
She was encouraged to continue to revise her clinical skills by reading her text and by watching the videos provided by the college. This will also
assist her to increase her critical thinking, problem solving and decision making skills. She was reminded that increased theoretical knowledge will
also help her to develop her heath assessment skills as well. Good Job Maria!

Grade

Satisfactory

Referred to Clinical Excellence Committee (CEC)

Grade

Satisfactory

Unsatisfactory

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