Self Assessment

2015 - 2016 - 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 :

Tenzin Lektsok
Yeu Yin Hwang
Judy Martin
William Osler Health Centre/Etobicoke General
Hospital
Agency
L7W NM
06-Sep-2015
168
168

To 31-Dec-2015

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 and

Satisfactory

procedures.
T.L. : I have followed college and hospital policies, code of behavior and standards and guidelines. For instance, dressing codes, punctuality and
documentation

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

Satisfactory

T.L. : I have always considered that i am accountable for any action that I have done. for instance, proper medication administration and client
centered care.

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

Satisfactory

T.L. : I have considered client, nurse and environment while giving the care to client. for instance, considering the client need, safety and team work
with other nurses.

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

Satisfactory

T.L. : I used obtained vital signs and assessment of physical and mental conditions of patient for care. for instance, certain medication I didn't give
after their heart rate and blood pressure were low under defined no.

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

Satisfactory

safe environment.
T.L. : I have used railing and helped patient to stand up and encourage using assistive devices. I always make sure that i change my gloves before
working on other patient because it causes contamination and client can be at risk for infection.

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

Satisfactory

T.L. : When ever there is changes in any medications or order i makes sure with my primary nurse about the changes.

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

Satisfactory

unacceptable and/or unprofessional behavior.

T.L. : I have asked for help and waited my nurse to transfer my patient to bed which is 2 person transfer by ceiling lift .

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

Satisfactory

T.L. : I have attended some bullet round to find about what other health care provider have to say about my assigned patient.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

T.L. : Most of the time i share my point of view at post conference that we held after every shift.

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

Satisfactory

T.L. : It was difficult in beginning to do the documentation because of computer problem and unable to spend time by nurses to teach or they do it too
fast but now I am more confident how to document clearly and accurately in proper time farame.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

T.L. : After i have taken the vitals and assessment of patient, i always inform my nurse about it

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

Satisfactory

T.L. : I have used my non verbal communication to patient who doesn't understand English and can't hear properly. I spoke Hindi with an Indian client
who didn't understand English.

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

Satisfactory

(PHIPA).
T.L. : I always make sure i give privacy to my client for example i make sure curtains are pulled on when i give them care and i always ask my client
before i share any information with the client. Furthermore i also make sure that curtains are pulled over while i give care to my client.

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

Satisfactory

T.L. : I used the computer resources in the hospital to document and did research on the medication. i have searched their lab data to find more
about their

3. CARING RELATIONAL PRACTICE

3. 1 Use effective communication techniques.

Satisfactory

T.L. : I used both verbal and non verbal to communicate with patient depending in their situation. I have also been good listener to client's concerns. I
have always respect my client and inter-professional team members.

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

Satisfactory

health care team members.

T.L. : i respected other cultures and their beliefs, values and attitudes. I have always shown my caring attitude towards all clients without any
discriminations.

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

Satisfactory

T.L. : I have educated my client and provide a cultural competent care because it is client centered care. I always make sure that i am able to gain
the trust of client by maintaining therapeutic nurse-client relationship.

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

Satisfactory

relational practice.
T.L. : It is true that our believes and values effects our ability to work but i always sure i do put my believes or values on other people . However i try
to make sure i learn from my experience and it helps a lot in improving my skills and hence its better for client.

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

Satisfactory

appropriately.
T.L. : Whenever i assess my client i always inform either my teacher or my primary nurse and i always ask her about the order she get from doctor.
For example my client got new order for medication and her medication was not at unit so i told my primary nurse and she sent it to pharmacy .

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

Satisfactory

T.L. : i know every client has its own culture and i do respect client's diversity and culture. Furthermore i also respect my professional team members
their value and role int his diverse client.

3. 7 Display sensitivity and respect for clients cultural, religious, and other beliefs and values

Satisfactory

influencing their choices and decisions.

T.L. : I always provide culture sensitive care to my client for example, respecting the religious materials that patient is wearing and appreciating the
vegetarian diet that patient preferred.

3. 8 Provide effective client education.

Satisfactory

T.L. : I educated my patient who was on thicken fluid diet and wants to drink water. One of patient who wants to smoke in hospital.

4. LEADERSHIP AND ADVOCACY

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

Satisfactory

T.L. : I always use conflict resolutions skills like therapeutic communication as well as listening to others to prevent conflict. for example my nurse
asked me to give medicine that she signed it so i explained her that i am sorry i cant really do it. The way i talked to her it was polite and she didnot
feel bad.

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

Unsatisfactory

T.L. : i have to improve on leadership.

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

Satisfactory

professional health care team.

T.L. : I have given positive and negative feedback to my peers to improve their nursing skills and I have accepted their feedback as positive thing as
means to improve my skills and knowledge.

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

Satisfactory

T.L. : I know my strengths and weakness so i always ask before i do something if i am not sure about. This helps in giving good quality service to my
client. I also adapt my plan according to patient's need.

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

Satisfactory

T.L. : So far I have not faced unacceptable and unprofessional behaviors from peers and nurses.

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

Satisfactory

T.L. : I reported to nurse about the patient who wants to get out of bed all the time and finally we have put the patient on least restraint by putting all
the rails up.

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

Satisfactory

best interests of the public and protect the public through collaboration and consultation.
T.L. : I always make sure my client gets best service so i always take help from my teacher and primary nurse if i am unsure about something
because it is client centered care. For example, administering IV medications.

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

Satisfactory

T.L. : I have implemented what my instructor and nurse told me to do and helped my peers when they need help.

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-centred

Satisfactory

plans of
care.
T.L. : I have learnt about different client's impairment (respiration , hearing, vision, unconscious cognitive, etc). for instance, trach patient, effective
airway breathing is expected outcome because of excessive sputum in the airways.

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

Satisfactory

competently in writing and orally.

T.L. : We have done written care plan twice for the patient where i have considered the care from different perspectives.

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

Satisfactory

T.L. : I applied my knowledge I learnt from my textbooks and in classroom. For eg, how to take vital signs, assess there skin , prioritizing their needs
according to their diagnosis.

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

Satisfactory

T.L. : On week second, my patient had 3 bowel movement in the morning shift and she is taking two different kind of laxative so i told my nurse and
she reduce the no of laxative to one.

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

Satisfactory

in a manner that demonstrates knowledge and skill.

T.L. : In order to prevent the pressure ulcer, i have done re-positioned of patient every 2hour.

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

Satisfactory

T.L. : Decisions are always made based on three factor frame: nurse, client and environment. In this way i made sure that my client's outcomes are
stable and i competent to provide my skills and i have proper environment or proper equipment to perform my assessment

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

Satisfactory

resources.
T.L. : I have priotize giving medication on time and checked any ulcer while doing body assessment.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

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

Satisfactory

clients, determine health needs, and to achieve mutually agreed expected outcomes.
T.L. : I work collaboratively with clients and members of the inter-professional health care team to achieve mutually agreed expected outcome

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

Satisfactory

needs and expected outcomes of clients.

T.L. : I have gathered the subjective and objective data, provided care in a timely manner, and documented all the informations in the computer
inorder to contribute as a member of the inter-professional health care team to respond to the changing needs and expected outcomes of the clients.

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

Satisfactory

T.L. : I seek help when I was not sure about administration of IV medication and feeds.

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

Satisfactory

outcomes.
T.L. : I helped my nurse and peers in patients care. for instance, bath bathing, transferring patient,

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

Satisfactory

T.L. : i have provided proper care at proper time with and without nurse. I have discussed the changes with nurses about the client. For instance,
fever and

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

Satisfactory

T.L. : I talked with nurses, charge nurse, Occupational therapist and family of the clients.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

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

Satisfactory

consultation with members of the inter-professional health care team and through competent and safe
practice.
T.L. : I used least restraint on patient and worked with the nurse to provide safe environment. I worked with nurse and peers to transfer client to
prevent him from any injury and harm. i asked my nurse about medication which i was not sure about the dosage.

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

Satisfactory

feedback into practice.

T.L. : I always take feedbacks in a positive manner and reflect upon it to improve in the areas that I am lacking at.

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

Satisfactory

(CNO).
T.L. : I have done three care plans with consideration of quality assurance.

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

Satisfactory

integrate these into practice.

T.L. : I took feedback from my peers but have to do more from other health care members.

7. 5 Use nursing research to foster professional development.

Satisfactory

T.L. : I have used computer resources to do nursing research on diagnosis and medications that patient is taking.

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

Satisfactory

T.L. : I have used the vital signs record to find out the clients health conditions and their well being.

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

Satisfactory

affect nursing practice.

T.L. : We used the Meditech to document and to learn more about the cleints.

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

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

Satisfactory

T.L. : I used my critical thinking in problem solving and decision making skills.

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

Satisfactory

determine nursing diagnoses, expected outcomes, nursing interventions, and evaluative criteria.
T.L. : I referred client's diagnosis to take appropriate interventions. for eg, referring there blood pressure before administering their hypertensive
medication.

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

Satisfactory

improve
these.
T.L. : Nurses in their efforts to implement critical thinking should develop some methods as well as cognitive skills required in analysis, problem
solving and decision making. These skills include critical analysis, introductory and concluding justification, valid conclusion, distinguishing facts and
opinions to assess the credibility of sources of information, clarification of concepts, and recognition conditions. Experience, theoretical knowledge
helps i improving problem solving skills, critical thinking and decision making.

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

Satisfactory

provide safe and competent care.

T.L. : In order to provide safe and competent care, I always utilize the knowledge gained from the lectures, textbooks, clinical instructor, lab practice,
and nursing skills and assessment videos.

8. 5 Prioritize effectively.

Satisfactory

T.L. : i took the vital signs every beginning of the shift. By reflecting on the feedbacks from my clinical instructor, I have worked and learned to
organized my care according the priority needs of the client

8. 6 Demonstrate professionalism and accountability.

Satisfactory

T.L. : I have demonstrated my professionalism and accountability by arriving hospital on the time , addressing the client by proper name, informing
client about the procedure before starting and obtaining the consent before any interventions.

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

Satisfactory

guide practice.
T.L. : Decisions are always made based on three factor frame: nurse, client and environment. In this way i made sure that my client's outcomes are
stable and i competent to provide my skills and i have proper environment or proper equipment to perform my assessment. I used least restraint on
patient and worked with the nurse to provide safe environment.

Student Final Summary with Strategies for Continued Growth

It was such a wonderful experience for me and I have learnt a lot from my clinical from last 14 weeks. I'll do more self reflection and critical thinking for
my continues growth. I'll review what I have learnt so far in the college and hospital to develop further.

Student's References

Student weekly assessment,

Peers, Therapeutic Nurse-Client Relationship,
Potter and Perry,
CNO.org.

Submitted Date: 11-Dec-2015 12:50