Professional Documents
Culture Documents
Jacqueline Benjamin
Elaine Willard
Judy Martin
William Osler Health Centre/Etobicoke General
Hospital
Agency
8E Orthopedics
06-Sep-2015 To 31-Dec-2015
168
168
168
I declare that this is my original work and the sources used are acknowledged.
Teacher Rating
Satisfactory 1. 1
J.B. : I comply with regulatory standards, relevant legislation and the practice setting's policies when I perform hand hygiene before
entering a patient's room and after leaving a patient's room.
E.W. : Also observing hip precautions, charting after vital signs, confidentiality, Humber and WOHS uniform policy, isolation procedures
etc.
Satisfactory
Satisfactory
Satisfactory
Satisfactory 1. 3
Determine how the three factor and practice decision-making frameworks influence client care.
J.B. : The three factor is based on the nurse - client - environment. These three factors work together to provide the best plan of care for
the patient. The client's care is not only based on the nurse's decision, it is collaboration between the nurse and patient while taking into
consideration the environment in order to have the best health outcome for the patient. For example, If a patient complains of a feeling hot,
the nurse may remove blanket or covers, provide cool fluids or ice chips as appropriate to client's diet.
Satisfactory
Satisfactory
Satisfactory Satisfactory 1. 5
Carry out safety-based practices and risk management principles to ensure client safety and a safe environment.
Satisfactory
Satisfactory
J.B. : I carry out safety-base practices by checking my patient's IV line to ensure there is no occlusion and my patient is not experiencing
infiltration or phlabitis at the IV sight.
E.W. : Also, use of bed rails, call bell, wheelchair brakes, clean environment, staying with patient when up for the first time post-operative,
keeping patients NPO before surgery as ordered.
Satisfactory
Satisfactory 1. 6
Ask questions and clarify the plan of care, unclear orders or directions, and whenever uncertain.
J.B. : When I am uncertain of my patient's plan of care, I ask my Staff Nurse or Clinical Teacher for clarification. For example, my Clinical
Teacher asked me why my patient was having two different IV solutions of which I was not sure. I immediately checked the patient's MAR
and seeked clarification from the Staff Nurse who explained to me that the IV solutions were given as fluid replacement because of my
patient's was on an NG tube.
Satisfactory Satisfactory 1. 7
Demonstrate professional behavior by seeking assistance in situations in which there is unsafe, unacceptable and/or
unprofessional behavior.
J.B. : I demonstrate professional behaviour by seeking assistance from my Clinical Teacher to change my patient's gown who had an
active IV line that should not be disconnected because of the risk for infection.
Satisfactory
Satisfactory
1. 8 Demonstrate understanding about the role of the nurse within health care.
J.B. : I demonstrate understanding about the role of the nurse when I follow the uniform policy, start my shift early, give client-centered
care to all patients, follow the six right of medication, check my patients every hour, ensure my patients IV solution types and rates are
correct, and the IV lines are running without any problems.
Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Jacqueline has been able to safely and competently care for two patients and has demonstrated understanding of this outcome through
her clinical examples. She always clarified her plan of care with staff and clinical teacher and would not proceed with any care until sure of
what was to be expected.
Satisfactory
Satisfactory
Satisfactory 2. 2
Document clearly, accurately, concisely in a timely manner using written and electronic methods.
J.B. : I use the Meditech electronic method to clearly, accurately, and concisely document all required findings about my patient health, so
that other members of the professional health team may clearly understand the care given to my patient.
Satisfactory
Satisfactory
Satisfactory
Satisfactory 2. 4
Use communication techniques with the client and the inter-professional health care team.
J.B. : I communicated well with my client and the Physiotherapy team by telling them I needed to inspect my obese patient's buttox area
when she is moblized, so that I can assess her skin integrity to see if there is any skin breakdown or possible risk for pressure ulcers.
Satisfactory
Ensure privacy and confidentiality according to the Personal Health Information Protection Act (PHIPA).
Satisfactory 2. 5
J.B. : I ensure privacy and confidentiality with my patients when giving their baths or administering personal care.
E.W. : Also, by logging off from Meditech when documentation is completed, not leaving the screen open, and not discussing your
patients private information where it could be heard by others.
Satisfactory
Satisfactory 2. 6
Use technology to retrieve and share information including research, data and other information.
J.B. : I use LEXI-con and other apps to look up medications, research any medical diagnosis, medical terms, or medical abbreviations that
may be unclear to me and that I may be able to share with others at some time.
Satisfactory
Satisfactory Satisfactory 3. 2
Establish therapeutic caring, compassionate, and culturally safe relationships with clients and health care team members.
J.B. : I establish therapeutic care, compassionate, and culturally safe relationship by communicating through my patient's daughter her
mother's preference to have her traditional breakfast instead of the hospital meal. I was also able to communicated my patient's plan of
care through her daughter because of language barrier.
Satisfactory
Satisfactory
E.W. : Also, your calm and un-rushed manner would have been appreciated by your patients.
Satisfactory Satisfactory 3. 4
Use self-awareness to identify the effects that beliefs, values, and personal experiences have on relational practice.
J.B. : I use self-awareness by maintaining a pleasant facial expression when I am giving a bedbath to my patient and I can smell my
patient's body odour.
Satisfactory
Collaborate with clients and members of the inter-professional health care team and consult appropriately.
Satisfactory 3. 5
J.B. : I collaborated with my client who wanted to have her meal but was NPO due to an NG tub. I carefully checked the patient's MAR and
appropriately consulted with the Staff Nurse regarding my patient's diet before reminding my client of her diet plan.
Satisfactory
Satisfactory
3. 6 Support the diversity of clients and the inter-professional health care team.
J.B. : I support clients diversity and inter-professional health care team when I am plesant, polite, and respectful to my clients and
interprofessional team. When I ask another nursing student or staff nurse of similar culture to interpret my client's language or give
explanation to my client, so that I am able to give the best care to my client.
Satisfactory Satisfactory 3. 7
Display sensitivity and respect for clients cultural, religious, and other beliefs and values influencing their choices and decisions.
J.B. : I display sensitivity and respect for my client's culture when another female nursing student and I gave pericare to a female patient,
who preferred to have her personal care done by nurses of the sex because of her cultural beliefs and values.
Satisfactory
Satisfactory
Satisfactory
4. 1 Apply appropriate conflict resolution skills in therapeutic client and other interactions.
J.B. : I apply conflict resolution skills when I offered to perform assessments on a patient I was sharing with another student nurse and
complete the documentation in Meditech which was also the other nursing student's responsibilities. My actions helped to maintain a
positive relationship with the inter-professional team and it was also done in the best interest of the patient.
Satisfactory
Satisfactory 4. 2
Evaluate and refine leadership skills to develop solutions and create a positive work environment.
J.B. : I evaluated and refined leadership skills when I offer to assess a patient and document my findings rather than wait on the other
nursing student to perform these task.
4. 3 Provide feedback to peers and accept feedback from peers and members of the interprofessional
health care team.
J.B. : I give feedback to my peers and accept feedback from my peers regarding my strengths and weaknesses. I also accept daily
feedback from the Staff Nurse, daily and weekly feedback from my Clinical Teacher through one and one discussions, pre and post
conferences, and k4y assessments.
Satisfactory
Satisfactory
Satisfactory
Satisfactory
Satisfactory
Satisfactory
Satisfactory
Satisfactory
Satisfactory Satisfactory 4. 7
Collaborate and consult when implementing health care and nursing practices that are in the best interests of the public and
protect the public through collaboration and consultation.
J.B. : Collaboration and consultation are done with the nursing students, Humber health care team, and the clinical health care facilities
team to have all nursing students vaccinated against the flu virus. These vacinnations are given to protect the health care staff, all
patients, and the general public from cotracting the flu virus.
Satisfactory
Satisfactory
5. PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES
Satisfactory
Incorporate the clients unique needs and expected outcomes into holistic and clientcentred plans of care.
Satisfactory 5. 1
J.B. : A holistic and client-centered care was given to fulfill my client's unique need when she had her traditional, cultural breakfast
incorporated in her meal plan instead of her eating the hospital meal. The expected outcome was great because my patient ate a full meal.
Satisfactory Satisfactory 5. 2
Develop theory-based plans of care that are holistic and client centered and are articulated competently in writing and orally.
J.B. : At the start of my shift I prepare a daily plan of care for my patient while taking into consideration the Doctor's order, physiotherapist
notes, nurses information, and the client's preferences which will physically, emotionally, psychologically, and spiritually benefit my
patient.
Satisfactory
5. 3 Use knowledge, skill and judgment to assess clients, prioritize needs and outcomes.
Satisfactory
J.B. : I will use my knowledge skill and judgement when administering Anti-hypertensive medication to my client. Before administering the
medication, I will take my patient's BP and pulse rate to ensure they are not low, so that when the medication is given, my patient will not
experience hypotension and go into possible shock.
Satisfactory
Satisfactory
Satisfactory Satisfactory 5. 5
Safely and competently implement and evaluate nursing assessments and nursing interventions in a manner that demonstrates
knowledge and skill.
J.B. : When administering a subcutaneous injection to my patient, I carfully assess the area before giving the medication to the patient to
ensure the skin integrity is good, and the area is not inflammed, broken, swollen, or bruised.
Satisfactory
Satisfactory
Satisfactory
Prioritize nursing care and nursing interventions in order to manage workload, time, and physical resources.
Satisfactory 5. 7
J.B. : Caring for two patients is challenging, but I prioritize my patients' care by giving full care first to the patient that is schedule for
physiotherapy, then continue care with my second patient who has less daily activities in her care plan.
Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Jacqueline has met this outcome by demonstrating with clinical examples. She submitted three good concept maps that included physical
assessment data. Prioritization and time management developed over time as she became more familiar with the surgical routines and
skills required to care for her patients.
Satisfactory
Satisfactory
Satisfactory
Satisfactory
6. 3 Seek out assistance and consult with members of the inter-professional health care team.
J.B. : When I needed more clarification on my patient's plan of care, and how to document a sitz bath, diabetic medication and NG tube
drainage, I consult with the staff nurse, Clinical Teacher, or other nursing students who usually advise me apprpriately or give help where
needed.
Satisfactory
Use teamwork, consensus building, and conflict resolution skills to meet expected client outcomes.
Satisfactory 6. 4
J.B. : My obese patient did not want to ambulate, but with help of the Physiotherapy team, we were able to get her to ambulate amd sit in
the chair for some time.
Satisfactory
Use effective, collaborative, and consultative strategies to meet clients needs within a changing environment.
Satisfactory 6. 5
J.B. : I was unable to communicate with my Nigerian patient because of the language barrier. Nevertheless, I used effective, collaborative
and consultative to communicate with my patient through her daughter, and I was able to meet the client's need and all expected outcome.
Satisfactory
Satisfactory 6. 6
Interact with members of the health care team respecting their unique role and competencies.
J.B. : The members of the health care team are competent in their unique roles. If IV fliuds are being administered to my patient, I will
check my patient's IV site for phabitis or infiltration and update my staff nurse. As a student nurse, I will not perform any venipuncture on
my patients, I will leave that task to the nures who are the experts at their jobs.
Satisfactory Satisfactory 7. 2
Engage in ongoing reflective practice to identify strengths, areas for improvement; and, integrate feedback into practice.
J.B. : I engage in ongoing reflective practices after every shift by mentally strategizing ways to improve my patient's care and time
management skills. I also participate in weekly post conferences where the group discusses strengths and weaknesses, and our Clinical
Teacher will alway teach us new skills and show us the way forward which becomes part of our daily routine so that the outcome is
favourable.
Satisfactory
Create, implement, and evaluate a learning plan consistent with the Quality Assurance program (CNO).
Satisfactory 7. 3
J.B. : I have created and implemented a learning plan consistent with CNO's Quality Assurance program. My Clinical Teacher will evaluate
my learning plan and grade me according. My learning plan indicates my need for IV and NG tubes management. I was later assigned a
patient who had IV, NG, foley catheter, and oxygen via nasal prongs, who I managed.
Satisfactory Satisfactory 7. 4
Seek out learning opportunities and feedback that foster professional development; and, integrate these into practice.
J.B. : I seek out new learning opportunities by learning how to remove a foley catheter from a female patient, empty and change an NG
suction container, change a patient's gown who has an active IV line, disconnect and reconnect an NG suction line, and view a suction
dressing being done by a staff nurse.
Satisfactory
Satisfactory
Satisfactory
Satisfactory
Satisfactory Satisfactory 7. 7
Apply knowledge of changes to the health care system, technology, and in society as these affect nursing practice.
J.B. : I apply knowledge of change according to the health care facility's system. For example, I was told by my Clinical Teacher that there
has been a to change in the way documention is done for assessments; we should no longer highlight every individual assessment like
'abdominal,cardiovascular, respiratory, etc' to document, but highlight 'physical assessment' and document accordingly.
Satisfactory 8. 1
J.B. : I used critical thinking and problem-solving skills when a lunch tray was placed on my NPO patient's table. I quickly removed the
tray, rechecked my patient's MAR, and consulted with my staff nurse about my patient's diet. I went back to my patient's room and quietly
explained to her the doctors orders about her diet plan
Satisfactory Satisfactory 8. 2
Use critical thinking, problem-solving and decision-making skills to assess clients and to determine nursing diagnoses, expected
outcomes, nursing interventions, and evaluative
criteria.
J.B. : If my patient is experiencing pain on a scale of 7/10, I will use the PQRST to assess her pain. I will monitor my patient's vital signs,
especially her pulse, blood pressure, and respiration. I will also carry out a respiratory assessment to check her breathing, and I will
administer pain medication as prescribed.
Satisfactory
Evaluate critical thinking, problem-solving, and decision-making skills and design a plan to improve these.
Satisfactory 8. 3
J.B. : I evaluate my critical thinking, problem-solving, and decision-making skills through daily self reflection, and I constantly elavtuate
my plans to ensure my goals are met.
Satisfactory Satisfactory 8. 4
Integrate knowledge from a variety of nursing, health, and other theory into nursing practice to provide safe and competent care.
J.B. : I will integrate knowledge from my class notes, text books, online modules, simulation labs, and online lectures and videos to
provide safe and competent care for my clients
Satisfactory
Satisfactory
8. 5 Prioritize effectively.
J.B. : I prioritize effectively when I was assigned two patients. I give partial care to both patients, then completed care first on the patient
that had a physiotherapy appointment .
Satisfactory
Satisfactory
Satisfactory
Use the practice decision-making and the nurse-client-environment frameworks to inform and guide practice.
Satisfactory 8. 7
J.B. : The nurse-client-environment is practice with all decision making about the client. The client may verbalize to the nurse that she is
feeling cold, the nurse will help the client by providing extra blankets for the client's comfort. The nurse's action will foster relationship and
practice.
There were many challenges throughout this semester, nevertheless, these challenges help to make me a stronger person. I will continue to review
my class notes, online texts, pocket guide to nursing skills & procedures, nurse's pocket drug guide, appropriate medical online videos, and CNO's
website so that I can stay updated with new skills and techniques.
Student's References
Barberio, J., Gomella, L., Underwood, S., & Beck, C. (2015). Nurse's pocket drug guide 2015. New York: McGraw-Hill Education.
College of Nurses of Ontario/Ordre des Infirmires et Infirmiers de l'Ontario. (n.d.). Retrieved November 28, 2015, from http://www.cno.org/ Jarvis, C.
(2008). Physical examination & health assessment (5th ed.). St. Louis, Mo.: Saunders/Elsevier.
Potter, P., & Perry, A. (n.d.). Canadian Fundamentals of Nursing, 5th Edition. Retrieved November 28, 2015, from
http://www.elsevier.ca/ISBN/9781926648538/Canadian-Fundamentals-of-Nursing
Perry, A., & Potter, P. (2015). Mosby's pocket guide to nursing skills & procedures (8th ed.). Maryland Heights, Mo.: Elsevier/Mosby.
Grade
Satisfactory
Unsatisfactory
Grade
Satisfactory
No
Yes
Student Sign Off
I met with my Clinical Teacher/Preceptor and discussed my evaluation
No
Yes
In general this evaluation accurately reflects my performance
No
Yes
Student Comment
My clinical experiences this semester was challenging but fulfilling. I am looking forward to gaining new experiences and having a great final semester
in 2016.