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 :

Raymond Robles
Margaret Baird
Judy Martin
Trillium Health Partners/Credit Valley Hospital
Agency
1D Acute Rehab/Geriatric
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.
R.R. : I am satisfactory in this area because I present myself in a professional manner at school and in clinical. I follow the institutions
policies and understand that it is important to incorporate these standards into my practice.

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

Satisfactory

Satisfactory

R.R. : I am satisfactory in this area because I take responsibility for all my actions in the clinical setting. I am accountable for my practice
and display professionalism and ethical demeanor when dealing with clients.

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

Satisfactory

Satisfactory

care.
R.R. : I understand that my actions, words, and presentation, along with my surroundings affect the care and therapeutic relationship I
provide for my clients. I understand that presenting myself in a negative manner will yield negative result with my clients.

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

Satisfactory

Satisfactory

R.R. : I try to incorporate what I have learned in my clinical experience and classroom teachings into my practice especially in regards to
client care, assessment and medications.

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

Satisfactory

Satisfactory

and a safe environment.

R.R. : I always check the status of my patient, precautions, and previous charting to be cautious of any potential dangers for my client,
myself, or others. I remember to assess the environment for potential dangers and encourage safety devices (such as walkers) to ensure
client safety.

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

Satisfactory

Satisfactory

uncertain.
R.R. : I am satisfactory in this area because I do not hesitate to approach my clinical teacher, peers, or other health workers whenever I
need clarity.

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

Satisfactory

Satisfactory

unsafe,
unacceptable and/or unprofessional behavior.
R.R. : In situations in which there is unsafe/unacceptable or unprofessional behaviour, I ensure that I stay professional by discouraging
the behaviour and report it when necessary.

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

Satisfactory

Satisfactory

R.R. : I understand that my role as a nurse is to provide the best possible care for my clients to help them recover or reach their optimum
level of health. This includes monitoring and assessing my patient physically, psychologically, etc. and providing nursing care and
medications.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Ray follows all hospital policies and CNO standards related to confidentiality, infection control, documentation, medication administration
and professional behaviour. He is accountable for completing all care and promptly attends to his patient's needs. He arrives early on the
unit and researches his patient's medications, diagnosis and reviews the chart and profile. He asks appropriate questions regarding the
plan of care and does not proceed with skills that he is not familiar with. He seeks assistance appropriately when transferring or
ambulating patients to ensure safety.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

R.R. : I believe I contribute to my team discussions by attempting to share relevant information when available and reporting occurrences
that may have transpired with my clients.

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

Unsatisfactory

Satisfactory

methods.
R.R. : I do my best to document accurate and relevant information in a timely manner. In clinical, I have experience in documenting using
written and electronic methods. At the moment, I am still working on documenting only relevant information rather than writing too much
unneeded information. I am also trying to improve documenting in a timely manner.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

R.R. : In clinical, I report any relevant information to the nursing professionals, my instructor, or my peers. This information is usually
regarding any abnormalities in my patient or information needed for charting or certain procedures. (i.e. client's vital signs or reports of
pain)

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

Satisfactory

Satisfactory

R.R. : In clinical, I am able to communicate and work with the health care team to report my responsibilities for the shift. To communicate
with the client, I also use various methods such as touch and eye contact. Every time I perform a nursing skill, I communicate my actions
with the client.

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

Satisfactory

Satisfactory

Protection Act (PHIPA).

R.R. : I am satisfactory in this area because I recognize the sensitivity of my client's information and I understand that divulging client
information outside of the work environment is against the law.

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

Satisfactory

Satisfactory

information.
R.R. : In school and clinical, I use resources such as laptops, textbooks, and other devices to retrieve and research information. An
example of this is when I research my medications during clinical.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Ray is an active participant in conference discussions. His documentation has shown continuous improvement and now contains all
relevant data. His understanding of descriptive terminology has improved. As he stated, he is now focusing on making his documentation
more succinct. Ray reports promptly any abnormal assessment findings or concerns regarding his patient's status. He uses effective
communication techniques and actively listens to his client's story without judgement or opinion. He inputs patient information on the
computer and is able to access relevant lab reports and consult notes.

3. CARING RELATIONAL PRACTICE

3. 1 Use effective communication techniques.

Satisfactory

Satisfactory

R.R. : In clinical I report any relevant information to my instructor, the nurses, or my peers in regards to giving reports, reporting
abnormalities, or signing off my shift.

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

Satisfactory

Satisfactory

and health care team members.

R.R. : I am able to set therapeutic relationships with my clients and professional relationships with my team members. I treat all individuals
with respect and professionalism and provide care, compassion and safety for my clients by closely monitoring them when needed.

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

Satisfactory

Satisfactory

R.R. : In clinical, I try my best to provide the best care for my patients by assessing my patients and the environment to ensure there are
no potential dangers. I also try my best to provide care to my clients to ensure their well-being. (assessments, vital signs, hygiene care,
medications, etc.)

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

Satisfactory

Satisfactory

have on relational practice.

R.R. : I understand and respect that a client's beliefs, values and experiences reflect their views on health and the health care setting. I
understand that patients are never exactly the same and I must adapt my care to fit my client's needs.

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

Satisfactory

Satisfactory

consult appropriately.
R.R. : I continue to demonstrate good communication with my clinical team and other health care staff by reporting and seeking
assistance when needed. In clinical, I also take the time to listen to the nurses to help guide my care for my patients.

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

Satisfactory

Satisfactory

R.R. : I understand that the inter-professional health care team are made up of professionals of many different backgrounds. All of these
professionals offer different expertise to help collaborate the best care possible for the clients.

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

Satisfactory

Satisfactory

influencing their choices and decisions.

R.R. : I am satisfactory in this area as I remain culturally sensitive to patient and families who make decision based on their different
beliefs with which I respect. For example certain religions that refuse to have a male nurse provide care for them.

3. 8 Provide effective client education.

Unsatisfactory

Satisfactory

R.R. : I believe I still need development in this area by continuing to find more opportunities to educate my clients during clinical.

Teacher comments for CARING RELATIONAL PRACTICE :

Ray has a very caring and empathetic attitude when delivering client care. He collaborates with clients and involves them in the plan of
care. He is sensitive to various cultural beliefs and customs. He explains all treatments and rationale for medications to his clients in
terminology they can understand.

4. LEADERSHIP AND ADVOCACY

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

Satisfactory

Satisfactory

R.R. : I am able to resolve conflict when needed and I understand it is important not to make conflicts personal or targeted towards
another person. I must stay professional and respectable towards the health care team and my clients.

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

Satisfactory

Satisfactory

environment.
R.R. : In school, I am able to practice my leadership skills by working in a group to research and present information during class. I was
responsible as the team lead to assign my group different tasks and organize the work and research involved.

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

Satisfactory

Satisfactory

professional health care team.

R.R. : I am able to provide feedback and receive feedback from my peers without taking feedback personally and learning how to
incorporate their feedback into my practice to help me become a better nursing professional.

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

Unsatisfactory

Satisfactory

R.R. : I believe I still need to improve in this area and gain more confidence in order for me to efficiently advocate for myself and others.

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

Satisfactory

Satisfactory

R.R. : I understand that a client's rights, dignity, respect and integrity must not be abused. A patient has the right to make their decisions if
they feel uncomfortable with certain procedures and medications. I understand that I must not force my will on a client.

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

Satisfactory

Satisfactory

R.R. : In clinical, I will not participate in any unsafe, unacceptable and unprofessional behaviours and I will report to my instructor or
nursing team anytime it is necessary to do so.

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.
R.R. : I understand that nurses must put the public in their best interest and promote health and well-being

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

Satisfactory

Satisfactory

R.R. : In clinical and school, I was able to practice this skill through concept mapping and care plans. This involved finding the right
diagnosis, interventions and treatments necessary to help the client's well being.

Teacher comments for LEADERSHIP AND ADVOCACY :

Ray is always willing to assist his fellow students and staff with care of their clients. He completed a peer evaluation on one of his fellow
students. He is capable of being a client advocate. He reports any client concerns or abnormal findings promptly to staff and myself. He
collaborates with the client when planning care and offers them choices when possible.

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.
R.R. : I understand that no clients are the same and I am able to adapt their needs, expected outcomes, and beliefs into my nursing
practice. I am able to do this by understanding what the patient needs from me and incorporating that into my care. (For example
monitoring urine retention and performing in and out catheters)

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

Satisfactory

Satisfactory

articulated competently in writing and orally.

R.R. : In clinical and school, I have written care plans and concept maps focusing on my client and the care that they need. In Theory
class, we are sometimes expected to orally communicate what type of care is needed for certain types of patients.

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

Satisfactory

Satisfactory

R.R. : I have used the knowledge I gained from clinical, class, and sim labs, and incorporated them into my nursing practice. I am able to
prioritize certain client needs over others through my knowledge, skill, and judgement. (For example, I understand that the priority
assessment for post-op patients are respiratory assessments.)

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

Satisfactory

Satisfactory

R.R. : I believe I am satisfactory in this area because I am able to use my knowledge and evidence based theories to collaborate with
others in creating plans of care. This is evident in my concept mapping and care plans.

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

Satisfactory

Satisfactory

interventions in a manner that demonstrates knowledge and skill.

R.R. : In clinical, I perform routine head to toe assessment on all my clients. Here, I use my practice and experience assessing neuro,
respiratory, musculoskeletal, circulation, etc. to ensure my client is stable. I am able to carry out interventions when needed in clinical. (For
example, changing the wound dressing on clients who need their dressing changed.)

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

Satisfactory

Satisfactory

R.R. : I understand that my actions, words, and presentation, along with my surroundings affect the care and therapeutic relationship I
provide for my clients. Therefore, I must use myself and the environment to guide my practice for the client.

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

Satisfactory

Satisfactory

physical
resources.
R.R. : In clinical, I try to organize my time to prioritize the tasks I need to complete from the beginning to end of my shift. I often note the
tasks and procedures I need to complete and prioritize what needs to be done first.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Ray arrives early on the unit so he can review the client's profile to plan his care for the day. He completes thorough bedside assessments
(LOC, chest sounds, bowel sounds, wound and skin condition, mobility) and monitors the client for ongoing problems (pain, nausea,
urinary retention). He is able to modify the plan of care when necessary (ex. client's pulse 160 - race team called). He has prepared and
administered meds correctly by a variety of routes (PO, subcutaneous, IV, g-tube). He has completed complex wound care (packings) and
has maintained aseptic technique. He is efficient with male catheterizations and maintained sterile technique. He was able to care for a
client with a colostomy and a continuous enteral feed. He follows techniques learned from physio to safely transfer and ambulate his
clients. He is able to effectively organize and prioritize care for 2 complex clients.

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.
R.R. : In clinical, I collaborate with my peers, my instructor and the nursing team to provide the best care possible for my clients.

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.

R.R. : In clinical, I understand the needs and expected outcomes of clients change. Knowing this, I try my best to assess what my client's
needs are and collaborate with others to help my client reach the desired goals.

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

Satisfactory

Satisfactory

R.R. : I am satisfactory in this area because I recognize my limitations and I understand that there are potential consequences to my
actions if I carry out an unpracticed procedure or skill without assistance. I do not hesitate to ask for assistance from my clinical teacher,
healthcare professionals, or my peers.

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

Satisfactory

Satisfactory

outcomes.
R.R. : 6.4I am able to work well with my peers in regards to planning through a conflict and carrying out the plan to meet certain outcomes.
An example of this would be working with my peers while changing a client's briefs, linens, and re-positioning a client.

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

Satisfactory

Satisfactory

changing
environment.
R.R. : In clinical, I was assigned to a patient that was new to the rehab unit. I effectively collaborated with other nurses and my instructor to
help provide efficient care for my client. I cared for this patient by checking vitals, physical assessment, hygiene care, and wound care.

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

Satisfactory

Satisfactory

competencies.
R.R. : I am able to communicate with the nursing team and recognize their competencies by observing their practice and incorporating
learned skills into my practice.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Ray collaborates with staff nurses and allied health professionals when planning and implementing care. He is always respectful and is
knowledgeable of the various roles of the health care team.

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.
R.R. : I use my knowledge, skill and experience from school and clinical to provide care for my clients. I collaborate with other nurses to
help me improve and provide competent and safe practice.

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

Satisfactory

Satisfactory

integrate feedback into practice.

R.R. : Before, during and after clinical, I take the time to reflect on my errors and reflect on why I made those errors and the importance of
correcting those errors. Afterwards, I plan certain ways in which to improve my performance. I've reflected on my medication
administration skills, charting, etc.

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

Satisfactory

Satisfactory

program (CNO).
R.R. : I have satisfactorily completed concept maps, care plans, and research papers supporting my concept maps throughout the school
year.

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

Satisfactory

integrate these into practice.

R.R. : I consistently try to find opportunities for me to perform and practice my nursing skills during clinical.

Satisfactory

7. 5 Use nursing research to foster professional development.

Unsatisfactory

Satisfactory

R.R. : I understand that this may be one of my biggest weaknesses. I need to continue to researching on many subjects in order to
improve as a nurse.

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

Satisfactory

Satisfactory

R.R. : In clinical, I use theory based approach and evidence-informed practice to guide my head to toe assessments and nursing skills
such as wound dressing change, catheters, etc.

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

Unsatisfactory

Satisfactory

these affect nursing practice.

R.R. : I need to continue learning and researching more in regards to this subject.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Ray seeks assistance appropriately from staff and physio to safely transfer and ambulate his clients. He responds positively to any
constructive feedback from teacher and nursing staff. He completed a satisfactory learning plan with specific goals and strategies. Ray
takes advantage of any learning opportunities on the unit. He researches information to make sure his practice is evidenced based
(medications, diagnoses, interventions) and skills are performed using scientific principles.

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.
R.R. : I believe there is still much room to improve my critical thinking skills. Though I am able to display satisfactory skills in decision
making skill during clinical, I need to continue studying to improve as a critical thinker.

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

Unsatisfactory

Satisfactory

Satisfactory

Satisfactory

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

criteria.
R.R. : I believe there is still much room to improve my critical thinking skills. See above.

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

R.R. : I plan on improving in these areas through self reflection, readings, and continuing to learn during my clinical experience.

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

Satisfactory

Satisfactory

practice to provide safe and competent care.

R.R. : I have been relating my nursing health, theory and other classes into my clinical to provide safe and competent care to my clients.
However, I believe I still need to improve in this area by continuing to integrate more knowledge into my care.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

R.R. : During clinical, class and sim lab, I have grasped a firm knowledge on how to prioritize.

Satisfactory

8. 6 Demonstrate professionalism and accountability.

Satisfactory

R.R. : In clinical, I am always on time and in full uniform. I treat my clients, peers, my clinical teacher and healthcare professionals with
respect and I conduct myself in a hardworking, professional manner.

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

Satisfactory

Satisfactory

and guide practice.

R.R. : I am able to guide my practice by forming a therapeutic bond with my patients and ensuring a safe environment.

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

Ray is developing his critical thinking skills and problem solving abilities. He is linking his assessment findings back to the clients
diagnosis and past medical history and can identify the rationale for various medications. As he identified, this is an area to always
continue to work on and develop. He is able to apply information from class (health assessment, pharmacology, theory) into his practice.
Ray is independently able to organize and prioritize care for 2 complex clients.

Student Final Summary with Strategies for Continued Growth

After my self evaluation, I believe my biggest weaknesses are critical thinking and focus on research.I plan on continuing to study and improve my
time management in order to focus on reading and improving my knowledge on theory and medication. I hope to improve as a nurse by improving my
critical thinking and my overall foundation of knowledge. I will continue to review patient history to gain a full understanding of my patients needs to
provide better care for my clients. Lastly, Thank you Margaret for your time, guidance and expertise in helping me develop as a nurse.

Teacher Final Summary with Strategies for Continued Growth

Ray has progressed very well over the past 14 weeks. I have no concerns regarding his practice or knowledge base. Both staff and clients, and their
families, have complimented Ray on his approach and practice. Continued experience will help Ray develop his critical thinking skills.
Continue to research medications and diagnoses
Review the clients chart and past medical history to fully understand the client's "story" and make connections regarding assessment findings and
prescribed treatments.
I have enjoyed having Ray as a member of the clinical group and I predict he will continue to do well during his preceptor placement.

Grade

Satisfactory

Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

Grade

Satisfactory

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

Student Comment
Thank you for the great learning experience.