Self Assessment

2016 - 2016 - NURS 151 Practical Nursing Practice 2 Final (201508)

NURS 151 Practical Nursing Practice 2 (PN, 12-Jan-2016 - 07-May-2016)
Student : Sachie Komaki
Clinical Teacher/Preceptor : Grace Jose
Program Coordinator : Wendy Chow
Location : Cawthra Gardens Long Term Care Residence
Placement Setting : Agency
Unit/Office/Clinic : LTC
Period : 12-Jan-2016 To 07-May-2016
Student hours : 168
Required Hours : 168
Validated hours : 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

Satisfactory Satisfactory
1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies and

procedures.

S.K. : I understand that these rule and regulation must be followed in order to keep clinical environment safe.

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

S.K. : When I leave clients after providing care, I pay attention to their safety. I think this is the way of responsible manner.

Satisfactory Satisfactory
1. 3 Determine strengths and limitations and when to consult and seek assistance from other

professionals.

S.K. : When I administer medications, I always ask other professionals to ensure double check.

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

S.K. : I introduce myself in the beginning of care because this makes relationships between clients and I closer.

Satisfactory Satisfactory
1. 5 Ensure client safety and a safe environment.

S.K. : I learned that elderly people tend to be choked by food. I followed the feeding policy in the clinical facility. For example, using small spoons to

keep potion small and one person assist one client for whole meal.

Satisfactory Satisfactory
1. 6 Ask relevant questions to clarify understanding of the plan of care and whenever uncertain.

S.K. : During morning care, I had many opportunities to provide care to clients who were not mine. In this case, I made sure how much support the

clients, and if there were particular things that I had to be careful by asking professional team members.

Satisfactory Satisfactory
1. 7 Identify ethical and unsafe situations and seek appropriate assistance to resolve these.
S.K. : When I realized that the brake of wheelchair was broken, I reported a PSW. When I recognized that care was carried out without closing the

curtains completely, I closed them.

Satisfactory Satisfactory
1. 8 Demonstrate understanding about the role of the student nurse.

S.K. : Nursing students are leaner. I learn how to approach clients by observing cares given by professionals, providing cares and receiving

feedback.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :

Student consistently demonstrated accountability in nursing practice. Student was able to consistently demonstrate preparedness for
practice, assumed responsibility for learning, and actively participated in learning. Weeks 11- 14: Student was able to care for 2 clients
independently; medication administration (teacher supervising), morning routine, ADL needs, and documentation.

2. ACCURATE AND RELEVANT COMMUNICATION

Satisfactory Satisfactory
2. 1 Participate in team sharing and discussions.

S.K. : I shared my experiences with my peers and asked how they communicated clients. When I was drawing concept maps, medical knowledge

were shared with the peers and I.

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

S.K. : I am practicing how to document accurately. I need to improve appropriate word choice and expression.

Satisfactory Satisfactory
2. 3 Report relevant information to the appropriate personnel.

S.K. : I report care providers things that I did or saw depends on the topics. For example, food intake is reported to PSWs, whereas I tell blood

glucose to RPNs.

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

S.K. : I experienced that communication is composed verbally and non-verbally such as eye contact, touching and the way of acting. For instance, a

client with depressed preferred to be padded over verbal communication.

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

(PHIPA)

S.K. : I do not write client full name or some information that is easy to be found out who they are in my note or worksheets in order to protect

privacy.

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

S.K. : I gather information regarding clients especially medication and diagnosis from electronic chart. I learn how to operate eMAR.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Student communicated clearly, concisely, and correctly in the written, spoken, and visual forms that met the needs of the clients. Also,
student responded to relevant information in a manner that ensured effective communication.

3. CARING RELATIONAL PRACTICE

 Satisfactory Satisfactory
3. 1 Utilize effective communication techniques.

S.K. : Even though clients are unconscious, I talk to them because sense of hearing may remain. If a client be touched without explanation by a care

provider, the client feel uncomfortable and scared.

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

and health care team members.

S.K. : I found that many clients prefer speak their mother language in the placement facility. Care providers attempt to talk to them in the language,

although they do not know the language well. I think that the clients' culture are respected and this leads to build relationships between them.

Satisfactory Satisfactory
3. 3 Apply knowledge of therapeutic use of self and identify its effect on client well-being.

S.K. : I try to listening to clients. I learn that active listening benefits both. Clients reduce stress and I find what they want to do. Determining

appropriate needs supports client well-being.

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

relational practice.

S.K. : I believe that even though clients are not able to speak, they hear, therefore, I always talk to them in order to showing respect.

Satisfactory Satisfactory
3. 5 Interact with clients and members of the inter-professional health care team; and, consult

appropriately.

S.K. : When I provide morning care at first time, I ensure clients ADLs by asking PSWs to assist them adequately since not enough care causes

incidents, whereas too much support doe not help their independence.

Satisfactory Satisfactory
3. 6 Apply knowledge of practices and systems that support the diversity of clients and the inter-

professional health care team.

S.K. : Many clients have something regarding their religion such as drawing in their rooms. Although the religions are not the same, each of them are

respected.

Satisfactory Satisfactory
3. 7 Apply knowledge of clients cultural, religious, and other beliefs and values as these influence

clients choices and decisions.

S.K. : There is church service in the facility. I understand that spending time for religious thought supports clients' mental management.

Satisfactory Satisfactory
3. 8 Provide effective client education.

S.K. : I explained to a client whose nursing diagnosis is risk for fall that it was important to wear shoes properly when she walked. However, she

tended to forget it due to Alzheimer's. I need to find different way of approach.

Teacher comments for CARING RELATIONAL PRACTICE :

Student was able to establish sound relationships with peers, staff, clients, and teacher. Student consistently utilized well developed
communication and interpersonal skills.

4. LEADERSHIP AND ADVOCACY

 Satisfactory Satisfactory
4. 1 Recognize conflicts and strategies for resolution.

S.K. : There is a limit about timing of care. Therefore clients are not likely to be given enough time to accomplish some. Take grooming as an

example, total assistance is given as a result of a client fasten buttons slowly even though they are able to do so. I realized that how to manage time

is significant and hard.

Satisfactory Satisfactory
4. 2 Demonstrate leadership skills that foster group work and a positive learning environment.

S.K. : Because I do not have enough confidence to lead, it is hard to accomplish this task.

Satisfactory Satisfactory
4. 3 Identify opportunities to improve health care service and nursing interventions by advocating for

client, self, others, and quality practice.

S.K. : I learn that health care service and nursing interventions should be client centered. When I carry out care, I prioritize how effective the care is

for the client.

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

professional health care team.

S.K. : I received feedback more than giving. For example, there are a variety of way of feeding. A client prefers sweet taste than others, while other

one likes milk more than juice. I need to encourage them to intake well balanced diets. However, it is essential to increase amount of intake. I learned

that I have to assess how to maintain volume and quality of intake.

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

S.K. : When clients get dress, I always ask them if the clothing that I prepare is okay for them or not. I have to respect their right to choose.

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

S.K. : In the facility whose floor is closed, some clients want to go out of the ward. While I understand their needs, I do not let them go because safety

has to be kept first.

Satisfactory Satisfactory
4. 7 Consult and collaborate when carrying out health care and nursing practices that are in the best

interests of the public and protect the public through collaboration and consultation.

S.K. : In the facility, there is a church service which is collaborated to the one in neighborhood. This is one of connections with public.

Teacher comments for LEADERSHIP AND ADVOCACY :

Student was able to demonstrate leadership skills related to peer interactions. Student Consistently demonstrated
professional nursing behavior.

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

Satisfactory Satisfactory
5. 1 Incorporate the unique needs and expected outcomes into individual clients plans of care.

S.K. : I learned that nursing care are provided individually. For example, a client needs to hygiene care, however, she does not like taking a shower.

In this case, the care is carried out by two people assist: one cleans the body, the other one sings a song that is the client's favorite things to do with

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

competently in writing and orally.

S.K. : Concept map is helpful to figure them out. When planning nursing plans, I concern clients' ADLs and medical conditions.

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

S.K. : I found that the vast majority of clients have risk of falls as nursing diagnosis, and many of them use devices to prevent falls. I pay attention to

them, and make sure the brakes of wheelchairs.

Satisfactory Satisfactory
5. 4 Provide information that contributes to the evaluation and refinement of plans of care.

S.K. : I understand that evaluation is one of part of nursing process. However, I did not spend much time for it.

Satisfactory Satisfactory
5. 5 Safely and competently carry out nursing assessments and nursing interventions that are theory-

based and within skill abilities.

S.K. : I always pay attention to hand hygiene. I wash or sanitize my hands after each care.

Satisfactory Satisfactory
5. 6 Carry out nursing care that reflects the practice decision-making framework.

S.K. : I try to think logically while assessing for clients. When critical thinking is done well, clients' needs are satisfied.

Satisfactory Satisfactory
5. 7 Complete nursing care responsibilities and nursing interventions in an organized and timely

manner.

S.K. : Time management is the task that I need to improve. I need to practice how I provide care without rushing.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :

Student practiced within the ethical guidelines of the care facility, expectations of Humber College, and the CNO.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

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

determine health needs, and to achieve mutually agreed expected outcomes.

S.K. : When I carried toileting care with a PSW, she provided ample time for a client since the client usually has bowel movement at the time. I

learned that each care need to be considered depends on time and situations.

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

needs and expected outcomes of clients.

S.K. : I found that clients needs change when their conditions transform. For instance, for the clients who are isolated, new issues appear such as

stress due to staying their room whole time, and hygiene or rest to get better. As a result of this, certain cares are prioritized.

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

S.K. : When administering medication, I always ask RPNs or my clinical teacher to double check the medication in order to carrying out it safely.
 Satisfactory Satisfactory
6. 4 Use teamwork, consensus building, and conflict resolution skills.

S.K. : Information about clients and nursing knowledge are shared between my peers and I. This helps us to improve our abilities.

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

changing environment.

S.K. : I found that clients' needs are influenced by physical, mental, social situations. Therefore, when I assess for their needs, I consider these facts.

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

S.K. : In the afternoon, before dinner, recreation which was singing songs and dancing was carried out by PSWs. During it, clients were awake and

enjoying. I learn that this activity affects their cognition because many of them are more active before the recreation.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Student developed strong relationships both with peers, hospital staff, teacher, and clients. Student utilized effective interpersonal skills
and therapeutic communication.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

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

consultation with members of the inter-professional health care team and through competent and safe

practice.

S.K. : Providing nursing care could be harmful. I as a student am under regulation because I have not trained enough. Therefore, I always make sure

I administer medication correctly by asking my teacher and RPNs to double check.

Satisfactory Satisfactory
7. 2 Participate in self-reflection to identify strengths, areas for improvement.

S.K. : I am aware that I get nervous easily, especially time is running. I attempt to be calm. I know how nervousness impacts me in a negative way, I

do not make clients in hurry.

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

(CNO).

S.K. : I worked on the goals based on the learning plan. Although I did not reach the goals perfectly, I think my skills have improved.

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

integrate these into practice.

S.K. : In terms of injection skills; S.C. and IM, not only receiving feedback after administering the medication but also observing peers' skill are

learning opportunities.

Satisfactory Satisfactory
7. 5 Utilize nursing, health and other theory and literature to improve nursing practice.

S.K. : I learned that Erickson' s theory helps to understand how people develop differently in each age group. This is also useful to assess for clients.

Satisfactory Satisfactory
7. 6 Use a theory-based approach and evidence-informed practice.
S.K. : In terms of medication, both effects and adverse effects have to be monitored. Take anti-hypertensive medication example, if it affects

negatively, blood pressure becomes too low. Thus, blood pressure needs to be checked before taking medication.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Student consistently sought knowledge and provided evidence based rational for decisions. Student was able to use acquired knowledge
and apply it to practice. Student increased ability to organize and prioritize related to client care.

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

Satisfactory Satisfactory
8. 1 Utilize problem-solving skills to inform decision making in all aspects of nursing care.

S.K. : It is important to assess accurately. I consider why this happens and clients' background. I realized that each factor connects each other and

influences the clients.

Satisfactory Satisfactory
8. 2 Use problem-solving and decision-making skills to assess clients and to determine nursing

diagnoses, expected outcomes, nursing interventions, and evaluative criteria.

S.K. : I attempt to assess for clients logically and timely. However, practice is still required.

Satisfactory Satisfactory
8. 3 Use self-reflection to design a plan to improve problem-solving and decision-making skills.

S.K. : when I struggle something, I think about it why it is not successful, what kind of skills or knowledge are missing, and what things are priority.

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

provide safe and competent care.

S.K. : Each client has different levels of health. For example, using wheelchair does not mean unhealthy or out of standard. Health assessment ought

to be done both physically and psychologically.

Satisfactory Satisfactory
8. 5 Use prioritization strategies for client care.

S.K. : I want clients to be comfortable all the time. I think satisfying their needs is one of purpose of nursing interventions. However, safety has to

prior to others. I consider that how I provide care safely and comfortably.

Satisfactory Satisfactory
8. 6 Demonstrate professionalism and accountability.

S.K. : In administering medications, I follow six rights in order to prevent incident. In this case, providing safe environment is professionalism and

accountability.

Satisfactory Satisfactory
8. 7 Recognize strengths and limitations and seek appropriate assistance and support.

S.K. : I need to study nursing skills and gain knowledge such as documentation skills and communication skills by reviewing class and using

materials, textbooks and videos.

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

Student successfully cared for 2 clients for several weeks. Student was able to apply analytical, interpersonal, and technical skills to
implement a safe effective plan of care.

9. SIM number of hours

9. 1 SIM number of hours

S.K. : 6

G.J. : 6

Teacher comments for SIM number of hours :

Student had no significant issues in SIM, completed all hours, and assignments.

Student Final Summary with Strategies for Continued Growth

I am aware that it takes me long time to improve nursing skills. I have to manage time wisely and keep studying.

Teacher Final Summary with Strategies for Continued Growth

You did an awesome job in clinical keep up the great work! Please continue to practice your nursing skills, develop your critical thinking by reading
your nursing theory books, and improve on your problem solving skills by communicating with the inter-professional team. Well Done!

Grade Satisfactory Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

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

I really appreciate my supportive peers and clinical teacher. If I had not done this clinical placement with them, I would not have learned a lot of things.