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BON SECOURS MEMORIAL COLLEGE OF NURSING

BSN PROGRAM
2014-2015 School Year
NUR 4143 Clinical Immersion
PRACTICUM EVALUATION TOOL
The student will have multiple opportunities in clinical areas to meet practicum outcomes. The
student, preceptor, and faculty will meet at selected times during the practicum to assess progress
toward attaining practicum competency outcomes. Students must attain three (3) or greater on the
practicum evaluation tool in order to pass the practicum. It is expected that students will be active in
the assessment process of their progress. Students need to cite specific examples of how progress is
being made towards the successful achievement of practicum competency outcomes. Each student
will be provided feedback at least once during the semester (formative) and upon completion of the
practicum work (summative).

Student Name:

Preceptor:

Tiffany Thomas

Semester:

Ashley Kennison

Spring

Year: 15

Faculty: Carrie Butler

Facility: _SMH PTU/IMCU___

PRACTICUM GRADE (P/F)
Formative (Midterm)

Summative (Final)

Pass
Fail
ATTENDANCE

Pass
Fail

The student must participate in 100% of the 225 practicum hours in order to pass
the course.
Direct Care
Acute
82.5

Direct Care
Community
16

Direct Care
Simulation

BSMCON NUR 4143 Clinical Immersion

Observation
4

Alterative
Experiences

Other
3

TOTAL
105.5

Definitions for the Rating Scale for Clinical Evaluation Tools

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Self-Directed: demonstrates reasonable consistency in meeting the competency related to

the five program outcomes; provides safe evidence-based accountable care; demonstrates
ability to individualize nursing care and identify innovative and creative solutions;
documentation is mostly in-depth; routinely embraces the altruistic values of Bon Secours;
meets the expected outcome consistently

Directed: demonstrates a need for faculty intercession in meeting the competency related to
the five program outcomes; provides safe evidence-based accountable care; documentation is
a mix of superficial and in depth; embraces the altruistic values of Bon Secours with direction;
this is average performance where most students fall; meets the expected outcomes with
direction

Remedial: demonstrates inconsistent and unreliable behavior related to the five program
outcomes; documentation is superficial; care is safe but inconsistent; this is below functioning
for a student at this level; inconsistently meets expected outcomes even with detailed direction

Ineffective: demonstrates unreliable behavior, lack of safety, accuracy; documentation

superficial and inaccurate; lack of accurate knowledge; unable to meet expected outcome

**3 or 4 required in ALL areas for successful passing of the Practicum

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FORMATIVE
EVALUATIONS
(midpoint)

PROGRAM OUTCOME
DATE

SUMMATIVE
EVALUATION
(final)

3/3/15

Communication and Collaboration: Engage in communication and collaboration with the

interprofessional health care team
Course Objectives
1. Student creates healing-trusting relationships with
4
patients, families, and interprofessional team members
2. Student actively engages in interprofessional
3
communication and collaboration
3. Student communicates and collaborates effectively
with all members of the interprofessional healthcare team
3
to effectively address system issues
4. Provide an organized and thorough change of shift
report on my patients to the oncoming nurse utilizing
3
SBAR by 101 hours of clinical experience.
Communication and Collaboration
Student Comments

Communication and Collaboration

Faculty/Preceptor Comments

MIDTERM DATE:
1.I have created a healing and trusting relationship with
my patients by providing them with information to the best
of my knowledge and also being a listening ear for their
concerns and advocating for their needs. I have created
trusting relationships with fellow nurses and other
members of the interdisciplinary team by offering to help
where I can and always verifying any questionable
actions I have, showing them the safety in my practice.

MIDTERM DATE: 3/3/15

Per her preceptor, Ashley Kennison, Tiffany is
communicating more effectively with the
interprofessional team.
Communicating well with her patients and working as an
advocate for them.
She has provided shift report on one patient but needs
to do so more throughout the remainder of the semester.

2. Every morning around 10am the unit holds

interdisciplinary rounds, and although I do not report off
directly in rounds, I offer any information that I may have
that my nurse may not have been aware of.
3.I have communicate with the monitor technician and
with the PCTs when the telemetry monitors are not
displaying readable rhythms and figure out if it is a lead
issue.
4. I have received report on all most all of my patients
and have completed a change of shift report on one of my
patients. The oncoming nurse said, you didnt leave
anything out.
FINAL DATE:4/16/15
1. I have focused on creating a trusting and healing
environment with my patient families more so this second
half, by reassuring them of what is going on and making
sure to tend to their needs as much as those of the
patient.
2. I have begun giving and receiving change of shift
report on all of my patients, as well as participating in
rounds with various members of the interdisciplinary
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team.
3.I have to call respiratory therapy to communicate issues
with a patients BiPAP or not having the correct connector
pieces for a face tent. I have also spoke with the PA from
pulmonary on adjusting the HighFlow settings of a patient
so they may have better oxygenation.
4. I have provided change of shift report on all of my
patients during my last 6 shifts or so, as well as give
report on my patient being discharged to a skilled nursing
facility.

FORMATIVE
EVALUATIONS
(midpoint)

PROGRAM OUTCOME
DATE

SUMMATIVE
EVALUATION
(final)

3/3/15

Caring: Practice empathetic caring within the framework of the Catholic health ministry
Course Objectives
1. Student embraces the altruistic values of Bon Secours,
respects the Catholic health ministry, and practices with
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loving kindness
2. Student demonstrates the ability to be the caring3
healing environment
3. I will establish a stronger nursing presence when
servicing patients through emotional or spiritual
experiences by listening and providing available
3
resources (i.e., Chaplin) by 101 hours of clinical
experience
Caring
Caring
Student Comments
Faculty/Preceptor Comments
MIDTERM DATE
1. I always show empathy to my patients and compassion
for their current situation

MIDTERM DATE: 3/3/15

Per her preceptor, Tiffany demonstrates the BSHS
values at the bedside providing care.

2. I tried to become the healing environment for a patient

of mines whom was anxious about ambulation by
addressing her fears and concerns directly and letting her
know that I believed in her ability and that I would be there
with her every step of the way.

Is respectful of the professional team.

Provides education to improve patient outcomes.

3. During my hospice rounds at MRMC for my community

immersion experience, there were two instances where I
consulted and referred the chaplain to families that were
going through the end of life transitions for their family
members. I provided the families with my nursing
presence and therapeutic listening.
FINAL DATE: 4/16/2015
1. I had a patient who had a severely altered mental
status and every time we touched her to give meds or turn
her she would scream. Although it was frustrating I
maintained a calm presence and would agree with and
support her when she would mention aspects of her
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religion.
2. I practiced with loving kindness making sure to tell her
we were there to help her and that everything was okay.
3. I have not had to incorporate the Chaplin in the care of
any of my patients, but I did however provide a listening
ear and a strong nursing presence to a family of three who
began to cry when discussing the possibility of the father,
the patient, going into hospice care.

FORMATIVE
EVALUATIONS
(midpoint)

PROGRAM OUTCOME
DATE

SUMMATIVE
EVALUATION
(final)

3/3/15

Servant Leadership and Global Health: Integrate servant leadership into nursing practice
to promote global health
Course Objectives
1. Student integrates servant leadership into nursing
3
practice to promote global health
2. Student appreciates the attributes of global health
including social justice, and demonstrates a commitment
3
to the health of vulnerable populations and the elimination
of health disparities
3. I will build on my servant leadership qualities by
empowering and motivating patients to be more involved
3
in their health by 101 hours of clinical experience.
Servant Leadership and Global Health
Student Comments

Servant Leadership and Global Health

Faculty/Preceptor Comments

MIDTERM DATE:
1.I had a patient who needed to ambulate but did not
because of anxiety and fear of falling. I was a servant
leaders for this patient as I encouraged her heart and
motivated this patient to ambulate to the bedside
commode which in turn did a service to protect her skin
from sitting in urine.

MIDTERM DATE: 3/3/15

Per her preceptor, Tiffany provides nonjudgmental care
to her patients.
Advocates for pain management for her patients.
Educates to improve patient outcomes to promote
health.

2.I had an older adult patient who lived in a lower income

community and needed help getting a bigger wheelchair
and more oxygen tanks prior to discharge home. I
partnered with the case manager to make sure that
despite her health and financial disparities that the patient
had sufficient equipment and supplies to be safe at home.
3.I motivated and empowered one of my patients to be
more involved in her healthcare and well-being
improvement by creating an out-of-bed chart for the
patient to use to keep track of her ambulation and
pushing her to be in the chair for all three meals per day
while in the hospital.
FINAL DATE: 4/16/15
1. With every patient I am a servant leader because I
make sure to educate them on their clinical issues while
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making sure to meet them where they were as far as
ability and readiness to learn.
2. I had a 94 y.o. patient whom had previously lived by
himself that did not want to participate in services form
physical therapy. Because my patient and I had such a
good rapport I was able to be a servant leader in this
instance and convince him of the benefits of physical
therapy and even help during the process.
3. I had a patient that refused more than anything to wear
BiPAP. I empowered this patient by reminding her that we
must honor her rights if she is of sound mind that we
cannot force her to do something she does not want to
do. I used the power she had to motivate her to try using
the BiPAP and assured her that if she wanted it off we
would take it off.

FORMATIVE
EVALUATIONS
(midpoint)

PROGRAM OUTCOME
DATE

SUMMATIVE
EVALUATION
(final)

3/3/15

Safe, Quality, Evidence-based Care: Provide safe, quality care incorporating evidence
based nursing practice
Course Objectives
1. Student delivers compassionate, patient-centered, safe,
evidence-based care that demonstrates clinical judgment
3
to promote high quality patient outcomes
2. Student create, implements, and revises the plan of
care based on an ongoing evaluation of patient outcomes

3. I will demonstrate critical thinking by working with

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multiple patients and managing my time and prioritizing
patient care by 101 hours of clinical experience.
Safe, Quality, Evidence-based Care
Safe, Quality, Evidence-based Care
Student Comments
Faculty/Preceptor Comments
MIDTERM DATE:
1.I had a male patient that had stage 4 cancer that had
metastized to his brain which caused him to have
frequent falls. I instructed him to use the call bell when he
needed to use the rest room. I showed my patient
compassion and understanding of the fact that always
having to call and ask for assistance was a major life
change for him.
2. One of my respiratory patients had prn orders for
BiPAP. She had been on NC all morning and started
talking about discharge. Even though she was utilizing
her breathing techniques her oxygen saturation levels
began to dip low and, I was forced to restart her BiPAP
and ultimately change her plans or thoughts of going
home.
BSMCON NUR 4143 Clinical Immersion

MIDTERM DATE: 3/3/15

Per her preceptor, Tiffany has improved her ability to
prioritize patient care and manage her time efficiently.
Ashley believes she has made significant progress but
there is still room for improvement.
Is interpreting diagnostics to implement interventions to
promote positive patient outcomes.

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3.I am far from an expert at time management, however I
have cared for a total of three patients per shift on
occasion and have administered all meds and completed
all documentation on my patients with only a few areas of
documentation having been missed.
FINAL DATE: 4/16/15
1. I had a patient that had severe altered mental status.
She did not follow directions but I was informed that she
took her medications with applesauce. Upon attempting
to give her morning meds it became clear that the patient
was a huge aspiration risk, so I held all PO meds notified
the NP and had it put it in for a speech eval.

FINAL DATE:

2. One of my patients had a blood pressure that had been

steadily trending up. Upon reading a progress note it was
clear that the patient was previously on antihypertensives but had not been receiving them. I notified
the NP and suggested that she be started on two of the
three previously prescribed meds.
3. Since the midpoint I have been working with a total of
three patients. I have completed all assessments,
administered meds and completed all documentation with
my errors becoming fewer and fewer.

FORMATIVE
EVALUATIONS
(midpoint)

PROGRAM OUTCOME AND EXEMPLARS

DATE

SUMMATIVE
EVALUATION
(final)

3/3/15

Professionalism and Lifelong Learning: Demonstrate commitment to the nursing

profession and lifelong learning
Course Objectives and Exemplars
1. Student demonstrates the professional standards of
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moral, ethical, and legal conduct
2. Student demonstrates professional attributes including
the abilities to prioritize and organize care, maintain
3
stamina, and display confidence
3. Student synthesizes previous learning to approximate
the knowledge, skills, and attitudes of a beginning nurse
3
generalist
4. Student evaluate ones own practice, and assume the
responsibility for supporting the nursing profession and
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continuing lifelong learning
5. Student manages care to maximize health,
independence, and quality of life for a group of individuals
3
that approximates a beginning practitioners workload
6.I will increase my level of punctuality to a degree where
I arrive early to the unit to look up my patients and their
4
conditions and medications before the start of the shift by
101 hours of clinical experience.
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Professionalism and Lifelong Learning
Student Comments

Professionalism and Lifelong Learning

Faculty/Preceptor Comments

MIDTERM DATE:
1. It is policy within the hospital to have all insulin double
checked and signed off on by another nurse. Many nurses
will simply say okay when asked to verify the insulin and
do not actually visualize the amount of insulin or ask the
blood sugar level. I make it my duty to myself and my
patient to make sure the nurse who verifies physically
sees the amount of insulin and is aware of the blood sugar
level.

MIDTERM DATE: 3/3/15

Per her preceptor, Tiffany seeks out opportunities to
promote learning.
Tiffany is starting to have more independence and not
need to be reminded to complete tasks.
She has increased use of skill application.

2.I use my stamina each shift and make sure to complete

my hourly observations, sometime more often depending
on the amount of work for the shift. In stances where there
is information or assessment findings I am unsure of I
make sure to display confidence while in the presences of
patients and take the matter straight to my preceptor or a
senior nurse.
3.Every experience I have on my immersion unit builds
upon another, as well as my knowledge gained from
lecture. Every day I learn another new aspect to a disease
process and how one health illness is related to and
intertwines with another.
4.I feel as a nurse I have many opportunities for growth
from skills to professionalism and I try every day to work
on my communication and assessment skills, as well as
how to provide my individual nursing presence to my
patients based off their situation and personalities. I know
that as a nurse lifelong learning will contribute to my
growing proficiency, and try to retain and reinforce the
knowledge I learn each shift.
5.All of the interventions I do for my patients I base on
what I learned from EBP (as far as safe ambulation,
administration of meds, and any personal patient
concerns) and try to implement with the multiple patients I
have each shift
6.My preceptor does not come in prior to the beginning of
the shift and nor does she ask of me to do so. I have not
arrived early enough to look up information on all of my
patients, but I have been on the unit in time to look up two
patients before the start of huddle. I have arrived on time
every shift so far.
FINAL DATE: 4/16/15
1. It is the standard and expectation of the facility to
complete dual skin checks upon admission/ transfer of a
patient. I make sure to complete this with every patient to
avoid any negative fallback
2. I have been able to prioritize care each shift by
determining which of my three patients is highest priority
as far as morning assessments and administering
medications
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3. I placed a NG tube in a patient and made sure to use
my previous knowledge and policy to place the tube
properly. After doing such and taking the xray it was
determined that the tub was not far enough down. I
learned from this experience that after measuring the
length for my tube to always go a little further in.
4. At the end of each shift I talk with my preceptor and
evaluate my performance for the day and discuss
concepts that I need more knowledge on or expand on any
my concerns.
5. Since my mid-point period I have assumed care for a 3
patient load which is is the normal nurse patient ratio in
IMCU. I have done what I can to maximize the health of
my patients by encouraging them to participate in physical
therapy.
6.Although it has not been consistent, I have managed to
arrive to the unit early enough to get all the information on
my patient prior to receiving report from the night shift
nurse.

Mid-point
Carrie Butler, RN, MSN 3/11/15
Tiffany Thomas 3/12/15

BSMCON NUR 4143 Clinical Immersion

Final
Tiffany Thomas 4/16/15