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NURS1020 Clinical Course Evaluation

Final Evaluation

Student: Natalie Selkirk


Clinical Instructor: Kristen Cecchetto
Missed Clinical Hours: 0

Missed Lab Hours: 0

Satisfactory
Unsatisfactory
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NURS1020 Clinical Course Evaluation


Program Goals
Students graduating from this program are prepared as generalists entering a self-regulating profession in situations of health and
illness.
Students graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups,
communities and populations) in a variety of settings.
Students graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups,
communities and populations) in a variety of settings.
Graduates will learn to continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing
knowledge in their practice.
Students graduating from this program will be prepared to demonstrate leadership in professional nursing practice in diverse health care
contexts.
Graduates will be prepared to contribute to a culture of safety by demonstrating safety in their own practice, and by identifying, and
mitigating risk for patients and other health care providers.
Students will demonstrate the ability to establish and maintain therapeutic, caring and culturally safe relationships with clients and
health care team members based upon relational boundaries and respect.
Graduates of this program will be able to enact advocacy in their work based on the philosophy of social justice.
Graduates will effectively utilize communications and informational technologies to improve client outcomes.
Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed
interventions and outcome measures.
Year One Goals
Define and describe the term 'self-regulating' and what it means to a part of a 'self-regulating' profession. Build a sense of identity
between building a sense of self and profession.
Demonstrate the ability to work with the aging populations in the residential settings.
Recognize the meaning and relevance of the five foci within the nursing program.
Define the ways of knowing and learning with a focus on critical and scientific inquiry.
Recognize the experience of leadership in nursing and undertake a leadership role in peer groups.
Articulate their role as individuals and professionals in providing safe nursing care.
Establish and maintain a professional relationship with peers and an engaged, caring, and culturally safe relationship with older adults.
Understand the concepts of advocacy and social justice. Begin to develop self-advocacy skills.
Explain the relevance of information and technology skills that are essential to safe health care.

Explain the components of the nursing process. Perform a basic biopsychosocial assessment of an individual.
Identify evidence informed interventions and outcome measures with guidance.

Course Objective
Established therapeutic nurse-resident relationships
in residential long-term care settings.

Progress
Evidence/Indicators: (The student has ...)
The following examples demonstrate how I have
established therapeutic nurse-resident relationships in
a residential long term setting:
1. I cared for a resident with severe dementia;
this resident often presented with signs of
impaired judgment and reasoning,
disorientation to time and place, memory loss
and inappropriate behaviours. In this
situation I had to establish a therapeutic
relationship in order to provide the best care
possible. For example, I had to establish
effective communication in order to gain her
trust and respect. The development of this
trust and respect allowed me to successfully
encourage her to attend meals, engage in
physical activities (e.g. walks) and provide
personal care (e.g. pericare).
2. Therapeutic relationships involve providing
client centered care. Client centered care
involves actively including the residents in
their own care and discussing expectations. I
was able to collaborate with numerous
residents and actively involve them in
various forms of care. For example, before
performing pericare I determine whether or
not the resident is able to perform their own
care or if they require assistance. I think it is
important for residents to remain as
individual as possible, therefore I encouraged
them to do as much as possible and assisted
only when required.
3. Over the course of this semester I was
assigned to 3 different residents; I had a

Met
Objective

Did not
meet
objective

unique relationship with each one. I was able


to establish a therapeutic relationship with all
3 residents by spending time with them,
talking about personal topics (e.g. family),
providing care and understanding all their
unique abilities and limitations (e.g. through
completing care cards). I value my
relationship with all my residents.
Over the course of this semester I was able to
establish numerous therapeutic nurse-resident
relationships. Key factors of these relationships
included trust, respect, professional intimacy and
empathy. By establishing these relationships I was
able to contribute to the health and well being of
residents. I believe that I have successfully completed
this course objective.
(College of Nurses of Ontario [CNO], 2006)
One of my goals from my learning plan was I will
demonstrate a body of knowledge from nursing and
other disciplines concerning current and emerging
health care issues by engaging in effective and
efficient therapeutic communication with vulnerable
elders who have been diagnosed with dementia in a
long-term care setting; I have successfully
completed this goal. I have been able to successfully
communicate and provide care for older adults who
have been diagnosed with dementia.
Natalie has met this objective
Performed skills relevant to situating an individual
within his/her personal, familial and community
context

The following examples demonstrate how I have


performed skills relevant to situating an individual
within his/her personal, familial and community
context:
1. On February 22, 2016 I was introduced to a
new resident (MC). I was able to situate her

within her personal environment and learn


about her ethnic descent by asking her about
herself. I learned that MC was born and
raised in Jamaica; she told me how proud she
is to have a Jamaican ancestry. I was able to
learn about her past and where she grew up.
2. I have learned that situating an individual in a
familial context can be hard; it can be
emotional for the residents. Over the course
of this semester I was able to situate various
residents into a familial context. Many
residents shared stories about their spouses,
parents, children, grandchildren and siblings
with me. Throughout these discussions I
prompted the conversations using
communication techniques (e.g. using
photographs as cues).
3. On March 14, 2016 I was able to situate
numerous residents within their Centennial
Place community. On this day there was a
young man who came to the unit to play
guitar and sing. Some residents were
gathered around him, enjoying the music and
singing along. I made an effort to go around
to multiple residents rooms to inform them
that there was an opportunity to enjoy some
live music if they were interested. One
resident in particular stood out to me in this
situation; this resident tends to isolate herself
in her room, however she agreed to come
down and listen to the music. She became
engaged in the music and was even singing
along; it was nice to see this resident become
involved in her community and enjoy herself.
Over the course of this semester I was able to situate
numerous residents into personal, familial and

community contexts. I was able to do this through


effective communication, active engagement in
conversations (e.g. talking and listening), using cues
(e.g. pictures and personal items) as guides and being
empathetic in vulnerable situations. I believe that I
have successfully completed this course objective.
Natalie has met this objective
Developed and demonstrated skills in basic
assessment techniques relevant to the long-term care
population

The following examples demonstrate how I have


demonstrated skills in basic assessment techniques
relevant to the long-term care population:
1. I have developed and improved my basic
assessment techniques by attending all my
scheduled labs and classes over the course of
this semester. By attending NURS1002
(Introduction to Foundational Practice
Concepts) lectures and seminars I have
learned an extensive amount of theory related
to geriatric nursing. By attending NURS1020
(Clinical Practice Residential) labs I have
been able to learn and practice basic
assessment skills such as vitals, abdominal
assessments, respiratory assessments, mental
assessments, etc.
2. On March 21, 2016 I was able to demonstrate
skills I have learned related to personal
protective equipment (PPE). I was asked to
bring food and drinks to a resident who was
on droplet precaution isolation. My instructor
ensured that I had all the proper equipment. I
then demonstrated my skills by putting the
PPE on in the correct order. Furthermore, I
demonstrated my skills by taking my PPE off
in the correct order, ensuring to remember
that hand hygiene is crucial between each

step.
3. I have been able to further develop and
demonstrate my basic assessment skills by
practicing my OSCE assessments at my
residential setting. Through the completion of
assessments on various residents (e.g. vitals,
respiratory assessments, etc.) I have been
able to practice my skills and improve these
skills based on feedback from my clinical
instructor.
4. Being confident in the basic assessment skills
is important; therefore I have dedicated a lot
of personal time to developing my
assessment skills. I have continued to
practice taking blood pressure measurements
on my family and friends (through the use of
my own blood pressure cuff) and I have spent
a lot of time reviewing the OSCE checklists
to ensure that I have a full understanding.
Over the course of this semester I was able to develop
and demonstrate skills in basic assessment
techniques. I was able to do this by taking an active
role in the learning process and by demonstrating
what I have learned to my lab and clinical instructor. I
believe that I have successfully completed this course
objective. One of the goals from my learning plan
was I will demonstrate a body of knowledge in
nursing science by performing accurate blood
pressure measurements on three (3) residents in a
long-term care setting; I have successfully
completed this goal. I look forward to more
opportunities over the last 2 weeks of my placement
that will allow me to surpass my goal even further.
Natalie has met this objective

Demonstrated skills in providing (resident) clientcentered support for activities of daily living

The following examples demonstrate how I have


demonstrated skills in providing (resident) clientcentered support for activities of daily living:
1. I have helped bathe numerous residents over
the course of this semester. Furthermore I
have been able to experience a wide variety
of bathing techniques including bed baths,
showers and baths. On March 14, 2016 I had
a unique experience with bathing. My
resident was incontinent throughout the
night, however she refused a shower in the
morning. I had to demonstrate my skills and
modify my techniques in order to clean the
urine off her skin. As she was getting
dressed and completing her pericare I asked
her if I could wash her legs and body with a
warm/wet/soapy cloth. She agreed; this
helped to keep her clean and protect her skin
until she had a shower.
2. Over the course of this semester I have
groomed many residents who were not
capable of grooming themselves, I have
assisted with grooming and I have prompted
grooming. On March 21, 2016 after helping
my resident get dressed, she requested that I
brush her hair.
3. In terms of toileting I have assisted
numerous residents with physically getting
to the toilet or commode, I have assisted
with and completed pericare and I have
assisted with the changing of briefs. On
March 7, 2016 I cared for a resident who
was having very frequent bowel movements;
she felt extremely embarrassed. This
situation required me to demonstrate my
skills in toileting and pericare, but it also

required me to apply my therapeutic


communication skills to ensure her that she
did not need to feel embarrassed.
4. In terms of feeding, I have assisted and
encouraged various residents with their
feeding. I have fed residents who are fully
dependent and I have assisted and prompted
residents who are semi-independent. I have
also had the opportunity to run the snack
cart; this involved delivering snacks and
drinks to each resident in between meal
times.
5. In terms of dressing, I have encouraged
residents to assist me in choosing their
outfits for the day, I have assisted residents
with dressing and I have cued residents who
were able to dress themselves. For example,
my one resident was able to dress herself,
however she just needed some guidance in
order to stay on track. I always encouraged
residents to do as much they could on their
own, as I believe this helps promote a form
of independence.
6. In terms of transferring, I have demonstrated
my ability to assist and perform manual lifts
and transfers, as well as lifts and transfers
involving transferring mechanisms. On
March 21, 2016 I experienced a new form of
transferring. My resident has a standing
pool; she requires some assistance with
getting her feet to the floor, then she firmly
grips the pole with 2 hands and pulls herself
up from bed. I was responsible for ensuring
that she was safe while getting herself up.
Over the course of this semester I was able to
demonstrate skills in providing resident-centered

support for activities of daily living. I was able to do


this by partaking in all opportunities available related
to activities of daily living; including bathing,
grooming, toileting, feeding, dressing and
transferring. I believe that I have successfully
completed this course objective.
One of my goals from my learning plan was I will
demonstrate my knowledge of population health;
more specifically the health of geriatric residents in a
long term care setting. I will be able to distinguish
determinants of health that are unique to each
individual resident I work with, thus allowing me to
be able to provide client-centered support for the
activities of daily living; I have successfully
completed this goal. Through communication with
residents and staff and the completion of my care
cards I was able to distinguish determinants of health
that unique to each resident. This allowed me to
successfully support all these activities of daily
living.
Natalie has met this objective
Developed knowledge about the experience of
residents living in a long-term care setting

The following examples demonstrate how I have


developed knowledge about the experience of
residents living in a long-term care setting:
1. I have developed knowledge about the
experience of residents in LTC by attending
my NURS1002 lectures. This course focuses
on geriatric nursing and the changes that one
experiences when they become an older
adult. On March 23, 2016 we discussed a
unique topic, coming to terms with death.
Many residents are experiencing this daily in
some form, so I was able to learn more about
their thought processes in relation to this

topic.
2. I was able to develop knowledge about the
experience of residents in LTC by completing
my therapeutic encounter and health history
assignment. This assignment required me to
acquire a lot of information about human
functioning and development in social
groups, human life and functioning, level of
activity and rest, developmental stage, etc.
All of this information allowed me to develop
a greater understanding about MCs
experience in a LTC setting.
3. Over the course of this semester I was able to
develop knowledge by interacting with
various different residents. By spending time
with multiple residents I was able to gain
insight into all their unique experiences
(good and bad). I have learned that each
residents experience is unique (e.g. MG feels
that her experience has been good mainly due
to her involvement in scheduled activities,
whereas MC has showed signs of loneliness
and isolation at times due to her lack of
family support and involvement in
Centennial Place activities).
Over the course of this semester I was able to develop
knowledge about the experience of residents living in
a LTC setting. I was able to do this through the
completion of assignments, attending class,
completing readings and by communicating with
residents, family and staff. I believe that I have
successfully completed this course objective.
Natalie has met this objective

Demonstrated safe and ethical clinical practice at the


level appropriate for a year one nursing student

The following examples demonstrate how I have


demonstrated safe and ethical clinical practice at the
level appropriate for a year one nursing student:
1. I provided safe, compassionate, competent
and ethical care by engaging in
compassionate care through my speech and
body language techniques. When interacting
with a resident I always ensured that I would
position myself at eye level (e.g. I would sit
or kneel if the resident was in a wheel chair)
and speak slowly and loudly, annunciating all
my words. This demonstrated my effort to
understand and care for residents according
to their needs.
2. I have continued to demonstrate ethical care
by maintaining privacy and confidentiality.
For example, when discussing any of my
residents in papers, assignments or
conversations I ensured that I did not use
their full names (e.g. I used their initials
instead). Furthermore, I ensured that I only
collected and disclosed the information
necessary to complete my task.
3. I was able to demonstrate ethical care by
collaborating with other health care providers
in order to maximize all outcomes. For
example, if I was unsure of how to complete
a specific task for a resident (e.g. toileting,
transferring, dressing, etc.) I would approach
a PSW or nurse. I recognize and respect that
they have a higher degree of knowledge, skill
and perspectives in terms of these residents.
Over the course of this semester I was able to
demonstrate safe and ethical clinical practice at the
level appropriate for year one nursing student. I was
able to do this by first developing an understanding

of what it means to provide ethical care (e.g. I read


the Code of Ethics for Registered Nurse, 2008
Edition which was provided by the Canadian Nurses
Association). After developing this understanding I
then applied my skills and knowledge to ensure that I
was providing safe and appropriate care. I believe
that I have successfully completed this course
objective.
Natalie has met this objective
Participated in professional development based on
reflective practice and clinical inquiry

The following examples demonstrate how I have


participated in professional development based on
reflective practice and clinical inquiry:
1. I have participated in professional
development by attending all my classes,
labs, seminars and clinical days.
Furthermore, I have ensured that I have
completed all my assignments and readings
over the course of this semester. This has
allowed me to enhance my skills and develop
as a professional student-nurse. My
involvement in professional development is
allowing me to evolve as a student-nurse,
encouraging me to provide the best care
possible.
2. I have participated in reflective practice in
numerous ways: by actively participating in
weekly debriefings, by completing all weekly
journal reflections, by discussing my
experiences (ensuring to keep the residents
identities anonymous) with my peers,
professors and instructors.
3. I have participated in reflective practice by
completing my scholarly paper for
NURS1002. This paper required me to focus

on one resident and reflect on key life events


that have impacted their process of healthy
aging.
Over the course of this semester I was able to
participate in professional development based on
reflective practice and clinical inquiry. I was able to
do this by actively engaging in all facilitated learning
opportunities (e.g. attending class, participating in
seminars and debriefings, etc.). Furthermore, I have
collaborated with numerous individuals in order to
further develop my own skills and contribute to the
nursing program. I believe that I have successfully
completed this course objective.
Natalie has met this objective
Examined personal attitudes regarding the elderly
and other residents of long-term care homes

The following examples demonstrate how I have


examined personal attitudes regarding the elderly and
other residents of long-term care homes:
1. The main way I have examined personal
attitudes of the residents is by completing my
weekly journal reflections. This gives me the
opportunity to examine and reflect on what I
have learned at each clinical placement. I
find it very helpful to display my personal
attitudes through written expression. For
example, I am always happy when I am able
to successfully provide care for the residents,
however I feel discouraged when I am unable
to provide sufficient care due to something
such as a language barrier (e.g. unable to
understand what the resident is asking for).
2. I have been able to examine my personal
attitudes by discussing my personal
experiences with my family members
(ensuring to maintain confidentiality and

privacy). I have recently found out that my


Nana will be entering into a LTC facility; this
situation has allowed me to take these
personal attitudes that I have learned and
examined and apply them to a more personal
situation.
3. Writing my final reflection for this course has
allowed me to examine my personal attitudes
toward the residents in LTC and towards
nursing in general.
Over the course of this semester I have examined
personal attitudes regarding the elderly and other
residents of LTC homes. I was able to do this by
having in depth conversations with multiple residents.
By establishing therapeutic relationships I was able to
gain insight about personal attitudes of residents at
Centennial Place. I believe that I have successfully
completed this course objective.
Natalie has met this objective
Developed a basis knowledge of the clinical
manifestations and relevant nursing interventions of
chronic diseases

The following examples demonstrate how I have


developed a basis knowledge of the clinical
manifestations and relevant nursing interventions of
chronic diseases:
1. I have developed a basic knowledge of many
clinical manifestations by working with
multiple residents; each resident is unique,
therefore I have been able to learn about
various different diseases and conditions. For
example, MG has high levels of anxiety and
MC has been diagnosed with dementia.
2. I have been able to develop a basic
knowledge of clinical manifestations and
relevant nursing interventions by completing
my care cards. It has been very helpful to

research each diagnosis and learn about


appropriate interventions that help promote
better care. For example, MC has type II
diabetes. Researching type II diabetes has
allowed me to have a better understanding of
the signs and symptoms (e.g. frequent
urination) and appropriate interventions (e.g.
encourage a healthy diet and regular
exercise).
3. I have been able to further understand
diagnoses and interventions through the
completion of my therapeutic encounter and
health history assignment. The most helpful
part of this assignment in terms of this course
objective was the NANDA diagnosis and
researching a nursing intervention.
Over the course of this semester I have developed a
basis of knowledge of clinical manifestations and
relevant nursing interventions by completing all
assigned course work, interacting with multiple
residents and questioning the nurses and PSWs when
required. I will continue to develop new knowledge
as I continue my education, however I think that I am
off to a good start and I believe that I have
successfully completed this course objective.
Natalie has met this objective

Identify 3 personal strengths developed in this placement.


1. Confidence: coming into this placement I was a little nervous, however now I feel much more comfortable and confident
with myself and with my skills.
2. Collaboration and communication skills: over the course of this placement I have been able to develop and effectively
collaborate with my fellow students and employees of Centennial Place. Furthermore, I have been able to develop strong
communication skills through interactions with residents, my fellow students, my instructors, nurses and PSWs.
3. Adaptability: this placement has taught me you need to always stay on your toes and that nursing is an unpredictable
profession; this has allowed me to develop the proper strengths and skills to be able to adapt to different situations.
Identify 3 areas requiring further development.
1. Although I feel as though I have significantly improved, I would like to become more comfortable/confident/skilled with
my blood pressure measurements.
2. I would like to further develop my skills in patient handling and mobility; more specifically I would like to be more
comfortable with the use of mechanical lifts (e.g. Hoyer lifts). I did not have many opportunities to use the lifts. Patient
handling and mobility is crucial in preventing injury to the residents and myself.
3. I would like to become more confident in taking initiative. Sometimes I feel intimidated to take initiative because I am a
student.

Clinical Instructor Comments


Natalie has shown confidence since day 1 and has continued that throughout the semester. She is very comfortable talking with the
residents and provides personal care with ease. Natalie has had the opportunity to care for 3 different residents over the course of the
past 12 weeks. She has developed good therapeutic relationships with all of them as well as other residents in her home areas. Natalie
is always respectful and professional to the residents, her peers, the staff, and her instructor. Natalie has had the opportunity to do bed
baths, bathe residents in the tub and shower rooms, feeding, bed making, and assist with mechanical lifts as well as many other tasks.
Natalie shows great initiative and is a true leader, she works very well independently. She has had the opportunity to vital signs and
head to toe assessments as taught in the lab with her instructor. She now does these more comfortably and independently. Keep
working on your assessment skills. Natalie has successfully completed her first clinical rotation in the long-term care setting. Keep up
the good work and good luck in the future!
~Kristen
Attendance
Week 1
Week 4

Week 2
Week 5

Week 3
Week 6

Week 7

Week 8

Week 9

Week 10

Week 11

Week 12

Total number of clinical hours completed 72 HOURS


Peer Evaluation Completed ____________ _____________________
Signature of Instructor___________________________________________________

Date____________________

Signature of Student_____________________________________________________

Date____________________

References

College of Nurses of Ontario (CNO). (2006). Therapeutic Nurse-Client Relationship, Revised 2006. Toronto, ON.