Self Assessment

2015 - 2015 - Final NURS-151 Course Learning Outcomes

NURS 151 Practical Nursing Practice 2 (PN, 13-Jan-2015 - 30-Jun-2015)
Student :
Clinical Teacher/Preceptor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Natasha English
Janet Jeffery
John Stone
William Osler Health Centre/Etobicoke General
Hospital
Agency
9CCC
23-Apr-2015 To 02-May-2015
156
168
156

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.
N.E. : I followed all standards and legislation while in the clinical setting. This involved things like hand hygiene, patient instructions such
as mobility issues, and appropriate PPE such as wearing an N95 for a patient I saw who was on droplet precautions.

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

Satisfactory

Satisfactory

N.E. : Every time I was in the EGH setting, I made sure to act in a responsible, ethical and accountable manner. I acted in the way that
nurses and students should act.

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

Satisfactory

Satisfactory

professionals.
N.E. : I was able to ask my peers, clinical teacher, and members of the health care team when I wasn't able to complete a task on my own.
Either for hands on help, or for help with information.

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

Satisfactory

Satisfactory

N.E. : For any procedure or intervention that I had to perform I studied prior to clinical in our required textbooks.

1. 5 Ensure client safety and a safe environment.

Satisfactory

Satisfactory

N.E. : I always ensured that the client was safe, and properly using their required assistive devices. For example, whenever a client used
their wheelchair I made sure their seatbelt was on as to prevent falling from the wheelchair.

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

Satisfactory

Satisfactory

N.E. : I always clarified with a nurse, member of the health care team, or clinical teacher if I wasn't sure about a plan for the client. For
example when a client needed wound care, I asked about the materials listed on the Kardex so I was sure to use the right materials.

1. 7 Identify ethical and unsafe situations and seek appropriate assistance to resolve these.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

N.E. : I did not identify any ethical or unsafe situations.

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

N.E. : I understood that my role was to take on the tasks of the RPN and PSW while in the clinical setting.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Natasha consistently demonstrated accountability and responsibility each clinical/lab day. She has upheld both Humber's student
handbook guidelines, as well as the policies and procedures at Etobicoke General Hospital 9E/9W LTC/Reactivation. She consistently
ensures that her practice and conduct demonstrate respect and professionalism and abided within the ethical/legal framework. I agree
that she has promoted client safety by taking appropriate actions such as ensuring brakes on bed and other equipment, bed rails and
bed in lowest position and maintaining infection control in an isolation room. I agree that she is aware of her limitations and will call for
help when necessary.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

N.E. : I feel as though anytime we had a team discussion at the end of the clinical day, I was not hesitant to share information about what I
had experienced.

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

Unsatisfactory

Satisfactory

methods.
N.E. : I believe this is an area where I need development. I believe my accuracy and clarity is okay, but I need to learn to be faster with my
documentation and do it in smaller amounts throughout the day. I also need to work on nursing notes and how to write them in a detailed
but concise way.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

N.E. : I believe I did this at a satisfactory level. One example is handing off to the nurse and PSW every break and at the end of shift.

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

Satisfactory

Satisfactory

N.E. : I utilized many communication techniques with the clients. Some of the clients had hearing impairments so I slowed my pace and
increased my volume. I had two clients who had language barriers, so I used short sentences, closed ended questions, and if needed I
would use gestures.
I communicated regularly with the team, from handing over and letting them know anything new with my weekly patient, to asking for help
when needed.

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

Satisfactory

Satisfactory

Protection Act (PHIPA)

N.E. : I maintained privacy by not using the clients full name on any Humber documents, locking the computer when finished so no
patients/family could access them, and I also refrained from speaking about patients outside of the clinical setting.

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

Satisfactory

Satisfactory

N.E. : I utilized the Meditech, Mar, and client's chart during every shift to look up any relevant and necessary information.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Natasha confidently used effective communication strategies within the interdisciplinary and among her peers in the clinical setting. I
agree that she shared relevant information regarding new learning with her peers in post conference. She used Medi-tech to retrieve
patient data as well as daily documentation of ADL flow sheet, Vital Signs, Mental/Emotional Status, Braden Scale,Wound Care, Catheter
Care and Narrative Nurses Notes. She fully understands the importance of maintaining confidentiality and privacy. Natasha, although
you have fulfilled your documentation responsibility in this clinical setting, I agree that you are not yet adept at Medi-tech
documentation and writing DARE and Narrative notes in a timely manner.

3. CARING RELATIONAL PRACTICE

3. 1 Utilize effective communication techniques.

Satisfactory

Satisfactory

N.E. : I made sure to communicate effectively with patients, peers, and the health care team. If needed I adjusted communication style
depending on if the client had difficulty.

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

Satisfactory

Satisfactory

clients and health care team members.

N.E. : I demonstrated this with every client I encountered. I made sure to be caring and compassionate as it is important to treat them with
warmth. I developed good rapport with several clients and received compliments for smiling and being cheerful with them.

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

N.E. : I believe I was able to apply this and see how it affected my clients.

3. 4 Use self-awareness to identify the effects that beliefs, values, and personal experiences
have on relational practice.
N.E. : I am able to identify how these 3 values influence relational practive.

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

N.E. : I interacted really well with all my clients and the nurses and did not have any issues with the task. I enjoyed listening and speaking
to the patients and giving explanations, and I also enjoyed interacting with the team as I found I was able to learn a lot during this time,

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

Satisfactory

Satisfactory

inter-professional health care team.

N.E. : I was respectful of the diversity of clients and I believe when I provided care that I was able to do it with respect to their differences
(i.e. providing hygiene to males vs. females)

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

Satisfactory

Satisfactory

N.E. : I didn't experience too many cultural differences however I did respect that some clients had meal preferences due to religious
beliefs and I respected that.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

N.E. : I made sure to tell clients what I was doing, and why I was doing it. For example when taking a client's vitals I made sure to tell them
the reason why and also what the values were and if they were within their normal range. If a client asked about their medications I advised
them what it was and what it was for.

Teacher comments for CARING RELATIONAL PRACTICE :

Natasha confidently interacts with clients and their family members. She established and maintained therapeutic-nurse client relationship.
She is respectful to clients' religious beliefs and preferences.
She also maintained professional relationships with the interdisciplinary team.

4. LEADERSHIP AND ADVOCACY

4. 1 Recognize conflicts and strategies for resolution.

Satisfactory

Satisfactory

N.E. : I did not have many encounters with conflicts however I did have one patient who got increasingly agitated as the day progressed
(due to dementia and confusion), as he was starting to create conflicts. I tried to give him things to keep him occupied so there would be
less conflicts with his agitation.

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

Satisfactory

Satisfactory

N.E. : I believe I showed leadership skills by assisting my peers when they needed help, looking for situations where I could help, and also
giving direction to some peers who needed assistance.

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

Satisfactory

Satisfactory

advocating for client, self, others, and quality practice.

N.E. : I believe I was able to identify these opportunities regularly. One patient's wife notified me that her husband's ankles were very
swollen so I did a bilateral assessment on his feet, documented, and left a note for his Dr to check the next time he was in.

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

Satisfactory

Satisfactory

professional health care team.

N.E. : During the last few weeks of clinical we were required to provide peer feedback. I provided three pieces of feedback to a peer based
on what I had seen of her in clinical. I gave both positive and constructive feedback, and accepted the same for myself. I used the feedback
to shape my learning plan.

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

Satisfactory

Satisfactory

N.E. : I always keep in mind that client's have the right to make choices for their own care. I had a patient who refused his prescribed
laxatives because he felt he no longer needed them. We had a discussion about it and the laxative was held. I did not want to try and
encourage him to do something he was not comfortable with.

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

N.E. : I did not have to deal with any of these noted behaviours.

Satisfactory

Satisfactory

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

Satisfactory

Satisfactory

the best interests of the public and protect the public through collaboration and consultation.
N.E. : I did not encounter these collaborations during this clinical period.

Teacher comments for LEADERSHIP AND ADVOCACY :

I agreed that Natasha demonstrated leadership when she willingly shared information to support her peers.
She has also demonstrated advocacy regarding her clients' needs. Natasha has excellent communication skills and strong leadership
skills. She is encouraged to continue to seek out opportunities to demonstrate her leadership skills in the clinical setting.

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

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

Satisfactory

Satisfactory

care.
N.E. : I believe that I was able to incorporate unique needs. For example, I had a patient with several pressure ulcers and I made so to put
that the patient had to be turned q2h into the plan of care.

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

Satisfactory

Satisfactory

articulated competently in writing and orally.

N.E. : I believe I was able to develop plans of care that were holistic and client centred. I used my knowledge and knowledge of the clients
to develop a plan.

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

Unsatisfactory

Satisfactory

Unsatisfactory

Satisfactory

N.E. : This is an area where I need to work more to develop the skill.

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

N.E. : While I do think I did this at times, I believe I can improve. An area of improvement that would lead to this is being more diligent in
performing assessments to so I provide good quality information to make a contribution.

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

Satisfactory

Satisfactory

theory-based and within skill abilities.

N.E. : I believe that every time I did any assessments and interventions, I made sure I was safe and my patient was safe. I did not attempt to
do anything that would put anyone at risk. For example, when patients needed to be transferred, I had a PSW or nurse assist.

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

Unsatisfactory

Satisfactory

N.E. : Even though I believe I have the ability to make decisions and carry them out, I think I need more work in this area to make decisions
on my own, or without guidance.

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

Satisfactory

Satisfactory

timely manner.
N.E. : This is a skill in which I need to practice and become more proficient in. I need to create and follow a daily organizational plan to
ensure I develop these skills.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Most times, Natasha had good level of preparedness each clinical day. Medication and Diagnoses Research was adequate. Her initiative,
time-management, organizational skills and prioritization skills has improved throughout the semester. Natasha performs vitals signs
including SPO2 and Pain assessment. Other nursing assessments are improving and need to be practised on a daily basis. Nursing
Interventions that she completed included complete bed bath, transfers with assistance, wound care, catheter care. She safely
administered medications administrations orally and subcutaneously. She maintains the unit protocol when she administered hazardous
substances. Natasha, I agree that your knowledge, skills and judgement to assess, prioritize clients' needs and outcomes and decisionmaking is still developing.Please continue to practice.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

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

Unsatisfactory

Satisfactory

clients, determine health needs, and to achieve mutually agreed expected outcomes.
N.E. : This is another area that I did okay in, but could improve greatly with more use of assessments on a regular basis.

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

changing needs and expected outcomes of clients.

N.E. : I believe I contributed where needed to the inter-professional health team.

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

N.E. : Every clinical day I consulted and spoke with nurses and PSW's in regards to the patient in my care. One example was when a
patient would not take his scheduled pain medication because he wanted a stronger one. I went to the nurse also in charge of that patient
and we discussed ways to try and talk to the patient about taking it and she also stepped in to administer the narcotic med.

6. 4 Use teamwork, consensus building, and conflict resolution skills.

Satisfactory

Satisfactory

N.E. : I worked with my peers every week. We worked as a team when needed, we would help each other, I would ask for advice about care
but also provide answers to my classmates.

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

a changing environment.
N.E. : I don't believe this is a skill I really was able to practice.

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

N.E. : I interacted with the members of the health care team often and respected their roles. For example, I would go to the nurses to
discuss nursing/medical care, and the PSW's with respect to things like feeding, bathing, turning, and general physical care of the client.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Natasha attended Patient Rounds and In-services on Stroke, the Role of the Recreational Therapist and Feeding a Patient with Stroke by
the Speech Language Pathologist. She organized her clients' care each clinical day to ensure that they were ready for their therapy. She
fully understands the role of each interdisciplinary team member in the rehabilitative care of the client. She interacted well within the
interdisciplinary team.
Please review your understanding of 6.1

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.
N.E. : I consistently collaborated and consulted when need be for the clients to ensure that my care was competent. I did not want to make
an error or provide wrong information that would go against their best interest.

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

Satisfactory

Satisfactory

N.E. : I did a self reflection at the end of the semester where I had to identify my strengths and weaknesses. I found it very helpful to sit
down and see where I can improve for my next clinical.

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

Satisfactory

Satisfactory

program (CNO).
N.E. : I created a learning plan and came up with ways to improve my weak areas. This will begin during clinical semester 3.

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

Satisfactory

Satisfactory

integrate these into practice.

N.E. : I often sought out learning opportunities, especially from the nurses. I enjoyed watching to learn new things such as removing
staples, and giving medication through an IV.

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

Satisfactory

Satisfactory

N.E. : I often utilized my knowledge from other courses mostly from theory and pharmacology in order to improve my knowledge about my
practice. If I didn't know about something surrounding my patient I was able to look it up in my course notes/textbooks in order to learn.

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

Satisfactory

Satisfactory

N.E. : I centred my client care around the information I had learned in both class and from the text. I thought it was important to stick to
this way of care so I made sure I was providing the correct and most safe care.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Natasha demonstrated awareness of areas that needed improvement throughout the semester. In our feedback meetings, she responded
positively and improved her performance the following clinical week. She is encouraged to continue to reflect daily and devise ways for
continuing competence. Self Assessment, Peer Feedback and Learning Plan were submitted.

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

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

N.E. : I was able to use problem-solving skills in clinical with regards to my patients.

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

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

N.E. : I believe that I was able to problem solve and make decisions, but my ability determine nursing diagnoses was lacking and needs to
be improved. However even though I required some assistance with that, I was able to make expected outcomes, interventions and how to
evaluate. I consistently did care plans and was able to practice throughout the semester.

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

Unsatisfactory

Unsatisfactory

skills.
N.E. : I created a self reflection to address other areas of improvement, but I did not incorporate problem-solving and decision making
skills into it.

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

Satisfactory

Satisfactory

to provide safe and competent care.

N.E. : I often utilized my knowledge from other courses including theory and pharmacology in order to care for my patients. This included
information about diseases and the medications they were taking. At times I had to be prompted to give the right information about the
meds, but I would research and come back the next clinical ensuring I had the correct information.

8. 5 Use prioritization strategies for client care.

Satisfactory

Satisfactory

N.E. : I made sure to think about the client's highest priority issues every clinical. For example, turning a patient who is not able to get out
of bed, q2h would be my priority for them for the day. After that, prioritizing any remaining interventions.

8. 6 Demonstrate professionalism and accountability.

Satisfactory

Satisfactory

N.E. : I was professional while in the setting, respecting the other staff and patients, acting appropriately, and doing my work. I was
accountable for my actions and I was on time to every clinical day.

8. 6 Recognize strengths and limitations and seek appropriate assistance and support.

Satisfactory

Satisfactory

N.E. : I was able to ask my peers, clinical teacher, and members of the health care team when I wasn't able to complete a task on my own.
Either for hands on help, or for help with information. For example when I had to turn a patient who was unable to assist.

Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING EFFECTIVELY :
Natasha is developing critical thinking, problem-solving and decision-making skills. She has participated in clinical reasoning throughout
the semester.
Natasha is encouraged to stay curious and seek out rationales for actions and new learning and continue to seek out opportunities to
make decisions.
What have you done to resolve 8.3 ?

Student Final Summary with Strategies for Continued Growth

My goal is to review all my class notes and re-read the chapters from first year over the summer. I want to ensure I retain the knowledge learned so
when I go to fourth semester I am able to build off that knowledge. I want to pick up where I left off this semester and keep increasing my skills instead
of regressing.

Teacher Final Summary with Strategies for Continued Growth

Natasha successfully completed the requirements of Semester 2 nursing clinical practice. Her interactions were effective both with clients and the
staff. As she increased her level of preparedness, she was able to take better charge of her client assignment.Natasha, please continue to incorporate
your assessments in your provision of care. Continue to be full prepared each clinical day. Continue to use your leadership, critical-thinking, problem
solving and decision-making skills. You have great potential!

Program Coordinator comment

Needs to elevate their level of preparedness and the ability to incorporate this increased level of knowledge to demonstrate their critical thinking and
decision making skills to ensure patient's safety. Keep up the positive progress.

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

Submitted Date: 29-Apr-2015 23:20