BON SECOURS MEMORIAL COLLEGE OF NURSING

BSN PROGRAM
2015-2016 Academic Year
NUR 4111P Nursing Care of Women and Childbearing Families Practicum
PRACTICUM EVALUATION TOOL
The student will have multiple opportunities in clinical areas and in simulation
laboratories to meet practicum outcomes. Student and instructor(s) will meet at
selected times during the practicum to assess progress toward attaining practicum
competency outcomes. Students must attain a passing grade in the clinical area 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 examples provided are not inclusive. Each student will be provided
feedback at least once during the semester (formative) and upon completion of the
practicum work (summative).

Student Name:

Harrison Black

Semester:

Pre-Licensure
Coordinator:

Amy Feurer, MS, PhD(c)

Fall

Clinical
Faculty:

PRACTICUM GRADE (S/US)

Formative (Midterm)
Summative (Final)
x

Satisfactory
Unsatisfactory

CLINICAL HOURS MISSED

Midterm ________.25________
Final __________________

Satisfactory
Unsatisfactory

Year: 2015

Robin Nasi

CLINICAL HOURS COMPLETED

Direct Care
Acute
27.75

Direct Care
Community

Direct Care
Simulation

Observation

Alterative
Experiences

Other
8

Definitions for the Rating Scale for Clinical Evaluation Tools

4

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 in order to pass the Practicum

TOTAL
47.75

Evaluation Scale
4 = Self Directed
3 = Directed
2 = Remedial
1 = Ineffective
FORMATIVE
EVALUATIONS

1.0 PROGRAM OUTCOME AND EXEMPLARS

SUMMATIVE
EVALUATION

DATE

Communication and Collaboration: Engage in communication and collaboration with the

inter-professional health care team
Course Objectives and Exemplars
1.1 Student applies therapeutic communication
skills when working with women and childbearing
families

Provides appropriate teaching regarding health care plan

Provides nursing presence
Utilizes SBAR

Collaborates in care-planning for patients

Listens to report and reports findings to appropriate team
members

1.2 Student demonstrates proficiency in written and

electronic documentation

Adheres to hospital/facility policies and procedures and

documents nursing care
Satisfactorily completes assigned clinical paperwork

1.3 Student is authentically present with women

and childbearing families

Submits reflective journaling

Presents during Post-conference clinical examples
Incorporates Watsons Theory of Caring into nursing
practice
Shows a calm presence and confident manner

Communication and Collaboration

STUDENT EXAMPLES/COMMENTS

Communication and Collaboration

FACULTY EXAMPLES/COMMENTS

MIDTERM DATE: 10/4/2015

1 Every day in clinical I collaborate on care plans
and listen to report. I have utilized SBAR on
multiple occasions when explaining a situation
regarding a patient to another healthcare worker.
I am very good at providing a caring, nursing
presence. When I am with my patients I am
present physically as well as mentally and
emotionally.

MIDTERM DATE:

2. I am getting better at documentation, but I know I still

have a lot of work to do with regards to electronic
documentation. I believe I could be quicker and more

Harrison participates in post-conferences and simulation

debriefings by contributing relevant in-depth content
information.
Harrison is working hard to learn the correct Connect
Care charting requirements for the postpartum and
newborn patient population.

efficient. I have also completed almost all of my clinical

paperwork. I only need to complete two more asignments

During post-conference I am always present,

listening and participating in discussion. On a
daily basis I strive to have and maintain a calm,
yet confident demeanor.

DATE:

DATE:

DATE:

DATE:

FINAL DATE:12/3/2015
1. I am very good at providing a caring, nursing
presence. When I am with my patients I am
present physically as well as mentally and
emotionally. Every day in clinical I collaborate on
care plans and listen to report. I have utilized
SBAR on multiple occasions when explaining a
situation regarding a patient to another
healthcare worker. On 11/19 I was on the mother
infant unit and had a patient that was transferred
from L&D. After a time she was still reluctant to
get up and ambulate to the bathroom due to pain.
I was able to give her some pain meds and a little
more time to rest and then she was able to
ambulate to the bathroom to void.

FINAL DATE:

2. I always complete my clinical paperwork on time and

have noticeably improved on my documentation speed
and accuracy. I can be difficult to keep track of the
different places you need to chart information in connect
care especially when you are switching from MI unit,
L&D, and pediatrics, but by a little after halfway through
the semester I was able to sort it out successfully. I
believe my documentation skills have progressed very
well and while they are not perfect, they have definitely
improved and they are currently at a sufficient level.

2. During post-conference I am always present,

listening and participating in discussion. On a

daily basis I strive to have and maintain a calm

yet confident demeanor. On 10/29 I was able to
provide a confident, yet calming presence to a
new mother with a history of depression who was
nervous about the responsibility of having a child.

Evaluation Scale
4 = Self Directed
3 = Directed
2 = Remedial
1 = Ineffective
FORMATIVE
EVALUATIONS

2.0 PROGRAM OUTCOME AND EXEMPLARS

SUMMATIVE
EVALUATION

DATE

Caring: Practice empathetic caring within the framework of the Catholic health ministry
Course Objectives and Exemplars
2.1 Student utilizes therapeutic use of self when
working with women and childbearing families

Recognizes symptoms of stress that may interfere with

functional ability
Adheres to dress code policy
Incorporates Watsons Theory of Caring into nursing practice

2.2 Student demonstrates integration of the altruistic

values of Bon Secours into practice

Provides patient with non-judgmental nursing care

Introduces self and refers to patient by preferred name
Acknowledges family as vital component to the patients
plan of care

2.3 Student tailors individualized nursing care to

meet the needs of culturally diverse women and
childbearing families

Asks patient and /or family about their cultural and /or
religious preferences
Maintains personal and professional boundaries

Initiates pastoral/spiritual care consult if requested

Caring
STUDENT EXAMPLES/COMMENTS
MIDTERM DATE: 10/4/2015
1 On 9/24 I recognized that my patient was a little
stressed out with having a lot of people in her
room before she was about to give birth. However,
the nurse got them to leave before I could bring it
to her attention. I always adhere to the dress code
and come to clinical prepared.

2. I believe I have done a great job at providing nonjudgmental nursing care to the patients and families in the
MIU, L&D, and NICU even though some of them made
decisions I would not have made. I believe I have a
healthy understanding of people, for my age and level of
experience, and accept them as they are, without passing
judgment. I am aware of the importance of the family unit
in the in the process of pregnancy, labor, delivery and in

Caring
FACULTY EXAMPLES/COMMENTS
MIDTERM DATE:
Harrison provides non-judgmental nursing care to his
patients and includes the family in the plan of care while
being an advocate for the patient.

the postpartum phase of care. I try to include the family

whenever possible or beneficial.

I maintain personal and professional boundaries at

all times, while still able to be myself. During my
assessment I ask if the there are any special
rituals regarding the birthing process that they
plan to engage in.

DATE:

DATE:

DATE:

DATE:

FINAL DATE: 12/3/2015

FINAL DATE:

1. I always adhere to the dress code and come to

clinical prepared. On 10/29 I was able to provide a
confident, yet calming presence to a new mother
with a history of depression who was nervous
about the responsibility of having a child. I could
definitely tell the stress of having a child was takin
its toll on this new mom. One thing that that really
seemed to help her was having someone to talk to
and listen to her experiences. Building this rapport
helped later in the day when we did patient
teaching.

2. I always introduce myself first thing when I walk into the

room in the morning before report. I believe I have done a
great job at providing non-judgmental nursing care to the
patients and families in the MIU, L&D, and NICU. I am
aware of the importance of the family unit in the in the
process of pregnancy, labor, delivery and in the
postpartum phase of care. I try to include the family
whenever possible or beneficial. I include the family in
conversation and patient teaching because they will also
be helping the mother and child once they leave the
hospital.
2. I maintain personal and professional boundaries at

all times. One of the more common cultural

practices I have seen during clinical is
circumcision. Even if it is already documented, I
always ask/remind the mother that their child is
scheduled for the procedure just to make sure we
are all on the same page.

Evaluation Scale
4 = Self Directed
3 = Directed
2 = Remedial
1 = Ineffective
FORMATIVE
EVALUATIONS

PROGRAM OUTCOME AND EXEMPLARS

SUMMATIVE
EVALUATION

DATE

3.0 Servant Leadership and Global Health: Integrate servant leadership into nursing
practice to promote global health
Course Objectives and Exemplars
3.1 Student demonstrates principles of servant
leadership when caring for women and
childbearing families

Processes difficult situations and reacts appropriately

Provides patient centered care with sensitivity and
respect
Meets the needs of others through active listening
Uses concepts of caring through empathy, gentleness
and encouragement
Improves performance through functioning as a team
member
Provides constructive feedback with empathy
Utilizes economy when selecting resources

3.2 Student utilizes concepts of family-centered

care including respect for families differences,
values, preferences, and expressed needs

Performs cultural and spiritual assessments

Values the patients own expertise with health and
symptoms
Expresses awareness of biological differences
Describes strategies at a novice level to empower
women and families in all aspects of the healthcare
process

Servant Leadership and Global Health

STUDENT EXAMPLES/COMMENTS

Servant Leadership and Global Health

FACULTY EXAMPLES/COMMENTS

MIDTERM DATE: 10/4/2015

1 I believe the clinical on 9/24 was a tough day for
nearly everyone on the unit. Despite the difficult
situation I saw everyone, including myself, deal
with the events in an acceptable manor. On 9/17 I
had a patient that needed some nipple cream
and I believe sensitive and respectful care by
supply said nipple cream in a timely fashion.

MIDTERM DATE:

I have performed two cultural and spiritual

assessments one on 9/3 and another on 9/17.

Harrison has been complimented by the nursing staff for

demonstrating professional behavior and caring actions
for the patients that he is assigned.

Both times I received very different information. I

show that I value the patients own expertise by
listening to them and acting on their behalf based
off of their concerns. I feel a little out of my
element sometimes on L&D or the MIU, but I
always try to empower women and families by
giving them the education and resources they
need to take care of themselves.

DATE:

DATE:

DATE:

DATE:

FINAL DATE: 12/3/2015

1. On 10/29 I had a postpartum patient with a
history of depression who definitely needed
someone to talk to. Her husband was not able to
be with her for the majority of her hospital stay
and she seemed lonely and nervous. Through
active listening I was able to calm her and even
lift her spirits a little. This rapport paved the way
for what seemed to be very successful patient
teaching later on in the day.

FINAL DATE:

2. I value the patients own expertise with health and

symptoms. On 11/19 I had a postpartum patient who did
want to get up and void due to pain. Through the use of
pain meds, therapeutic communication, and a little extra
time to rest she was able to get up and void with some
assistance. I feel that I empower my patients with
emotional support, patient education, and therapeutic
communication. I do this to help optimize their growth and
healing in holistic way.

Evaluation Scale
4 = Self Directed
3 = Directed
2 = Remedial
1 = Ineffective
FORMATIVE
EVALUATIONS

PROGRAM OUTCOME AND EXEMPLARS

SUMMATIVE
EVALUATION

DATE

4.0 Safe, Quality, Evidence-based Care: Provide safe, quality care incorporating evidence
based nursing practice
Course Objectives and Exemplars
4.1 Student utilizes critical thinking with the
nursing process in the development of quality,
safe, patient-centered care for women and
childbearing families

Ensures that therapeutic nursing interventions are

performed safely according to published nursing
standards of care and are consistent with healthcare
policies and procedures.
Communicates observations or concerns related to
hazards and errors to the health care team
Uses organizational error reporting systems for near
miss
Recognizes and reports changes in patient status and
critical results to appropriate personnel using policies and
procedures of healthcare agency
Demonstrates appropriate clinical judgment and reasoning

4.2 Student collaborates with the interdisciplinary

health care team to develop and manage the
holistic plan of care for women and childbearing
families

Seeks information about outcomes of care for populations

served in care setting
Explores information about quality improvement projects
in the care setting
Identifies gaps between local and best practice

Values own and others' contributions to outcomes of care

Demonstrates the ability to organize and prioritize care in
an efficient manner

4.3 Student integrates evidence-based nursing

actions into the care of women and/or childbearing
families in primary, secondary, and tertiary settings

Participates in individualized plan of care based on patient

values, novice level expertise and evidence
Locates and reads on evidence based clinical practice
topics to enhance patient care
Integrates research and evidence reports related to area
of practice to enhance learning

Safe, Quality, Evidence-based Care

STUDENT EXAMPLES/COMMENTS

Safe, Quality, Evidence-based Care

FACULTY EXAMPLES/COMMENTS

MIDTERM DATE: 10/4/2015

1 During my first clinical on 9/3 I assured
therapeutic nursing interventions were being
carried out by charting my assessments on the
fetal heart per unit protocol. I am a good
communicator and always complete the
communication loop.

MIDTERM DATE:
Harrison works at incorporating concepts learned in the
didactic class and applying the principals in the clinical
environment. He strives to provide evidenced based
nursing care and continues to seek information about
best practices.

2.I have collaborated with other healthcare professionals

on the unit and in the OR. These healthcare
professionals include doctors, NICU nurses, and L&D or
MI nurses. I have definitely identified gaps between local
and best practice. Some local practice is to not seek
any prenatal care and only visit the doctor when it is time
to have the baby! That is not best practice. I do need to
improve on prioritizing my care in a quick and efficient
manor.

Whenever I have had a patient I have

participated in an individualized care plan. I have
also looked up scholarly articles during clinical to
help to help me better understand the care I am
giving and to answer questions I might have
about the care I need to give my patient. I
integrate this research into my growing practice
to help give better care to my patients.

DATE:

DATE:

DATE:

DATE:

FINAL DATE: 12/3/2015

1. During my clinical on 11/5 I was on L&D and had
a patient that was on oxytocin. Here I
demonstrated appropriate clinical judgement and
reasoning and helped ensure that therapeutic
nursing interventions were being performed
safely. While I am not allowed to give oxytocin or
interact with the pump giving oxytocin in any way
I did talk extensively with the nurse during the
whole process.

2. I have collaborated with other healthcare professionals

on the unit and in the OR. These healthcare
professionals include doctors, NICU nurses, and L&D or
MI nurses. I have definitely identified gaps between local
and best practice. I believe I have improved on giving
patients quicker and more efficient care while still
maintaining a high quality of care. My skills in this
department are not perfect yet, but I believe I have seen
noticeable improvement.

2. Whenever I have had a patient I have

participated in an individualized care plan. I have
also looked up scholarly articles during clinical to
help to help me better understand the care I am
giving and to answer questions I might have
about the care I need to give my patient. I
integrate this research into my growing practice
to help give better care to my patients. Since the
start of my OB clinical I have learned to utilize
scholarly articles and Bon Secours policy
documents to help further my knowledge of best
practices. I used to always ask someone what
the best practice was, and I still do sometimes,
but now I have learned of the resources to find
the answers myself.

FINAL DATE:

Evaluation Scale
4 = Self Directed
3 = Directed
2 = Remedial
1 = Ineffective
FORMATIVE
EVALUATIONS

PROGRAM OUTCOME AND EXEMPLARS

SUMMATIVE
EVALUATION

DATE

5.0 Professionalism and Lifelong Learning: Demonstrate commitment to the nursing

profession and lifelong learning
Course Objectives and Exemplars
5.1 Student demonstrates the professional
standards of moral, ethical, and legal conduct

Allows for patient privacy and confidentiality

Follows Health Insurance Portability and Account ability
Act (HIPAA) guidelines
Answers promptly patient and healthcare team requests
Accepts responsibility for errors and takes corrective
action with staff/instructor
Maintains professionalism when collaborating with other
disciplines
Demonstrates respect for authority

5.2 Student demonstrates accountability for

personal and professional behaviors

Follows dress code policy and attendance policy

Completes all clinical assignments on time

5.3 Student integrates previous learning to more

fully develop the knowledge, skills, and attitudes of
a beginning nurse generalist

Identifies strengths and personal learning needs and

verbalizes these needs to faculty

Advocates for own self learning
Demonstrates self-directed awareness
Incorporates knowledge from required general education
courses

5.4. Student evaluates ones own practice through

ongoing written and verbal reflection

Completes all reflective exercises

Participates in self-evaluation
Seeks out experiences to improve clinical skills
Demonstrates flexibility and adaptability related to nursing
practice within an ever changing healthcare system
Accepts and incorporate constructive feedback
Identifies appropriate clinical mentors

5.5 Student demonstrates competent nursing care

and actively seeks opportunities for continued
learning

Collaborates in development of nursing plan of care

Provides quality nursing care appropriate to patient needs
in a timely manner
Communicates therapeutically
Identifies strengths and personal learning needs and
verbalizes these needs to faculty
Seeks own learning opportunities
Accesses learning materials for patient, staff, peers, self
Engages in quality self-reflection

Professionalism and Lifelong Learning

STUDENT EXAMPLES/COMMENTS

Professionalism and Lifelong Learning

FACULTY EXAMPLES/COMMENTS

MIDTERM DATE: 10/4/2015

1 I always allow for patient privacy and
confidentiality. On the clinical of 9/24 I had a
patient that was going into labor and she
requested that only her mom and husband be in
the room. So I told the receptionist/person in
charge of the waiting room to hold all visitors for
her until further notice. During clinical I always
accept responsibility for my actions and have a
healthy respect for authority.

MIDTERM DATE:
Reflective Journaling Developmental Level:

2. I follow the dress code and turn in all clinical paperwork

in on time. So far I have completed 4 of the 6
assignments. My plan is to finish them as early as
possible.

3. (Focus on setting goals for the remainder of the

semester) I would like to get more comfortable with the
assessment of new born babies. I would also like to be
more familiar with charting. I think my charting as of now is
slow and ideally I would like to be much faster and more
efficient

4. I have completed all written and reflective exercises. I

also actively seek out opportunities on the different units to

Harrison submits all clinical course work in a timely

manner. He has been late to clinical on 9/10/2015 and
10/8/2015. He comes to clinical dressed appropriately
for the clinical experience.
For the remainder of the semester I would like to see
Harrison continue to seek out new learning
experiences and to work on gaining more
independence and autonomy in performing her nursing
assessments and skills and with documentation in
Connect Care.
I also expect Harrison to arrive to clinical by 0645 to be
fully prepared to assume care of his assigned patient.

grow and learn as a nurse and get involved in my patients

care. As of now I have already see a vaginal birth and a
cesarean section. The only reason I have not seen more is
because I stepped aside to allow other students to have
those experiences since I have already experienced them.
I find every clinical packed full of new experiences and
information.
DATE:

DATE:

DATE:

DATE:

FINAL DATE: 12/3/2015

1. I always allow for patient privacy and
confidentiality. During clinical I always accept
responsibility for my actions and have a healthy
respect for authority. I always take responsibility
for any mistakes that I make. I also always
maintain professionalism when interacting with
other disciplines.

FINAL DATE:
Reflective Journaling Developmental Level:

2. I follow the dress code and turn in all clinical paperwork

in on time. This semester I have arrived late to clinical
more times than I would have liked. While it does not
happen often, it could have been avoided on the days I
was late. I completely understand and agree that it is
unprofessional to arrive late, this is something I am
working on in both my personal and professional life. I will
improve on this aspect professionalism.

2. One goal I focused on during the midterm was

getting better at documentation. I believe I have
improved on my documentation speed, accuracy
and efficiency. I was able to get more organized
with how I set up my connect care folders and
tabs, and also learned a few helpful tips from the
nurses as well.

I have completed all written and reflective exercises. I

also actively seek out opportunities on the different units to
grow and learn as a nurse and get involved in my patients
care. I find every clinical packed full of new experiences
and information. I am at ease with the ever changing
nature of the hospital setting. For example, on 11/19 I did
not get my patient on the MI unit until 1130, so I assessed
my nurses other patients and helped them until my patient
got up the floor. It was a different day than I am used to
but I adapted to it successfully.
3.