Multi Rater Competency Assessment

2015 - 2016 - NURS 253 Practical Nursing Pre-graduate Experience MRA Mid (201508)
NURS 253 Practical Nursing Pregraduate experience (PN, 18-Jan-2016 - 07-May-2016)
Student :
Clinical Teacher/Preceptor :
Advisor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Tenzin Lektsok
Ewa Brzostek
Ramandeep Sasrao
Judy Martin
Lakeshore Lodge
Agency
CC
18-Jan-2016 To 07-May-2016
200
200
200

I declare that this is my original work and the sources used are acknowledged.

Abilities and Outcomes / Learning Outcomes

Student Rating

Teacher Rating

1. Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and procedures of the
practice setting.

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

Satisfactory

Satisfactory

procedures.
T.L. : I have always complied with regulatory standards, relevant legislation and the practice setting's policies and procedures. For instance, I
adhered to the dressing code and I have been punctual and documented in a timely manner.

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

Satisfactory

Satisfactory

T.L. : I have always considered that i am accountable for any action that I have done. For instance, proper medication administration and considering
client
centered care.

1. 3 Use the three factor and decision making frameworks to determine strengths and limitations and

Satisfactory

Satisfactory

when to collaborate and consult with other professionals.

T.L. : I have considered client, nurse and environment while giving the care to client. for instance, considering the client need, safety and team work
with other PCAs and nurse. Moreover, I always consider the stability and predictability of the client's condition and the environment before providing
care to the client and I have informed my preceptor whenever there is any changes to the client's condition.

1. 4 Integrate evidence-informed practice and a theory based approach into nursing care.

Satisfactory

Satisfactory

T.L. : I used obtained vital signs and assessment of physical and mental conditions of residents to evaluate their status. For instance, certain
medication I didn't give
after checking resident's pulse rate lower under defined number.

1. 5 Assess practices and risk management principles and take action to ensure safety of clients,

Satisfactory

Satisfactory

self, and others.

T.L. : I have carried out safety-based practices and risk management principles to ensure client's safety and a safe environment by making sure to
put the client's bed in the low position, I elevated the head of the bed during giving medication in the morning, placed call bell within reach of the
client, and assisted clients with transferring from bed to the toilet/shower/wheelchair and vice versa.

1. 6 Question and clarify unclear orders or directions and when uncertain.

Satisfactory

Satisfactory

T.L. : I made sure about the medication if I am uncertain about it. I follow my preceptor's directions if am not sure about the procedure. For instance,
Catheterization procedure and insertion of Butterfly SC.

1. 7 Question, clarify or challenge questionable orders, decisions or actions by others.

Satisfactory

Satisfactory

T.L. : I clarified the resident's new medication order with my preceptor after physician visited to the floor. I also clarified with my preceptor about
unclear nursing abbreviations in charts and reports.

1. 8 Respond in a professional manner to situations in which there is unsafe, unacceptable or

Satisfactory

Satisfactory

unprofessional behavior.
T.L. : I always put client's safety in top priority and I have sought for help from the clinical preceptor when the situation required me to.

1. 9 Demonstrate understanding about the role of the nurse within health care.

Satisfactory

Satisfactory

T.L. : I demonstrated by providing proper care and taking proper assessments of the residents. For instance, taking vital signs, wound dressing,
following the instructions of preceptor, reading the previous reports to PCAs before shift begins.

Teacher comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies
and procedures of the practice setting. :
Follows up all relevant policies [policies are based on legal and regulatory frameworks]

2. Communicate using strategies and technology to effect accurate and timely information sharing including data, research, and other
information.

2. 1 Contribute to team sharing and discussions.

Satisfactory

Satisfactory

T.L. : I read the previous reports to health care team in the morning and discussed about the unusual incident and well-being of residents. i was
always ready to help health care team member when they need any help.

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

Satisfactory

Satisfactory

T.L. : While documenting, I always write about the significant things that I noted during my client care and assessment, I try my best to document
clearly and accurately in a timely manner and always do a final check with my preceptor before finalizing the report for next shift.

2. 3 Use effective communication techniques when reporting relevant information and providing

Satisfactory

Satisfactory

feedback to the appropriate members of the interprofessional heath care team.

T.L. : I have used verbal and non verbal communication techniques to patient who doesn't understand English and can't hear properly.

2. 4 Evaluate and refine techniques used to communicate and share information with clients and the

Satisfactory

Satisfactory

interprofessional health care team.

T.L. : I utilized both verbal and non-verbal communication techniques with the clients and inter-professional health care team.

2. 5 Ensure privacy and confidentiality.

Satisfactory

Satisfactory

T.L. : While doing catheterization and dressing of wound, i provided privacy by closing door. I ripped the medcation package in proper techniqueso
other people might dont know about their medication.

2. 6 Use technology to retrieve information including research and other date and to obtain and

Satisfactory

Satisfactory

forward information both within and outside the practice setting.

T.L. : I used Fax machine to reorder the medication of residents from pharmacy and used computer to write the report of the shift.

Teacher comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Uses internet to gather needed information, asks questions, reads and follows relevant policies and procedures

3. Engage in relational practice that is caring, compassionate and respectful.

3. 1 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and

Satisfactory

Satisfactory

health care team members.

T.L. : In order to establish therapeutic caring, compassionate, and culturally safe relationships with clients and health care team members, I have
maintained privacy of the client and have been respectful towards the client's decision and the health care team members. I have always shown my
caring attitude towards all clients without any discrimination. I respected other cultures and their beliefs, values and attitudes

3. 2 Establish a caring environment that supports clients in meeting their needs and outcomes,

Satisfactory

Satisfactory

managing their illness, or experiencing a peaceful death.

T.L. : I established a caring environment that supports clients in meeting their needs and outcomes, managing their illness, or experiencing a
peaceful death. for instance, giving their medication on right time, providing comfort measures, re-positioning Q2hr to prevent any pressure ulcers,
dressing their wounds.

3. 3 Demonstrate therapeutic use of self to foster client well-being.

Satisfactory

Satisfactory

T.L. : I make sure that I provide client centered care during my clinical practice because every client differs from one another.

3. 4 Utilize relational knowledge and skills, and ethical principles to support clients and to interact

Satisfactory

Satisfactory

with health care providers.

T.L. : I utilized relational knowledge and skills, and ethical principles to support clients and to interact with health care providers by showing respect
towards other cultures and beliefs.

3. 5 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on
relational practice.

Satisfactory

Satisfactory

T.L. : It is true that our believes and values effects our ability to work but i always make sure i do not impose my believes or values on other people.
for instance, i don't share my religions values and beliefs to other religion followers as they have there own way of thinking according to their religions.

3. 6 Collaborate with clients, members of the interprofessional and health care teams; and, consult

Satisfactory

Satisfactory

appropriately.
T.L. : I make sure that I inform the clinical preceptor about the care provided to the client and document the assessment, provided care and client's
condition in a timely manner.

3. 7 Uphold practices and systems that support the diversity of clients and of the interprofessional

Satisfactory

Satisfactory

health care team.

T.L. : I have respected and shown support to the diversity of clients and the inter-professional health care team. I have applied culturally sensitive
care to the clients to meet their comfort level and have always shown respect to the client's cultural, religious, and other beliefs and values.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

T.L. : I have explained the importance of medication to resident who refuse to take it. Some of them agreed to take it after the explanation. I have
explained the resident to use walker properly.

Teacher comments for Engage in relational practice that is caring, compassionate and respectful. :
Very gentle and patient, interacts with clients in respectful manner.

4. Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the profession.

4. 1 Evaluate and refine leadership skills to develop solutions, resolve conflict, create a positive work

Satisfactory

Satisfactory

environment and organizational culture, and to strengthen advocacy role.

T.L. : I always ask for consent from the client before providing any care. I remain calm, non-defensive, respectful and respond appropriately in order
to prevent conflicts.

4. 2 Provide feedback to peers and accept feedback from peers and members of the

Satisfactory

Satisfactory

interprofessional health care team.

T.L. : I always accept feedback from my clinical preceptor and health care team members in a positive manner so that I could improve my nursing
skills by referring to the feedback.

4. 3 Advocate for clients, self, others, and quality practice environment.

Satisfactory

Satisfactory

T.L. : I know my strengths and weakness so i always ask for help before i do something if i am not sure about. This helps in giving good quality
service to my client. I also adapt my plan according to resident's need. I always remind myself about the accountability of any actions that i have to
perform.

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

Satisfactory

Satisfactory

T.L. : I have always asked for client's consent before providing any care and have respected client's decisions. For instance, I respected the client's
decision when the client refused to eat their food and to take vital sign.

4. 5 Respond appropriately to unsafe, unacceptable, and unprofessional behaviors.

Satisfactory

Satisfactory

T.L. : I responded appropriately to unsafe, unacceptable, and unprofessional behaviors by administering PRN medication to agitated residents and
explaining wrong doing of residents.

4. 6 Demonstrate public protection and acting in the interests of the public through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional health care teams.

T.L. : In order to maintain safety and provide the best care to my clients, I always made sure to inform the clinical preceptor about the care provided
to the client and asked for help from the preceptor whenever I was unsure about a procedure in order to practice safely in the clinical setting.

4. 7 Contribute to the creation of quality practice strategies and solutions.

Satisfactory

Satisfactory

T.L. : I have provided assistance to the nurse and PCAs whenever they needed assistance. For example, repositioning residents, transferring from
bed to wheel chair and feedings.

4. 8 Assign, supervise, teach as appropriate, and provide feedback to unregulated care providers

N\A

N\A

(UCPs) in collaboration with the interprofessional health care team.

T.L. : I have not done that yet.

E.B. : o

Teacher comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :
Takes leadership role at shift exchange [report] assigns duties and clients to PSW's in the morning.

5. Integrate the nursing process into all aspects of nursing care and across diverse practice settings.

5. 1 Formulates clinical judgments that meet clients unique and changing health needs and priorities,

Satisfactory

Satisfactory

outcomes, and overall condition and incorporates these into evolving plans of care.
T.L. : I always read the chart and progress note to determine client's priority in order to meet the client's unique and changing health needs and
priorities, outcomes, and overall condition and conduct documentation client's condition in a timely manner.

5. 2 Devise evidence-informed plans of care that are holistic and client-centred.

Satisfactory

Satisfactory

T.L. : I addressed the client's individual needs, by assessing their physical and emotional state. And document about the care provided and the
client's status, complaints, and progress.

5. 3 Use clinical judgment to assess clients, prioritize needs, outcomes, and nursing interventions.

Satisfactory

Satisfactory

T.L. : I applied the knowledge learnt from lectures, textbooks and clinical preceptor's guidance during my clinical practice. For example, prioritizing
client's needs according to her/his diagnosis and current status.

5. 4 Collaborate in the evaluation, refinement and modification of plans of care.

Satisfactory

Satisfactory

T.L. : I have made sure to document on the care provided to the client, any changes in client status and the response of the client so that it could be
use for evaluation and modification of the plan of care.

5. 5 Safely and competently perform treatments and use techniques, and technology autonomously

Satisfactory

Satisfactory

and in collaboration with clients and members of the interprofessional health care team.
T.L. : In order to prevent the pressure ulcer, i have done re-position of resident Q2hr and applied cream on pressure point and done dressing change
and wound assessment.

5. 6 Collaborate with the clients across the lifespan and with members of the interprofessional health

Satisfactory

Satisfactory

care team to create a client centered plan of care that is articulated with competence both in writing
and orally.
T.L. : I interviewed the newly admitted resident and her family regarding the resident's need and wellbeing to create a client centered plan of care.

5. 7 Use awareness of own knowledge and skills, the three factors of nurse, client and environment

Satisfactory

Satisfactory

and the practice decision-making framework to guide practice.

T.L. : Decisions are always made based on three factor frame: nurse, client and environment. In this way i made sure that my client's outcomes are
stable and i am competent to provide my skills and i have proper environment or proper equipment to perform my assessment

5. 8 Manage workload, time, and physical resources to provide effective, efficient and ethical care.

Satisfactory

Satisfactory

T.L. : I have managed workload, time, and physical resources to provide effective, efficient and ethical care. For instance, I have prioritized my
assignments and administered medications, and documentation on time.

Teacher comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
Able to administer medications and treatments safely with minimal supervision, evaluates the effectiveness of treatments and therapies. Participates
in providing direct care as needed. Uses acquired knowledge and knows how it applies to the practice but needs to build up confidence in his
judgment.

6. Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and holistic health care in a
complex and changing environment.

6. 1 Collaborate with clients to determine needs, mutually agreed health outcomes, approaches to

Satisfactory

Satisfactory

care, and to evaluate care.

T.L. : I worked collaboratively with clients and members of the inter-professional health care team to achieve mutually agreed expected outcome. For
instance, transferring client from wheelchair to bed and vice versa. I collaborate with my resident and PCA in ambulation and assisted him/her with
walker in hallway.

6. 2 Contribute as a member of the interprofessional and health care teams to respond to changing

Satisfactory

Satisfactory

client needs and outcomes.

T.L. : I have gathered the subjective and objective data, provided care in a timely manner, and documented all the information in the his/her record
inorder to contribute as a member of the inter-professional health care team to respond to the changing needs and expected outcomes of the clients.

6. 3 Consult with and seek out assistance from members of the interprofessional health care team.

Satisfactory

Satisfactory

T.L. : I have consulted with and sought out assistance from the clinical preceptor and inter professional health care team. For instance, asking about
the Intake & output and medication of residents.

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

Satisfactory

Satisfactory

expected client outcomes.

T.L. : I have provided proper care at proper time with and without nurse. I have discussed the changes with nurses about the resident. For instance,
fever, pain and amount of I&O to my preceptor.

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

Satisfactory

Satisfactory

changing environment.
T.L. : I have provided care on time and ensured that the client is comfortable before exiting the client's room and have performed documentation of
the client's status and response and have informed the clinical preceptor regarding client's condition.

6. 6 Respect the unique role and competencies of all members of the interprofessional health care

Satisfactory

Satisfactory

team.
T.L. : I have always respected the unique role and competencies of all members of the inter professional health care team.

6. 7 Collaborate as a member of the interprofessional health care team to respond to changes in

Needs
Development

Satisfactory

nursing knowledge and practice and in the health care environment.

T.L. : Although i spoke with other inter-professional health care team but i was not very much involve in practice.

Teacher comments for Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and
holistic health care in a complex and changing environment. :
Collaborates with team members [clients, families,OT,PT, RSA, PSW, SW, MD] and shares/gathers information to provide client oriented care.

7. Engage in Quality Assurance consistent with the regulatory framework.

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

Satisfactory

Satisfactory

consultation with other members of the interprofessional and health care teams and by through
competent and safe practice.
T.L. : I have performed competent and safe practice by working collaboratively with the client and health care team members and followed the
guidance and instructions of the clinical preceptor in assessment, wound care, safe medication practice, and proper documentation.

7. 2 Commit to Quality Assurance practice to identify strengths and areas for professional growth and

Satisfactory

Satisfactory

in accordance with the regulatory framework (CNO).

T.L. : I have utilized Quality Assurance practice to identify my strengths and areas for professional growth. For example, I reflect on the feedbacks
that I have received from the clinical preceptor and health care teams in order to improve my nursing skills.

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

Satisfactory

Satisfactory

T.L. : I have done learning plan on medication administration as I struggled in the beginning and now I feel much comfortable and finishes in timely
manner.

7. 4 Assume responsibility to seek out feedback for colleagues and peers and learning opportunities

Satisfactory

Satisfactory

Satisfactory

Satisfactory

that foster professional development.

T.L. : I seek out feedbacks from my peers and colleagues to develop my skills.

7. 5 Consistently review nursing research and information about health care to improve competence
and to support clients.

T.L. : In order to improve my competence and to support clients, I have utilized technology and their files to research on resident's diagnosis and
medications.

7. 6 Develop professional responses to health care system changes resulting from advances in

Satisfactory

Satisfactory

research, technology, and changes in societal and political forces.

T.L. : I have used computer resources to do nursing research on diagnosis and medications that patient is taking.

Teacher comments for Engage in Quality Assurance consistent with the regulatory framework. :
Seeks feedback and asks questions, works on all identified issues, makes good progress.

8. Use critical thinking, problem solving and decision making skills to meet the health care needs and expected outcomes of clients.

8. 1 Use critical thinking to inform decision making in all aspects of nursing care.

Satisfactory

Satisfactory

T.L. : I have utilized critical thinking to inform decision-making in my nursing practice, for example, prioritizing client's needs and care.

8. 2 Use clinical judgment to assess and refine assessments in collaboration with the

Satisfactory

Satisfactory

interprofessional health care team, formulate nursing diagnoses, plan nursing interventions, and
outline evaluative criteria.
T.L. : I access the client's chart and recent progress note entry to determine client's priority need and formulate nursing diagnosis, plan nursing
interventions, and evaluate the outcome.

8. 3 Evaluate and refine critical thinking, problem solving, and decision-making skills.

Satisfactory

Satisfactory

T.L. : In order to evaluate and improve critical thinking, problem-solving, and decision-making skills, I referred the knowledge gained from the
textbooks and lectures and experience gained at clinical placement and feedbacks given by preceptor.

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

Satisfactory

Satisfactory

provide safe and competent care.

T.L. : In order to provide safe and competent care, I always utilize the knowledge gained from the lectures, textbooks, preceptor, lab practice, and
assessment videos.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

T.L. : I organize my care according to the priority needs of the residents. I took the fasting blood sugar level of patient before taking their breakfast inorder to get the accurate reading.

Satisfactory

8. 6 Demonstrate professionalism, responsibility, and accountability.

Satisfactory

T.L. : I have demonstrated my professionalism and accountability by arriving hospital on the time , addressing the client by proper name, informing
client about the procedure before starting and obtaining the consent before any interventions.

8. 7 Use critical thinking, the practice decision-making framework and the nurse-client-environment

Satisfactory

Satisfactory

framework to inform clinical judgments and practice.

T.L. : Decisions are always made based on three factor frame: nurse, client and environment. In this way i made sure that my client's outcomes are
stable and i am competent to provide my skills and i have proper environment or proper equipment to perform my assessment.

Teacher comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Able to analyze and prioritize effectively, good critical thinking skills - needs to show more confidence in own capabilities.

Student Midway Summary with Strategies for Continued Growth

It was such a great pleasure and learning opportunities for me so far. I learnt so many new skills and knowledge in this new setting from my preceptor
and health care team. In-order to further develop of my knowledge and skills, i will reflect on any actions that i have performed in the setting and use
my critical thinking and apply my knowledge that i acquired from college in the setting as much as possible. Further more, i will implement and
consider the feedback of my preceptor to develop further in all aspects of my skills and knowledge.

Teacher Midway Summary with Strategies for Continued Growth

Continue to develop practical skills, ways to apply theoretical knowledge and build confidence. Keep up the good job Tenzin!

Advisor Midway Summary with Strategies for Continued Growth

Ewa reported that Tenzin is doing very well in the clinical setting, he is able to administer medications, and do wound care with minimal assistance.
He documents with minimal assistance. He asks questions if he needs any clarification. He collaborates with the allied health care team members
regarding patient care. He is punctual. He needs to continue working on developing his nursing skills for the rest of the semester and be more
confident.

Student's References
Peers feedback
CNO modules
Clinical preceptor's feedback
CNO documents
Potter and Perry Textbook

Refer to Clinical Excellence Committee (CEC)

Grade

Grade

Satisfactory

Needs Development

Satisfactory

Unsatisfactory

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: 28-Feb-2016 18:03