Clinical Evaluation Process for the Trent Fleming School of Nursing

Instructions for use

The Mid-Term Evaluation document will be completed at the mid-point of
the clinical placement to assist the student in taking inventory of their
current development and assist them to make plans for future clinical
practice. Reflection will be used to assist the student in measuring their
progress against the established program and course objectives, with
specific examples from clinical practice identified as evidence of learning.
The broad indicators listed in the accompanying document entitled NURS
2021 Program and Course Objectives may be used to support student
reflection, although the list of indicators is not exhaustive and should not be
used to cut and paste as evidence of learning. Specific examples of progress
must be provided that are unique to each student. The student will submit
the Mid-Term Evaluation document to the clinical instructor prior to the
formal mid-term student evaluation.
After receiving the students Self Mid-Term Evaluation, the clinical instructor
will add to the evidence of progress and complete the comment section
providing feedback and evaluation of the students progress. The clinical
instructor will provide suggestions for improvement. If a student is in a
failing position at mid-term, the student and instructor will develop a
Learning Plan outlining strategies the student will engage in, along with
clear expectations that must be met, for the successful completion of this
clinical course.
At the end of the rotation, the Final Evaluation document is to be
completed by the student to archive their achievements and areas for future
development. It will assist the clinical instructor in their assessment of the
student. The clinical instructor will add to the evidence of progress and
complete the comment section providing feedback and evaluation of the
students progress.
The clinical instructor will collect evidence in the form of the student selfassessment, comments of the health care team members, patient input,
student submissions (including portfolio) and observations to complete
Final Evaluation. A summary of achievement as well as implications for
future learning shapes the outcome of this document. The attendance
section and record of completed hours is to be filled in completely. The
completed document is to be shared with the student and signed. The
signed copy must be returned to the TFSON within 10 days. The Course
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Instructor will assess the completion of the Learning Center Component, if

applicable. An electronic copy of the students completed final evaluation
must be uploaded by both the student and by the clinical instructor within
48 hours of the final evaluation delivery.

NURS 2021 Program and 2nd Year Outcomes

Program Outcomes
Students graduating from this program:

1. Prepared as generalists entering a selfregulating profession in situations of

health and illness.
2. Prepared to work with people of all ages and
genders (individuals, families, groups,
communities and populations) in a variety of
settings.
3. Expected to have an enhanced knowledge of
the program foci: indigenous and women's
health, aging, mental health, and rural
populations.
4. Prepared to learn to continuously use critical
and scientific inquiry and other ways of
knowing to develop and apply nursing
knowledge in their practice.
5. Prepared to demonstrate leadership in
professional nursing practice in diverse health
care contexts.
6. 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.
7. Able to establish and maintain therapeutic,
caring and culturally safe relationships with
clients and health care team members based
upon relational boundaries and respect.
8. Able to enact advocacy in their work based on
the philosophy of social justice.
9. Able to effectively utilize communications and
informational technologies to improve client
outcomes.
10. Prepared to provide nursing care that includes
comprehensive, collaborative assessment,
evidence-informed interventions and outcome
measures.

On completion of 2000 level courses students will

be able to:
Begin to practice and experience self-regulation in
a variety of health care settings.
Explore the broader role for nursing in a variety of
communities and populations.
Understand and appreciate the contextual
components of working with families, groups,
communities, and populations.
Demonstrate an understanding the relevance of
five foci in relation to individual and communities
experience of health.
Begin to apply critical and scientific inquiry to
nursing knowledge and practice.
Understand health experiences using a variety of
ways of knowing.
Discover leadership in self and others when
working with individuals, families and
communities.
Understand the context and attributes of the
culture of patient safety.
Establish an engaged, caring, and culturally safe
relationship with families and communities.
Explore the influence of determinants of health on
health and wellness of individuals, families and
communities.
Identify situations where advocacy is indicated.
Effectively utilize information and technology skills
to promote positive outcomes.
Perform an assessment of a community.
Collaborate with group to identify priority health
goals and create evidence informed plans of care

NURS 2021H Clinical Course Evaluation

Mid-Term Evaluation

Student: _____Sabrina Singler______

Clinical Instructor: _______Cathy Graham____________
Placement: ___NURS2021 Ontario Shores_____
Missed Clinical Hours: _12__

Missed Lab Hours: _0__

NURS 2021H Clinical Course Mid-Term Evaluation

Course Objective

Progress
Evidence/Indicators

Recognize and begin to navigate the I have begun to recognize the complexities of family
nursing especially being on an adolescent unit. Where
complexities of family nursing.
the input of the family members is frequently crucial.
Many of the parents of the patients are their SDM's
due to the extent of their psychosis. The roles the
parents of these patients play can vary. In the example
of one of the patients, his parents are separated. The
father believes that the medication and therapies
being used at Ontario Shores are effective, where as
the mother wants to return home to their native
country to pursue more religious treatments. With C.S
his family dynamic as written in his charts is quite
complex. His family has a history of schizophrenia, so
it is possible his family has experience with dealing
with psychosis in a positive manner but it also possible
they do not. His mother has a history of substance
abuse which in individuals with psychosis in particular
schizophrenia can be especially detrimental. There is
also the knowledge that the usage of marijuana may
be correlated to schizophrenia and cause symptoms; it
is also known that the rate of youth participating in the
usage of marijuana within first nations communities is
high. This is something to be taken into consideration
for C.S. In his charts it has been noted that he has
been educated on the possible impact of substance
abuse as well as staying on his medications and
following his treatment plan. His father expressed that
previously he had not participated in ensuring his son
continued treatment and feels guilty. He is determined
to be more proactive and participate in being a
5

Satisfac
tory

Unsatisfac
tory

Integrate knowledge from previous

courses to support diverse
populations.

facilitator of his sonssons treatment. His community is

also playing a role; he has to participate in Youth
Worker facilitated indoor and outdoor activities, w.
Which is an essential a part of his reintegration into
society as well as a way to maintain his health. And
monitor his progress. The police in his area are also
going to be involved in ensuring he follows the
stipulations around his curfew and where he is allowed
to go within the community. His father is also
facilitatingon his probationary work at his own place of
work. All of these tie into the patientspatients health
and recovery.
How are other 2021 activities- lbs, HESIs ,e tc.
Enhancing your learning?
How is NURS 2001 expanding your understanding?
In NURS1000 NURS1000 and NURS1002, we discussed
the indigenous population in Canada, in regards to
health care. Being placed at Ontario Shores has
exposed me to a sub-population of Canada's
indigenous population that suffers from mental illness.
The facility has a large number of individuals from Big
Trout Lake which is the largest First Nations community
in Ontario.
The lectures and seminar topics which introduced the
importance of recognizing the influences of an
individual's culture and environment. Being aware of
the frequent inaccessibility to health services or
education within many indigenous communities has
allowed me to better understand the patients on my
unit that are from these communities. All those
courses also introduced the importance of ethics and
relational practice. There are many ethically dilemmas
that can occur within a mental health facility. For
example enforcing seclusion on a patient and utilizing
restraints. In certain instances, such as on Thursday
October 20th, it is important to make decisions

regarding these subjects, to ensure the safety of

patients and staff. This past Thursday, the staff on the
unit dealt with a crisis in which they decided to utilize
restraints. Although the patient was quickly removed
from these restraints, the ethical dilemma that they
must have dealt with while coming to their decision is
recognized. They also decided that it would be in the
best interest of the patient to leave her in seclusion.
I also believe that the information that I learned in
these classes in particular regarding the indigenous
communities has allowed me to be better prepared to
find options for patients to have access to health care
within their communities. I have done some research
inside and out of the clinical setting to find out what
resources are accessible to my patient upon his return
to his community.
Critically appraise relational inquiry -2016-09-22 I was paired with Annette who explained
processes and begin to develop
some of the patients to me and how the unit worked
meaningful relationships with
-2016-09-29 I was again paired with Annette who
health care providers and family
showed me how to use Meditech
members.
-2016-10-06 I shadowed Cathy who helped me with
some information for my drug cards as well as showed
me medications. She also allowed to observe her do
the first injection of Risperidone on a patient.
-I spoke with Barb and one of the other staff members
on the unit when we went to baking Sept 29th and Oct
20th, for these patients some of the staff are like family
to them. I feel this has helped me to start being able
to form relationships with patients family members,
since I have had next to no interaction with the
patients biological family members.
How do these examples illustrate relational inquiry?
Collaboratively formulate a plan of
care based on knowledge of family
nursing, related theories and
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After I chose my initial patient C.S, I began reading

the patients chart so become familiar with the patients
history. I noted that the patient lived with his

scholarly literature.

Develop, implement and evaluate

the effectiveness of healthpromoting, evidence-based practice,
reflecting principles of family
nursing as relational practice.

grandparents prior to being hospitalized. He has plans

to move in with his father. His mother suffers from
substance abuse. His father has visited multiple times
while he has been at Ontario Shores.
Although I haven't been able to participate in the plan
of care for any of the patients, as it is beyond my
scope of practice, I do know that the environment in
which a patient lives as well as family relationships
have a large impact on patients recovery. I have paid
attention to C.S's history and notes in regards to his
family. I have also had multiple interactions with C.S in
which his family, such as his grandmother, were
mentioned. He expressed happiness during these
interactions. I was able to apply and practice relational
practice and therapeutic relationship forming during
each of my 12 hour shifts on the unit. My experience in
mental health have varied largely from long term care
in that I cannot always be sure of my safety. The state
of the patient can vary when they suffer from
psychosis. From writing my NURS2001 paper I have
realized that patients experiencing psychosis are more
likely to be aggressive. With that I have become more
aware of ensuring my constant awareness of a
patient's state. Describe the theoretical basis of your
practice
For past four 12 hour clinical shifts we have journaled.
Journaling is a way to reflect on events that have
occurred during the day. I have spoken with the nurses
on the unit I am on regarding health promotion.
Specifically the importance of informing patients of
continuing to take your medication. For C.S the nursing
station in his community, his family (specifically his
father) as well as other community members have
committed to ensuring they help with this.
I noticed that the patients really enjoy the DBT and
CBT programs that occur. These are displayed on

Demonstrate increasing competence

and confidence in the application of
psychomotor skills in practice
settings.

Demonstrate accountability and

professionalism that is consistent
with a nurse entering a selfregulating profession.

Select appropriate community

support services for families
needing referral to enhance coping
with diverse transitional
experiences.

posters in the main area. They are also posted in the

washroom for the nurses to remind staff of what each
weeks focus is.
How are you facilitating health promotion?
September 29nd I took the vitals of one of the patients.
October 6th I took the temperatures and documented
the symptoms (respiratory or gastrointestinal) of
several of the patients on the unit because of the
potential respiratory outbreak. As well as took some of
the vitals on patients the nurses asked me to. On
October 20th I took the weights and heights of four of
the patients.
I am now far more confident when taking vitals. And
hope to continue to practice taking vitals on patients.
Other skills- eg. meditech?
I demonstrated accountability and professionalism
when I recognized I was struggling and the potential
eaffect that it would have on my presence at clinical. I
also did so when I informed the nursing staff of one of
the patients hanging out by the main door. This patient
has a history of elopement and is also aggressive.
When I entered the unit I ensured I closed the door
behind me and then spoke with the nurses. I also
ensure I am practicing hand hygiene constantly in
particular when I have been ill or presented with a
cough and or runny nose. This limits the spread of
illness, which can occur easily on such a small unit
with so few individuals.
For my patient I have looked into the resources
available within his community. Since my patient lives
in a community that is fairly remote, their access to
health care is limited. Specifically their access to
health care providers trained in mental health is
limited. There is a nursing station in the community,
with minimal services available but there are services
at the hospital in Thunder Bay that the patient has

previously used. The patient will also be working with

a youth worker to continue treatment to reintegration
into the community.
Eg Other community resources beyond your patient

Clinical Instructor Comments (All areas marked as unsatisfactory must have a

comment); these comments are insightful- please respond to my questions and re-submit
a revised LEARN1; as I indicated in our conversation 2 weeks ago, I did not have sufficient
data to indicate that that your progress would result in meeting the course outlines, so
focusing on these course goals are very important at this point; where is your reference
list?
Signature of Instructor_____________
12, 2016_________________________

______________________________________

Signature of Student_____________________________________________________
______________________________

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Date

Date ____Nov.