NURS 3021H Clinical Practice Focused on Chronic Disease Management

Mid-Term Evaluation

Student: Alicia Jeffery

Clinical Instructor: Wendy Symons

Clinical Placement Hospital: PRHC Unit: D2

Date: February 18, 2018

Missed Clinical Hours: 0 Missed CLC Lab Hours: 0

 NURS 3021H Clinical Practice Mid-Term Evaluation
Program Goals
Students graduating from this program will be:
1. Prepared as generalists entering a self-regulating
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, women's and environmental health and
aging 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.
3000 Level Outcomes
On completion of 3000 level courses students will be
able to:
Fully understand how to practice in a self-regulating
profession.
Analyze clinical situations and reflect on individual roles of the
nurse as it impacts upon patients and the nursing profession.
Rationalize the link between health and illness.
Understand the complexity adults, of all genders, to achieve
optimal health.
Use a critical perspective in applying the foci to nursing
knowledge and practice.
Integrate critical reflective evidence-informed care using
multiple ways of knowing.
Develop and embody leadership at the point of care.
Expand awareness of leadership in nursing.
Identify strategies to develop leadership potential.
Anticipate, identify and manage risk situations.
Demonstrate awareness of resources related to risk
management.
Engages in deliberative personal centred relational practice to
assist individuals, families and communities to achieve health.
Acknowledge own potential to contribute to effective
collaborative team function.
Advocate for individuals, families, and communities
recognizing the influence of public policy on health.
Recognize contextual influences on persons lived experiences
within the health care system.
Integrates and applies critical thinking to the use of
information technology and dissemination strategies as related
to clinical outcomes.
Critically assess the individuals, family and community health
status.
Collaborate to identify priority health needs.
Identify evidence informed interventions and health outcome
evaluation in complex care situations.
Before completing the evaluation form, students and preceptors should review the objectives and sub-objectives. While
students and preceptors should comment on each of the seven course objectives, it is not necessary to write comments about
each sub-objective. It is better to provide specific and detailed comments about a few sub-objectives than to write broadly
about many.

Each objective should be awarded one of the following ratings:

Midterm:
Satisfactory Progress (SP): The student demonstrates sufficient knowledge, and skill and ability to safely practice or achieve
the objective with an average level of teaching support and guidance; or the level of performance is what the instructor would
expect of an average student at that level and point in time; and the instructor reasonably anticipates that if the student
continues at the current pace of practice and achievement, the student should be able to fully meet the objective at the end
of the course.

Needs Development(ND): The student demonstrates sufficient knowledge and ability to safely practice or achieve the
objective, but requires more than average teaching support and guidance; or the student demonstrates knowledge but needs
more practice to achieve the competency; or the level of performance is below what the instructor would expect of the
average student at that level and point in time; and the instructor reasonably anticipates that if the student focuses his/her
learning in the required area, and gains sufficient practice, the student has the potential to meet the objective at the end of
the course.

Unsatisfactory Progress (UP): The student does not demonstrate sufficient knowledge, or skill, or ability to safely practice or
achieve the objective, even with constant, intensive teaching support and guidance; or the level of performance is far below
what the instructor would expect of the average student at that level and point in time; and the instructor reasonably
anticipates that if the student continues at the current pace of practice and achievement, the student is not likely to meet the
objective at the end of the course.
Final:
Satisfactory (S): The student demonstrates sufficient knowledge, and skill and ability to safely practice or achieve the
objective with an average level of teaching support and guidance; or the level of performance is what the instructor would
expect of an average student at that level.

Unsatisfactory (U): The student does not demonstrate sufficient knowledge, or skill, or ability to safely practice or achieve
expected objectives, even with constant or intensive teaching support and guidance; or the level of performance is far below
what the instructor would expect of the average student at that level.
 NURS 3021H Clinical Practice Evaluation

Progress
Course Objective Evidence/Indicators SP/S ND UP/U
1. Demonstrate accountability and responsibility in the - I always complete my assignments on time
teaching-learning relationship. - I am always early for my shift, labs and
SIM and always in uniform
- I am always prepared with the necessary
knowledge
ALICIA COMPLETES HER PRE AND POST
CLINICALS AS REQUIRED. ON THE PRE CLINICALS
I WOULD LIKE TO SEE AREAS SHE FEELS SHE
NEEDS ASSISTANCE WITH, THIS WAY I CAN
ASSIST HER. SHE DID SEEK ASSISTANCE
APPROPRIATELY WHEN ADMINISTERING
MEDICATIONS, WAS KNOWLEDAGBLE, AND X
FOLLOWED ADVICE/SOLUTIONS AS REQUIRED.
(ADMINISTERING MEDS TO PT ON ISOLATION)
ALICIA TOOK ACTION IN A SITUATION WHERE
HER PATIENTS SAFETY COULD HAVE BEEN
POTENTIALLY COMPROMISED.SHE DISCOVERED
HER PATIENTS BOWEL MOVEMENT SHEET HAD
BEEN LABELLED WITH TWO DIFFERENT NAMES,
HER PATIENTS, AND ANOTHER PT.SHE BROUGHT
THIS TO MY ATTENTION, THEN TO THE CHARGE
NURSE, WHO THEN FILED THE ENCOM.
2. Explain the experience of chronic illness in individuals - I have supported a patient who was
receiving care in chronic care settings emotional after the physician told him he
would not be returning home
- I have interacted with family members of
patients who are concerned and I have
tried to help them, explain things and
X
reassure them
- MAiD program presentation
- Observed goodbye as patient went for
MAiD

3. Interpret critical aspects of the person’s experience of
chronic illness in relation to the nursing process such as
common signs and symptoms, responses to treatment,
patterns of coping, and impact on individual and family
relationships.
4. Identify symptoms and common medical treatments of
selected chronic illness.
- ALICIA INTERACTS PROFESSIONALLY WITH
HER PATIENTS AND THEIR FAMILIES.SHE HAS
WORKED WITH DIFFERENT AGES,
DIAGNOSIS’S, AND IS DEVELOPING HER
COMMUNICATION SKILLS. SHE IS
EMPATHETIC, ACKNOWLEDGES HOW THE
PATIENT AND HER FAMILES ARE COPING, HAS
A GOOD UNDERSTANDING ON HOW THE
CHRONIC ILLNESS IS AFFECTING EVERYONE
INVOLVED.
- I ensure to assess pain in each of my
patients frequently during shifts—
especially before care or transferring. I
ensure to get a pain rating before and
after administration of pain medications
to ensure the medications are effective at
controlling the patient’s pain
- I have observed the emotional impact that
chronic illness can have on a patient and
their family. One of my patient’s family
told him that they would most likely not
come to see him again and I observed how
this negatively affected the patient’s X
mood. I also recognized how people have
different ways of coping and that this may
have been the family’s way of coping
- ALICIA CAN PERFORM HER ASSESSMENTS
WITH MINIMAL ASSISTANCE.SHE
EXPERIENCED THE HOPELESSNESS OF A
DYING PATIENT WHEN HIS FAMILY
COMMUNICATED TO HIM AND THE STAFF
THEY DIDN’T WANT TO BE CALLED UNTIL
THE PATIENT PASSED. I OBSERVED THE
EXTRA TIME SHE SPENT WITH HIM,
COMFORTING HIM.
- Completed pre- and post-clinicals each
week, ensuring to research and fully X
understand each diagnosis, associated

5. Demonstrate select nursing and collaborative interventions
related to caring for the person with chronic illness such as
specific assessments, medication administration, physical
and chemical restraints, enteral feeding & residual
volumes, NG tube insertions, wound care, patient
controlled medication administration pumps.
signs and symptoms and two possible
medical treatments/diagnostics for the
diagnosis
- Identified why each patient would be
taking each medication they were ordered
- ALICIA IS THROUGH IN HER POST
CLINICALS.SHE IS FAMILIAR WITH
READING THE DR’S ORDERS, ABLE TO
UNDERSTAND WHY CERTAIN TESTS/LAB
WORK HAVE ORDERED, AND IS ABLE TO
DOCUMENT HER FINDINGS ACCURATELY.
- Administered oral medications to patient
during 4 shifts
- Administered subq injection
- Inserted a subq line
- Prepared and administered medications
through subq line
- I assess the integumentary system of each
of my patients when I turn my patients to
ensure prompt recognition and treatment
of pressure wounds. I have applied topical
creams and sprays to broken skin and I
have repositioned bedbound patients
frequently throughout shifts X
- Observed insertion of subcut lock and
CADD pump attachment
- Emptied ostomy bags
- Observed PleurX drain
- Applied topical cream to tumour
- Obtained urine specimen from foley
catheter
- ALICIA PERFORMS EACH SKILL WITH
COMPETENCY.SHE IS BECOMING MORE
CONFIDENT EACH WEEK IN HER
ASSESSMENTS, DUTIES.SHE IS EAGER,
SEEKS OUT NEW EXPERIENCES EACH

6. Identify potential consequences/complications of select
chronic illnesses and related interventions.
7. Under the supervision of a Registered Nurse, demonstrate
CLINICAL.
- When completing my pre-clinicals, I wrote
about priority assessments. For each
assessment, I would think about what
would be abnormal and then what I would X
do about that abnormal finding. For
example, a complication of end-stage lung
disease is hypoxia, which I would assess by
getting an SaO2 reading and titrating the
supplemental oxygen as per the doctor’s
order
- I have recognized that a patient with a
past hemicolectomy and on narcotics will
likely not have regular bowel movements.
I have performed the appropriate
abdominal assessment. I recognized that
without regular bowel movements,
complications such as abdominal pain,
bloating, bowel obstructions, and
excessive straining can occur. I did the
appropriate nursing intervention by
ensuring the patient was ordered laxatives
and stool softeners.
- ALICIA HAS A GOOD UNDERSTANDING OF
THE PATHOPHYSIOLOGY OF HER
PATIENT’S CHRONIC ILLNESSES.SHE
COMPLETES HER PRE CLINICALS
ACCURATELY, AND DISCUSSES BEFORE
START OF SHIFT. SHE REVIEWS THE
PATIENTS CHART BEFORE SHIFT,LISTENS
ATTENTIVELY AT REPORT. SHE ASSESSES
HER PATIENTS BEFORE INTERVENTIONS,
AND REASSESSES AFTER, DEVELOPING
HER KNOWLEDGE.SHE DOCUMENTS
WELL.
- I apply a nursing theory to my clinical
 safe, competent, evidence-informed, holistic nursing
practice with clients with chronic illness
a. Use a wide range of effective communication
strategies and interpersonal skills to appropriately
establish, maintain, re-establish and terminate the
nurse-client relationship
b. Demonstrate accountable, responsible and ethical
practice
c. Engage in respectful, collaborative, therapeutic
and professional relationships
i. Demonstrate therapeutic use of self
ii. Create a culturally safe environment
d. Apply nursing models and theories
e. Demonstrate health promotion and illness
prevention practices
f. Demonstrate patient advocacy
g. Predict outcomes of nursing care
h. Evaluate client response to nursing care
i. Critically appraise own practice in relation to
nurse-client/family interactions and as a member
of the health care team
8. Critically appraise own practice in relation to nurse-
client/family interactions and as a member of the health
care team
shifts each time I write my post-clinical
- I always explain what I am doing to
patients and I try to talk with them
throughout to make them comfortable
- When I see something I think is unethical,
or not right, I try to politely but assertively
talk to the person who is doing the action
X
and try to advocate for my patients and
make it right.
- I always wash my hands and don and doff
PPE correctly to prevent the transmission
of illnesses
- ALICIA IS ALWAYS PREPARED FOR
CLINICAL. SHE PROVIDES CARE THAT
DEMONSTRATES EVIDENCE BASED
INTERVENTIONS AND OUTCOMES. SHE
APPLIES NURSING THEORISTS, HAS HAD
THE OPPORTUNITY TO CARE FOR
PATIENTS IN ISOLATION-PERFORMED
CORRECT PROCEDURE RE GOWNING.SHE
ALWAYS WASHES HER HANDS BEFORE
ENTERING PATIENTS ROOMS, AFTER
CARE, AND LEAVING THE ROOM. AS
STATED EARLIER, SHE ADVOCATES FOR
HER PATIENT, RE WRONG LABEL. SHE
CAN PREDICT OUTCOMES, ASSESSES HER
PATIENTS WITH THE PAIN SCORE AND
THE PPS SCALE.
- During and after shifts, I am constantly
seeking feedback from my peers
- During lab and SIM I am reflective of the
skill I have performed and I ask my X
instructors for feedback. I later try to
implement this feedback into my practice
- I collaborate with my peers and the staff
on the floor. I am constantly asking others

9. Participate in professional development based on
reflective practice and critical inquiry
Areas of Strength Identified by Student
1. Documentation
2. Communicating and building therapeutic relationships with patients
3. Teamwork
for help and asking if there is anything I
can do to help them.
- ALICIA LISTENS APPROPRIATELY TO HER
PATIENTS AND THEIR FAMILIES,
COMMUNICATES WELL WITH THEM AND
THE STAFF. SHE HAS A GOOD
RELATIONSHIP WITH HER PEERS,
OFFERING ASSISTANCE WHEN NEEDED.
- I have completed a reflection, which
enabled me to reflect upon an experience X
and to think about what went well and
what I could improve on
- I read my instructor’s comments on my
assignments each week, and I ensure to
implement the feedback
- I have identified goals I want to reach by
the end of this semester and have thought
about ways to accomplish these goals
- ALICIA’S REFLECTION DEMONSTRATED
HER CRITICAL INQUIRY INTO HER
NURSING PRACTICE. SHE REFLECTED ON
THE ASSESSMENT OF HER PATIENT WHILE
PREPARING MEDS, REALIZING WHEN TO
HOLD MEDS AND HOW TO DOCUMENT
THE REASON, AND THE IMPORTANCE OF
REASSESSMENT.
 Areas for Future Development Identified by Student

1. Practicing drawing up injections

2. Confidence in my nursing skills

3. Knowledge about different medications

Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)
ALICIA IS ACHIEVING THE OBJECTIVES OF THE COURSE. SHE IS DEVELOPING HER KNOWLEDGE, IS ALWAYS PREPARED
FOR CLINICAL AND REQUIRES MINIMAL SUPERVISION.SHE IS COMPETENT CARING FOR TWO PATIENTS, ADMINISTERING
MEDICATIONS UNDER SUPERVISION, AND GIVING VERBAL REPORT AT END OF SHIFT. SHE SEEKS OUT OPPORTUNITES TO
LEARN, ASSISTS OTHERS AND IS A ROLE MODEL TO OTHER STUDENTS.

Clinical Practice Attendance (8 Hours Per Shift)

Thurs Fri Thurs Fri

Week 1 8 8 Week 6
Week 2 8 SIM Week 7
Week 3 8 8 Week 8
Week 4 8 8 Week 9
Week 5 8 SIM Week 10
Total number of clinical practice hours completed: 64 /128 Hours

Clinical Practice Outcome (completed by Clinical Instructor): Satisfactory X Unsatisfactory

Clinical Learning Centre

Total number of clinical simulation hours completed 7 / 14 Hours

Total number of lab hours completed 12 / 22 Hours

Clinical Learning Centre Outcome (completed by Course Lead): Satisfactory Unsatisfactory

Signature of Course Lead: Date:

Signature of Clinical Instructor:Wendy Symons RNBScN Date: Feb.25/18

Signature of Student: Date: