Self Assessment

2017 - 2018 - NURS 208 Course Learning Outcomes Final (201708)

NUR 208 Practical Nursing Practice 4 (PN, 05-Sep-2017 - 31-Jan-2018)
Student : My Hoa Duong
Clinical Teacher/Preceptor : Fiona Neil
Program Coordinator : Judy Martin
Location : William Osler Health Centre/Etobicoke General
Hospital
Placement Setting : Agency
Unit/Office/Clinic : 7W medicine
Period : 05-Sep-2017 To 08-Dec-2017
Student hours : 196
Required Hours : 196
Validated hours : 120
Teacher comment for validated hours:
Total clinical hours - 132. Student was absent for a 12 hour clinical day.

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: Consistently practice safely,
competently, and ethically within legal and regulatory frameworks and the policies and procedures of the practice setting.
Satisfactory Satisfactory
1. 1 Comply with regulatory standards, relevant legislation and the practice setting’s policies and

procedures.

M.H.D. : One of the practice setting's policies is that RPN Nursing Students are not allowed to check blood sugar on patients. When I have a diabetic
patient that needs to get his blood sugar checked prior to medication administration, I always ask the nurse to check his blood sugar, then I would give
him his meds.

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

M.H.D. : I'm responsible and accountable for being on time at placement, fully dressed with necessary equipment. I'm responsible for my own
actions. If I did something, I would say that I did it.

1. 3 Determine how the three factor and practice decision-making frameworks influence client care. Satisfactory Satisfactory

M.H.D. : When i receive a patient assignment, I consider the client, environment, and nurse factors to make sure that the client condition is

appropriate with my ability to provide care.

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

M.H.D. : I apply the knowledge I learn from theory class into practice. I learn how to perform some procedures by watching online videos. For

example, performing a wound care, I learn that the first step is to clean the wound with normal saline or sterile water, then apply inadine dressing.

1. 5 Carry out safety-based practices and risk management principles to ensure client safety and a Satisfactory Satisfactory

safe environment.
M.H.D. : When changing or bathing a patient in bed, I always make sure that all the side rails are up. When cleaning the patient, I do it with care and

patient to avoid sheer or tears in the skin. I lower the bed when I finish to prevent fall.

1. 6 Ask questions and clarify the plan of care, unclear orders or directions, and whenever uncertain. Satisfactory Satisfactory

M.H.D. : Whenever I'm uncertain about a certain topic, I would definitely clarify with the nurse or my clinical teacher to make sure I'm doing it right. I
had an order of 0.5mg solution and the given syringe is 1ml/cc. I clarified with the nurse to draw up to 50 units, which also represents half a ml.

Satisfactory Satisfactory
1. 7 Demonstrate professional behavior by seeking assistance in situations in which there is unsafe,
unacceptable and/or unprofessional behavior.

M.H.D. : I always seek assistance or opinion from the nurse or the clinical teacher when I feel the situation is unsafe to practice. I would tell them how
I perform a procedure before I actually perform it.

1. 8 Demonstrate understanding about the role of the nurse within health care. Satisfactory Satisfactory

M.H.D. : I understand the role of nurse within heath care. Nurses are as important as other health care providers to monitor, provide care and support
to patients.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK: Consistently
practice safely, competently, and ethically within legal and regulatory frameworks and the policies and procedures of the practice setting. :

Throughout the semester you have demonstrated competence and always ensured that you acted in a professional manner with your
peers, staff, patients and their families. You always asked for clarification if unsure of a task prior to performing it.

2. ACCURATE AND RELEVANT COMMUNICATION: Communicate using strategies and technology to affect accurate and timely documentation,
reporting, and information sharing.

2. 1 Participate in team sharing and discussions. Satisfactory Satisfactory

M.H.D. : I participate in post-conference discussion and ask questions whenever I'm uncertain about certain topics. However, I need to be involved in
group activities and discussion.

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

M.H.D. : Before I go on break or finish the shift, I make sure to document everything I have done such as head-to-toe assessment, vital signs, ADLs

on a computer.

2. 3 Report relevant information to the appropriate personnel. Satisfactory Satisfactory

M.H.D. : I ask a nurse about what are some considerations that I should be mindful of when I take care of a particular patient. I also clarify with the

nurse about the appropriateness of the use of some syringes.

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

M.H.D. : When talking to an elderly patient, I always make sure to use elder speak, which is speak clearly and loudly in a normal tone, maintain eye

contact while communicating, and provide time for the patient to respond.

2. 5 Ensure privacy and confidentiality according to the Personal Health Information Protection Act Satisfactory Satisfactory

(PHIPA).
M.H.D. : When I begin any assessments (skin on extremities, lower body and the back) or care procedures (wound dressing change, perineal care,

bed bath) on a patient, I make sure to close the curtain or sometimes the door to provide privacy.

Satisfactory Satisfactory
2. 6 Use technology to retrieve and share information including research, evidence based data, and

other health information.

M.H.D. : I use my electronic drug book to research about some medications that my patients take. I also use the textbook to look up some diseases

to better understand the patient's conditions.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION: Communicate using strategies and technology to affect accurate and
timely documentation, reporting, and information sharing. :

You are very active in group discussions and always share information with the group. You always report important information to myself,
or the primary nurse about the care of your patients.

3. CARING RELATIONAL PRACTICE: Establish and evaluate relationships that are caring, compassionate, and respectful of clients and others.

3. 1 Use effective communication techniques. Satisfactory Satisfactory

M.H.D. : When I speak with other health care providers or with my teacher, I talk with respect. When I talk with the elderly patients, I speak loudly,

simply and clearly in a normal tone. I also maintain eye contact so that the patient knows that i'm talking to him. Thus, i establish a therapeutic
relationship between myself and the patients.

Satisfactory Satisfactory
3. 2 Establish and evaluate therapeutic caring, compassionate, and culturally safe relationships with
clients and health care team members.

M.H.D. : I establish a therapeutic relationship with my patients by showing them that I care for their health. I talk to them in a professional, caring, and

respectful manner. I do not judge their reasons on refusing a certain treatment.

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

M.H.D. : I use my personality, opinions, and judgement as a component of the therapeutic process. I understand how a client may feel about a

particular situation. Thus, I always make the choices based on what I feel is good, because the client might feel the same way like I do.

Satisfactory Satisfactory
3. 4 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on

relational practice.

M.H.D. : I am aware of myself and I know what I believe and value. I believe that the best treatment is the absence of pain. Thus, I would make sure
to report or give pain medication if needed.

Satisfactory Satisfactory
3. 5 Collaborate with clients and members of the inter-professional health care team and consult

appropriately.

M.H.D. : When I was taking vital signs on a patient, I noticed her breathing rate was quite fast even I sat her up at high's fowler position. I
communicated with the nurse the she assessed the patient again. The patient was fine after all.

3. 6 Support the diversity of clients and the inter-professional health care team. Satisfactory Satisfactory

M.H.D. : I acknowledge the diversity of clients and other health care providers. I never show racism toward anybody.
 Satisfactory Satisfactory
3. 7 Display sensitivity and respect for clients’ cultural, religious, and other beliefs and values

influencing their choices and decisions.

M.H.D. : I never judge or disagree with a patient's decision. I think their decisions are made based on their cultural belief and what they value. I would

want other people to respect my choice so I would do the same for the patients.

3. 8 Provide client education and evaluate effectiveness. Unsatisfactory Unsatisfactory

M.H.D. : I have not provided client education and evaluate effectiveness.

Teacher comments for CARING RELATIONAL PRACTICE: Establish and evaluate relationships that are caring, compassionate, and respectful of
clients and others. :

You consistently demonstrate a caring being with the patients. It is good that you are aware of your own beliefs and values and do not
impose them on the care that you are providing to your patients.

4. LEADERSHIP AND ADVOCACY: Use leadership skills to promote quality practice.

4. 1 Apply appropriate conflict resolution skills in therapeutic client and other interactions. Satisfactory Satisfactory

M.H.D. : When administering medication for a patient who has bipolar, he told me that he did not want the medication to be crushed. The MAR and

the nurse tell me to crush the meds. I said sorry and explained to him why he should take crushed med. He seemed to be angry and told me to get
away. I managed my anger and understood his condition, I remained calm and explained to him what he did was not right.

Satisfactory Satisfactory
4. 2 Evaluate and refine leadership skills to develop solutions and create a positive work

environment.

M.H.D. : I demonstrated leadership skill when the group did not have a lot of things to do. I reminded them that we need to do something, not just
standing around. The group actually had some work done.

Satisfactory Satisfactory
4. 3 Provide feedback to peers and accept feedback from peers and members of the inter-
professional health care team.

M.H.D. : I provided peer feedback on the areas he did well and what he needs development on. I also accepted feedback from the peer.

4. 4 Advocate for clients, self, others, and quality practice environment. N\A Unsatisfactory

M.H.D. : I have not got a chance to demonstrate this skill.

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

M.H.D. : I always ask the patients what they would like to eat, how they like to position their pillows, blankets, or other personal belongings. By doing
that, I promote client's right for self-determination and choice.

4. 6 Respond appropriately to unsafe, unacceptable, and unprofessional behaviours. N\A Unsatisfactory

M.H.D. : I have not overcome any situation that is considered unsafe, unacceptable or unprofessional.

4. 7 Collaborate and consult when implementing health care and nursing practices that are in the Satisfactory Satisfactory

best interests of the public and protect the public through collaboration and consultation.
M.H.D. : I taking care of clients, I consult with the nurse, clinical teacher, and my peers to provide the best care to all clients.

4. 8 Contribute to the creation of quality practice solutions and strategies. Unsatisfactory Unsatisfactory

M.H.D. : I need more development on this criterion. I have not practiced this skill.

Teacher comments for LEADERSHIP AND ADVOCACY: Use leadership skills to promote quality practice. :

You always have a great attitude and have advocated for the patients and yourself on many occasions. You still need to practice your
leadership skills, but that will come with time and taking on leadership roles.

5. PLANS OF CARE: MEET CLIENTS’ NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES: Develop, evaluate, and modify mutually
agreed upon plans of care that maintain, promote, and restore health, prevent illness, support rehabilitation, and provide palliation.
5. 1 Incorporate the clients’ unique needs and expected outcomes into holistic and client-centred Satisfactory Satisfactory

plans of

care.

M.H.D. : A patient's unique need is to gain the ability to self-feed. The expected outcome would be the patient will be able to feed herself without
assistance. This need is to promote patient's the sense of independent and promote muscle strength.

Satisfactory Satisfactory
5. 2 Develop theory-based plans of care that are holistic and client centered and are articulated
competently in writing and orally.

M.H.D. : When creating a concept map, one of the care plans for a patient who suffers from ICH is to promote mobility as much as possible. The care

plan is client-centered and it is presented in front of the group and written down on a piece of paper.

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

M.H.D. : When caring for a patient who has multiple sclerosis, one of the priority nursing diagnosis is impaired physical mobility rt motor weakness
a.e.b limited ROM. The outcomes would be the patient will be able to move all extremities and use the available assistive device properly.

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

M.H.D. : I seek consultant from my peers and clinical teacher when developing plans of care for a particular patient. After that, I would evaluate the

effectiveness of the treatment.

Satisfactory Satisfactory
5. 5 Safely and competently implement and evaluate nursing assessments and nursing interventions

in a manner that demonstrates knowledge and skill.

M.H.D. : I performed perineal assessment and perineal care safely and competently. I make sure to provide privacy prior to perform any
assessments. Before the brief change, the patient showed discomfort. However after I changed the brief, he became more comfortable.

5. 6 Use the Three-Factor and practice decision-making frameworks to guide practice. Satisfactory Satisfactory

M.H.D. : When i receive a patient assignment, I consider the client, environment, and nurse factors to make sure that the client condition is

appropriate with my ability to provide care.

5. 7 Prioritize nursing care and nursing interventions in order to manage workload, time, and physical Satisfactory Satisfactory

resources.
M.H.D. : I had to administer insulin for patient 1 after he ate and a acetaminophen for patient 2 for pain. I realized that insulin is more important than

the tylenol. I gave the insulin first, then the tylenol. I demonstrated prioritization skill.

Teacher comments for PLANS OF CARE: MEET CLIENTS’ NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES: Develop, evaluate, and
modify mutually agreed upon plans of care that maintain, promote, and restore health, prevent illness, support rehabilitation, and provide palliation. :

You have demonstrated that you are aware of the importance of meeting the patient's needs and not that of your own or what fits into your
schedule/plan. You are flexible and know how to prioritize your care

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM: Work effectively as a member of the inter- professional health
care team to develop and carry out holistic plans of care recognizing age-specific changes.
Satisfactory Satisfactory
6. 1 Collaborate with clients and members of the inter-professional health care team to assess
clients, determine health needs, and to achieve mutually agreed expected outcomes.

M.H.D. : A patient told me that she is tired of laying in bed all day. I thought about moving her to sit in a wheelchair so i told the nurse about it. The
nurse agreed that the patient should be moved to the wheelchair. The outcome was the patient felt better and able to eat her meal properly.

Satisfactory Satisfactory
6. 2 Contribute as a member of the inter-professional health care team to respond to the changing
needs and expected outcomes of clients.

M.H.D. : When I was preparing medications for a patient, I noticed that the heparin was missing. i noticed the nurse. She filled the missing medication
form and contact the physician. The physician said to administer right away when received. The medication was administered and the patient

tolerated well.

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

M.H.D. : I always seek assistance or opinion from the nurse or the clinical teacher when I feel uncertain. I would tell them how I perform a procedure

before I actually do it.

Satisfactory Satisfactory
6. 4 Use teamwork, consensus building, and conflict resolution skills to meet expected client
outcomes.

M.H.D. : Whenever the group has different opinions, I would listen to all of their opinions and respect their ways of thinking and choosing. Some other
peers and I would choose the most benefit approach for the team and revolve the conflict.

Satisfactory Satisfactory
6. 5 Use effective, collaborative, and consultative strategies to meet client’s needs within a changing
environment.

M.H.D. : When I was preparing medications for a patient, I noticed that the heparin was missing. i noticed the nurse. She filled the missing medication

form and contact the physician. The physician said to administer right away when received. The medication was administered and the patient

tolerated well.

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

M.H.D. : I respect the members of the health care team no matter what their roles are. I feel like if I respect them, they will respect me as a return.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM: Work effectively as a member of the inter-
professional health care team to develop and carry out holistic plans of care recognizing age-specific changes. :

You collaborate well with your peers, nurses, and allied staff.
7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE: Provide safe, competent care by using reflective practice and Quality
Assurance practices.
Satisfactory Satisfactory
7. 1 Act in the best interests of clients and protect clients from harm through collaboration and
consultation with members of the inter-professional health care team and through competent and safe
practice.

M.H.D. : I demonstrated the skill of protecting clients from harm through bathing, changing , and re-position a patient with the assistance of a peer. By
bed-bathing and changing a patient, I prevent patient's feeling of discomfort and infection. Re-positioning helps the patient to prevent pressure ulcer.

Satisfactory Satisfactory
7. 2 Engage in ongoing reflective practice to identify strengths, areas for improvement; and, integrate
feedback into practice.

M.H.D. : I submitted a self reflective paper identifying my strengths and areas for development. I also received feedback from a peer about my

strengths and weaknesses. I make sure to keep up the strengths and improve the weaknesses.

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

(CNO).

M.H.D. : I identified some of my strengths and areas for improvement, as well as strategies on how I would do it. A part of my learning plan is that I
need to review nursing skills such as wound care, trach suctioning, ect.

Satisfactory Satisfactory
7. 4 Seek out learning opportunities and feedback that foster professional development; and,
integrate these into practice.

M.H.D. : Whenever there is a learning opportunity in clinical practice, I would always love to take that opportunity to learn new things. If there is a

wound care or blood drawn procedure, I would love to watch how it is done if I am allowed to.

7. 5 Use nursing research to foster professional development and implement nursing care plans. Satisfactory Satisfactory

M.H.D. : Whenever I'm not sure about some medications or conditions, I would research them to make sure I know it so that I can take better care for
the patients. Researching also helps me to foster professional development.

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

M.H.D. : When caring for a dementia patient, I am mindful that this particular patient might not be able to communicate full sentences, but sometimes
he can demonstrate needs by nonverbal cues. I always ask the patient for his choice on food and treat him like a normal patient. I would repeat the

question multiple times and allow him time to respond.

Satisfactory Satisfactory
7. 7 Apply knowledge of changes to the health care system, technology, and in society as these
affect nursing practice.

M.H.D. : I am well adapt to changes of technology, society and maybe even health care system in the future.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE: Provide safe, competent care by using reflective
practice and Quality Assurance practices. :

Well done
8. CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING: Use critical thinking, problem solving, and decision making skills to meet the
health care needs and expected outcomes of clients.
Satisfactory Satisfactory
8. 1 Use critical thinking and problem-solving skills to inform decision-making in all aspects of nursing

care.

M.H.D. : I saw a patient was eating on his bed but sliding to one side of the bed, which made him difficult to eat. I decided to re-position him to a

high's fowler position, and placed a pillow against the bed rail in case his head hit the buttons of the bed and reposition the bed.

Satisfactory Satisfactory
8. 2 Use critical thinking, problem-solving and decision-making skills to assess clients and to

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

M.H.D. : When caring for a patient with multiple sclerosis, I determined one of the priority nursing diagnosis is risk for bed sores on lower back due to
decreased sensation of position. The nursing intervention would be provide regular skin care and re-position patient every 2 hours. The expected

outcome is patient's skin remain intact and show no signs of bed sores.

8. 3 Evaluate critical thinking, problem-solving, and decision-making skills and design a plan to Satisfactory Satisfactory

improve

these.

M.H.D. : I need to improve more on critical thinking, problem-solving, and decision-making skills. My plan is to practice these skills more frequently
and get in a habit of asking questions.

Satisfactory Satisfactory
8. 4 Integrate knowledge from a variety of nursing, health, and other theory into nursing practice to
provide safe and competent care.

M.H.D. : When caring for a dementia patient, I am mindful that this particular patient might not be able to communicate full sentences, but sometimes

he can demonstrate needs by nonverbal cues. I always ask the patient for his choice on food and treat him like a normal patient. I would repeat the
question multiple times and allow him time to respond. I will never force any one to eat if I see they eat too little, but I will encourage them.

8. 5 Prioritize effectively. Satisfactory Satisfactory

M.H.D. : I had to administer insulin for patient 1 after he ate and a acetaminophen for patient 2 for pain. I realized that insulin is more important than

the tylenol. I gave the insulin first, then the tylenol. I demonstrated prioritization skill.

8. 6 Demonstrate professionalism and accountability. Satisfactory Satisfactory

M.H.D. : I demonstrate professionalism and accountability by being on time for clinical, dress in full uniform with all necessary equipment and ready

to go. I complete all the assignments and hand them in on time. I responsible for my own actions and words.

Satisfactory Satisfactory
8. 7 Use the practice decision-making and the nurse-client-environment frameworks to inform and

guide practice.

M.H.D. : When i receive a patient assignment, I consider the client, environment, and nurse factors to make sure that the client's condition is
appropriate with my ability to provide care.

Teacher comments for CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING: Use critical thinking, problem solving, and decision
making skills to meet the health care needs and expected outcomes of clients. :
You are very open to evaluations and take constructive criticisms well. Critical thinking is a skill that you will be proficient in with more
experience and being faced with more challenging issues.

Student Final Summary with Strategies for Continued Growth

My strategies for continued growth is that I need to improve more on critical thinking, problem-solving, decision-making, and leadership skills. I would
practice these skills more frequently whenever the situation permits. I also need to review some nursing skills for instance, wound care, trach
suctioning, inserting a NG tube, ect. I will review the online videos the textbooks to improve these skills. I will need to communicate more with patients
and other staff to establish positive impression and relationship with them.

Teacher Final Summary with Strategies for Continued Growth

It was a pleasure having you as a student. You have grown from week 1 to today. Continue to seek clarification for things that you are unsure about,
and continue to be open to new learning opportunities.

Student's References

CNO documents, CNO Ethics, Lewis textbook, Perri & Potter textbook, my own knowledge, peer and teacher feedback.

Grade Satisfactory Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

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

Student Comment
Thank you