NURSING 3020 Clinical Evaluation

NURS 3020H

Clinical Evaluation
Midterm

Student Name: Amanda Carpenter

Clinical Instructor: Jen Parris

Missed Clinical Hours: 0 Missed Lab Hours: 0

Medication Test: 100%

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Program Goals
Graduates are generalists entering a self-regulating profession in situations of health and illness.

Graduates are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a
variety of settings.
Graduates continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their
practice.
Graduates will demonstrate leadership in professional nursing practice in diverse health care contexts.

Graduates will 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
Graduates will establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based
upon relational boundaries and respect.
Graduates will be able to enact advocacy in their work based on the philosophy of social justice.

Graduates will effectively utilize communications and informational technologies to improve client outcomes.

Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed
interventions and outcome measures.

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Progress
Objectives Developing Needs Does not meet
Indicators/Evidence as expected Improvement expectations
1 Prepared to provide During my acute clinical experience on a telemetry floor of
nursing care that includes PRHC, I have provided nursing care that includes
comprehensive, comprehensive, collaborative assessment, evidence-informed
collaborative assessment, interventions and outcome measures. Three example of my
evidence-informed nursing are as follows:
interventions and 1. I was assigned at least 1 patient per week that I was
outcome measures. responsible for. With these patients I would complete at
least two comprehensive head-to-toe assessments per
shift. During assessment I would recognize and clinically
acknowledge my understanding from pre-clinical
preparations with individual patient assessment findings.
Such as, edema, rales, and fluid retention seen in CHF.
Recognizing that my patient’s diagnosis of pneumonia
was caused by aspiration related to comorbidities of
developmental delay.
2. I tailored my assessments to the specific patient needs by
adding evidence-informed outcome measures such as; a
full neurologic vital sign assessment for a patient with
cerebrovascular accident, thorough and frequent
respiratory assessment on a patient with pneumonia,
abdominal and airway assessments of NPO patient, and
ensured an apical pulse reading of >60bpm of a patient
receiving Digoxin.
3. I worked collaboratively with the patient’s primary nurse
in order to advocate for abnormal vital sign findings,
changes in patient status such as; difficulty breathing due
to an adjustment in oxygen therapy, epistaxis on a patient
taking anticoagulants, and above baseline tachycardia on
a patient with Atrial Fibrillation.

MIDTERM
Amanda has arrived to clinical each week fully prepared with
each of her patient’s diagnoses and comorbidities researched.
Amanda introduces herself to the primary nurse and then
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heads directly to her patient’s room to start her assessments.

Amanda admittedly states that she still feels uncomfortable
waking up her patients but also understands the importance
of a head to toe assessment at the beginning of every shift.
Additionally, Amanda formulates a plan with her primary
nurse to provide optimal care throughout the day. This
coincides directly with the CNO ETP#6 whereby Amanda
displays initiative, confidence, and self-awareness, and
encourages collaborative interactions within the nursing and
health care team, with the client as the center of the health
care team. As per CNO guideline #33, Amanda proactively
seeks new information, knowledge, and best practices for use
in the provision of nursing care. She asks appropriate
questions and has identified areas of learning from her
mistakes, such as measuring urinals when on diuretics. Most
importantly, Amanda can analyze and critique the
information gathered from her patient’s assessments and
presentation and identify a sick patient or further
interventions.

2 Establishes and maintains I have demonstrated therapeutic care, culturally safe practices
therapeutic, caring and and effective communication by demonstrating therapeutic use of
culturally safe self by engaging meaningfully with my patients to understand
relationships through their unique illness experience and identifying personal
effective communication. situational challenges by:
1. Supporting a patient while accompanying them to an
endoscopy to insert an NG tube and advocating for their
fears, wishes and concerns to the medical staff there.
Such as requesting that the staff speak up in order for the
patient to hear them and gain a more meaningful response
from the patient. Further, acknowledging and supporting
a patient’s experience of vivid dreams due to the effects
of their medication, Prednisone.
2. Establishing trust and nonverbal communication with a
patient with expressive aphasia. Using creative body
language and facial expressions to effectively
communicate our goals. I believe that this challenge and
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outcome was rewarding for both of us.

3. Understanding and anticipating needs of persons with
acute illness by applying knowledge that family support is
meaningful to patient outcomes. I intentionally completed
patient cares around times of visitors, as possible.

MIDTERM
Amanda has an easy and approachable communication style
and it is able to naturally create therapeutic relationships
with each of her patients. There is a quiet confidence that
patients respond well to and feel comfortable sharing their
experiences with. On week one, Amanda was given a
challenge to care for a non verbal, developmentally delayed,
full care patient. With only a moment of hesitancy, Amanda
pushed passed her nerves and by shift end, I could see her
sitting at bedside, smiling and interacting with her patient in
a very special way. In line with the CNO ETP # 51, Amanda
addresses client’s health challenges and can identify
strategies for health planning.

3 Applies the four ways of I applied the 4 ways of knowing for diverse, acutely ill patients
knowing and by:
informational 1. Understanding and observing the unique needs for ethical
technologies to considerations of a patient undergoing an emergency
effectively care for cardiac catheterization.
diverse, acutely ill 2. Trusting my aesthetic way of knowing when I ensured all
patients. my patient’s rooms were set up for a suction, particularly
NPO and SVA patients.
3. Using the information available in telemetry monitoring
on the unit to understand the unique medical
manifestations of my various patients with; atrial
fibrillation, STEMI, NSTEMI, CVA, CAD, CABG, and
aortic stenosis.
MIDTERM
Amanda is reliable, punctual, and accountable. She works
very well independently yet just as effectively with the
primary nurse or peer. Each week, Amanda submits a
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comprehensive list of skills obtained/observed and also self

identifies learning needs.
Documentation is concise and systematic and coincides with
the CON ETP # 43 wherein the student documents
assessment data in accordance to evidenced-informed
practice. However, one area for development is for
documentation to be completed in a more timely manner.

4 Adheres to professional Adhering to professional practice standards by:

practice standards and 1. Demonstrating accountability by reflecting and
organizational polices to acknowledging when and how it is best for me to improve
contribute to a culture of my skills and abilities, such as to follow-up with patient
safety. outcomes of my nursing interventions and recognizing
my obligations to closely monitor and balance patient
intake/output records.
2. Meeting organizational expectations and responsibilities
by completing protocols such as; hand-hygiene courses,
timely documentation, and recording the tour of duty.
3. Demonstrating a commitment to patient and staff safety;
by ensuring bed rails are up, curtains/doors are closed
during intimate care, maintaining hand hygiene, ensuring
medication rights and bedside checks, and cautiously
practicing infection control protocols.
MIDTERM
As per CNO guideline #59, Amanda applies workplace health
and safety principles, including infection control practices
and appropriate protective devices, when providing nursing
care to prevent harm to clients, self, and others by following
the PPE standards and policies set at PRHC. Proper use of
call bells, patient tables, side rails, bed alarms, and
mechanical lifts are followed for patient protection.
Amanda has demonstrated safe and efficient medication
administration while following all of the related “Rights”.
During week 4, Amanda had a patient that was at risk for
aspiration and an NG was ordered. It was determined by
Amanda and the nursing team that the NG was not safe to
insert by an RN at the bedside for fear of further
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risk/complication. While awaiting tube placement in

Endoscopy, Amanda ensured safe positioning and suction
equipment was available to the patient.

5 Exercises leadership to I have exercised leadership and professional practice by:

enhance patient care, and 1. Supporting my peers with their patients whenever
support professionalism possible. Whether it be a quick boost of their patient in
in practice. bed or assisting them with a new client’s bed bath.
2. Encouraging my peers by complimenting their new
experiences, such as; congratulating their first successful
enema or lending support during a colostomy bag change.
3. Demonstrating leadership and professional practice by
asking questions in group settings and questioning
procedures for deeper understanding and commitment.
MIDTERM
Amanda is professional and accountable every shift. She is
engaged and open to every new experience that presents
itself. Each week, pre and post clinical is done thoroughly
and mindfully. Amanda contributes to group discussions and
new ideas for the clinical group.
As her first reflective practice assignment, Amanda identified
some major take away pieces from her experience in the Cath
Lab. Besides being “impressed at the level of technology”,
Amanda appeared to appreciate the direct approach that the
Cardiologist took with the patient to deliver a serious
prognosis.

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

MIDTERM
Amanda is excelling this semester. She displays a quiet leadership quality that her peers and staff respond well to and has a level of
professionalism that is notable. The rest of this rotation can be devoted to providing competent care for a two patient assignment as well as
gaining as many skills and experiences as possible to build upon her personal practice.

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Signature of Instructor___________________________________________________ Date _____________________________

Signature of Student_____________________________________________________ Date ______________________________