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 :
Description :
Period :
Student hours :
Required Hours :
Validated hours :

Nicholas Mackay
Jocelyn Aves
Romi Sandhar
Judy Martin
Christie Gardens Residence
Agency
Residence
Retirement Home
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.
N.M. : I have familiarized myself with the standards, legislation, and Christie Gardens' policies and I follow these rules to the letter at all times.

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

Satisfactory

Satisfactory

N.M. : I always act appropriately in any clinical setting. I work hard to hold myself to account with regards to my behavior.

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.

N.M. : I keep the 3 factor framework in mind during the course of my practice. In particular, I am aware of my limits as a nursing student and I seek
guidance when it is needed. I consider each patient as a unique case.

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

Satisfactory

Satisfactory

N.M. : I keep my knowledge of theory in mind whenever I approach a situation and when there is a gap in my knowledge I will seek a reputable,
evidence based source to fill that knowledge gap.

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

Satisfactory

self, and others.

N.M. : I seek to limit the risk in any situation to ensure client well-being. I consider which practice is best and act accordingly.

Satisfactory

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

Satisfactory

Satisfactory

N.M. : I try to think before I act or speak but if the answer is still unclear I will ask questions or clarify orders.

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

Satisfactory

Satisfactory

N.M. : I have questioned a few orders in order to advocate for the clients but this has been rare because most circumstances are not raising my
concerns.

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

N\A

N\A

Satisfactory

Satisfactory

unprofessional behavior.
N.M. : There have been no relevant situations.

1. 9 Demonstrate understanding about the role of the nurse within health care.
N.M. : I understand my role as a provider of care that works as part of the healthcare team.

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. :
Nicolas has demonstrated himself to be a professional and competent student nurse who learns quickly and acts in accordance with legal and
regulatory frameworks as well as within our policies and procedures.

Advisor comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and
procedures of the practice setting. :
Nicholas is safe and works within the policy and procedures.

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

N.M. : I contribute to the extent that is possible for someone with limited experience. I try to be as enthusiastic as possible during these discussions.

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

Satisfactory

Satisfactory

N.M. : With some assistance, I am able to document events in a precise and efficient manner using mainly electronic methods with a limited range of
written records.

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

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

N.M. : I am able to communicate clearly and quickly important information within the healthcare team.

2. 4 Evaluate and refine techniques used to communicate and share information with clients and the
interprofessional health care team.

N.M. : I evaluate my communication techniques and this has improved as a result of practice and familiarity with the clients and facility.

2. 5 Ensure privacy and confidentiality.

Satisfactory

Satisfactory

N.M. : I ensure privacy at all times and I am confidential with regards to client information. I do not discuss the clients in front of those outside the
healthcare team.

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.

N.M. : I am proficient with technology and the system used in the facility. I have not communicated outside the practice setting (ie the pharmacy)
because this is not currently my responsibility.

Teacher comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Nicolas communicates well with the nursing team in a clear an concise manner. Documentation skills and communication with other members of the
interdisciplinary team (doctors, dietary, care-partners etc.) need to develop further and will do so with more experience and opportunities.

Advisor comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Nicholas will improve in this area as suggested above with further exposure and experience at the site.

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

Needs
Development

health care team members.

N.M. : I make a conscious effort to always be polite with the clients during care. I try to get to know the residents in order to help them and to
understand them.

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.

N.M. : I meet the needs of the clients, both medical and emotional. I have yet to encounter a client death or ongoing palliative status.

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

Needs
Development

Needs
Development

N.M. : I honestly don't know exactly what this question means. I try to facilitate client well-being as much as possible.

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

Satisfactory

Satisfactory

with health care providers.

N.M. : I keep my nursing theory in mind when interacting with both the clients and the health care team. I try to relate to others in order to work as a
team.

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

Satisfactory

relational practice.
N.M. : I try to understand myself in order to understand the effects of my actions and how I might misunderstand others.

Satisfactory

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

appropriately.
N.M. : I collaborate when it is appropriate and work independently when it is possible.

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

N.M. : I support diversity among the clients and the health care team through tolerance and respect for differences.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

N.M. : I engage in client education where possible but many of the residents are incapable of significant medical education at this point in their lives.

Teacher comments for Engage in relational practice that is caring, compassionate and respectful. :
Nicolas has a friendly and approachable demeanor that allows for satisfactory interactions with residents. However, in this care setting where
relationship building is key to providing effective care for our residents, genuine interactions that are not necessarily health related are very important.
Nicolas can improve on his therapeutic approach to care by using gentle touch, engaging in eye-contact and listening to residents. Sharing
information about yourself while maintaining professional boundaries is also beneficial. Even if a resident does not remember the interaction, they are
often left with a positive feeling of being heard, known and loved. Our goal is to make all residents feel this way.

Advisor comments for Engage in relational practice that is caring, compassionate and respectful. :
It was identified that Nicholas should strive to build more relationships with the residents. Upon visit, the preceptor stated that Nicholas was observed
attempting to build bonds with some residents.

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.

N.M. : As a student my role as a leader is pretty limited. I make an effort to resolve any conflicts and create a positive environment. I work hard to be
an advocate for the clients' well-being.

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

interprofessional health care team.

N.M. : I provide feedback and accept feedback that is then taken to heart so that I can improve myself.

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

N.M. : I respectfully advocate for myself and clients. I do not have any concerns at this time with the environment.

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

Satisfactory

Satisfactory

N.M. : I try to convince a client of the best course of action but if they refuse a treatment or medication or activity then I respect their right to refuse
and their choices.

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

N\A

Needs
Development

N.M. : This has yet to be relevant.

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.

N.M. : To the extent that the resident's family is the public I have acted in their interests by preserving the well-being of their loved ones.

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

Needs
Development

Needs
Development

Satisfactory

Satisfactory

N.M. : I have yet to help create practice strategies.

4. 8 Assign, supervise, teach as appropriate, and provide feedback to unregulated care providers
(UCPs) in collaboration with the interprofessional health care team.

N.M. : As a student, my ability to manage UCPs is limited. Where it has been necessary I have asked UCPs to carry out certain tasks in order to
ensure the well-being of clients.

Teacher comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :
Nicolas carries himself as a confident leader and his leadership skills will continue to develop with experience. He can improve in this area by taking
initiative to improve the practice setting and asking to take on additional tasks as appropriate and as needed. Although he has not encountered
unsafe, unacceptable or unprofessional behaviours, he can consider how he would deal with this in the future as well as ask the nursing team about
past incidents and how they handled the situation.

Advisor comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :
Nicolas is very calm and confident individual and although not faced with such a situation, he demonstrates that his demeanour would prove useful
should future situations of that nature occur.

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.
N.M. : I treat each client as unique and I familiarize myself with their relevant orders and diagnosis in order to form a plan of care.

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

Satisfactory

Satisfactory

N.M. : I try to see the whole picture when making a plan of care while considering hard evidence that relates to each individual client.

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

Satisfactory

Satisfactory

N.M. : I tend to take a minute to think things through to ensure the best outcome. I regularly use my best clinical judgement in collaboration with more
experienced staff.

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

Satisfactory

N.M. : I work with my assigned nurse to take a close look at each plan of care for each client and we modify as is appropriate.

Satisfactory

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.
N.M. : I have competently preformed the available treatments and techniques; initially in collaboration and later independently. It has been a process
of development.

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

Satisfactory

Needs
Development

care team to create a client centered plan of care that is articulated with competence both in writing
and orally.
N.M. : All the clients are elderly in terms of lifespan. We have considered this when creating their plan of care in a written and verbal form.

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.

N.M. : As a student nurse, I am aware of my need for further development. The factor that I can most control is the nurse. By improving as a nurse I
make better decisions and produce better outcomes.

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

Satisfactory

Satisfactory

N.M. : I am efficient and ethical. I am virtually always on schedule and I have the supplies I need on hand.

Teacher comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
Although this practice setting is limited in that our residents are all senior seniors, experiencing many of the same diagnoses and problems from the
aging process, Nicolas can use this opportunity to learn to collaborate with and, to an extent, provide care and comfort for resident's family members.
Our nursing team are often providing therapeutic approach to family members to guide them through their loved one's aging process. Attending more
care conferences and making phone calls to families as needed will help Nicolas to develop these skills further.

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.

N.M. : To the extent possible I work with the client to meet their needs. Consent is essential and clients have a degree of insight into their best care.

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

client needs and outcomes.

N.M. : I contribute as much as is correct during any contact with the inter-professional team.

6. 3 Consult with and seek out assistance from members of the interprofessional health care team.
N.M. : I consult and seek assistance when needed from the health care team.

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

N.M. : I use teamwork to resolve many challenges that occur during a shift. There have been few cases of conflict to resolve.

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

Satisfactory

Satisfactory

changing environment.
N.M. : I meet the client's needs no matter what the situation is by relying on myself and the health care team.

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

Satisfactory

Satisfactory

N\A

Needs
Development

team.
N.M. : I am always respectful of everyone's role and worth in the facility.

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

nursing knowledge and practice and in the health care environment.
N.M. : There has not been enough time at the facility for this to be relevant.

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. :
Nicolas's collaboration and consultation with the interdisciplinary team is satisfactory at this point and will continue to improve with further experience
and opportunities to do so. Nicolas can further develop his knowledge of new information in the health care field by reading memos from the
pharmacy, reading current journal articles about nursing topics that affect our residents and their families as well as paying attention to news stories
about health related topics - families and residents are often reading and listening to these stories and ask questions about them.

Advisor 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. :
satisfactory.

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.
N.M. : I act in the best interests of my clients at all times, including through collaboration with other members of the team.

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).

N.M. : I try to reflect at the end of everyday to assure that the quality of my work is within the regulatory framework.

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

Satisfactory

Satisfactory

(CNO).
N.M. : I have privately created a learning plan in accordance with the CNO in order to structure my pursuit of improvement.

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

Satisfactory

that foster professional development.

N.M. : I take responsibility for my actions and welcome feedback from colleagues so that I can improve my practice.

Satisfactory

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

Satisfactory

Satisfactory

and to support clients.

N.M. : Whenever I discover an aspect of a client's profile ( ex. medication, procedure, diagnosis) that I am not familiar with I will write it down and
research it after the shift to improve my competence.

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.

N.M. : I review peer reviewed material in order to improve my practice.

Teacher comments for Engage in Quality Assurance consistent with the regulatory framework. :
Nicolas demonstrates competence in his nursing practice that is evident of his dedication to increasing his knowledge. Self-reflection of his practice on
a daily basis is a great way to ensure his own quality practice and consider how to improve in the same situations the next time.

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

N.M. : I always take the time to think critically so that errors do not occur and I ensure the ideal outcome for each client.

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.
N.M. : Each morning I review the notes and information for each client to keep up to date and produce the best possible care plan that include
relevant diagnoses and interventions.

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

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

Satisfactory

N.M. : To the extent that problems arise I solve them competently with strong decision- making skills.

8. 4 Integrate knowledge from variety of nursing, health, and other theory into nursing practice to
provide safe and competent care.
N.M. : I provide safe and competent care based upon my nursing knowledge that is improving daily.

8. 5 Prioritize effectively.
N.M. : My punctuality and efficiency proves my ability to prioritize effectively.

8. 6 Demonstrate professionalism, responsibility, and accountability.

N.M. : I am consistently professional, responsible for my actions and clients and accountable to myself, the clients and my colleagues.

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

Satisfactory

Satisfactory

N.M. : I use critical thinking to inform my decision making process in partnership with the 3-factor framework to deliver the best possible results for
the clients and the facility.

Teacher comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Nicolas has demonstrated competence in his nursing skills, these skills will continue to develop as new problems and experiences arise.

Advisor comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Nicolas demonstrates sound critical thinking at this time.

Student Midway Summary with Strategies for Continued Growth

I am doing well. Things are going smoothly and I am efficient. I look forward to developing my existing skills further and learning new skills. There is
always room for improvement.

Teacher Midway Summary with Strategies for Continued Growth

Nicolas has a solid background knowledge of nursing theory and applies his knowledge appropriately on a consistent basis. His positive attitude and
eagerness to learn and gain independence has allowed him to fit into the community well. Nicolas will improve his practice further by working on his
bedside manner, continuing to hone his therapeutic approach skills as well as develop more meaningful relationships with residents and their family
members. Although confidence and efficiency are positive qualities in a nurse, at times, in the retirement setting, it is appropriate to sacrifice being on
schedule in order to spend a little extra time with a resident in need of support.

Advisor Midway Summary with Strategies for Continued Growth

Nicholas is a calm and collected individual and a wonderful attitude. His nursing skills are sound and is learning that spending time with residents are
often just as important as getting day to day job tasks completed.

Student's References
RN and RPN Practice: The Client, the Nurse and the Environment. (2014). CNO.

Refer to Clinical Excellence Committee (CEC)

Grade

Satisfactory

Grade

Needs Development

Satisfactory

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: 02-Mar-2016 23:13

Unsatisfactory