Self Assessment

2015 - 2015 - Final NURS - 208 Course Learning Outcomes (201509)

NUR 208 Practical Nursing Practice 4 (PN, 06-Sep-2015 - 31-Dec-2015)
Student :
Clinical Teacher/Preceptor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Anzhela Fedoronchuk
Emillie Etcubanez
Judy Martin
William Osler Health Centre/Etobicoke General
Hospital
Agency
10W Resp
06-Sep-2015 To 31-Dec-2015
168
168
168

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

1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies

Satisfactory

Satisfactory

and procedures.
A.F. : I follow regulatory standards, legislation, and policies in order to safe practice at the hospital setting. I respect and responsible for
actions that I do for my clients as I am allowed in my practice according to College of Nurses of Ontario (CNO) standards and guidelines.
All procedures that I perform to patients have reasonable understanding of standards and policies.

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

Satisfactory

Satisfactory

A.F. : I am very responsible, accountable, and use ethics in my nursing practice. For example, I care for my patients in respect to their
culture, beliefs, ethical values and other personal perspectives. I am responsible for my decisions and actions when I am in charge for
providing care to my patients. Small things like to promise to come back later to a client with a cup of water gives better idea for him to
understand that I am responsible for his care.

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

Satisfactory

Satisfactory

care.
A.F. : I developed different health models to provide best possible care to my clients. Three factor framework (nurse, client, and
environment) takes an important role in my decision making about health care. For example, I make sure my patient has calm environment
around him, I use therapeutic relationship, and care about patient well-being.

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

Satisfactory

Satisfactory

A.F. : I use evidence informed practice and theory based approach for patient health care. In order to understand his basic needs, I look for
bigger picture around his health, body and mind together. I apply my theory knowledge about medication therapeutic effect, side effect,
interactions, route of administration and safe checks for administering it. Moreover, I always apply knowledge about procedures that I am
doing to my patient; for example, I use sterile techniques during wound care.

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

Satisfactory

Satisfactory

and a safe environment.

A.F. : I care about safe environment and safe performing of procedures. I apply my knowledge and may predict violation behavior of
clients in particular situation. I try to avoid stressed and unsafe situations. For example, I concentrated my attention and was applying my
knowledge when patient raises his voice to me and other nurses and he is violated verbally and physically pushing subjects around him. In
this situation, I tried different strategies to reduce his violated behavior by explaining what procedure I will be doing, why he needs
medication. It was not successful ,so I gave him time to calm down and came back in a few minutes to try one more time with other nurse
to provide care to him. That was my professional nursing strategy for effective management of unsafe situation regarding a patient care.

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

Satisfactory

Satisfactory

uncertain.
A.F. : I always ask questions to clarify some points regarding doctor`s order when I am not sure above patient`s medication changes or
time that it is supposed to be given. For example, my patient health status has been changed, and he had swallowing problems, so his
doctor requested NPO for his care. I clarified with my clinical teacher what medication and how he would be given, so that I can avoid
misunderstanding and possible mistake for his medication administration.

1. 7 Demonstrate professional behavior by seeking assistance in situations in which there is

Satisfactory

Satisfactory

unsafe,
unacceptable and/or unprofessional behavior.
A.F. : I demonstrated my professional nursing attitude and personal behavioral characteristics by clarifying and looking for assistance
when patient needs more care, or expressing violate behavior, or in response to unsafe situations. For example, I sometimes asked my
peers to help me with a patient`s bed bathing in the morning because of weight and uncooperative changes in his health status. It is always
great when other health care professionals demonstrate their behavior and help with patient care by working in team for best possible care
for patient.

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

Satisfactory

Satisfactory

A.F. : I demonstrate my understanding about nurses role withing hospital setting related to plan of care and effective interventions.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Anzhela had excellent attendance and she was consistently prepared for clinical. In addition, she is able to manage her two patient
assignment independently and when she is uncertain or needs help she has asked for clarification and assistance in a timely manner.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

A.F. : I always participate in team discussions and share my own ideas with other peers and nurses about better choices and maybe
changes about care. Moreover, I always initiates discussions on how to improve client care and plan ahead client`s care by collecting all
needed supplies at the begging of the shift for proving morning care to patients. It saves time and always safe to practice when isolated
patient needs to change their cloth or request care.

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

Satisfactory

Satisfactory

A.F. : I always make sure I document all procedures and patient changes on the computer and inform my nurse and clinical teacher about
patient health status changes. I document within one hour by using my time manner while taking patients` vital signs and after performing
procedures that was done to clients. I use written and electronic methods to document my data.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

A.F. : I usually report health status and any changes about person who I care above to nurse in charge, clinical teacher, and or POA when
needed.

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

Satisfactory

Satisfactory

team.
A.F. : I use my therapeutic nurse-client relationship while communicating with patients and family members. I use professional language
while communicating with other health care professions by using appropriate nursing related words and being careful and respectful for
other professional health care position within the hospital setting. For example, I communicated with pharmacist about time when I can
administer IV antibiotic medication by using my professional communicative skills for better resolution of the problem since that was a
new physician order for NPO patient.

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

Satisfactory

Satisfactory

Protection Act (PHIPA).

A.F. : I always ensure privacy and confidentiality according to the PHIPA. I provide privacy to my clients during care by clothing door and
windows. I do not talk about patient personal information with other people, at the corridor at the floor or any other places to avoid
disclosure of personal information.

2. 6 Use technology to retrieve and share information including research, data and other

Satisfactory

Satisfactory

information.
A.F. : I always use technologies to collect my data, to research on medication, and other valuable data related to patient care.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Anzhela frequently participated in post conference by sharing new experiences attained during the clinical experience and by initiated
discussion by asking questions. Also, she documented the vital signs of her assigned patients within 1 hour and ensured that all
assessment documentation was complete prior to lunch break. All necessary information was reported to primary nurse and covering
student nurse before breaks and at the end of shift. Anzhela became proficient in retrieving patient lab report, using lexi-comp for IV
administration research and reviewing consultation notes for a thorough health history of the patients. Furthermore, she is able to
communicate abnormal findings with the primary nurse and collaborate with the primary nurse to identify possible nursing interventions to
be completed with her scope.

3. CARING RELATIONAL PRACTICE

3. 1 Use effective communication techniques.

Satisfactory

Satisfactory

A.F. : I always use effective therapeutic nurse-client relationship while communicating with clients, family members and other health care
professions in order to follow nursing standards of practice. My therapeutic nurse-client relationship includes trust, respect, professional
intimacy, empathy, and power.

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

Satisfactory

Satisfactory

A.F. : I realize that it is very important to behave in therapeutics manner, to be compassionate and to be culturally educated person in
order to provide safe client care and communicate with others within the hospital setting. I demonstrate my professional relationship to
support clients basic needs and to help with their achieving of goals to get better.

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

Satisfactory

Satisfactory

A.F. : I demonstrate my ability to give care to patients and ensure clients well-being. I prevent harm to the client by proving safe and calm
environment. I use my knowledge to balance patients basic needs and promoting health by teaching them on how to balance diet, cope
with stress, quit smoking, safe self-administering of inhalator, using supportive walkers when they need to go somewhere, and always use
bell ringer when they want to get nursing help.

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

Satisfactory

Satisfactory

have on relational practice.

A.F. : I understand other beliefs and values. Beliefs are the assumptions we make about ourselves, and about others in the world. That is
how we expect things to be. On another hand, values are about how we have learnt to think things ought to be or people ought to behave,
especially in terms of qualities such as honesty, integrity and openness. I am very careful and respect other beliefs and personal
behavioral and cultural values.

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

Satisfactory

Satisfactory

consult appropriately.
A.F. : I usually collaborate with other health care professions for effective client health treatment plan appropriate to the situations. For
example, I communicate with other nurses, physiotherapists, physicians, and pharmacists. I make sure I understand their position and
orders for client care, medication to be administer, and requests for changing dietary plan, orders for NPO health status, or physical
changing the client position every two hours to prevent bed sores.

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

Satisfactory

Satisfactory

A.F. : I support the diversity of clients and inter-professional health care team. I am respectful for any religion , race, and ethnicity. We are
all different with our own personal behaviors, inherited traits, and background.

3. 7 Display sensitivity and respect for clients cultural, religious, and other beliefs and values

Satisfactory

Satisfactory

influencing their choices and decisions.

A.F. : I show sensitivity and respect for clients cultural beliefs, religion, and values. I always learn about their personal characteristics,
choices and preferences regarding health care. I review their background information, health history, and sometimes search in internet
about diversity of culture, specific cultural advantages and disadvantages, and languages.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

A.F. : I try my best to provide effective client education related to specific situation. For example, I teach all 6 family members including my
patient about antibiotics through IV route. I explained why the patient needs that medication, what would be possible outcomes if will take
antibiotics, and side effects of medication.

Teacher comments for CARING RELATIONAL PRACTICE :

Anzhela effectively communicates with the patients, members of the patients family and the health care team by demonstrated genuine
empathy and caring presences. In addition, she uses self-awareness to identify areas of improvement which has been demonstrated in her
learning plan.

4. LEADERSHIP AND ADVOCACY

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

Satisfactory

Satisfactory

A.F. : I apply an appropriate conflict resolution strategies into my nursing practice when dealing with clients and their families. I am able to
prevent and unsolved problems by respecting clients choice, promoting safe environment, reflecting on their behavioral attitudes.

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

Satisfactory

Satisfactory

environment.
A.F. : I evaluate my nursing practice and develop useful strategies for workplace conflict resolution. I am responsible and follow hospital
policies when the situation is unsafe, or abusive, or may lead to harm. I report to the appropriate personnel in case if working conditions
are poor or violation behavior is present.

4. 3 Provide feedback to peers and accept feedback from peers and members of the inter-

Satisfactory

Satisfactory

Satisfactory

Satisfactory

professional health care team.

A.F. : I usually provide and accept feedback to my peers and nursing professions.

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

A.F. : I advocate for my clients, and others, and quality work place practice environment. For example, when I saw how one client`s family
members requested more attention then other patients, because they were close to bed side almost 24/7, it is unfair to give priority to them,
and to answer right away, because the nurse may be busy or have to provide care to other her clients. I advocate for my nurse and tried my
best to explain that we are busy now and care will be provided as soon as possible.

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

Satisfactory

Satisfactory

A.F. : I always support clients` rights and choices. I understand that the client has a right to refuse medication and has different
preferences while providing care or giving them meals.

4. 6 Respond appropriately to unsafe, unacceptable, and unprofessional behaviours.

Satisfactory

Satisfactory

A.F. : I usually respond to unsafe , unacceptable, and unprofessional behaviors. When I see that somebody from nurses or peers or other
health care professions have unprofessional and unacceptable behavior, I need to speak up and tell them that it is not right and they need
to calm down and solve the problem in peace.

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

Satisfactory

Satisfactory

the best interests of the public and protect the public through collaboration and consultation.
A.F. : I collaborate and consult with other inter-professions team member about related topics for the best possible outcome and for the
best interest for the client. I follow guidelines to protect public and to prevent any kind of harm.

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

Satisfactory

Satisfactory

A.F. : I create my own quality practice solutions and strategies. I follow that strategies in order to ensure my clients needs and nursing
care.

Teacher comments for LEADERSHIP AND ADVOCACY :

Anzhela has demonstrated her ability to constructively provide and receive feedback through her accurate completion of the peer and selfevaluation.

5. PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES

5. 1 Incorporate the clients unique needs and expected outcomes into holistic and client-

Satisfactory

Satisfactory

centred plans of
care.
A.F. : I always use my nursing judgment in order to meet clients' unique, specially when client's health care needs are changing. For
example, I make sure the preferences of my patients are done , because it reduces resident's behavior changing from agitating to calm and
make them feel happy. For example, one patient requested his medication to be given with breakfast and not after breakfast, because he
feels nauseous when taking meds on empty stomach.

5. 2 Develop theory-based plans of care that are holistic and client centered and are

Satisfactory

Satisfactory

articulated competently in writing and orally.

A.F. : I created my theory-based plans of care that are holistic and client-centered. I always think about patient as a whole and threat them
in respect to their beliefs, values, and cultural aspects .

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

Satisfactory

Satisfactory

A.F. : I use my knowledge, skills, and judgment to provide health assessment and to provide care to my patients. I always prioritize
clients`s needs and effectively review possible outcomes.

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

Satisfactory

Satisfactory

A.F. : I collaborate in evaluations and changes in care plans. For example, I was with my nurse when she discussed about possible
discharge from the hospital.

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

Satisfactory

Satisfactory

interventions in a manner that demonstrates knowledge and skill.

A.F. : I practice safely and demonstrated my knowledge to implement, evaluate, and create intervention.

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

Satisfactory

Satisfactory

A.F. : I use three factor framework and practice my decision-making skills. Nurse, client and environment are very important to successful
client health care.

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

Satisfactory

Satisfactory

physical
resources.
A.F. : I always prioritize my nursing care and nursing interventions so that I can manage my workload, time, and physical resources.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Anzhela has progressed very well in her management of her two patient assignment by completing necessary assessments, providing am
care, and medication administration in a timely manner, while also identifying and completing other nursing care such as wound care, foley
catheter management and insertion, monitoring feeds, providing trach and g- tube site care as needed.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

6. 1 Collaborate with clients and members of the inter-professional health care team to assess

Satisfactory

Satisfactory

clients, determine health needs, and to achieve mutually agreed expected outcomes.
A.F. : I usually communicate, assist and collaborated with clients to find their needs in order to enhance their holistic health. I consult with
clients about their health outcomes, approaches to care, and evaluate care for them.

6. 2 Contribute as a member of the inter-professional health care team to respond to the

Satisfactory

Satisfactory

Satisfactory

Satisfactory

changing needs and expected outcomes of clients.

A.F. : I always respond to clients personal basic needs and expected outcomes of clients.

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

A.F. : I look for assistance when I feel that the situation is not safe or needs extra help from other inter-professionals.

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

Satisfactory

Satisfactory

outcomes.
A.F. : Use teamwork, consensus building, and conflict resolution skills to meet expected client outcomes.

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

Satisfactory

Satisfactory

changing
environment.
A.F. : Use effective, collaborative, and consultative strategies to meet clients needs within a changing environment.

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

Satisfactory

Satisfactory

competencies.
A.F. : I always interact with other members of the health care team to respect their unique professional role and to respect their own
competencies.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Anzhela is a team player she offers assistance to her fellow nursing students and coordinates her care with her patients based on her
assigned patients preferences. She also collaborates and consults with the primary nurse and clinical instructor when she is learning a
new skill and when assessment findings for a patient is abnormal.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

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.

Satisfactory

Satisfactory

A.F. : I usually act for best possible clients outcomes. I prevent clients from harm and collaborate with inter-professional health care team
for providing client-centered care to patients.

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

Satisfactory

Satisfactory

integrate feedback into practice.

A.F. : I usually take part in a reflective practice to identify my strengths, areas for improvement, and to create feedback into nursing
practice.

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

Satisfactory

Satisfactory

program (CNO).
A.F. : I always create, implement, and evaluate my learning plan according to the Quality Assurance program and determine my straights
and sides for improvement in clinical practice. For example, my weakness was for improving practice in timely manners, and to the end of
my clinical practice I improved it.

7. 4 Seek out learning opportunities and feedback that foster professional development; and,

Satisfactory

Satisfactory

integrate these into practice.

A.F. : I sometimes seek out for assistance and learning opportunities that foster my professional development. For example, I asked my
nurse to explain more about patient blood work result for INR test and possible need for contacting a doctor.

7. 5 Use nursing research to foster professional development.

Satisfactory

Satisfactory

A.F. : I maintain my nursing research to help me in professional development. I use internet sources as well as printed books to retrieve
information.

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

Satisfactory

Satisfactory

A.F. : I use theory-based approach and evidence-based practice to provide best possible health care to my clients. Moreover, I use my
nursing knowledge and practical skills.

7. 7 Apply knowledge of changes to the health care system, technology, and in society as

Satisfactory

Satisfactory

these affect nursing practice.

A.F. : I always apply my nursing knowledge of health care system, electronic technology, and within society as these affect my nursing
practice.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Anzhela consistently sought out learning opportunities by assessing her patients needs and identifying nursing interventions documented
in the plan of care while also asking other floor nursing for other possible learning opportunities.

8. USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING

8. 1 Use critical thinking and problem-solving skills to inform decision-making in all aspects

Satisfactory

Satisfactory

of nursing care.
A.F. : I use effective strategies for my critical thinking and problem solving skills and for my decision-making for all aspects of my nursing
care.

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

Satisfactory

Satisfactory

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

criteria.
A.F. : I maintain critical thinking, problem-solving and decision-making skills to better understand my clients and their needs for care.
Moreover, I discover patients diagnoses, predict their outcomes, plan patients interventions, and evaluative effective or not effective
interventions. It is always important for me to use SMART goals which includes specific, measurable, achievable, realistic and timed goals.

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

Satisfactory

Satisfactory

to improve
these.
A.F. : I usually evaluate myself for my critical thinking, decision-making, and problem solving skills. Sometimes I need to review my plan of
care regarding patient health needs.

8. 4 Integrate knowledge from a variety of nursing, health, and other theory into nursing

Satisfactory

Satisfactory

practice to provide safe and competent care.

A.F. : I use my knowledge and theory-based approach while providing care to my patients. I always check medication what I am giving to
my patients and checking doctors` orders recently for any changes. I am very competent in my nursing practice and showing my nursing
ability to be successful in what I practice at the hospital setting.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

A.F. : I always prioritize effectively my clients` needs for care. I understand that it is depends on situation and urgency of care. I use my
knowledge and create a plan to avoid negative outcomes, and sometimes I need to step out of the room when clients are having violate
behaviors.

8. 6 Demonstrate professionalism and accountability.

Satisfactory

Satisfactory

A.F. : I demonstrate my professionalism and accountability for my decisions and client health care. For example, I follow protocol for
wound care dressing change, by cleaning with normal saline, putting gauze, and covering with Tegaderm transparent dressing.

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

Satisfactory

Satisfactory

and guide practice.

A.F. : I use my decision-making safe practice, and nurse-client-environment three factor framework in my nursing practice. I ensure my
decisions are based on my theory knowledge and critical thinking skills.

Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING :

Anzhela has progressively improved in her ability to prioritize her time and patient care needs effectively by administering medications on
time and documenting in a timely manner.

Student Final Summary with Strategies for Continued Growth

I practice safely and in responsible, accountable manner for client well-being by giving a client-choice as much as possible. I communicate with other
inter-professional health care givers for better treatment plan for my clients. I always ensure for privacy and confidentiality of patient information and
during health care procedures. I use my critical thinking skills, decision-making skills, theory-based approach and knowledge. I plan my day at the
begging of each shift and manage my time according to priority of nursing care between patients. I will continue to learn and to practice my skills on
administering medication through different routes. Moreover, I will continue to review videos about procedures and making patient care plan for better
interventions and improvement on it. Thank you for a great opportunity to learn and to practice at Etobicoke General Hospital at Respiratory Unit.

Teacher Final Summary with Strategies for Continued Growth

Continue to develop assessment skills and providing quality holistic care to patients and members of their family by enhancing critical thinking skills
through the use of concept maps.

Student's References
College of Nurses of Ontario (CNO). Retrieved from www.cno.org

Grade

Satisfactory

Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

Grade

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