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 :

Karthika Poologanathan
Elaine Willard
Judy Martin
William Osler Health Centre/Etobicoke General
Hospital
Agency
8E Orthopedics
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.
K.P. : I comply with regulatory standards , relevant legislation and the practice setting's policies and procedures by making sure that I
document my patients vital signs according to the William Osler's policy within an hour of taking them and also documenting my other
assessments on a timely manner.

E.W. : As well as following hip precautions, charting medications in the MAR, Humber and WOHS uniform policy.

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

Satisfactory

Satisfactory

K.P. : I act in a responsible, ethical and accountable manner by using sterile procedure when I did the coccyx dressing on my patient.

E.W. : Also, your overall manner was good when interacting with all staff, peers, clinical teacher, and clients.

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

Satisfactory

Satisfactory

care.
K.P. : If the patient prefer to washed after breakfast, I will agree to their choice and work accordingly with the patients choice.

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

Satisfactory

Satisfactory

K.P. : I use evidence informed practice and a theory - based approach to care when I am administering medications to my patient I always
make sure I check the medications side effects, intervention and contraindication before administering the medication to my patients.
Especially, when I am administering hypertensive medication , I always make sure that I check the patient's blood pressure and pulse
manually before administering it.If the blood pressure and the pulse is abnormal I hold the medication. I always use two identifiers to
identify my patients by using the MAR and the patients arm band.

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

Satisfactory

Satisfactory

and a safe environment.

K.P. : I carry out safety- based practices and risk management principles to ensure client safety and safe environment by ensuring at the
start of my shift I make sure that my patients IV is in place and correct IV solution is running , make sure my patient oxygen is on with the
correct amount of liter. Also, throughout my shift I closely monitor the side rails are up and the calling bell are always within the patients
reach.
I also follow the safety by follow the hip precaution protocol when ambulating and re-positioning the patients with hip surgery.

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

Satisfactory

Satisfactory

uncertain.
K.P. : I always ask questions and clarify the plan of care with my nurse or my clinical teacher to ensure that I am doing the right care for
my patient. If I am not sure about the documentation on Meditech I will clarify with the nurse or the clinical teacher before I put it into the
system. Also, any doctors order if I do not understand I ask the nurse or my clinical teacher for clarification to have a better understanding.

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

Satisfactory

Satisfactory

unsafe,
unacceptable and/or unprofessional behavior.
K.P. : I demonstrate professional behavior by seeking assistance from my nurse which I am washing my patient with an IV line , I ensure I
ask the nurse to take off the gown by disconnecting the IV line and connecting them back.

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

Satisfactory

Satisfactory

K.P. : I demonstrate understanding about the role of the nurse within health care by
- Arrive half hour early to get bed site report
- Following the policies and procedures of the facility. Documenting the vital signs within the hour of taking them.
- Reassessing the abnormal assessment of the patients
- assessing for fall risk
- Following the post-op precautions
- Encouraging client centered care
- Accurate documentation
- Following professional uniform polices
- Monitor patients every hour

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Karthika has demonstrated understanding of this outcome by using her clinical examples from her practice. She is safely and competently
able to manage two patients with guidance from her clinical teacher and staff if the medical situations are new.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

K.P. : I participate in team sharing and discussions by giving my thoughts and ideas with my clinical groups. For example I helped my
peers by sharing my knowledge and work experience in giving a sitz bath, priming IV and doing a sterile dressing. Also, I participate in post
conference about the plan of care for my patients every week.

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

Satisfactory

Satisfactory

methods.
K.P. : According to the facility policy I make sure I document the vital signs of my patients within an hour of the time taken and document
the other assessments clearly, accurately , concisely in a timely manner in Meditech.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

K.P. : I ensure that I report to my nurse or my clinical teacher any abnormal assessments on my patients. When my patients pulse was 58 I
ensure it was reported.

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

Satisfactory

Satisfactory

team.
K.P. : In the beginning of my clinical experience I use medical term with my patients which makes it hard for them to understand, but now I
corrected myself and I make sure I use correct communication techniques while communicating with my patients. I tell my patients I am
going to take your blood pressure rather than saying vital signs . Also, I say I am going to listen to your stomach rather than saying
abdomen.

E.W. : Saying abdomen or stomach if they don't understand is OK. Saying blood pressure is better.

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

Satisfactory

Satisfactory

Protection Act (PHIPA).

K.P. : When I am giving personal care to my patients I ensure I provide privacy and also if I have to leave my computer to attend a patient I
will ask an another nursing student to watch my computer to maintain confidentiality of my patients information on Meditech.

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

Satisfactory

Satisfactory

information.
K.P. : I always use the William Osler internet LEXI-comp and the PIXIS to research my patients medications and diagnosis. I also use the
magic key shift F12 on Meditech to look up the laboratory data of my patients.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Karthika has met this outcome and has used good examples from her clinical practice. Documentation on Meditech was done well as was
reporting at the appropriate times to staff.

3. CARING RELATIONAL PRACTICE

3. 1 Use effective communication techniques.

Satisfactory

Satisfactory

K.P. : I use effective communication techniques when giving health teaching for my patients like deep breathing , deep coughing and leg
exercises.

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

Satisfactory

Satisfactory

K.P. : I use therapeautic care, compassion and culturally safe realtionships with my client when my client was crying because she was in
pain. I looked up the MAR then consulted with my nurse so that i can adminster the PRN pain medications to relieve the clients pain and
discomfort.

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

Satisfactory

Satisfactory

K.P. : I demonstrated therapeautic use of self to foster client well-being when my patient requested daily newspaper I ensure I brought him
a newspaper the next morning and my patient was extermely happy to have a newspaper.

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

Satisfactory

Satisfactory

have on relational practice.

K.P. : I use self-awareness when my patient had a bowel movement I ensure I maintain neutral facial expression while changing the patient
brief. when I changed the dressing on my patient I maintained my composure to make my patient feel comfortbale with their body image
and free of fear.

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

Satisfactory

Satisfactory

consult appropriately.
K.P. : I collaborate with my patients when she wanted to wear her own personal clothing during her hospital stay.

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

Satisfactory

Satisfactory

K.P. : I support the diversity of clients and the inter- professional health care team by respecting and treating everyone equally by not
showing any difference based on their cultures.

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

Satisfactory

Satisfactory

influencing their choices and decisions.

K.P. : I display sensitivity and respect for clients' culture when the female patient was assigned to a male student nurse,the male student
nurse asked me to give personal care to patient which she preferred to have done by a female nurse.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

K.P. : When my patient was discharging home I ensure I gave a good client education for the patient with right breast mastectomy by
reminding her that she should go to the emergency if she suspects inferction or any medical emergencies regarding her condition. I gave
her health teaching to my patient to do deep breathing , deep copughing , and hand exercises every hour.

Teacher comments for CARING RELATIONAL PRACTICE :

Karthika is a caring student who demonstrated cultural sensitivity with all her patients.

4. LEADERSHIP AND ADVOCACY

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

Satisfactory

Satisfactory

K.P. : I apply conflict resolution skills when my peer had difficulty identifying the abdominal sounds on her patient , I double checked it for
her and assessed together before we reported to the nurse.

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

Satisfactory

Satisfactory

environment.
K.P. : I evaluated and refined leadership skills when my peer was not sure how to do a sitz bath and discontinuing a catheter I
demonstrated to my peer how to do it.

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

Satisfactory

Satisfactory

professional health care team.

K.P. : I provided feed back to peers when they are giving personal care ,skills on how to turn a heavy patient, and how to make an
occupied beds.I accept feedback from peers about my strengths and weakness and I correct my mistakes through peer feedback. I also
accept feedback from my nurse and my clinical teacher through pre and post conference and Knowlege4You assessments.

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

Satisfactory

Satisfactory

K.P. : I advocate clients and others when I care for my patient I ensure I explain what I am going to be performing and then start my
care.For example when I cared for the patient with Jackson Pratt drain tube I ensure I explained to the patient and the daughter what I am
going to do and how I am going to do the procedure. I maintain a quality practice environment by ensuring that my patients room is cluster
free and safe mobility for the patient.

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

Satisfactory

Satisfactory

K.P. : I support my clients' rights for self-determination and choice by asking them when they want to be washed before or after breakfast.
I ask my patient choice if they want soap on their face and also if they want lotion after the bath.

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

Satisfactory

Satisfactory

K.P. : If the student nurse did not follow the proper sterile procedures when administering an injection and also discarding the syringe in
a proper method I will calmly and professionally address the mistake and explain the right procedure to be done.

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.
K.P. : collaboration and consultation is done to protect the public, students , all the health care staffs by taking the flu vaccine for clinical
practice.

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

Satisfactory

Satisfactory

K.P. : I make sure I contribute to the creation of quality practice solutions and strategies to make sure I fulfill my patients needs by giving
holistic approach care. I appear in full uniform and half hour early on the unit to get bed site report from the nurse to start my shift.

Teacher comments for LEADERSHIP AND ADVOCACY :

Karthika has demonstrated understanding and has met this outcome by her clinical examples. She actively participated in post
conferences by sharing her day's experiences with the clinical group.

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.
K.P. : I incorporated the clients' unique needs by understanding the different preferences of my patients. Throughout my clinical
experience I met patients with unique conditions. When my patients says I want to be washed in the washroom I respect their preference
because some patients are capable to ambulate to the washroom.

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

Satisfactory

Satisfactory

articulated competently in writing and orally.

K.P. : I develop theory - based plans at the beginning of my shift I ensure I use the daily organizational plan to prepare my patients plan of
care so that my patient can be satisfied at the end of the day.

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

Satisfactory

Satisfactory

K.P. : I use knowledge, skill, and judgement when I have to administer hypertension medication I ensure I check my patients blood
pressure and pulse manually and ask my peer to double check it. If the blood pressure is low and the pulse is less then 60 I hold the
medication.

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

Satisfactory

Satisfactory

K.P. : I collaborated in the evaluation and modification of plan of care when it was time for my patient to be discharged on start of my
shift, her pain score was 8 on a scale. The nurse collaborated with me about the change in plan for my patient that she have to stay until
her pain is fully relieved.

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

Satisfactory

Satisfactory

interventions in a manner that demonstrates knowledge and skill.

K.P. : I safely and competently evaluated the nursing assessments by checking the blood pressure and pulse before administering
hypertension medication. I also held the stool softener because my patient had loose stool.

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

Satisfactory

Satisfactory

K.P. : I make sure my patient is safe all the time by observing their IV sites every hour, ensure bed rails are up, make the environment
cluster free so the patient can ambulate and also practice best practice guidelines to give patients safe care.

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

Satisfactory

Satisfactory

physical
resources.
K.P. : I manage workload by prioritizing my patients care by doing the assessments and documenting them right away rather than leaving
it to the last minute.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Karthika has met this outcome and demonstrated his through her clinical examples. She submitted three good concept care maps. Time
management and organizational skills improved over the semester while caring for two patients.

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.
K.P. : I collaborate with clients and members of the inter- professional health care team when the patients doctor, physiotherapist comes
in to room to talk to the patient I ensure I collaborated with them to have a better understanding of the patients health needs.

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

Satisfactory

Satisfactory

changing needs and expected outcomes of clients.

K.P. : At the beginning of my shift I make sure I check my patients chart to see if there is any new doctors orders such as discontinuing
catheter, discontinuing IV fluid transfusion, new medications, removal of staples, and also change in patients diet.

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

Satisfactory

Satisfactory

K.P. : I seeked out assistance with the inter-professional health care team when I am doing IV medications and doing any type of dressing
on the patient and also giving my PRN medication. I consulted with the pharmacist when I had to hold the patients hypertension medication
because the patients blood pressure and pulse was low.

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

Satisfactory

Satisfactory

outcomes.
K.P. : I use conflict resolution skills with my patient when she was scared to be transferred into a commode chair to go to the washroom
because she worried that she might fall again and end up being hospitalized for longer period. I encouraged her to get up and explained
her that she have to ambulate because she can get other complications such as pneumonia. I encouraged her to get up and ambulate
safely and transfer to the commode with no problem and she was able to tolerate the activity well.

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

Satisfactory

Satisfactory

changing
environment.
K.P. : I use effective , collaborative strategies when my patient oxygen saturation was low , I raise the head of my patient and re checked
the saturation level but it was not going back to normal. I collaborated with my nurse and gave 2 liters of oxygen.

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

Satisfactory

Satisfactory

competencies.
K.P. : I interact with the members of the health care team by respecting their unique role and competencies. When I have a day 1 post op
patient I ensure I do not ambulate the patient, I leave it for the physiotherapy team who are competent at their job.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Karthika has met this outcome and has provided examples from her practice to demonstrate this.

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

K.P. : I ensure my patients are protected from harm by observing their IV sit every hour, if my patient has a restrain I monitor them closely,
bed rails are up, and proper IV solution is running, doing a fall risk assessment on Meditech. I also collaborate with doctors and
physiotherapist if I have any questions regarding my patients.

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

Satisfactory

Satisfactory

integrate feedback into practice.

K.P. : I reflect on my clinical practice every week and identify my strengths and weakness. I read the Medical Surgical Nursing Canada and
Canadian Fundamental of Nursing book to improve my knowledge. I also talk among my peers to get feed back so that I can do better.

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

Satisfactory

Satisfactory

program (CNO).
K.P. : I am practicing throughout my clinical practice on how to create, implement , and evaluate a learning plan.

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

Satisfactory

Satisfactory

integrate these into practice.

K.P. : I seeked out learning opportunities when I watched my peer do an in and out catheter on her patients and watched her doing an
abdominal dressing which will be a good learning experience for me because if I had to do an in and out catheter on my patient I will have a
better knowledge and will be more comfortable performing it.

7. 5 Use nursing research to foster professional development.

Satisfactory

Satisfactory

K.P. : I use nursing research to foster professional development when I ensure I look up my patients medical and surgical diagnosis if I am
not sure of it and also I use the LEXI-comp to research my patients medication.

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

Satisfactory

Satisfactory

K.P. : I use a theory- based approach when I am administering medications to my patients I use the 8 rights of medication.I use evidenceinformed practice when I use the LEXI-comp to research my medications.

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

Satisfactory

Satisfactory

these affect nursing practice.

K.P. : I apply knowledge of changes to the health care system when my clinical teacher informed about the new change in documenting
the physical assessments of the patients. We do not need to highlight individual assessment and document there anymore. The resource
of the hospital came up with new physical assessments icon where we can document the findings, but if the findings are abnormal we can
re check it during our shift and document them individually.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Karthika has demonstrated understanding of this outcome by her good clinical examples.

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

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

Satisfactory

Satisfactory

K.P. : I critically think when I give hypertension medication to my patient I double check the blood pressure and pulse before giving the
medication to avoid complications. I report it to my nurse , to my clinical teacher, and also document on Meditech that I have held the
hypertension medication due to abnormal blood pressure and pulse.

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.
K.P. : I use critical thinking , problem- solving and decision- making skills when I am assessing patients with different conditions. For
example, I had a patient with left wrist fracture I assessed her MSK, CSM, and the 5 P's.

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

Satisfactory

Satisfactory

to improve
these.
K.P. : I evaluate critical thinking, problem-solving and decision-making skills by reflecting on my clinical experience and using the nursing
text books and doing the NSO modules online to improve my knowledge.

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

Satisfactory

Satisfactory

practice to provide safe and competent care.

K.P. : I watched videos on priming an IV , inserting a PICC line, vaginal hysterectomy to have a better understanding on how to care for
these patients and how the procedure are done.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

K.P. : I ensure I prioritize my patients assignment by giving them the insulin at the requested time and giving them the bath after as it takes
long to do.

8. 6 Demonstrate professionalism and accountability.

Satisfactory

Satisfactory

K.P. : I act professionally with my patients by maintain a therapeutic relationship and giving them good care and communicating with the
nursing interpersonal team in a professional manner. I maintain accountability by being accountable with all my actions and procedures
with my patient because I am responsible for what I am doing to my patients.

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

Satisfactory

Satisfactory

and guide practice.

K.P. : I ensure I maintain the nurse- client - environment when I am giving care to my patients. I ensure that my patients are comfortable
and happy in the environment. I ensure that I give them a feel that they are at their own home by keeping their room clean and attending to
them right away and help them with everything they need. Also, I make sure that my patients are safe by observing them closely.

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

Karthika has met this outcome and has developed good critical thinking skills throughout this semester.

Student Final Summary with Strategies for Continued Growth

I will continue to work hard and gain more knowledge through out my clinical experience. I will ask questions to my clinical teacher and my nurse
when I am not sure of anything regarding my patients.

Teacher Final Summary with Strategies for Continued Growth

Karthika has done well in this clinical and has successfully managed two patients providing complete care for them. She provided health teaching,
learned the Meditech system for documenting, assisted her peers and provided culturally sensitive care. Keep up your learning plan goals to have
good time management, do abdominal assessments well, and practice IV administration. I think that you did meet these goals this semester.
I enjoyed having you in my clinical group this semester, Karthika, and I wish you much success in your next clinical.

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