Nurs208 K4y

Self Assessment
2016 - 2016 - Final NURS - 208 Course Learning Outcomes (201509)

NUR 208 Practical Nursing Practice 4 (PN, 06-Sep-2016 - 09-Dec-2016)
Student : Maria Guineva Galvey
Clinical Teacher/Preceptor : Yvonne Asomaning-Dapaah
Program Coordinator : Judy Martin
Location : William Osler Health Centre/Brampton Civic Hospital
Placement Setting : Agency
Unit/Office/Clinic : N2 NM
Period : 06-Sep-2016 To 09-Dec-2016
Student hours : 196
Required Hours : 196
Validated hours : 184
Teacher comment for validated hours:
Absent on November 8, 2016
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
Satisfactory Satisfactory
1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies and
procedures.
M.G.G. : I ensure to follow the safe practice and follow hospital policy protocols at all times and practice according to the legislation and procedures. I
ensure to wear the proper uniform with the use of the appropriate footwear that nurses are expected to wear (white enclosed shoes). I also practice
good hygiene at all times before and after providing client care and most importantly, I practice my nursing skills only within my scope of practice as a
student nurse.
1. 2 Act in a responsible, ethical and accountable manner.
M.G.G. : I practice in a responsible and ethical manner by attending to my clinical practice every Tuesday, 30 minutes prior to my shift. I make sure to
do my research about the medications my patient have to be able to do the proper assessments and apply the right nursing considerations to be
aware of. I only practice nursing skills that are within my limits as a student nurse. I make certain to respect and build rapport with my group mates,
my primary nurse and most of all my client.
1. 3 Determine how the three factor and practice decision-making frameworks influence client care.
M.G.G. : I am well aware of my capabilities and limitation as a student nurse, if I have observed that my client is not capable of helping himself/herself
in turning and looks like that he/she is heavy. I would ask for help from other clinical students to do my client's bed bath. In this way, I am showing that
the I have assessed the client factor, I have also assessed my own capabilities and asked for help and support to do my bed bath. I am reducing the
risk for increased fatigue to my client if I will be the only one doing the bed bath as well as protecting myself from not doing proper body mechanics.
1. 4 Use evidence informed practice and a theory-based approach to care.
M.G.G. : I ensure to make use of an evidence-practice and a theory based approach when providing care to my assigned clients. I exhibit this by
reviewing the proper way of doing system assessment from our Jarvis book, referring as well to the checklist that was given to us from first semester
and I include the pathophysiology, nursing interventions and clinical manifestations of a diagnosis by referring to our Theory class and notes because
I know that information about a specific medical diagnosis needs a factual and reliable source to have a better understanding and to do the optimal
plan of care for my client.
1. 5 Carry out safety-based practices and risk management principles to ensure client safety and a
safe environment.
M.G.G. : I establish a safe environment for my client and ensuring their safety by positioning their bed in the lowest position, side rails up and putting
their personal belongings within reach to avoid falls and injury. In addition to that, I would also put the call bell beside them and would always tell my
client, before leaving their room, to press the call light whenever they need help or whenever they feel any pain while I am not with them. I ensure to
visit my client around the clock during my shift, especially that I am working in neurology unit where most of the clients are confused and may not
understand how to use their call bell.
1. 6 Ask questions and clarify the plan of care, unclear orders or directions, and whenever uncertain.
M.G.G. : Whenever I am unsure of something I'm about to perform or about a medication to administer, I make sure that I clarify my understanding
before carrying out the task. When I am unsure, I would speak to my primary nurse and clinical instructor before I perform a task. For example, Prior
to administering my client's medication (Metoprolol), I took his BP and heart rate, the BP was in the range to give his medication; however, the heart
rate was kind of confusing. Because of that, I had to hold his metoprolol for awhile, and speak to my clinical instructor and primary nurse, explained
the situation and give my reasons why I need tp withheld the medication and my plan of giving it a later time and then asked their input about the
situation.
1. 7 Demonstrate professional behavior by seeking assistance in situations in which there is unsafe,
unacceptable and/or unprofessional behavior.
M.G.G. : Whenever I feel that the situation is unsafe not just for myself but mostly for my client, I would seek assistance and report it to my primary
nurse and clinical instructor to be addressed. For example, one my assigned client's was lethargic and kept sleeping when breakfast tray arrived. He
was diabetic as well. I spoke to my primary nurse and clinical instructor on what should I do because the client is sleeping and not waking up that
could increase his risk for a choke if I insist on feeding him; however, would also be dangerous because he is a diabetic. we then tried giving him with
at least milk to prevent hypoglycemia as well as the instance of choking.
1. 8 Demonstrate understanding about the role of the nurse within health care.
M.G.G. : I demonstrate my understanding of the role of the nurse within the health care team by providing and facilitating the best possible care to the
client. For example, I had a client who is able to walk with assistance and sits in the chair all day, every day. I know that nurses should be assisting
him during mobility; however, to achieve the client's optimal function, aside from assisting him always and just sitting in the chair, I did some health
teaching about the importance of moving and walking around the hospital as tolerated.
Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
M.G.G. has excelled to be a competent nurse, capable of providing care that is safe and is within her professional, legal and ethical
framework. M.G.G. continues to show an exceptional level of competency that is beyond her years of experience.
2. ACCURATE AND RELEVANT COMMUNICATION
2. 1 Participate in team sharing and discussions.
M.G.G. : During our clinical post-conference, I would participate more now by having the chance to be the team leader for the day; this means, I had
to facilitate the post-conference for that week and ask every one day was. Moreover, I also had the chance to do a presentation about Intercerebral
Hemorrhage. I had to do my presentation as well as engage my groupmates by asking them questions about the said medical diagnosis.
2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic methods.
M.G.G. : Because we need to document every assessment every Tuesday in MediTech, I can competently document my client's findings on the right
category in Meditech in a timely manner and be able to document every possible assessment and intervention needed to be documented. For
example, I know where to find the laboratory values in MediTech that would be needed prior to administering medications and be able to edit my
status board as I am having two clients every shift.
2. 3 Report relevant information to the appropriate personnel.
M.G.G. : I demonstrate this by reporting all the vital signs that I have taken to my primary nurse, as well as telling him/her the medications that I held
and the status of my client prior to having my break. I also demonstrate reporting to the appropriate personnel by giving relevant information to one my
groupmates who will be covering for my clients while I'm on break.
2. 4 Use communication techniques with the client and the inter-professional health care team.
M.G.G. : I utilize my communication techniques well with both my client, clinical group and staff in the unit by informing my clients the nursing skill
that I will be performing, asking for a consent and I would walk them through and during the procedure of care. For the inter-professional health care
team,I show this by reporting my findings (i.e, vital signs, patient's concerns) to my instructor and/or primary nurse, and to my classmates by giving
reports when they had to look for my client while I'm on break and asking questions and information about medications.
2. 5 Ensure privacy and confidentiality according to the Personal Health Information Protection Act
(PHIPA).
M.G.G. : I ensure that I do not leave my client's CMar in view of unauthorized personnel. I make sure to not disclose any information about my client's
health information that will not be necessary to the discussion. I can also demonstrate privacy by simply closing the curtain when doing bed bath to my
clients.
2. 6 Use technology to retrieve and share information including research, data and other information.
M.G.G. : I often use technology to retrieve information especially research about the medication that I will be administering to my client. In addition to
that, I have use technology to have enough information for my presentation during our post-conference, but I would also make sure that I would only
use credible sources to become more informed with the right information that I need.
Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :
M.G.G. has demonstrated to convey accurate and relevant communication. M.G.G. is able to document, as well as retrieve relevant
information regarding patients. M.G.G. has done excellent work with her verbal communication; she is able to give verbal reports to the
nurses on the unit, as well as to her peers when going for her breaks and at the end of her shifts.
3. CARING RELATIONAL PRACTICE
3. 1 Use effective communication techniques.
M.G.G. : Effective communication techniques such as verbal -- open and close-ended questions, and non-verbal, is what I would usually enforce
using during clinical. I once had a client who speaks Portuguese, the language barrier is obviously a big factor in providing care. I provided care by
using verbal -- using common Portuguese words such as she she (pee), coco (BM), dor (pain) and decanse (have a rest); moreover, I would also
incorporate nonverbal such as gestures and point a finger to things that are to be done to provide care. In addition to that, I also had a chance to take
care of a patient with expressive aphasia, I had to utilize effective communication while providing care to him.
3. 2 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and
health care team members.
M.G.G. : I demonstrate therapeutically and compassionate care by listening to my patient's stories as this will help them to regain respect and worth
of themselves (Touhy, 2012). Giving attention and actively listening to my patient would also build rapport and relationship between us and that would
make them more cooperative in their care. Together with good communication and active listening, I also make sure to provide therapeutic care and
culturally safe care to my clients by making sure that my client. For example, I had the chance to be assigned to the same client after 3 weeks and
because of the rapport that I had built with him from our previous encounter, He is very cooperative with all the care that I am providing.
3. 3 Demonstrate therapeutic use of self to foster client well-being.
M.G.G. : Interactions with my assigned clients must be conducted in a way that is fair to all other patients regardless of their race, gender or beliefs. I
examine my own feelings and biases toward my patient's attitudes, behavior, gender, race and even their medical diagnosis. For example, I would
usually get clients that are males, regardless of their gender, I would still give them bed baths just like giving bed baths when I have a female client.
3. 4 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on
relational practice.
M.G.G. : Self- awareness as defined in Canadian fundamentals of nursing as being aware of our own biases and choices. I tend to reflect on my
feelings, culture biases and thoughts prior, during and after giving care. In this way, I won't be biased when providing care to my client's, especially
that we are assigned to two clients this clinical practice.
3. 5 Collaborate with clients and members of the inter-professional health care team and consult
appropriately.
M.G.G. : I am certain that I am with my primary nurse when giving shift reports to ensure that I will be having the appropriate information regarding
my assigned client and I would make sure that I am giving reports to my primary nurse about my client's vital signs and head-to-toe assessment.
I collaborate with other professional in the health care team to achieve the best possible care for my client. For example, I once had a client who's
having discharge on both eyes. As the doctor is doing his rounds, I have reported what I have assessed and told the doctor my possible
recommendation.
I collaborate with my client by involving them with the care that I am providing as well as asking for consent and walking them through my
assessments.
3. 6 Support the diversity of clients and the inter-professional health care team.
M.G.G. : I apply practices and support the diversity of clients by accepting and not being picky with whatever client I have on my shift. Moreover, I
also show respect to my primary nurse even we are not in the same race.
3. 7 Display sensitivity and respect for clients cultural, religious, and other beliefs and values
influencing their choices and decisions.

M.G.G. : I am respecting and not questioning decisions that are made with considerations of their own values and beliefs. For example, one of my
group mates had to insert a catheter to a client who does not speak and understand English; however, based on his reactions, he does not want an
audience when doing this kind of stuff to him and as I recognize that, I voluntarily exited the room to give the client privacy. Moreover, some of my
clients would usually have a radio on their bedside, playing a ritual song throughout the day. Because I am aware that it is in their beliefs to listen to it,
I didn't ask them to turn it off while I am providing care to them or assessments.
3. 8 Provide effective client education.
M.G.G. : I ensure that I effectively do health teaching to my client about their plan of care and medications that I am administering. For example, I
once had a client who is capable of walking with assistance and walker; however, he would usually just sit in the chair the whole day. As I am
administering his medications, I provided him the importance of moving and walking around, even in short distances every day and as tolerated.
Moreover, I also incorporate the importance of using the appropriate footwear to prevent falls. I assisted him that day in walking and reminded him
about mobility before I finished my shift. After two weeks, I had the chance to see the said client, walking around with his walker and he's doing better
plus he's using the proper footwear.
Teacher comments for CARING RELATIONAL PRACTICE :
M.G.G. has done an excellent job achieving a caring relational practice with her patients. M.G.G. has demonstrated this ability as one of her
main strengths this semester. M.G.G. takes her time to talk to the patients and ensures her presence is felt. M.G.G. is very attentive to her
patients.
4. LEADERSHIP AND ADVOCACY
4. 1 Apply appropriate conflict resolution skills in therapeutic client and other interactions.
M.G.G. : I do my best to recognize conflicts in regards to my client's care. I would try to critically think to find a resolution and seek assistance. For
example, my client is on Lasix, but I am not allowed to do a push. My primary nurse told me that I can administer the said medication through IV for
learning purposes. As I have asked my clinical instructor to assist me, she questioned me about the said medication and then from there, I have
realized that I shouldn't be giving Lasix through IV because it is contraindicated to the goal of using Lasix.
4. 2 Evaluate and refine leadership skills to develop solutions and create a positive work
environment.
M.G.G. : I have shown leadership and created a positive work environment during our post-conference when I had to do a presentation about
intracranial hemorrhage. I have raised questions ad asked my group mates to brainstorm about the possible clinical manifestation, nursing diagnosis,
and interventions that we should be aware of wit this kind of medical diagnosis.
4. 3 Provide feedback to peers and accept feedback from peers and members of the inter-
professional health care team.
M.G.G. : I have provided and received feedback from one of my clinical groupmates and clinical instructor. I make sure to review and acknowledge
the feedbacks that I am receiving from other people because it will help me to improve my skills and abilities. As an example, I would usually receive
a feedback every week through k4Y from my clinical instructor. For example, I was advised to speak up and share ideas during our post-conference, I
have reflected her feedback and try possible solutions to improve my weaknesses and improve my confidence. In regards to feedback from inter-
professional healthcare team, I would also consult and include my primary nurse's input to the care that I will be providing to my client.
4. 4 Advocate for clients, self, others, and quality practice environment.
M.G.G. : I ensure to advocate for my clients by listening to their concerns regarding their care. For example, one of my clients noticed that his
breakfast tray doesn't have any cereal which he said he would usually have. He spoke to me about it and I address his concern by writing onto the
paper in the tray and personally giving it to the personnel in charge of the trays.
4. 5 Support clients rights for self-determination and choice.
M.G.G. : I feel that I have shown support for my client's choice by asking consent and explaining the procedure when I am providing care. For
example, my client had a BM and I told him that I will change his briefs together with giving a shower. He refused the shower but accepts his briefs to
be changed. I respected his decision about the care that he wanted to receive. Another example is when I had a patient who is independent and I
have asked him if he needs assistance with his bath but says no, I have accepted his decision and just told him that I will just be outside the
bathroom, in case he needs any help. I offered my help but didn't insist as he declines.
4. 6 Respond appropriately to unsafe, unacceptable, and unprofessional behaviours.
M.G.G. : I had noticed some nurses in the unit are wearing long artificial nail polish while on their duty and providing care to their clients. The said nail
polish is against the regulatory standards because it would increase transmission of bacteria and viruses. Because I am aware of that, I comply with
the regulatory standard and didn't follow the said conflict. In addition to that, I would always follow the proper use of PPE when entering in an isolation
room even I would just check or ask something to a client. Sometimes nurses would enter the isolation room without donning PPE (when asking or
checking the client for a short period of time) which is unsafe not only to themselves but also to other clients in the unit.
4. 7 Collaborate and consult when implementing health care and nursing practices that are in the
best interests of the public and protect the public through collaboration and consultation.
M.G.G. : I ensure to collaborate with other health care professionals in the unit, such as my primary nurse, clinical instructor or other clinical students
when providing care to my clients. For example, I would usually ask during the bedside shift report how my client is feeding, ambulating, allergies or
any fluid restrictions that I should be aware of.
4. 8 Contribute to the creation of quality practice solutions and strategies.
M.G.G. : I believe that I m contributing to the creation of quality practice solutions and strategies by adhering to the eight rights of medication
administration; thus I am contributing in preventing or minimizing medication error in the unit. Moreover, I would also ensure that my client's bed are in
it's lowest position to decrease the incidence of fall in my clients.
Teacher comments for LEADERSHIP AND ADVOCACY :
M.G.G. has improves significantly in the role as a leader and an advocate for her patients. M.G.G. did an excellent job when she was the
team leader for one of the shifts. M.G.G. did great with leading post conference as the team leader and engaging her peers when educating
them about inter-cranial haemorrhage. M.G.G.advocates for her patients by ensuring the care she is providing is patient-centered and
speaking on behalf of the patients when necessary.
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-centred
plans of
care.
M.G.G. : I make certain that I provide care to my patients depending on their needs and I would prioritize assessments and nursing skills to be done
that are in most need for the patient to obtain optimal health and comfort. As I'm working on the unit, I would talk to my client or even to their family
members and read about their progress notes that would be beneficial for me to tweak my care plan and priorities accordingly to make an
individualized plan of care to meet my client's needs.

5. 2 Develop theory-based plans of care that are holistic and client centered and are articulated
competently in writing and orally.
M.G.G. : During our week 5 in clinical, we were asked to submit a concept map about one of our client's medical diagnosis, I was informed that my
concept map is client specific. I believe that in this way, I have utilized my competency in developing a theory based care plan that is holistic and
client-centered. Furthermore, I would also utilize a client centered care for my clients by respecting and listening to their concerns about the way they
think a nursing care should be provided to them.
5. 3 Use knowledge, skill and judgment to assess clients, prioritize needs and outcomes.
M.G.G. : Because of the patient's unique needs and changing environment, I would still come to my clinical setting early enough to be able to check
on my patient's and nursing notes to see if I should be focusing on any restrictions, allergies or new orders and medications. As I start taking vital
signs, head to toe assessment on my client, I would usually observe how they interact, cooperate and involve themselves in their therapeutic regimen
and start to work out other interventions or health teaching that is needed.
5. 4 Collaborate in the evaluation and modification of plans of care.
M.G.G. : I make certain to report my patient's vital signs, LOC or concerns to my primary nurse and clinical instructor, especially if I find it doubtful
and unusual. For example, my client had Dilantin, the said medication can irritate the veins and would have the burning sensation. moreover, the
client's IV would always beep because of an occlusion. I had reported it my primary as well as the assessment that I have noticed in my client's iv site.
the signs and symptoms would tell me that the client might be experiencing phlebitis and would need a new IV to be reinserted especially that the
client is receiving most of his medications through IV. Another example is when my client is on Lasix, but I am not allowed to do a push. My primary
nurse told me that I can administer the said medication through IV for learning purposes. As I have asked my clinical instructor to assist me, she
questioned me about the said medication and then from there, I have realized that I shouldn't be giving Lasix through IV because it is contraindicated
to the goal of using Lasix.
5. 5 Safely and competently implement and evaluate nursing assessments and nursing interventions
in a manner that demonstrates knowledge and skill.
M.G.G. : I ensure to carry out a safe and competent nursing care, interventions, and assessments that are theory base and within my limitations and
scope of practice. I do this by researching my client's medications using my drug book prior to administering it.For example, taking vital signs such as
blood pressure and heart rate prior to administering metoprolol, checking INR in lab flowsheet before injecting warfarin.
5. 6 Use the Three-Factor and practice decision-making frameworks to guide practice.
5. 7 Prioritize nursing care and nursing interventions in order to manage workload, time, and physical
resources.
M.G.G. : I usually complete nursing care to my patient in an organized and timely manner. I demonstrated this by taking a set of vital signs in the
morning, together with a head to toe assessment. Do my medication research to make sure that their meds will be administered at the scheduled
time. I always ensure to do nursing tasks that are important first such as vital signs, assessments, and medications before doing ADLs such as bed
bath or changing bed linens.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
M.G.G. has done an exceptional work with developing a care plan that meets patients' needs and mutually agreed expected outcomes.
M.G.G. is able to collaborate with her primary nurse to ensure the care she is providing is the same as what the primary nurse would
provide to the patient. M.G.G. is able to appropriately modify her plan of care when unexpected changes happen and act accordingly.
Excellent work.
6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM
6. 1 Collaborate with clients and members of the inter-professional health care team to assess
clients, determine health needs, and to achieve mutually agreed expected outcomes.
M.G.G. : I ensure to involve my client in their therapeutic regimen such as when taking a set of vital signs, I would tell them and inform them about it
and as well as to be reported to my primary nurse. I would also involve my client's and my primary nurse's input when I am providing care to my client
unless otherwise contraindicated. For example, one of my client's is able to walk with assistance using her walker. I explained to her that because she
is able to walk, I can assist her in the bathroom rather than doing a bed bath for her ADLs, I also explained that I will be assisting her even she is
mobile. She then agreed and be done with her ADLs, involving her to do some of the baths.
6. 2 Contribute as a member of the inter-professional health care team to respond to the changing
needs and expected outcomes of clients.
M.G.G. : I contribute as a member of the inter-professional health care team by taking a set of vital signs (morning and afternoon), do a head to toe
assessment and administer medications to my assigned clients within my scope of practice and limitations. Moreover, I would also ensure to
document all the findings I had for my whole shift in Meditech to utilize the continuing of care for the client and it would benefit the next nurse that
would be taking care of the client, as the information and assessments are up to date.
6. 3 Seek out assistance and consult with members of the inter-professional health care team.
M.G.G. : whenever I am unsure of a certain situation and I feel uncomfortable with doing it, I would seek assistance and ask questions to my clinical
instructor to clear things out. For example, I noticed that my client's INR is still not updated in her lab flowsheet; however, there's a warfaring
scheduled to be administered. I spoke to my clinical instructor, discussed the said problem with her and also to our team leader to address the
problem.
6. 4 Use teamwork, consensus building, and conflict resolution skills to meet expected client
outcomes.
M.G.G. : Mostly when opportunities arise and when one of our group mates are given the chance to perform nursing skills such as wound dressing
change and foley catheter insertion, the whole group would be working as a team and everyone is willing to lend a hand, especially if the nursing skill
to be performed requires a sterile work field. Thus, showing our teamwork to meet the client outcomes. Another example to show my conflict
resolution skills are being utilized during clinical practice is when I was taking my client's vital sign, his O2 Sat is not reading because of his cold
hands. I spoke to my primary nurse about it and asked where I can get warm blankets that I can use to warm my client's hands and be able to read
her O2 Sat.
6. 5 Use effective, collaborative, and consultative strategies to meet clients needs within a changing
environment.
M.G.G. : Every week as a new client is being assigned to me, I would make sure to make reports and inform my primary nurse and clinical instructor
of my client's vitals signs and any significant findings. In this way, I can include their input into my plan of care and be able to be flexible enough to
change and adapt to my client's needs and an environment. For example, consulting my teacher of any medications that I couldn't do connections
with my client's medical diagnosis or PMH. In addition, I once had a client who had a medium amount of yellow discharges in his eyes that started to
hardened, keeping his eyes closed. When his doctor came in, I reported the said discharged and told him my recommendation.
6. 6 Interact with members of the health care team respecting their unique role and competencies.
M.G.G. : The member of health care team that I usually have an interaction is my primary nurse; with that said, I show respect to their role and
competencies by reporting to them their client's VS, assessment I did for the clients, ADLs and meds administration that I did, So they are aware of
the nursing practice that I have performed to my assigned client.
Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :
M.G.G. has done an excellent job when it comes to collaborating with the interprofessional health care team. M.G.G. is able to identify the
role of each disciplinary team member and collaborate with them as needed to achieve the best goal for the patients. This include the
physiotherapist, occupational therapist, dietitian etc.
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.
M.G.G. : I try my best to provide safe and competent care to my clients but I am well aware that there are certain things about my client's condition
are to be consulted and collaborated with healthcare team professional to achieve their optimal health. For example, during a bedside shift report, The
night shift nurse, reported that the client does not have any allergies; however, I am sure that the client has allergies in some medications because I
have read his charts and Kardex, before engaging to the shift report. I have raised my concern to make sure that there will be no medication error or
further complications. Another example is when I have to administer metoprolol to my client; however, his parameter for heart rate is low but the blood
pressure is high. I spoke to my clinical instructor about this to make sure if I had to hold the medication or not.
7. 2 Engage in ongoing reflective practice to identify strengths, areas for improvement; and, integrate
feedback into practice.
M.G.G. : I am engaging in an ongoing reflective practice to identify my strengths and weaknesses by incorporating my clinical instructor's weekly
feedback from K4Y in my practice every week, thus figuring out possible ways to improve it.. I have also given and received a peer feedback, and did
my CNO Quality Assurance.
7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance program
(CNO).
M.G.G. : I have done a clinical summary about my strengths and weaknesses as I have reflected on my practice and also obtain my group mate and
clinical instructor's input to help me determine my strengths and areas for improvement and learning needs. From last semester's Quality Assurance, I
recognized my time management skills as my weakness and tried to carry out practices and ways to improve it. This time, I can now manage all my
nursing tasks for my two clients in a timely manner. For this semester, I will try to improve my weakness again that would be very helpful for my pre-
grad. I will try to carry out practices to improve it and as my clinical practice end, I would be hoping that I have improved my area of weaknesses.
7. 4 Seek out learning opportunities and feedback that foster professional development; and,
integrate these into practice.

M.G.G. : Whenever I am on the unit, I do my best to seek out new learning opportunities in order to develop my own professional skills and integrate
it into my practice.To illustrate, I observed a fellow student do an NG tube insertion, catheterization of a female and male client and IV medication
administration. I may not have integrated the NG tube insertion and catheterization in my clinical practice, but I have integrated what I have learned
both in lecture and through observation into my own plan of care for my client's scheduled IV medication.
7. 5 Use nursing research to foster professional development.
M.G.G. : I utilize nursing research to foster professional development by using credible websites, textbooks, and lectures to develop a plan of
care/concept map about a specific medical diagnosis in a general way. For example, doing my research for my client's medications prior to
administering it. In this way, I am not only ensuring my client's safety and preventing medication error but also improving my nursing skills and
knowledge about medication.
7. 6 Use a theory-based approach and evidence-informed practice.
M.G.G. : I include notes and knowledge from anatomy, physiology, NURS 103, 150, 104, 101, 151 and lastly pharmacology into my plan of care. For
example, I am able to perform a head to toe assessment and vital signs without mistake because of the practice in NURS 104, 101 and 151. I also
ensure to watch videos in Mosby's Nursing Videos that would demonstrate nursing skills such as removal of staples, wound dressing, injections and
etc., that will be relevant to my patient's plan of care.
7. 7 Apply knowledge of changes to the health care system, technology, and in society as these
affect nursing practice.
M.G.G. : I have adapted well to the new way of using vital machines in the unit. I have also learned a new way to use Meditech. This is the use of the
status board when you are assigned to two or more clients. It would make the documenting for all your client's information easier to handle.
Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :
M.G.G continues to improve her nursing skills and will only get better from here. M.G.G. always is prepared to perform any task and go
above and beyond to provide information that is beyond what is expected of her. M.G.G. is always receptive to feedback and is very quick
to act on the feedback to ensure she is performing at her absolute best.
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.
M.G.G. : An example to show my critical thinking skills are being utilized during clinical practice is when I was taking my client's vital sign, his O2 Sat
is not reading because of his cold hands. I spoke to my primary nurse about it and asked where I can get warm blankets that I can use to warm my
client's hands and be able to read her O2 Sat.
8. 2 Use critical thinking, problem-solving and decision-making skills to assess clients and to
determine nursing diagnoses, expected outcomes, nursing interventions, and evaluative criteria.
M.G.G. : I utilize critical thinking, problem-solving and decision-making skills by evaluating my taking my client's vital signs , checking their lab flow
sheet and asking the primary nurse if their medications are to be crushed or not prior to administering their medications. For example, taking vital
signs such as blood pressure and heart rate prior to administering metoprolol, checking INR in lab flowsheet before injecting warfarin.
8. 3 Evaluate critical thinking, problem-solving, and decision-making skills and design a plan to
improve
these.
M.G.G. : On a weekly basis, I do my best to use the feedback that I receive from my clinical instructor provided not only through k4y but also verbally
during our clinical day. I am well aware that it would help me utilize critical thinking, to solve problems and to better my decision-making skills. I would
try my best to critically think during medication administration with all those side effects and therapeutic effects that my client would exhibit.
8. 4 Integrate knowledge from a variety of nursing, health, and other theory into nursing practice to
provide safe and competent care.
M.G.G. : I include notes and knowledge from anatomy, physiology, NURS 103, 150, 104, 101, 151, 208, 217, 209 and lastly pharmacology into my
plan of care. For example, I am able to perform a head to toe assessment and vital signs without mistake because of the practice in NURS 104, 101
and 151. I also ensure to watch videos in Mosby's Nursing Videos that would demonstrate nursing skills such as removal of staples, wound dressing,
injections and etc., Use the slides from pharmacology to have an idea about the medications I am about to administer to provide a safe and
competent care.
8. 5 Prioritize effectively.
M.G.G. : I make certain that I provide care to my patients depending on their needs and I would prioritize assessments and nursing skills to be done
that are in most need for the patient to obtain optimal health and comfort. As I'm working on the unit, I would talk to my client or even to their family
members and read about their progress notes that would be beneficial for me to tweak my care plan and priorities accordingly to make an
individualized plan of care to meet my client's needs. Moreover, I always ensure to do nursing tasks that are important first such as vital signs,
assessments, and medications before doing ADLs such as bed bath or changing bed linens.
8. 6 Demonstrate professionalism and accountability.
M.G.G. : I practice in a professional way by attending to my clinical practice every Tuesday, 30 minutes prior to my shift. I ensure to follow the safe
practice and follow hospital policy protocols at all times and practice according to the legislation and procedures. I ensure to wear the proper uniform
with the use of the appropriate footwear that nurses are expected to wear (white enclosed shoes). I also practice good hygiene at all times before and
after providing client care and most importantly, I practice my nursing skills only within my scope of practice as a student nurse. I make sure to do my
research about the medications my patient have to be able to do the proper assessments and apply the right nursing considerations to be aware of to
show accountability.
8. 7 Use the practice decision-making and the nurse-client-environment frameworks to inform and
guide practice.
Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING :
M.G.G. has demonstrated to be exceptional with her critical thinking, problem-solving and decision-making skills. This was most evident
when M.G. has assessed her patient's IV site and noticed the site was inflamed with signs of phlebitis; she was quick to recognise that the
IV needed to be re-sited to ensure no further damage. Other times include identifying that a patient on wafarin had no blood work ordered
to know the INR level; as such she was able to collaborate with her primary nurse to get a doctor's order for INR. Excellent work.
Student Final Summary with Strategies for Continued Growth
**I am short of 12 hours in my clinical hours due to my absence on Week 10, November 8th, 2016 (Doctor's note were submitted to my clinical
instructor and our program coordinator)**
All in all, I am present and prompt for all my clinical practices. I ensure to comply with the regulatory standards of the hospital policy at all times, as
well as to the handbook provided by the college. I am in uniform, 30 minutes prior to my shift and prepared in the best way I can. I ensure to provide
care in an accountable manner, question accordingly and ask assistance whenever I require especially in medication administration to prevent
medication errors. I establish a safe environment for my client and ensuring their safety by positioning their bed in the lowest position, side rails up
and putting their personal belongings within reach to avoid falls and injury. I ensure to use therapeutic techniques in communicating not only to my
clients but also to other health care professionals. I practice my documentation in Meditech accurately and thoroughly in a timely manner. I ensure
that all of my findings, particularly things that are abnormal, i.e. vital, blood work results, is documented and shared with the appropriate persons such
as my primary nurse and my clinical instructor. I am aware of my own limitations as a student nurse and only implements nursing interventions which I
know and understand how to perform. When there are any changes to my patient, I ensure to report this to my primary nurse or to my clinical
instructor, so the care plan can be tweaked accordingly; I will try my best to be as flexible as possible to adapt my client's changing environment and
unique needs. I still need to build my confidence whenever I am in the unit and facing different kinds of people. I will continue to engage in an on-
going self-reflection to be aware of my own strengths and weaknesses so that I can seek assistance whenever needed and accordingly.
Teacher Final Summary with Strategies for Continued Growth
M.G.G. is an exceptional student who acted professional at all times and had the knowledge of an experience nurse. However, M.G.G. lacked the
confidence in herself and was timid to speak up more during post conference. Strategies to continued growth would include building her self-
confidence in the decisions she makes in her clinical practice and not doubt herself. M.G.G. should utilise all the resources around her, including the
nurses and clinical instructor to build her confidence.
Student's References
Jarvis, C., Browne, A. J., MacDonald-Jenkins, J., Luctkar-Flude, M., & Camera, I. M. (2014). Physical examination & health assessment (Second
Canadian ed.). Toronto, ON, Canada: Elsevier Canada.
Mosby's Nursing Videos
Potter, P. A., & Kerr, J. C. (2014). Canadian fundamentals of nursing (5th ed.). Toronto: Elsevier Mosby Canada.
Practical Nursing, Diploma program, 2016-2017, Student handbook
Grade Satisfactory Unsatisfactory
Referred to Clinical Excellence Committee (CEC)
Program Coordinator Feedback

The Program Coordinator has reviewed the evaluation Yes No
Student Sign Off

I met with my Clinical Teacher/Preceptor and discussed my evaluation Yes No
In general this evaluation accurately reflects my performance Yes No

Nurs208 K4y

Caricato da

Informazioni sul documento

Titolo originale

Copyright

Formati disponibili

Condividi questo documento

Condividi o incorpora il documento

Opzioni di condivisione

Hai trovato utile questo documento?

Questo contenuto è inappropriato?

Copyright:

Formati disponibili

Nurs208 K4y

Caricato da

Copyright:

Formati disponibili

Self Assessment

2016 - 2016 - Final NURS - 208 Course Learning Outcomes (201509)

Abilities and Outcomes / Learning Outcomes Student Rating Teacher Rating

my primary nurse and most of all my client.

plan of care for my client.

understand how to use their call bell.

unacceptable and/or unprofessional behavior.

at least milk to prevent hypoglycemia as well as the instance of choking.

2. ACCURATE AND RELEVANT COMMUNICATION

status board as I am having two clients every shift.

groupmates who will be covering for my clients while I'm on break.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

3. CARING RELATIONAL PRACTICE

health care team members.

that we are assigned to two clients this clinical practice.

influencing their choices and decisions.

plus he's using the proper footwear.

Teacher comments for CARING RELATIONAL PRACTICE :

4. LEADERSHIP AND ADVOCACY

professional health care team.

any fluid restrictions that I should be aware of.

it's lowest position to decrease the incidence of fall in my clients.

Teacher comments for LEADERSHIP AND ADVOCACY :

individualized plan of care to meet my client's needs.

competently in writing and orally.

think a nursing care should be provided to them.

to the goal of using Lasix.

in a manner that demonstrates knowledge and skill.

bath or changing bed linens.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

needs and expected outcomes of clients.

the nursing practice that I have performed to my assigned client.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

feedback into practice.

my CNO Quality Assurance.

integrate these into practice.

knowledge about medication.

etc., that will be relevant to my patient's plan of care.

affect nursing practice.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

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

client's hands and be able to read her O2 Sat.

provide safe and competent care.

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

Teacher Final Summary with Strategies for Continued Growth

Grade Satisfactory Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

Program Coordinator Feedback

Student Sign Off

In general this evaluation accurately reflects my performance Yes No

Potrebbero piacerti anche