Nurs 3020h Final Evaluation

NURS 3020H Clinical Evaluation Final Evaluation Student Name: Marissa Brown Clinical Instructor: Marco Fontanos Missed Clinical Hours: ______

Missed Lab Hours: ______

Final Grade (circle): (S=Satisfactory; U=Unsatisfactory) Clinical component S U Lab component S U Simulation component S U

Program Goals Graduates are generalists entering a self-regulating profession in situations of health and illness. Graduates are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a variety of settings. Graduates continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their practice. Graduates will demonstrate leadership in professional nursing practice in diverse health care contexts. Graduates will contribute to a culture of safety by demonstrating safety in their own practice, and by identifying, and mitigating risk for patients and other health care providers Graduates will establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based upon relational boundaries and respect. Graduates will be able to enact advocacy in their work based on the philosophy of social justice. Graduates will effectively utilize communications and informational technologies to improve client outcomes. Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidenceinformed interventions and outcome measures.

Progress Indicators/Evidence

Objectives 1

Prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed interventions and outcome measures.

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2

Establishes and maintains therapeutic, caring and culturally safe relationships through effective communication.

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3

Applies the four ways of knowing and informational technologies to effectively care for diverse, acutely ill patients.

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Changed a nephrostomy appliance. This included cleaning and measuring the stoma. Continued to gain more experience with simple and complex dressing changes. This includes reading doctor’s orders, using sterile or clean technique, measuring the wound and charting about the wound and its drainage. Flushed, reconnected and restarted an NG tube on low intermittent suction. Got the opportunity to watch a patient perform tracheostomy care as well as learn about the challenges with having a tracheostomy. Crushed medications to mix with applesauce to administer to a patient with difficulty swallowing. Continued to use therapeutic communication to interact with patients especially those who are hard of hearing or are confused. Using active listening skills in order to fully understand the situations and wholistic aspects for my patients in order to give them the care they need. Taking a genuine interest in the lives of my patients and being there for them if they need it throughout their healing and letting them know repeatedly that if they need anything to not hesitate to ask me even if they think they are distracting me from my other work or patients. I used my empirical way of knowledge to understand lab values and blood glucose readings in order to give medications and understand the patient’s health history and present condition. I use my personal way of knowing to evaluate situations throughout the semester that have happened and reflect of them for further development (ie. Living with a tracheostomy for the

Satisfactory

Unsatisfactory

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4

Adheres to professional practice standards and organizational polices to contribute to a culture of safety.

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5

Exercises leadership to enhance patient care, and support professionalism in practice.

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rest of your life) I used the esthetic way of knowing when changing dressings because sometimes you have to be creative in order to keep a dressing in place or a certain technique for maintaining sterility. I used the ethical way of knowing when faced with a situation where a patient really wanted to get home but was unable to because there was no safe plan of care in place for them at home yet. Throughout the semester, I have made sure my instructor was present when completing certain skills that I was not as confident in in order for me to complete them safely. This includes, flushing an NG tube and dressing changes. Continued to arrive on time in clean professional uniform. Spoke professionally when addressing the staff on the unit including nurses, doctors, patients, families etc. Continued to practice donning and doffing PPE when needed. Specifically, when giving a hazardous med or emptying a catheter bag of a patient who was receiving chemotherapy. Continued to support and assist my peers throughout the shift by offering help and guidance as well as assisting with transfers, baths and dressing changes. Continued to ask questions to the nurses as well as my instructor when I am unsure about a procedure of if a patient is in need of something that I need assistance with. Asking questions about lab values that are abnormal and other procedures and tests to further enhance my learning within the placement.

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

Signature of Instructor_______________________________________________

Date _____________________________

Signature of Student_________________________________________________

Date ______________________________

Attendance Thurs

Fri

Week 1 Week 2 Week 3 Week 4 Week 5

Thurs

Fri

Week 6 Week 7 Week 8 Week 9 Week 10

Total number of clinical hours completed_____________

Clinical Component

Satisfactory Unsatisfactory (Please circle the appropriate outcome)

Clinical Learning Center

Completed

Not completed

Signature of Instructor_________________________________

Date_______________________________

Signature of Student___________________________________

Date________________________________

Student Areas of Strength 1. I believe that I can successfully manage my time when assigned to 2 patients on a shift including assessments, charting and meds when it was my turn. 2. I believe that I have successfully demonstrated my skills pertaining to dressing changes and sterile fields. 3. I believe a strength I have is that I am not afraid to ask questions not only to my instructor but the other nurses so that I can fully understand and learn the most I can

Student Areas for Future Development 1. I believe I can further develop my patient teaching skills and sounding more confident. I can do this by making sure I understand to the fullest degree what I am explaining and directing questions to those who know more. 2. I can further develop my confidence when assisting with ambulating patients for the first time in a shift. I can do this by asking or reading in the chart how well the patient ambulates. 3. I can continue to develop my skills pertaining to thinking ahead and gathering all the supplies that I think I might need for a dressing change as well as when I have a patient in isolation. This can help me manage my time better because I am going in and out of the room less.

Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment) Professional Responsibility and Accountability –  Marissa had performed very well throughout the semester. She had shown growth in her professionalism and her accountability in all the nursing care she does. She displays initiative to provide nursing care. She has shown confidence in certain nursing skills such as simple wound care, her head to toe assessments as well. She ensures that the care she provides is safe. She also had been able to critically think and have an inquiring mind. Prior to asking questions, she first does her own research and tries to understand the information and discusses with the instructor afterwards. For example, inquiring what interventions if any, need to be done for a patient with abnormal hemoglobin. She had also shown her eagerness to learn or witness new experiences such as a patient performing his own tracheostomy care. She had been able to perform different nursing skills with little assistance. She first assesses the situation and thinks of the next action she needs to do and confirms it with the instructor. For example, when addressing a leaking nephrostomy with a packing dressing in very close proximity to the side, she was able to problem solve with minimal assistance and had successfully changed the dressing and at the same time protected the peristomal skin by applying a clear film barrier around. She had also successfully changed a newly operated foot wound dressing. She provides patient centered care and most importantly involves the patient in his/her care. Applies nursing knowledge that is relevant to patients health conditions (ie, vascular surgeries, GI surgeries). Therapeutic Relationships  Marissa has been able to develop therapeutic relationships with her clients on a daily basis. She has continued to be respectful of her patients and addresses them based on how they would like to be (ie, by first name). She has also maintained her professional boundary and ensures that her “contract” with the patient ends at the end of her clinical shift. She had shown her capacity to provide timely nursing care by being able to manager her time/workload. She’d also been accountable for her own work and knows when she needs to ask for assistance especially when faced with a nursing skill that she is not familiar with. Safety  Ensures that she provides a safe environment for the patient. Nursing care is delivered in a safe manner. She minimizes the risk of any harm to the patient in her actions such as ensuring that the bed is in the lowest possible position, assess pain and need to void, and by ensuring that the patient’s personal belongings are within reach. She also ensures that when doing nursing skills such as wound care, that she does so by following aseptic technique. She also performs proper hand hygiene at each of the 4 moments of hand hygiene. When administering medications, she ensures that she does her checks and follows the 10 rights of med administration, as well as have a good understanding of the medications and its actions.  She ensures patient privacy is respected by not mentioning patient’s name when in the hallways. Leadership

 Has proven that she is capable of being a leader in many ways. For example, she had shown her ability to supervise other peers in performing skills that she is very competent in such as discontinuing an intravenous, a simple wound dressing change. She has also shown that she is able to be a team-player by allowing herself to be open to criticism and opens herself to new learning. She has been approachable and pleasant as reported by the staff nurse and at times, her patients. Overall Throughout the semester, Marissa had performed exceptionally well. She had met the expectations of the clinical instructor and of the school. Marissa has shown that she is very passionate with nursing and it is reflected in her practice. Although she is still a student nurse, she has shown that she is capable of working in an acute setting and is able to adapt to rapid changing conditions. She will be a great asset in any field that she works in. I also believe she has a very bright future in nursing and whatever she sets her mind to. Given the opportunity, if ever, she would be a great student to take on for consolidation.