Self Assessment

2016 - 2016 - NURS 151 Practical Nursing Practice 2 Final (201508)

NURS 151 Practical Nursing Practice 2 (PN, 12-Jan-2016 - 07-May-2016)
Student : Jagrutiben Patel
Clinical Teacher/Preceptor : Zaynab Panchbhaya
Program Coordinator : Wendy Chow
Location : William Osler Health Centre/Brampton Civic Hospital
Placement Setting : Agency
Unit/Office/Clinic : N3 ACE
Period : 12-Jan-2016 To 07-May-2016
Student hours : 156
Required Hours : 168
Validated hours : 156
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.

J.P. : I always make sure that I follow the hospitals rules and regulations and always perform a safe practice. I make sure that I am always in a

proper uniform ( with hairs properly tied up, no jewelry, and puncture proof white shoes), perform hand hygiene before and after entering a patients

room, and perform appropriate nursing skills within the scope of my practice.

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

J.P. : I act in a responsible, ethical and an accountable manner by arriving on time during my clinical, looking up the assigned patient sign to see if

there are any new procedure done that I am not aware of, giving medications on time in an appropriate manner, taking the vital signs two times during

the shift, doing a complete head to toe assessment and making sure to document it in the medi tech. I always show respect to my peers, my clinical

teacher, nursing staffs and the patient. And if I am given any task I make sure to complete it in a proper manner and on time.

Satisfactory Satisfactory
1. 3 Determine strengths and limitations and when to consult and seek assistance from other

professionals.

J.P. : I always make sure that i know my strengths, weaknesses, and limitations of my nursing practice and when to consult and seek help from other

staffs in the clinical. Like when feeding my patient through G-Tube, I was not sure how to it as it was my first experience, so i seeked help from my

clinical teacher, who showed me the proper procedure to perform a G-tube feeding. Sometimes while giving bed bath to an obese patient, it is hard to

turn the patient, so i seek help from my peer to turn the patient, perform a good peri care and also to get the patient dressed.

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

J.P. : Every week when I get my patient assignment, I do a detailed research of the medical diagnosis by going through the textbooks that is on

evolve. Like, when i had to give a subcutaneous injection i went through the evolve online videos to know the correct procedure to do so. If i find any

topic not described properly in evolve then i go through peer reviewed journal and articles from online Humber library. this way i brush my knowledge

properly before going to the clinical through a theory based approach.

 Satisfactory Satisfactory
1. 5 Ensure client safety and a safe environment.

J.P. : Clients safety is my first priority. After entering a patients room i make sure that the bed is in the possible lowered position, call bell and the

phone is within reach, all the necessary items are placed on the table and the table is near the patient bed, and i also make make that the floor is

clean and no table or chairs or any other furniture is in the way of the way when the patient gets out of the bed to have a walk outside the room or to

go to the washroom. Before leaving the room i do everything mentioned above and also ask the patient, who needs assistance, if they want to go the

washroom, so that i can assist them.

Satisfactory Satisfactory
1. 6 Ask relevant questions to clarify understanding of the plan of care and whenever uncertain.

J.P. : Whenever I am uncertain of any nursing practice, I make sure to clarify it by asking relevant questions to my clinical teacher, my peers and

nursing staff assigned to that patient so that I am able to provide a proper care without any mistake. Like after auscultating for bowel sound i was

unsure how to describe the sound while documenting it in the meditech. So i asked my clinical teacher and she told me document it as hyperactive

sound.

Satisfactory Satisfactory
1. 7 Identify ethical and unsafe situations and seek appropriate assistance to resolve these.

J.P. : Whenever i encounter any situation that is unsafe for my patient and myself i make sure that i seek appropriate assistance at that moment. Like

while giving bed bath to one of my patient with a severe Parkinson disease, I seeked help from one of my peers because the patient was having a lot

of tremors and turning the patient on either sides for cleaning the back and doing pericare was hard for a single person.

Satisfactory Satisfactory
1. 8 Demonstrate understanding about the role of the student nurse.

J.P. : As a student nurse i make sure that i follow the hospitals policy and rules and regulations in my nursing practice. After taking the vital sign and

doing a complete head to toe assessment i make sure to give the data to my primary nurse and keep her updated with the condition of the patient.

Whenever I am not sure with any thing related to the patient i make sure to ask the primary nurse.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :

Jagruti was present and prompt for all clinical dates. Jagruti ensured she complied by the guidelines stated in the handbook. She was
prompt, in uniform and prepared to the best of her abilities. Jagruti submitted assignments in a timely manner and completed K4Y on time.
Jagruti took responsibility for her own actions and asked questions accordingly. She understands her role and responsibility as a student
nurse with respect to practice limitations, documentation and reporting. When able, Jagruti used theory to guide her learning. She ensured
a save environment for her patients by ensuring the bed was always in the lowest position, call bell was within reach and the patient had
their belongings within reach. When Jagruti provided care she used evidence-based researched to provide the care (i.e. following the rights
and routes of medication administration, changing dressings, etc).

2. ACCURATE AND RELEVANT COMMUNICATION

Satisfactory Satisfactory
2. 1 Participate in team sharing and discussions.

J.P. : During the clinical whenever I am off the unit, I help my peer by answering questions regarding documenting in the meditech or sometimes help

them in bathing their patient. I actively take part in the post conference that take place at the end of the clinical with my clinical teacher and my peers

and discuss any concerns and experiences that I had through out the day.

Satisfactory Satisfactory
2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic methods.
J.P. : I am pretty confident in the area of documenting now. As soon as i take my vital signs I document it instantly in the meditech not waiting to do

so at the end. Now I am able to properly manage my time for doing the assessments, giving a bedbath and giving the medications on time. Before I

was not pretty aware of the areas to focus during doing my assessment but now being familiar with the meditech system, I am able to do head to toe

assessment concisely in a timely manner.

Satisfactory Satisfactory
2. 3 Report relevant information to the appropriate personnel.

J.P. : I always report the relevant information to my primary nurse and clinical teacher. Like while taking the vital signs, the oxygen saturation of my

patient was 85%. I immediately informed the finding to my primary nurse and then she did put my patient on 2L oxygen via nasal prong. After 5min the

Oxygen saturation was normal. Even when i take a vital signs of my patient in the afetrnoon i make sure to provide the data to the afternoon shift

primary nurse so that she is aware of the readings.

Satisfactory Satisfactory
2. 4 Utilize communication techniques with the client and inter-professional health care team.

J.P. : I always make sure that I am constantly communicating with my patient, the primary nurse and my clinical teacher. Everytime I take vital signs i

make sure that I am communicating with my primary nurse to provide her with the readings and letting her know that I would be documenting the

readings in the meditech. Even while taking the vital signs, giving the medications and while giving bathe i go on communicating with my patient so

that they are aware of what I am doing and make sure to explain everything before doing it so that if they have any concerns hey tell me.

Satisfactory Satisfactory
2. 5 Maintain privacy and confidentiality according to the Personal Health Information Protection Act

(PHIPA)

J.P. : I always make sure to maintain privacy while drawing the curtains while doing any procedure. I ensure that that the patients records are in the

patient file. I never look upon any other patients details other then my patients to maintain privacy. Even i make sure that i don't discuss the findings of

my patients with any of my peers or any person out the hospital. Even if the patients discusses any personal information with me about his/her life i

make sure to keep the information to myself.

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

J.P. : I always use technology to do a detailed research on my patient's medical diagnosis before coming to the clinical. Like, I read the Jarvis, Potter

and Perry, and medical and surgical textbook to make myself more knowledgeable about my patients condition. Even I go though some online journal

and articles if i feel that the textbooks are not enough.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Jagruti has done a greatl job at communication throughout this clinical. Jagruti worked well with others and actively participated in group
discussions, sharing her experiences and thoughts. She understands the importance of communication and documentation. She
documents accurately and thoroughly, with minimal assistance. She communicates well with staff and patients, demonstrating a great
amount of patience when the patient does not understand. Jagruti ensures all of her findings, particularly things out of norm (i.e. vital
signs, blood work results, patients current attitude, etc) is documented and shared with the appropriate persons. She is cognizant of her
surroundings and the importance of maintaining patient privacy and confidentiality (i.e. not sharing information about patients in front of
other, discussing patients in the elevators or hallways). She used technology to find research to support her care and research
medications.

3. CARING RELATIONAL PRACTICE

Satisfactory Satisfactory
3. 1 Utilize effective communication techniques.

J.P. : I always use verbal and non-verbal communication technique and always make sure to ask open or close ended question depending on the

condition of the patient. The details of the proper communication technique i have learnt from the Potter and Perry textbook and from my clinical

teacher.
 Satisfactory Satisfactory
3. 2 Demonstrate therapeutic caring, compassionate, and culturally safe relationships with clients

and health care team members.

J.P. : I always make sure to maintain a therapeutic caring, compassionate, and culturally safe relationships with clients and the health care team

members. With health care team members i always make sure to communicate properly with them and share any concerns that i have about the

patient or vice - versa. Like my patient wanted to have the cereal with milk in between the breakfast and lunch but forgot to keep the bowl aside. So

she asked me if i can get a bowl for her. I asked the nurse but she had no idea from where I can get a bowl. Luckily i saw the lady who serves the

meal, so i asked her about getting a bowl. She gave me an extension number and told me to call and tell the anyone who picks the phone to provide

bowl to the patient, and makes sure to mention the name and the room number of the patient. the process was fast and my patient got the bowl in half

an hour.

Satisfactory Satisfactory
3. 3 Apply knowledge of therapeutic use of self and identify its effect on client well-being.

J.P. : I always make sure that i apply knowledge of therapeutic use of self and identify its effect on client well-being. Like while taking care of the

patient i always go on communicating with the patient to know more about the patient, like if something is bothering them which we are not aware of. If

they report any concerns i make sure to look upon it and discuss it my primary nurse, so that i am able to take a good care of my patient.

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

relational practice.

J.P. : I make sure that i keep aside my beliefs, values and feelings while taking take care of my patient. Proper communication with the patient will

help us to know our patients values and beliefs and will make us aware of how we should act and talk with our patients.

Satisfactory Satisfactory
3. 5 Interact with clients and members of the inter-professional health care team; and, consult

appropriately.

J.P. : I always make sure that I am interacting with clients and members of the inter-professional health care team and consulting with them

appropriately. Like while i entered the room of my patient for giving the afternoon medication, I found my patients wife and son were present there. So

while giving the medication kept on communicating with the patient and the family members by letting them know about the medications, like why is

he on it. Is this way I was involving the family members in the care of the patient too.

Satisfactory Satisfactory
3. 6 Apply knowledge of practices and systems that support the diversity of clients and the inter-

professional health care team.

J.P. : i always make sure to apply my knowledge of nursing practice while taking care of my patient. If any of my patient is going back to the

retirement home, i make sure that they get all the possible care they should be getting. Like i make sure that the primary nurse informs the

physiotherapist or the occupational therapist to visit the patient in the retirement home and take care of them.

Satisfactory Satisfactory
3. 7 Apply knowledge of clients cultural, religious, and other beliefs and values as these influence

clients choices and decisions.

J.P. : Whenever i start taking care of my patient i make sure that that i communicate with them so that i get to know about their cultural background,

beliefs and values so that i am able to provide a good care to my patient.

Satisfactory Satisfactory
3. 8 Provide effective client education.
J.P. : I always make sure that while i am taking care of my patient i am providing every bit details that i should be providing. Like while taking the vital

signs i let them know about their blood pressure and temperature reading. While giving medications i make sure I let my patient know about why they

are having that medication. Even before performing head to toe assessment I inform them and take their consent. Consent is needed because the

patients have the right to refuse and the right to ask about anything that's happening to them.

Teacher comments for CARING RELATIONAL PRACTICE :

Jagruti has been a caring professional. She has always respected the culture of others and has an appreciation of how that can effect ones
choice. When providing care Jagruti is aware of her own values and beliefs and makes sure they do not interfere with the care she is
providing. As she had the opportunity to work with patients with different cultural backgrounds, experiencing difference diagnosis, Jagruti
was able to appreciate how difference patients required different methods of care. For example: An aphasic patient who was still able to
communicate using physical signs, or a patient who was only able to communicate with her eyes, etc. She treated every patient with
respect, despite the level of care they required (independent versus total care). In addition, she provided effective patient education during
feeding, medications and their diagnosis.

4. LEADERSHIP AND ADVOCACY

Satisfactory Satisfactory
4. 1 Recognize conflicts and strategies for resolution.

J.P. : While taking care of my patient i always think critically before proceeding with any thing and try to find a resolution. Like, one of my patient was

scheduled for getting lactulose for constipation in the afternoon medication. But my primary nurse decided not to give it to her and hold it for few

hours. As soon as she said that I went through the patients medication and found a medication whose side effect was constipation. Immediately i went

to my clinical teacher and informed her about this. She talked to my primary nurse and made her realise that she is not doing right thing. After that my

primary nurse gave me the lactulose from the pyxis and then i gave that to my patient.

Satisfactory Satisfactory
4. 2 Demonstrate leadership skills that foster group work and a positive learning environment.

J.P. : Whenever i find that any of my peer need help, whether that be in documenting the vitals signs or assisting in bed bath. I always make sure that

I am always available to my peers as a helping hand. Like one of my patient had communication problem with the patient so she was not able to

understand what the patient replied when she asked the patient if she wants a bath on the bed or shower. So my peer seeked my help. So i became a

translator for my peer and the patient. and also helped my peer in giving the patient a complete bath in the wash room.

Once one of my peer needed my help in boosting her patient up in the bed as the patient was total. So i happily helped my peer.

Satisfactory Satisfactory
4. 3 Identify opportunities to improve health care service and nursing interventions by advocating for

client, self, others, and quality practice.

J.P. : I always make sure to analyse the areas that needs improvement for nursing intervention in order to advocate for my client and myself

whenever necessary. For example, one of my patient who was pretty independent but was on diaper, complained that at night no one changed her

diaper at night and because of that she was not able to sleep properly. So before leaving i made sure i informed the afternoon shift primary nurse to

change the patients diaper after dinner so that she is able to get a good sleep.

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

professional health care team.

J.P. : I have received feedback from my peers from the peer assessment that we did in the clinical at the end of the shift. Even i receive weekly

feedback from my clinical teacher that helps me to know that in which area in the clinical practice as a student nurse i need improvement. Weekly

evaluation also helps me to know my strengths and weakness.

Satisfactory Satisfactory
4. 5 Support clients rights for self-determination and choice.
J.P. : I always make sure that i always support the clients right for self determination and choice. Like one of my patient wanted to sit up on the chair

after every meal. So i made sure i did so and before leaving i made sure that i informed the primary nurse of the afternoon shift about it. Even the

patient wanted me to change the bed sheet and the floor as she was complaining that no one cleaned the floor. I informed the cleaning staff to clean

the floor and changed the bedsheets.

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

J.P. : So far I have not encountered with any situation that was unsafe but definitely came across a situation that was totally unacceptable and

unprofessional from my point of view. For example, I overheard some nurses talking about their patients, like why do they get the same patients, why

they have a hard patient and the other nurse has got an easy going patient. This kind of conversation was totally unprofessional and as a nurse we

should always respect our patients the way they are.

Satisfactory Satisfactory
4. 7 Consult and collaborate when carrying out health care and nursing practices that are in the best

interests of the public and protect the public through collaboration and consultation.

J.P. : I will make sure to collaborate with my peers, my clinical teacher and the primary nurse I work on the unit on the day of my clinical so that i am

able to provide the best nursing care to the patient I am assigned. Along with my peers and my clinical teacher, I was present for an infection control

in service where a detailed information on the importance of hand hygiene and PPE's was given.

Teacher comments for LEADERSHIP AND ADVOCACY :

Jagruti has demonstrated great leadership skills. She advocates for clients when she feels she needs too (i.e. with medications, nutrition,
ambulation, hygiene, etc). Jagruti supports the choices a client makes when she is positive they have enough information to make an
informed decision. When caring for patients who require close contact (i.e. helping with peri-care, have a strong cough), Jagruti protects
herself, others in the organization and the public by ensuring she wears gloves, wears a mask, and completes hand hygiene appropriately.
Jagruti is always supportive of her peers. She provides assistance when they require it, without being told too. Jagruti also provides
feedback to others in a non-judgemental way. She accepts feedback graciously, and attempts to make changes to her practice accordingly.

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

Satisfactory Satisfactory
5. 1 Incorporate the unique needs and expected outcomes into individual clients plans of care.

J.P. : Each week when I get my patient assignment, I make the care plan with proper nursing intervention that I can follow and expected outcomes.

After going to the clinical I go through my patients progress notes which helps me to prioritize my interventions. While taking care of the patient i

always make sure to follow my care plan and make changes whenever needed.

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

competently in writing and orally.

J.P. : Whenever I get my patient assignment I make sure that i go through Jarvis, Potter and Perry, and medical and surgical textbook and read the

topics related to my patients medical diagnosis, which will help me to take a better care of my patient by making a good care plan for them. After going

to the clinical i make sure to discuss the care plan with my clinical teacher so that if there is any mistake then she could correct me right away.

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

J.P. : i always make sure to use knowledge, skill and judgment to assess clients, prioritize needs and outcomes. I make sure to use my knowledge

gained from my classroom training, textbook, and my clinical teacher while performing my nursing skill on my patients. Like one of my patient was on

BP medication but in the morning when i took the vitals the BP was high. So monitoring the BP after every 3 hrs was my priority at that moment. So

before and after giving the BP medication i made sure i took the BP reading, so that i was able to know whether the medication was able to bring back

the patient BP to normal.

 Satisfactory Satisfactory
5. 4 Provide information that contributes to the evaluation and refinement of plans of care.

J.P. : I make sure that i take the vitals and do a proper assessment of my patients in an organised manner. I also make sure that i have proper

interventions to carry out on my patients. But suppose if the condition of the patient changes i make sure that i critically think and come up with new

interventions and outcome goals and discuss it with the primary nurse and my clinical teacher.

Satisfactory Satisfactory
5. 5 Safely and competently carry out nursing assessments and nursing interventions that are theory-

based and within skill abilities.

J.P. : After getting the patient assignment i make sure to do a detailed research on my patients medical diagnosis and come up with a good care

plan. I also prioritize the assessment based on my patients medical diagnosis and past medical history. I do so by going through the textbook, that is,

Jarvis, Potter and Perry, Medical and Surgical and some notes from the 1st semester NURS 101 course regarding safety of the patient.

Satisfactory Satisfactory
5. 6 Carry out nursing care that reflects the practice decision-making framework.

J.P. : I always prioritize my nursing care for my patient. This helps me to properly manage my time for all the stuffs that have to do. Like in the

morning i take my patients vital signs and while doing do i do the pain assessment and the neurological assessment and then chart it immediately.

Then after breakfast i wash them in a away depending on the condition of the patient. I do a skin assessment while giving a bathe and after dressing

the patient i do the respiratory and the cardiovascular assess

Satisfactory Satisfactory
5. 7 Complete nursing care responsibilities and nursing interventions in an organized and timely

manner.

J.P. : I always prioritize my nursing care for my patient. This helps me to properly manage my time for all the stuffs that have to do. Like in the

morning i take my patients vital signs and while doing do i do the pain assessment and the neurological assessment and then chart it immediately.

Then after breakfast i wash them in a away depending on the condition of the patient. I do a skin assessment while giving a bathe and after dressing

the patient i do the respiratory and the cardiovascular assessment. after the lunch i chart the ADL assessment.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :

Jagruti has worked exceptionally well at following a care plan and meeting the patients needs. Jagruti is aware that all patients are different
and they have different needs. She ensures her care is patient specific. She completes accurate and thorough head to toe assessments.
Her assessments are often specific to the patient and their clinical diagnosis. Jagruti is aware of her limitations as a student nurse and only
implements nursing interventions which she knows and understands how too. When there are any changes to the patient, she reports this
to the primary nurse or myself so the care plan can be changed accordingly. She has improved over the term in completing nursing
responsibilities and interventions in a time manner.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

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

determine health needs, and to achieve mutually agreed expected outcomes.

J.P. : After taking the vital signs i make sure that i provide the readings to my primary nurse. While doing the assessment if i find any abnormal

findings i make sure that i report it to my primary nurse and my clinical teacher. Like when I administered colace to one of my patient she had loose

bowel movement twice in an hour so the primary nurse decide to hold colace for a while and expected to see a normal bowel movement, if not then

she will notify the HCP.

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

needs and expected outcomes of clients.

J.P. : I always make sure that i contribute to the health care team and my patient. Like one of my patient decided to have the cereal, that she got

during breakfast, to have it in between the breakfast and lunch, but she had no bowl for it. the primary nurse had no idea from where to get the bowl.

So i asked the food service staff to help me out with it. so she gave me a number to call and give them the patients name, room number and the unit

name then they will bring a bowl for her. In this way i helped the patient with what she needed.

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

J.P. : i always make sure that i seek help from my peers or the nursing staff whenever i feel that one hand is not enough. Like i was giving bed bath

to a patient i had to be very careful in turning her as she had a severe back pain.So i seeked assistance of one of my peers to help me turn the patient

so that i was able to clean my patients back and give her a good peri care.

Satisfactory Satisfactory
6. 4 Use teamwork, consensus building, and conflict resolution skills.

J.P. : I always used teamwork, consensus building, and conflict resolution skills. I always make sure to seek help, if needed from my peers while

taking care of my patient and whenever my peers need my help i make sure that i help them. For example, one of my peer had problem

understanding what the patient was telling while my peer was giving the patient the med. Since i was able to understand the patient language, i talked

to the patient and then explained it to my peer about what the patient was saying. In this way we help each other in the unit.

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

changing environment.

J.P. : Before coming to the clinical i make sure to make a good and effective care plan for my patient. On the floor I make sure to go on

communicating with the primary nurse and my clinical instructor to make the strategies more effective for the client. For example, one of my patient

was getting a PRN rectal suppository medication for pain. When the patient got the first pain medication through rectal she was very uncomfortable

with it. So the next time when she was having pain she wanted to get some medication for pain but not rectally. But in the MAR the order was was

giving it rectally. So i talked to my primary nurse and clinical teacher like if it would be fine if i give the patient the pain medication through the G-tube

and then explained why I was saying so, the primary nurse agreed upon letting me give the medication through G-tube.

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

J.P. : As long as I am in the unit I make sure I keep on interacting with the nurses on the floor, especially my primary nurse so that i get to know my

patient very well and if there is something going on with my patient I am aware of it. I respect their role in the hospital. we had a pharmacy in service

and this helped us to their unique role in each unit and especially the unit i was working. along with my peers and myself we got to know the

communication technique of the nurse and the pharmacist and how important the role of pharmacist is in every unit.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Jagruti collaborated well with members of the healthcare team throughout the semester. She actively contributed as a member of the
healthcare team by caring out all nursing interventions within her limits. Jagruti has good team work skills. She worked will with her peers
and with other members. She goes above and beyond to assist other nurses with their patients as they required assistance. She has
knowledge of and appreciates the various members of the healthcare team. Although, she was not always able to collaborate directly with
them, Jagruti was able to discuss which members of the healthcare team she would consult in her patients care and why.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

Satisfactory Satisfactory
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.
J.P. : As soon as I step in and out my patient room safety is my first priority. Like I always perform hand hygiene before entering the patients room.

Make sure the bed is in the lowest position and the patient is in a comfortable position too. I always make sure that the call bell is within reach and is

working and will keep the table, with all the patients necessary items on it, beside the patients bed. i will make sure that the floor is clean and there are

no furniture or anything else in the way of the patient when they are going to the washroom by themselves. Even in an in service for infection control a

presentation was given to all my peers and myself too, where the importance of hygiene and how to stop the spread of infection through a proper

hygiene was taught.

Satisfactory Satisfactory
7. 2 Participate in self-reflection to identify strengths, areas for improvement.

J.P. : every week in knowledge for you, in which ever areas my clinical teacher grades me as needs development, i make sure to work hard on that

area so that i get satisfactory the next week in knowledge for you. If i get satisfactory in any area, then it makes me realize that, that's the area I am

strong at. In this way every week I am able to know my strenght and weakness.

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

(CNO).

J.P. : I make sure that i create, implement, and evaluate a learning plan consistent with the Quality Assurance program (CNO). Like through my

weekly evaluation i am able to know my strengths and weakness and this helps me to work on it and make an improvement in the area i need to. even

we did a peer feedback on the strengths and weakness.

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

integrate these into practice.

J.P. : I always make sure that I am able to learn something new everyday and if i get such an opportunity i don't miss it. For example, i watched one

of my peer give a subcutaneous injection and my clinical teacher was going on explaining the right procedure to do it. Two weeks later when I had a

patient to whom I had to give a Subcutaneous injection, i recalled the online video showing the proper procedure to give the subcutaneous injection on

evolve and recalled the explanation given by my clinical teacher and then gave the injection successfully without any hesitation.

Satisfactory Satisfactory
7. 5 Utilize nursing, health and other theory and literature to improve nursing practice.

J.P. : To improve my nursing practice i make sure i go through the texbooks, that is, Jarvis, Potter and Perry, Medical and Surgical and

pharmacology. Even i implement the proper bedside manner and proper communication skills that i had learned from NURS 101 from the first

semester. For example, in first semester, we were taught, that before entering the patients room to perform hand hygiene first, then draw the curtains

to provide privacy, introduce yourself, check the patients id band and tell them to state their name and date of birth, and explain what ever you are

going to do. So i make sure to always do the following above steps mentioned.

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

J.P. : To improve my nursing practice i make sure i go through the texbooks, that is, Jarvis, Potter and Perry, Medical and Surgical and

pharmacology. Even i go through some online peer reviewed journals and articles do do a detailed research on my patients medical diagnosis, so that

I am well prepared when I am on the unit and if there are any changes in the condition of the patients i am able to come up with new interventions

immediately. Textbooks and the online resources just provides us just all the information we need.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Throughout the term Jagruti has demonstrated ongoing competence. She participated in in-services and sought opportunities which came
up with her peers (i.e. administering medications via nebulizers, inserting and removing a foley catheter, watching complex wound care,
etc). Jagruti reflects well and honestly on her practice and progress both verbally and written. Her learning plan was accurate and she
honestly highlighted her areas of strengths and weaknesses. All of the care that Jagruti provided was supported by theory she had
previously acquired.

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

Satisfactory Satisfactory
8. 1 Utilize problem-solving skills to inform decision making in all aspects of nursing care.

J.P. : I always make sure that I utilize problem-solving skills to inform decision making in all aspects of nursing care. For example, while taking the

vital sign I noticed that the Blood pressure of the patient was too high. So I informed my primary nurse about the finding. She said that was normal for

the patient. in this way i came to know that sometimes that seems abnormal is normal for some one.

Satisfactory Satisfactory
8. 2 Use problem-solving and decision-making skills to assess clients and to determine nursing

diagnoses, expected outcomes, nursing interventions, and evaluative criteria.

J.P. : I always make sure that I used problem-solving and decision-making skills to assess clients and to determine nursing diagnoses, expected

outcomes, nursing interventions, and evaluative criteria. For example, while taking the vital sign I noticed that the oxygen saturation of my patient was

too low. So immediately i informed my primary nurse and then the primary nurse immediately did put nasal prong for 2L oxygen and i knew that i had

to monitor the oxygen saturation for two times after every 15 minutes after the patient was put on 2L oxygen. So i kept on monitoring for the oxygen

saturation and the breathing pattern of the patients through out the day and made sure to inform the nurse of the findings.

Satisfactory Satisfactory
8. 3 Use self-reflection to design a plan to improve problem-solving and decision-making skills.

J.P. : On the floor when ever I am corrected by my clinical teacher about any procedure i make sure that I don't make any mistake the next time. For

example while giving my first subcutaneous injection I was giving it at an angle of 90 degree but my clinical teacher told me that it should be 45

degree. So next time I made sure that the angle was correct. Even through the weekly evaluation on K4Y i am able to know my strength and

weaknesses and made sure to work more on my weaknesses. Like in the beginning i used to seek help from my clinical teacher to document in the

meditech and used to take a long time in doing it. But now I am pretty confident in it and do it in no time.

Satisfactory Satisfactory
8. 4 Utilize knowledge from variety of nursing, health, and other theory into nursing practice to

provide safe and competent care.

J.P. : I always make sure to refer to my textbooks from semester one and two to broaden my knowledge about the medical diagnosis of my patient. If

had to give puff, or an injection or feed through G-tube, then i made sure to watch the online videos that is on evolve to know the proper procedure.

Even i referred to the textbooks to make my care plan and also refereed to some online peer reviewed journals and articles to broaden my knowledge.

For the medication, mostly I went through the mosbys drug book but sometimes i also went through the pharmacology textbook to know about the

classification of the drug in detail.

Satisfactory Satisfactory
8. 5 Use prioritization strategies for client care.

J.P. : I always prioritize my duties when I am making the care plan for my patient. In this way it helps me to take a better care of my patient.

Sometimes the condition of the the patients changing while my on the floor, so at that i had to critically think and change my prioritization. Like one of

my patient had risk for falls so i made sure that i am instantly available for the patient when the patient rings the cal bell and also keep on checking on

the patient. But suddenly the patient had difficulty breathing so we had to put the patient on oxygen. So after that checking the oxygen saturation

frequently became my first priority.

Satisfactory Satisfactory
8. 6 Demonstrate professionalism and accountability.
J.P. : to demonstrate professionalism and accountability i make sure that i am in the unit on time and in a proper uniform. Then i make sure to take

report from the night shift nurse about my patient along with my primary nurse. I then let my primary nurse know what I can do and cant do as a

student nurse. Like i cant give insulin and IV medication. So i let the nurse know that so that she can do it if had to.

Satisfactory Satisfactory
8. 7 Recognize strengths and limitations and seek appropriate assistance and support.

J.P. : Every week through K4Y I am able to know my weaknesses and strengths. This helps me to work on my weaknesses. When I am on the floor I

make sure that I seek assistance from my peers and make sure to help them too when they need my help. Like i always seek help when needed

during giving a bed bath or while boosting up the patient.

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

Throughout the semester, Jagruti has been professional and demonstrated accountability for her own learning. Jagruti is aware of her
strengths and weaknesses. She asks for help when needed, and develops learning plans as she requires them. She has drawn on
knowledge acquired from other courses and previous life experiences. Jagruti ensures her practice is guided by theory, and demonstrates
professionalism when practicing as a student nurse. With every patient, Jagruti prioritizes their care (i.e. continuing a assessment versus
addressing pain). As Jagruti continues to practice, it is evident her confidence is increasing.

9. SIM number of hours

9. 1 SIM number of hours

J.P. : 6

Z.P. : 6

Teacher comments for SIM number of hours :

Student Final Summary with Strategies for Continued Growth

I am able to take the vital signs and to a total head to toe assessment and document the findings without any help. I am able to communicate with my
patients and their family members if present without feeling uncomfortable and i also maintain a good bedside manner. I have been able to gain
experience in many areas, like, i have watched one of my peer changing any osteomy bag, inserting a foley catheter, do a bladder scan, and me
myself had done a G-tube feeding successfully and also primed the feeding in the kangaroo machine in the presence of my clinical teacher. I also
successfully gave injections and puffs to my patients. I was also able to attend the infection control in service and the pharmacy in service and gained
a lot of information about hygiene and the role of pharmacy respectively. Before i was not able to find a connection between the medication and the
past medical history of the patients. but now i am able to do so and is very comfortable in giving the medications.

Teacher Final Summary with Strategies for Continued Growth

As the semester progressed Jagruti became a more competent and confident student nurse. She continued to adhere to the guidelines set by Humber
College and the practice facility. She demonstrated professionalism with her patients, her peers, and other staff. She competently completed head to
assessments and documented her findings into Meditech. She advocated for her patients and demonstrated leadership by supporting her peers.
Jagruti accepted feedback provided to her and made changes to her practice whenever she was able too. Jagruti administered medications through a
variety of routes (PO, SC injections, inhalation, nebulizers, and Peg-Tube). When administering medications, Jagruti was always prepared and was
usually able to make the connections between the medication and the patient's diagnosis and past medical history. To maintain her success, in the
upcoming semester, Jagruti needs to continue to practice her head to toe assessments skills. This will maintain her competence and help hone her
skills. She should explore other resources (i.e. peer-reviewed journals, videos, and text-books) to broaden her knowledge base, deepen her
understanding of concepts, and ensure her practice is evidence-based. Jagruti should maintain familiarity with the CNO practice standards to ensure
her practice is up to par. She should also ensure she seizes new opportunities and continue to challenge herself, as this will further increase her
confidence and competence enabling her to provide better patient care. Furthermore, it is important for Jagruti to engage in on-going self reflection to
recognize her strengths and weakness, and seek assistance accordingly. Lastly, Jagruti needs to ensure when administering medications it is critical
to understand why this patient is receiving this particular medication, and what the nurse should monitor pre and post (i.e lab work).

It has been a pleasure having Jagruti as a student nurse for this clinical rotation. I wish her the best of luck in the upcoming year.

**Was absent 12 hrs due to Good Friday**

Student's References

Potter and Perry textbook

Jarvis Health Assessment textbook
Pharmacology for the Canadian Health Care Practice textbook
Mosbys drug book
Nanda nursing list
NURS 101 and NURS 103 notes from first semester.

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