Multi Rater Competency Assessment

2015 - 2016 - NURS 253 Practical Nursing Pre-graduate Experience MRA Mid (201508)
NURS 253 Practical Nursing Pregraduate experience (PN, 18-Jan-2016 - 07-May-2016)
Student :
Clinical Teacher/Preceptor :
Advisor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Bose Lensi
Raquel Monaghan
Mary McGrory
Judy Martin
Deerwood Creek Care Community
Agency
No Unit
18-Jan-2016 To 07-May-2016
130
200
130

I declare that this is my original work and the sources used are acknowledged.

Abilities and Outcomes / Learning Outcomes

Student Rating

Teacher Rating

1. Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and procedures of the
practice setting.

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

Satisfactory

Satisfactory

procedures.
B.L. : My first duty in the long term care is to take the vital signs for selected patients and record and save in the MAR.

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

Satisfactory

Satisfactory

B.L. : Before giving medication to the patients I introduce myself and inform them that I am a student practical nurse and I inquire about their health
condition.

1. 3 Use the three factor and decision making frameworks to determine strengths and limitations and

Satisfactory

Satisfactory

when to collaborate and consult with other professionals.

B.L. : As a student nurse I never give medication without my preceptors supervision ( CNO practice guidelines: the client,nurse and environment)

1. 4 Integrate evidence-informed practice and a theory based approach into nursing care.

Satisfactory

Satisfactory

B.L. : While providing wound care I assess the patients skin condition such as length,depth and width of the wound. I further assess any irritation
around the wound or for any reddened area around the wound.I further record the significant findings (Potter and Perry P.853)

1. 5 Assess practices and risk management principles and take action to ensure safety of clients,

Satisfactory

Satisfactory

self, and others.

B.L. : Before taking the residents in the wheel chair I make sure that their hands and legs are safe and before leaving the patients in their room I
make sure that the wheel chairs are locked (Potter and Perry)

1. 6 Question and clarify unclear orders or directions and when uncertain.

Satisfactory

Satisfactory

B.L. : Before I give medication to the residents I familiarize myself with the patients medical diagnosis required. I clarify with my nurse and instructor
to explain any abbreviation that I am unfamiliar with.I ask my preceptor regarding certain medication such as metoprolol and why it should not be
administered to the residents under certain condition.Such as when the BP is below 100.

1. 7 Question, clarify or challenge questionable orders, decisions or actions by others.

Satisfactory

Satisfactory

B.L. : One of my resident was given two anti psychotic medication. He was sleeping all the day. I told my preceptor to refer to physician and stop one
of the medication or to lower the dose of medication. My preceptor accepted and referred the same to the doctor. He lowered the dose and asked us
to monitor a week.

1. 8 Respond in a professional manner to situations in which there is unsafe, unacceptable or

Satisfactory

Satisfactory

unprofessional behavior.
B.L. : One of my resident was sitting outside her room and drinking a cup of tea. Suddenly her cup fell in the floor and tea spilled all over.As it was
not safe for the resident. I cleaned up the place with the towel and dried it up..

1. 9 Demonstrate understanding about the role of the nurse within health care.

Satisfactory

Satisfactory

B.L. : I come to long term care wearing my uniform,white shoes and identification badge .

Teacher comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies
and procedures of the practice setting. :
Lensi follows our policies and procedures, such as locking med cart and blocking Mars screen when away from med cart.

Advisor comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and
procedures of the practice setting. :
Lensi is making steady progress and demonstrates a commitment to safe, competent and ethical practice. I encourage and seek clarification when
she is unsure or needs support at this setting.
She maintains a record of her clinical hours, keeps in contact with me and informs me of any changes or schedule update all of which demonstrate
her commitment to this clinical practice

2. Communicate using strategies and technology to effect accurate and timely information sharing including data, research, and other
information.

2. 1 Contribute to team sharing and discussions.

Satisfactory

Satisfactory

B.L. : We had a meeting in our facility. All the nurses and student nurses were involved. Everybody were given an opportunity to share their
experience. I shared my experience too. For example how my preceptor taught me too give medication to the complex and aggressive patient.

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

Satisfactory

Satisfactory

B.L. : Before I finish my clinical hours I make sure I documented vital signs, CSM ,care plan,progress note, Physical assessment and any other
important information.

2. 3 Use effective communication techniques when reporting relevant information and providing
feedback to the appropriate members of the interprofessional heath care team.

Satisfactory

Satisfactory

B.L. : Before our shift starts, the night nurse gives the report. I take note of all the relevant information and work accordingly. And when my shift ends
my preceptor asks me to provide report to the forthcoming nurse and I provide all the information. Such as any special care need to be given to any
patient or any blood work to be done.

2. 4 Evaluate and refine techniques used to communicate and share information with clients and the

Satisfactory

Satisfactory

Satisfactory

Satisfactory

interprofessional health care team.

B.L. : Before I start my clinical s I ask my preceptor questions about my assigned client.

2. 5 Ensure privacy and confidentiality.

B.L. : I never mention my residents medical diagnosis outside my clinical settings. I lock the medication cart soon after taking medication from the
medication cart. I always keep the chart and file closed after getting the requisite information.

2. 6 Use technology to retrieve information including research and other date and to obtain and

Satisfactory

Satisfactory

forward information both within and outside the practice setting.

B.L. : When ever I get time I check care plan, orders, UDA and alerts to learn more about my patients present condition and lab report, So I have a
better understanding of his condition.For example I was checking my patients lab report and I found his sodium,potassium and chloride (Lyte level)
was high I informed the nurse. she soon took his blood test and sent it to the lab for assessment.

Teacher comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Lensi has been involved in sharing changes in care plans via a number of methods such communication book, shift report, and system alert.

Advisor comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Lensi is making progress with the use of technology to communicate and document at this clinical setting. Her communication is developing well and
at this point progress is satisfactory.

3. Engage in relational practice that is caring, compassionate and respectful.

3. 1 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and

Satisfactory

Satisfactory

health care team members.

B.L. : One of my resident always cries when she is lonely. I approach her and ask her if she needs any help. She says according to her culture they
are never left alone. But here she feels lonely. I make sure that daily I spend at least few minutes with her.She feels happy and cared..

3. 2 Establish a caring environment that supports clients in meeting their needs and outcomes,

Satisfactory

Satisfactory

managing their illness, or experiencing a peaceful death.

B.L. : One of resident always feels lonely and cries. When I approach her she asks me to stay with her and not to leave her. I told hr to come outside
and mingle with other residents. So she will feel relaxed. She came outside and she asked me to stay with her. I accompanied her for few minutes.
When I visited her after sometime ,I saw she felt relaxed.

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

Satisfactory

Satisfactory

B.L. : I developed a good relationship with a resident who had parkinsons disease and he shared information about the tragedies in his personal life.
Later i noticed that he was relaxed and felt comfortable.

3. 4 Utilize relational knowledge and skills, and ethical principles to support clients and to interact

Satisfactory

Satisfactory

with health care providers.

B.L. : One of my resident in long term care had colostomy and she has arthritis too. Whenever I go to give her medication ,she refuses most of the
time. I asked her the reason and she recalled all her stories when she was young and she had no problem in walking. She cried . Later she was
relaxed.

3. 5 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on

Satisfactory

Satisfactory

relational practice.
B.L. : One of my uncle had low potassium level.Even though we gave medications for him.We provide him with the potassium rich diet. It helped my
uncle to regain his normal potassium level. One of the resident in long term care had the same problem, I told my preceptor , how we managed his
potassium level through diet. So, they included potassium rich food in his diet, like banana.

3. 6 Collaborate with clients, members of the interprofessional and health care teams; and, consult

Satisfactory

Satisfactory

appropriately.
B.L. : Before providing wound care I clarify with my preceptor regarding my residents condition. I also collaborate with my preceptor regarding my
wound care kit. I make sure that I carry all the necessary supplies with me. I consult with the preceptor regading the wound condition, whether it is
serous,purulent or serosanguineous.

3. 7 Uphold practices and systems that support the diversity of clients and of the interprofessional

Satisfactory

Satisfactory

health care team.

B.L. : I like to work with people from different diversities,this helps me to know more about them and provide their care efficiently.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

B.L. : One of my resident was suffering from productive cough. I educated her with the deep breathing exercises and taught her how to use a
spirometer.

Teacher comments for Engage in relational practice that is caring, compassionate and respectful. :
Lensi has developed a professional relationship with the residents assigned to her and is well liked within our team because she is respectful and
helpful.

Advisor comments for Engage in relational practice that is caring, compassionate and respectful. :
Satisfactory progress and based on my visit and feedback Lensi has developed the ability to connect with the clients, families and staff.

4. Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the profession.

4. 1 Evaluate and refine leadership skills to develop solutions, resolve conflict, create a positive work

Satisfactory

Satisfactory

environment and organizational culture, and to strengthen advocacy role.

B.L. : I had to do wound care for one of my resident. My classmate was on the other side of the facility, she had never had the chance of seeing this
procedure before. I called her and explained her the requisite technique and procedures to be followed for wound care.

4. 2 Provide feedback to peers and accept feedback from peers and members of the

Satisfactory

Satisfactory

interprofessional health care team.

B.L. : I usually finish care progress note with one or two sentence. My preceptor told me how to do a progress note. For example, if you didn't
administer a medication to a patient. First we have to write the fact, then proceed with the reason, like the medication was too big for the patient to
swallow and then what steps I need to correct it. For example I referred to the Doctor. I followed the same in my other progress notes.

4. 3 Advocate for clients, self, others, and quality practice environment.

Satisfactory

Satisfactory

B.L. : Whenever I provide care to resident I elevate the bed to waist level so that I wont injure my back and I can have a long nursing career. I also
make sure that my patients side rails are always up and intact to avoid fall risk. ( Potter and Perry)

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

Satisfactory

Satisfactory

B.L. : One of my client refused Euro-lac for bowel movement stating she was not feeling well that particular day. I respected her concern and I didn't
give that medication and documented in the MAR.

4. 5 Respond appropriately to unsafe, unacceptable, and unprofessional behaviors.

Satisfactory

Satisfactory

B.L. : I was updating my care plan, meanwhile one of my resident spill coffee in the floor. I wiped of the place with cloth and dried it off . So that no
other resident will be at risk for fall.

4. 6 Demonstrate public protection and acting in the interests of the public through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional health care teams.

B.L. : Before administering medications I collaborate with my instructor about the uses and side effects of the medications.For example, I ask my
preceptor that whether I could administer metoprolol to the patient if his B.P is below 100. My preceptor comes up with required solution.

4. 7 Contribute to the creation of quality practice strategies and solutions.

Satisfactory

Satisfactory

B.L. : One of my residents potassium level was low. So, she was prescribed for the potassium chloride.But, the medication was too big.All the time
she refuses to consume the medication.I suggested the preceptor to give capsule or liquid suspension. My preceptor agreed and referred the same to
the doctor. Next time we gave her the capsule.

4. 8 Assign, supervise, teach as appropriate, and provide feedback to unregulated care providers

Satisfactory

Satisfactory

(UCPs) in collaboration with the interprofessional health care team.

B.L. : One of the PSW working with me used to feed the residents without showing any interest and if they refused she use to wind up all the food. I
talked to my nurse. We called her asked if she was feeling good. Further we told her to feed the residents by talking to them. Also, by asking them
their choice of food. We asked her to have a pleasant face while feeding them.

Teacher comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :
Lensi was able to identified a resident with new swallowing problems, advocate for this resident, and developed a plan of care to maintain safety.

Advisor comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :

Lensi is making steady and satisfactory progress. I encourage her to seek out opportunities to advocate for her clients, participate in discharge
planning, communicate with the team, join and participate in patient rounds, communicate with support staff and food services to ensure patients are
receiving appropriate care. On my next visit I will discuss with how she can seek and find more opportunities to develop in all areas.

5. Integrate the nursing process into all aspects of nursing care and across diverse practice settings.

5. 1 Formulates clinical judgments that meet clients unique and changing health needs and priorities,

Satisfactory

Satisfactory

outcomes, and overall condition and incorporates these into evolving plans of care.
B.L. : One of my residents have constipation problem.We used to give her lactulose. She often tells me that she doesnt like the taste. So I gave the
same solution with resource ( nourishment health drink with vanilla flavour). She drank the whole content without leaving any residue.

5. 2 Devise evidence-informed plans of care that are holistic and client-centred.

Satisfactory

Satisfactory

B.L. : My priority is first taking the vital signs following up with respiratory assessment, abdominal assessment, CSM, assessing whether patient has
developed any pressure ulcers, rashes, bruises and whether there is any change in the colour and temperature of the skin. I further assess the
capillary refill and I document all this findings in the care of plan(Potter and Perry).

5. 3 Use clinical judgment to assess clients, prioritize needs, outcomes, and nursing interventions.

Satisfactory

Satisfactory

B.L. : One of my resident was suffering from pancreatitis.Usually his hydromorphone is due at 1400hrs. But he was suffering from pain. I told my
preceptor why dont we give the medication now, if he is experiencing pain. My preceptor agreed and she went and interviewed the resident. I
explained to him all the advantages and disadvantages. As well as I told him we cannot give any medication with another six hours. Then, we gave
him the hydromorphone. He got relief from his pain.

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

N\A

Satisfactory

B.L. : I give suggestions to my preceptor for modifying plan of care. But as a nursing student I am not allowed to modify plan of care.

5. 5 Safely and competently perform treatments and use techniques, and technology autonomously

Satisfactory

Satisfactory

and in collaboration with clients and members of the interprofessional health care team.
B.L. : One of my resident was suffering from Parkinson disease and Bipleural effusion.. After short time she started coughing rapidly and she said
that she was not able to breath.I raised the head of the bed and assessed the breath sounds and respiratory rates. I took her vital signs and
emphasized on the respiratory and oxygen saturation. I found that her oxygen level was 91. So I administered 2L s of oxygen as per doctors
order.Maximize respiratory effort with good posture and effective use with accessory muscles. When I checked her Oxygen level after 2hrs it was 96.
Encouraged patient to perform deep breathing exercises to promote wellness.

5. 6 Collaborate with the clients across the lifespan and with members of the interprofessional health

N\A

Satisfactory

care team to create a client centered plan of care that is articulated with competence both in writing
and orally.
B.L. : My preceptor ask me suggestions for creating a plan of care. As a second year student I am not allowed to create a plan of care.

5. 7 Use awareness of own knowledge and skills, the three factors of nurse, client and environment

Satisfactory

Satisfactory

and the practice decision-making framework to guide practice.

B.L. : As a student nurse I rely on the staff nurse who is experienced to give me guidance whenever I am not clear about a procedure. For example,
while performing colostomy or wound dressing.

5. 8 Manage workload, time, and physical resources to provide effective, efficient and ethical care.

Satisfactory

Satisfactory

B.L. : Before starting my shift. I prioritize my duties.I have to give medication to 35 residents. I first take the vital signs for all the residents. I note the
vital signs in the 24 hr book. Second, I start giving medication while they are having their breakfast or lunch. After, they finish their breakfast, I give
them their eye medication, puffers etc.Then I take them to their respective rooms.

Teacher comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
Lensi continues to develop care plans having in mind residents' history, care goals, preferences and dislikes, and target dates.

Advisor comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
I encourage Lensi to continue to work to improve her ability to assess clients, prioritize needs, outcomes, and provide appropriate nursing
interventions. Take time to review the resident care plans, suggest possible changes and learn from the process.
On a day to day basis review all nursing interventions, assess resident progress, implement changes if necessary and evaluate progress or actions.
Seek out any opportunities to inform/educate support staff, client or family as an aspect of this process. Satisfactory progress.

6. Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and holistic health care in a
complex and changing environment.

6. 1 Collaborate with clients to determine needs, mutually agreed health outcomes, approaches to

Satisfactory

Satisfactory

care, and to evaluate care.

B.L. : Most of the residents are affected by dementia and Alzheimer disease. Morning before we begin the shift our nurse, PSWs will develop a plan
of care for these patients and work accordingly.

6. 2 Contribute as a member of the interprofessional and health care teams to respond to changing

Satisfactory

Satisfactory

client needs and outcomes.

B.L. : One of resident is in anti psychotic medication. As the side effect of the medication , the resident is sleepy all the day. I told my preceptor. She
noticed too. We consulted the physicians. He asked us to lower the dose and to monitor.

6. 3 Consult with and seek out assistance from members of the interprofessional health care team.

Satisfactory

Satisfactory

B.L. : One of my resident had low blood pressure but his heart rate was normal. When i looked into his medication list I found that He had two
diuretics furosemide and spirolactone. He had also digoxin and metoprolol. I consulted the nurse and informed her that his B.P was low and his heart
rate was normal. Immediately the nurse put spironolactone on hold because it was potassium sparing diuretics.

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

Satisfactory

Satisfactory

expected client outcomes.

B.L. : One of my friends resident on other had in and out(catheter).She was very hesitant and resistive. My friend approached me stating that they
have to do the procedude for her. I approached her with my own language , I informed her about the importance of the procedure. Later, she agreed
to perform the procedure on her.

6. 5 Integrate effective, collaborative, and consultative strategies to meet clients needs within a
changing environment.

Satisfactory

Satisfactory

B.L. : We had to perform wound dressing for one of our resident every other day. For one week i saw there was no improvement in the wound.The
drainage was becoming worse. I told our preceptor to change existing wound dressing procedure. My preceptor agreed and referred to doctor. He
ordered for different procedure.

6. 6 Respect the unique role and competencies of all members of the interprofessional health care

Satisfactory

Satisfactory

team.
B.L. : In the morning after my preceptor assigns my residents .I get my patients details. I will inform my nurse regarding the plan of care I am about
to give to my patients. For example. I will inform them that iam going to take their vital signs, and inform them regarding the medications I am going to
administer to the patients.I will also inform them if any I am going to hold any medication.

6. 7 Collaborate as a member of the interprofessional health care team to respond to changes in

N\A

Satisfactory

nursing knowledge and practice and in the health care environment.

B.L. : N/A

Teacher comments for Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and
holistic health care in a complex and changing environment. :
Lensi have had the opportunity to work with our physician, dietitian, and physiotherapist by offering feedback on residents assigned to her.

Advisor comments for Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and
holistic health care in a complex and changing environment. :
Satisfactory progress - Lensi is learning to develop professional responses though effective collaboration with team members, residents and their
families.
With more clinical time Lensi can implement the nursing process into all aspects of client care, education and program planning to promote a holistic
environment for residents.

7. Engage in Quality Assurance consistent with the regulatory framework.

7. 1 Act in the best interests of clients and protect clients from harm through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional and health care teams and by through
competent and safe practice.
B.L. : Before giving medication to each client. I check several times in the MAR to see if it is the same patient and if all the meds are of the same
relevant resident. I even check the photo of the resident, whether it is same person. I show the medication to my preceptor and give them the
medication.

7. 2 Commit to Quality Assurance practice to identify strengths and areas for professional growth and

Satisfactory

Satisfactory

in accordance with the regulatory framework (CNO).

B.L. : During my last years clinicals I had difficulty giving insulin injections. I used to close the syringe after giving injections. My clinical teacher
explained me the consequences.Now, I use to give injection to my residents several times a day with ease. I adhere to all the safety procedures too
with care.

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

Satisfactory

Satisfactory

B.L. : I wrote in my last years learning plan that i had difficulty in documenting . Now as i am daily documenting .I find it very easy and I feel
comfortable documenting.

7. 4 Assume responsibility to seek out feedback for colleagues and peers and learning opportunities

Satisfactory

Satisfactory

that foster professional development.

B.L. : I had never seen colostomy procedure. One of my had colostomy and I observed the procedure performed by my preceptor. Now, I perform the
same procedure for my resident.

7. 5 Consistently review nursing research and information about health care to improve competence

Satisfactory

Satisfactory

and to support clients.

B.L. : Even though, I perform different procedures like wound care, colostomy, in and out. I still go home and view how these procedures are
performed and handled with care.

7. 6 Develop professional responses to health care system changes resulting from advances in

Needs
Development

Satisfactory

research, technology, and changes in societal and political forces.

B.L. : I am a student and I am learning these skills.

Teacher comments for Engage in Quality Assurance consistent with the regulatory framework. :
Lensi is involved in prevention of falls, prevention of pressure ulcers, prevention of weight loss and maintaining quality of life and dignity.

Advisor comments for Engage in Quality Assurance consistent with the regulatory framework. :
Lensi is learning to develop professional responses to the health care needs of the residents. She is aware of the professional requirements of the
CNO and she has completed this midterm evaluation. Lensi is participating in self evaluation which is an aspect of quality assurance. Through
leadership studies and discussion she is learning about the changes possible as a result of advances in research, technology, and changes in societal
and political forces.
Satisfactory progress in the various aspects - continue to reflect on practice.

8. Use critical thinking, problem solving and decision making skills to meet the health care needs and expected outcomes of clients.

8. 1 Use critical thinking to inform decision making in all aspects of nursing care.

Needs
Development

Satisfactory

B.L. : One of my resident was suffering from prolapse.He was also constipated. In his medication list I found docusate sodium and propylene glycol
to be administered.I told the nurse that both the medications are for stool softener. so it may lead to severe diarrhea which will end up in
dehydration.So why don't we give one medication and then see how he responds. Then continue with the second medication. The nurse said its o.k
we can administer both together. As a student nurse I think i need to further develop my skills and i am not allowed to take decisions.

8. 2 Use clinical judgment to assess and refine assessments in collaboration with the

Satisfactory

Satisfactory

interprofessional health care team, formulate nursing diagnoses, plan nursing interventions, and
outline evaluative criteria.
B.L. : Most of the residents in our long term care had respiratory problems.As usual, I checked her respiration ,pulse. She was normal. I checked her
oxygen level. I found it was 85. Soon , after consulting with my preceptor. I adminstered her oxygen 2L. I increased after every one hour. After four
hours, I found her oxygen level was 98.

8. 3 Evaluate and refine critical thinking, problem solving, and decision-making skills.

Satisfactory

Satisfactory

B.L. : I am learning new skills and I still need to develop.

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

Satisfactory

Satisfactory

provide safe and competent care.

B.L. : I had difficulty giving injections to patients. I went through various textbooks, journals,internet,you tube, to familiarize myself and to safely
handle the procedure. Now, I daily perform the procedure with care and caution.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

B.L. : Some my residents are prescribed for the metoprolol and toloxin. Before administering medication to them, I take their vital signs. If their BP is
below 90. I wont give metoprolol. Also if their apical pulse is below 60, I wont give them toloxin.

8. 6 Demonstrate professionalism, responsibility, and accountability.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

B.L. : I arrive to clinical s at right time,with my uniform ,identification badge and my white shoes always.

8. 7 Use critical thinking, the practice decision-making framework and the nurse-client-environment
framework to inform clinical judgments and practice.

B.L. : One of my resident is suffering from Parkinson disease. She came to me and said that she is having terrible shoulder pain. My preceptor was
in a meeting.I called the preceptor and asked her whether I could give the Tylenol. She informed me that I could give her Tylenol and document. I did
the same.

Teacher comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Lensi asks questions when in doubt and follows up problem solving decisions.

Advisor comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Satisfactory progress - with more clinical time Lensi will work to develop clinical judgment to assess and refine assessments. In collaboration with the
interprofessional health care team and her preceptor she is encouraged to formulate nursing diagnoses, plan nursing interventions, and follow up with
an evaluation process.
Keep up the good efforts.

Student Midway Summary with Strategies for Continued Growth

I am working in a long term care. I am assigned with the thirteen patients.My preceptor before the starting of the shift gives me full details about each
patient. So I gain full and accurate knowledge about the patients diagnosis, his medications. I have time to research on his medical diagnosis and to
give better every day. I enjoy working in the long term care.My preceptor is very cooperative and educative. She always gives me details about
medication, giving injection, she also asks me to do colostomy by myself. My preceptor allows me to perform wound care on patients. I have learned a
lot in my long term care facility. I come across different people with different ethical background.Now, I have gained knowledge about how to deal with
people from different background.

Teacher Midway Summary with Strategies for Continued Growth

Lensi is doing very well applying what she has learned at nursing school and following policies and procedures while being caring and compassionate.

Advisor Midway Summary with Strategies for Continued Growth

Lensi has made steady and satisfactory progress. I encourage her to continue to take the opportunity to practice and learn the nursing skills available
on this unit. Her preceptor has supervised her practice in this long term care facility and they work well together, this provides Lensi with an effective
learning experience. As Lensi moves forward I encourage her to participate in clinical rounds or team discussions, communicate with all of the
interdisciplinary health care team to develop professional communication and confidence.
She is managing her time well and on feedback and my visits she is gaining confidence and knowledge in this area of practice.
As you progress I encourage you to work independently and with less direct supervision. Review residents medical conditions, medications and plan
of care. Ask questions and engage with staff to advocate for the patient. Safe practice and positive patient outcomes are of utmost importance and
both you and your preceptor have this as your focus.
Keep up the good work.

Student's References
Potter and Perry, Fundamentals of nursing ( mosby Elsevier)

Refer to Clinical Excellence Committee (CEC)

Grade

Satisfactory

Grade

Needs Development

Satisfactory

Program Coordinator Feedback

The Program Coordinator has reviewed the evaluation

Yes

No

Student Sign Off

I met with my Clinical Teacher/Preceptor and discussed my evaluation

Yes

No

In general this evaluation accurately reflects my performance

Yes

No

Submitted Date: 29-Feb-2016 21:37

Unsatisfactory