Self Assessment

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

NUR 208 Practical Nursing Practice 4 (PN, 06-Sep-2016 - 09-Dec-2016)
Student : Kriz Lee Velasco
Clinical Teacher/Preceptor : Grace Jose
Program Coordinator : Judy Martin
Location : Halton Healthcare/Oakville Trafalgar Memorial Hospital
Placement Setting : Agency
Unit/Office/Clinic : 5C Nephrology
Period : 06-Sep-2016 To 09-Dec-2016
Student hours : 196
Required Hours : 196
Validated hours : 172
Teacher comment for validated hours:
12 hours missed for Thanksgiving holiday.
12 hours missed due to illness.

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.

K.L.V. : I have continued to comply with the school's as well as the hospital's regulation and policy. I attended all my clinical days in full uniform per

regulations and have followed Halton Hospital's policies and procedures in providing care for the patients. I continue to follow the IPAC method in

preventing the spread of infection by following the four point rule of hand hygiene as well as cleaning the hospital equipments after each use. I

continue to comply by the 8 rights of medication administration while providing care for my clients in order to avoid medication errors.

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

K.L.V. : I have respected each and every individual in my clinical setting by listening to other people's opinions and avoiding any conflicts with my

colleagues as well as the hospital team. I have demonstrated to be a great team member while working with the inter professional team.i offered my

help to all of my peers when they needed it and have acted in a responsible, accountable and ethical manner. i followed through all the instructions

given to me and acted accordingly in order to provide the best care for my client in a safe environment for me as well as others around me.

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

K.L.V. : I have considered the three frameworks of decision making into consideration all through my care for my clients. I have included the nurse,

the client, and the environment into considerations when making decisions for my clients care. I ensure the safety of my client before doing any

procedures such as assessments or hygiene, while also making sure that I will be working in a safe environment which would provide the least

probability of incidents to occur.

Satisfactory Satisfactory
1. 4 Use evidence informed practice and a theory-based approach to care.
K.L.V. : I enforce the theory-based skills I have learned and practiced in my time in school in providing the best care for my client. I ensure a

therapeutic nurse-client relationship in my clinical by following the guidelines provided by the CNO regulations. By respecting my client and being

attentive to their needs as well as providing privacy and following the four points of hygiene, I followed a theory-based approach to care during

clinicals.

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

safe environment.

K.L.V. : I ensure that my clients bed are at its lowest possible position in order to lower the risk for falls, as well as keeping their call bells where my

client can reach them I am carrying out safety-based practices and risk management principles. Having a good hand hygiene skill, following the four

points of hand hygiene also is an example of carrying out safety/risk measures in order to prevent the spread of infection and to continue to work in a

safe environment. I ask for assistance from my colleagues when I am unsure of a procedure and if I needed help in order to provide the safest

environment for me and for my client.

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

K.L.V. : I make sure to attend the every shift report in order for me to learn about my client's condition from previous nurses as well as to clarify any

questions I may have in order to provide the best care for my client that day. I ask for help and ask questions when I am unsure of a procedure or a

medication that needs to be given. I make use of my colleagues, my clinical teacher as well as my charge nurse as a resource when I have things that

needs to be clarified.

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

unacceptable and/or unprofessional behavior.

K.L.V. : Before any shift I make sure to do my research in order to familiarize myself with my client's situation and their needs of care. When I come

across something I'm uncertain of, I know to ask the staff, my instructor, or to check the computer to help clarify and help me understand things better.

I make sure to communicate with my head nurse when it comes to following the plan of care for my clients in order to avoid any incidents where I am

uncertain of what to do.

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

K.L.V. : As a student nurse I try to apply the academic learning provided in school in my clinical setting in order to demonstrate an understanding of

the role of the nurse within health care. I work as part of the care team at all times by ensuring that I report to my clinical teacher and my charge nurse

findings I have of my client. I ensure that my responsibilities are being met such as assessing the client, providing daily routine care and administering

my medications.

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

Student consistently demonstrated accountability in nursing practice. Student was able to consistently demonstrate preparedness for
practice, assumed responsibility for learning, and actively participated in learning. Weeks 9- 14: Student was able to care for 2 clients
independently; medication administration (teacher supervising), morning routine, ADL needs, and documentation.

2. ACCURATE AND RELEVANT COMMUNICATION

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

K.L.V. : I participate in our end of the shift meetings by sharing my thoughts and discussing them as a group. I answer questions thats asked of me

and am able to discuss my clients conditions accordingly and how I ensured safety for my client and how I provided care during my day.
 Satisfactory Satisfactory
2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic methods.

K.L.V. : I document clearly and accurately informations that I gather as I assess my client. I manage my time wisely in order to get my

documentations that needs to be done during the day in order to not forget any valuable information I may have encountered during my shift and to

keep the other health care members to provide the best care they can appropriately.I document my medication administrations, vital signs, and daily

care routine clearly, accurately, and concisely on meditech.

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

K.L.V. : I am able to communicate with my head nurse and peers about information I have gathered throughout the day that involves the care plan for

my client. I always report to my nurse my vital sign findings in order to ensure no complications with my client as I continue through the day with their

medications and plan of care. I ask questions when I am uncertain of something in order to prevent incidents that are out of my scope of capabilities. I

make sure to report any abnormal readings such as low/high BP, pulse, respiration, pain level, and low oxygen saturation in order to come up with the

most appropriate care for my clients condition..

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

K.L.V. : I communicate with my client and the inter-professional health care team in order to provide the best care for client. I make sure to be in the

room and showing respect when an inter-professional health care team is talking to my clients , this allows me to know what is going on with my client

not only in the nurses perspective but also in other aspects such as their food intake, their mobility status as well as procedures such as their dialysis

or rehabilitation.

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

(PHIPA).

K.L.V. : I comply by the privacy and confidentiality regulation according to PHIPA by respecting my clients personal matters and keeping information

to myself and the health care team providing care for my client. I do not enclose information to other people who do not need to know my clients

condition or information. I do not share my client information with other people outside the health care team who do not have the authorization to

know.

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

K.L.V. : I am comfortable accessing vital information regarding my client on the computer in order to provide the best care for them. I research my

clients information on my own before the start of my shift in order to help me come up with my care plan, such as my clients past lab results, baseline

vital signs, medications, mobility status, code and diet, in order to gain information and data regarding my client.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Student communicated clearly, concisely, and correctly in the written, spoken, and visual forms that met the needs of the clients. Also,
student responded to relevant information in a manner that ensured effective communication.

3. CARING RELATIONAL PRACTICE

Satisfactory Satisfactory
3. 1 Use effective communication techniques.

K.L.V. : I develop a therapeutic relationship with my client through communicating with them in a respectful manner. In order to provide the best care

for my client I have to build a trustworthy relationship for them to fully be comfortable with me as their caregiver. I also show respect to my client's

family when interacting with them in order for them to trust me with their loved ones.
 Satisfactory Satisfactory
3. 2 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and

health care team members.

K.L.V. : I pay close attention to my clients culture and provide my care accordingly, I ask how they prefer to do things and how they would like to be

taken care of as a show of respect for them. I keep my opinions to myself and I do not act according to my perspective on things and how I think

things should be done, I ensure to involve my client and their family in my care plan. I do not enforce my ways of thinking without consulting with other

members of the health care team to provide the most effective care for my client.

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

K.L.V. : I reflect on my actions and my ideals and compare with my clients cultural background in order to keep a balanced way of thinking and not a

biased one. I respect my clients preferences in order to foster client well-being, I make sure to ask for permission before doing a procedure and

explaining myself in order to create a mutual understanding between me and my client. Also considering that touch is a sensitive matter for some

cultures I ensure that I have my client's permission and that they are comfortable and I have provided privacy before resuming my responsibilities.

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

relational practice.

K.L.V. : Acknowledging the various differences between one culture and another changes how a person should act in order to build a therapeutic

relationship. In order to implement the most effective care for a client, the emotional and spiritual aspect should also be taken into regard and not only

their physical diagnostic. We can't treat patients by looking at them as a disease we need to be able to incorporate everything about them and treat

them as a whole to provide the best care. Putting my own preferences and beliefs aside allows me to see and think in my clients perspective

regarding their plan in achieving their well-being.

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

appropriately.

K.L.V. : I interact with my head nurse in order to provide an effective care plan for my client regarding their medications or their daily hygiene as well

as assessment results.I make sure that i collaborate with the inter-professional team in order to complete the interventions and goals my client needs

before discharge.For example, I had a client who weren't happy with their new meal plan, therefore we had a meeting with their dietitian to implement

a new meal plan which would work for the doctor's recommendation as well as incorporating the clients preferences. I also collaborate with the

physiotherapist in order to keep my clients moving to help with their recovery. I interact with the physicians regarding my clients situation and asking

for recommendations that may be appropriate with my client.

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

K.L.V. : I ensure to keep a good communication between my client and the inter-professional team in order to give the best care. For example, I act

as a communicator between my client and another health care team in order to rely information they need to help with the plan of care. If my client

needs to start ambulating I ensure to have contacted PT to help with the plans of moving the patient to a chair or walking with them through the day.

Also providing the best diet for my client in order for them to receive the appropriate nutrition they need to get better, a consult with the dietician needs

to be addressed in order to make the plan of care effective.

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

influencing their choices and decisions.

K.L.V. : I keep my clients' cultural, religious and other beliefs incorporated in my plan of care by asking them their preferences and ensuring that it is

followed as much as possible into the care plan. I do not implement my own belief when caring for my client because I am well aware that in order to

provide the most effective care i need to include my client in every decision made for their care and to achieve their well-being in the most effective

way.

Satisfactory Satisfactory
3. 8 Provide effective client education.

K.L.V. : By implementing our care of plan, I am able to explain to my client certain procedures and reasons as to why we need to do them. I

encourage my clients to try to do as much activities as they can in order to improve their conditions. For example, starting with simple things such as

doing a daily routine like feeding themselves, or brushing their teeth on their own allows for them to gain a sense of independent which may help with

their well-being. Being able to explain how walking will help them feel better, and why certain medications needs to be taken and allowing to expand

their knowledge of their own condition in order to effectively implement the care plan also allows for them to be more cooperative if they know the

rationale behind everything we make them do.

Teacher comments for CARING RELATIONAL PRACTICE :

Student was able to establish sound relationships with peers, staff, clients, and teacher. Student consistently utilized well developed
communication and interpersonal skills.

4. LEADERSHIP AND ADVOCACY

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

K.L.V. : Being able to develop a therapeutic client-nurse relationship I am able to apply appropriate conflict resolution by listening to my clients

concerns and doing the best of my ability to compromise and give what they need. I have learned the proper strategies in conflict resolution, such as

removing myself away from the situation and keeping a calm atmosphere if possible therefore I can come up with the most effective solution regarding

a conflict.

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

environment.

K.L.V. : I am able to suggest solutions to problems my client may have to my charge nurse and my clinical teacher which demonstrates my ability to

lead and develop solutions and create a positive work environment. I have learned and polished my new skills such as documenting, head to toe

assessment, doing bed bath, as well as administering medications on my own. Having this knowledge I am able to help with my peers when they

need a hand in our hospital setting.

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

professional health care team.

K.L.V. : I acknowledge my peers evaluation of me and work on the skills mentioned in order to better myself. We as a team encourage each other in

our clinical setting and help one another if needed therefore we see and observe how each one works in the hospital setting. Having the opportunity to

learn and give constructive criticism to one another helps all of us grow and improve on our nursing skills.

Satisfactory Satisfactory
4. 4 Advocate for clients, self, others, and quality practice environment.
K.L.V. : By having a good relationship with everyone in the health care team, I am able to advocate for clients, self and others. By giving my respect

to others opinion and not degrading anyone I can easily talk to nay member of my health care team and my peers which allows for a quality practice

environment, where every member of the team is able to express their ideas without the feeling of being judged or being wrong. By communicating

with my nurses I am able to implement the best care for my client regarding results I may find as an abnormal finding such as a high/low BP and with

holding medications accordingly. Implementing non pharmacological strategies to help relieve a patients pain such as re-positioning or giving them

more pillows for comfort or allowing them to get some rest if they need to by doing my tasks quicker yet still accurately.

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

K.L.V. : I allow my clients to do as much activity as they can on their own in order to help them gain independence and to help with their well-being. I

encourage my client when they would like to try to do something instead of me doing it for them,I respect their choices and preferences and do not try

to enforce my own decisions into caring for my client.According to their own capabilities I allow them to feed them self as well as perform their morning

hygiene with assistance if they are capable of doing so. During medication administration or performing procedures I always tell my client what I am

about to do and why I need to do them in order to give them the choice to either refuse or to let me proceed.

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

K.L.V. : I respond appropriate to unsafe, unacceptable and unprofessional behaviour by remaining calm during the situation. Reporting to my teacher

and charge nurse right away regarding the situation, I do not instigate the other person involved with the situation and instead I would take myself out

of the situation as soon as possible in order to avoid any further complications.

Satisfactory Satisfactory
4. 7 Collaborate and consult when implementing health care and nursing practices that are in the

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

K.L.V. : I often consult with my peers regarding procedures I am unsure of, if I really am not confident with something I ask my nurse or my instructor

for clarification and assurance in order to avoid harming myself and my client in doing a procedure I do not know. I am well aware of my capabilities

with providing a safe environment for my client therefore I also am aware when I have issues with a procedure or a situation. I do not act rashly and

always consult and collaborate with my colleagues when implementing the plan of care.

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

K.L.V. : I report unsafe situations to the charge nurse/clinical teacher in order to get it evaluated and corrected. I contribute to quality practice by

following the hospitals protocols in giving the safest and best care for my clients. I keep my client safe swell as myself when providing care, and I

consider possible unwanted outcomes when doing a procedure in order to come up with ideas or plans to avoid them when they occur.

Teacher comments for LEADERSHIP AND ADVOCACY :

Student was able to demonstrate leadership skills related to peer interactions. Student Consistently demonstrated
professional nursing behaviour.

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

Satisfactory Satisfactory
5. 1 Incorporate the clients unique needs and expected outcomes into holistic and client-centred

plans of

care.
K.L.V. : When giving care to a client we must care for them as a whole and not just their diagnosis. We have to consider other aspects to why the

client is in the condition they're in by assessing their emotional status and their environment prior to their diagnosis. In gaining knowledge of the

clients background we as health care providers are able to widen the scope of our knowledge and come up with a more accurate plan that will

promote well-being as well as to prevent future recurrence of their condition. Taking the client's cultural differences and preferences into

considerations when implementing our care of plan will provide the client security as we continue with our care.

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

competently in writing and orally.

K.L.V. : Being able to develop concept care maps for my clients allows me to develop a theory-based care plan that is holistic and client centered

that I can easily write but also explain in person. With the information I can gather through my research about my client and their conditions I can

come up with interventions that goes pass beyond their diagnosis to help with their condition such as incorporating interventions about their emotional

status or inability to cope or current struggles with changes in lifestyle. Being able to come up with a plan of care that goes pass beyond their

diagnosis that will help with their situation such as considering their emotional status or inability to cope with their current condition is an example of a

holistic and client centered care.

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

K.L.V. : With enough practice of making a concept care plan as well as doing assessments, I am now knowledgeable enough to know how to

prioritize my clients needs. I have to focus on what needs to be focused on in order to avoid further complications and what intervention would give

me the best result regarding my clients condition. For example, when caring for a patient who is vomiting but also is complaining of pain we must

prioritize assessing the reason why they have been vomiting rather than focusing on their pain because when the vomiting is fixed it might also relieve

the clients pain.

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

K.L.V. : Taking vital signs and pointing out abnormalities and doing a head to toe assessment on the client all contributes to the evaluation and

refinement of plans of care. When taking vitals we have to make sure that blood pressure is within normal range, or if taking anti-hypertensives we

have to make sure that the blood pressure isn't too low in order to avoid hypo-tension. When giving laxatives we have to be aware of the clients bowel

movement in order to be able to reassess the dosage or the type of medication to be administered or when it should be stopped. Also with diabetic

patients when administering insulin a blood glucose reading must be implemented in order to provide the appropriate dosage to promote health and

not harm the client.

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

in a manner that demonstrates knowledge and skill.

K.L.V. : Doing my research before implementing my plan of care and gaining knowledge about my client allows me to provide a safe and competent

care in my clinical setting. Being able to acknowledge the difference between a normal and an adverse result of an assessment allows me to

implement the appropriate intervention that demonstrates my knowledge and skills. Being able to re-assess and re evaluate the client's condition

when needed to in order to know what care should be implemented is a necessary skill needed in my scope of practice. Being aware of what is

expected of me, and what knowledge and skills I am supposed to have allows me to be safe and competent in my work place.

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

K.L.V. : When caring for the client one must consider the clients situation the environment you're in and also your safety. When doing assessments

or procedures we must include the client's preferences on how to do things accordingly and not just do it as I know or have learned, one must explain

the procedure and ask the client what way would make him most comfortable through it and to make sure to provide privacy and ensure safety.
 Satisfactory Satisfactory
5. 7 Prioritize nursing care and nursing interventions in order to manage workload, time, and physical

resources.

K.L.V. : Being able to keep track of my time during the morning as its the first contact I have with my client, I must be able to assess the situation as I

first see it and to provide care accordingly. I must complete a full head-to-toe assessment in order to come up with a plan of how I should prioritize my

care, I must finish my vital sign before the morning medications and also figure out when to provide their morning hygiene routine. With the use of a

daily planner I am able to go by my day smoothly and effectively.

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

Student practiced within the ethical guidelines of the care facility, expectations of Humber College, and the CNO.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

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

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

K.L.V. : Being prepared for the worst outcome when researching for a clients diagnosis, i am able to come up with a care plan of my own according

to the knowledge I have learned in school and in our clinical setting. With pain being most of our clients concern in the hospital setting, and with my

knowledge of pain medications I am able to come up with an appropriate plan to help relieve their needs by consulting and agreeing with other

members of the health care team that it is the best solution in order to achieve the expected outcome. For example, with pain being the most common

concern in the hospital setting, and with the knowledge i have of both pharmaceutical and non-pharmaceutical interventions I can consult and come to

an agreement with another peer before implementing my idea which would provide the most successful result for the client.

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.

K.L.V. : I have cooperatively contributed as a member of the health care team especially with caring for my clients according tot heir changing needs

and expected outcomes. With the knowledge and skills that I have, I am able to act appropriately with implementing interventions that will solve an

unexpected situation, for example if an IV therapy was mistakenly administered, I have the knowledge to calculate and adjust the rate in order to

correct the pervious mistake. I implement my plan of care according to the clients changing needs by consulting with my nurse about my plans before

implementing them.

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

K.L.V. : I ask for help and consultation when I am unsure of a procedure or what to do, I do not act on my own when an unexpected situation arises

in order to keep myself and my client safe. I am able to know my own capabilities therefore I make use of my resources such as my peers and

colleagues in order to help me provide a safe and effective care. For example, I make sure to ask for assistance when I make my client get out of bed,

I do not assume that I am able to do it on my own, I would need to consult with the physiotherapist in order to know how to handle the client and what

would be the most appropriate action when moving my client.

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

outcomes.

K.L.V. : I work with a team every time I am in the clinical setting, we help each other out as a health care team. In order to be effective in the hospital

setting, one must know how to cooperate and be appreciative of the help you get from your peers and clients family members. One must be willing to

provide help when someone else needs it in order for others to be willing to lend a hand when I need the help.
 Satisfactory Satisfactory
6. 5 Use effective, collaborative, and consultative strategies to meet clients needs within a changing

environment.

K.L.V. : By allowing the client to gain knowledge about their condition or diagnosis helps them understand why certain changes needs to be

implemented in their life style. Helping them to come up with a plan for an easier transition to a new lifestyle by listening to their preferences will make

implementing it much easier and more effective. Consulting with the family or community support and asking for help will make the change more

achievable also will help the client to fulfill the plan in a better and safer environment.

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

K.L.V. : Each week of the clinical setting I was able to interact with different members of the health care team, I respect each of them by allowing

them to do their own responsibilities and not interrupting and making decisions for them. Each member has their own roles and competencies

therefore we must relay our trust for each other because we all have the same goal which is the achieve our client's well-being.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Student developed strong relationships both with peers, hospital staff, teacher, and clients. Student utilized effective interpersonal skills
and therapeutic communication.

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.

K.L.V. : I ask questions regarding my clients condition when an inter-professional health care team member visits their room. I stay and talk to them

in order to gain knowledge on different aspects of how they're taking part in taking care of my client such as rehabilitation, nutrition and procedures

such as dialysis. I collaborate with my colleagues by asking for assistance, in order to prevent an unsafe environment for myself and my client as well

as to provide the best care for the patient.

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

feedback into practice.

K.L.V. : I reflect on my actions throughout the day in order to improve my skills and knowledge. I identify my strengths and weaknesses as a way of

self reflection in order for me to know which skills I need to practice and improve in order to become a better health care provider. With the help of my

peers and instructors feedback I am able to come up with plans on how I can improve my skills as well as how to implement each skill in the hospital

setting more effectively and efficiently. By acknowledging my weaknesses it is allowing me to grow and help gain motivation to be better for the future.

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

(CNO).

K.L.V. : Through practice and research I am working on improving my skills as a nurse in order to be consistent with the quality assurance of CNO. I

make use of the learning plans we create throughout the school year in order to come up with plans as to how I can help myself improve and achieve

my goals. As the semester went by I have gained confidence and improved more on my nursing skills by following learning plans that I have created

in order to help me achieve what I intended to achieve. I am now more confident with documenting accurately and in a timely manner, taking vital

signs has become easier and a more polished skill as well as doing a head to toe assessment, administering medications is also a skill that I have

improved a lot on through practice and implementing my learning plans.

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

integrate these into practice.

K.L.V. : I utilize my instructors feed back and use each time we talk as a learning opportunity in order to improve my nursing capabilities. I ask

questions when I come across something I am unsure of in order to effectively provide the best care for my clients. I practice and refresh my memory

by watching videos on how to do certain procedures in order to build confidence as well as gain more knowledge.I keep in mind feedbacks i get from

my peers as well as my clinical teacher, I continue to work on the skills i need to improve on in order to provide the best care for my client. I practice

new skills and incorporate my colleagues feedback into my practice in order to expand my knowledge and skills.

Satisfactory Satisfactory
7. 5 Use nursing research to foster professional development.

K.L.V. : I am capable of accessing my client's file on the computers in order to research the information I need throughout the day in providing my

care. I use my resources such as peer reviewed or textbooks in order to help me clarify information I may need help with, I make sure to use my time

to do research in order to keep myself up to date with the professional development in nursing care. I can easily retrieve information that I need from

the electronic medical records, MAR, KARDEX and patient charts as well as medicine books which are all available in our unit to help me improve my

nursing practice and assist and reassure me with procedures I am expected to do.

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

K.L.V. : Knowing the rational behind procedures and medications is a skill all health care providers should acquire. It is important to know the

meaning behind why we do things the way we do in a hospital setting as a student nurse. Our goal is to provide the best care for our clients therefore

we should be aware of the reason why we perform procedures and also be fully aware of how to act when unexpected situations occur. Performing

theory-based procedures such as hand hygiene allows me to not only protect my client but also myself from acquiring any infection from our work

setting. Being familiar with medications allows me to enforce the theory behind how each medications work and why my clients are taking them, also

following the 8 rights of medications prevents myself from making any medical error that may harm my client.

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

affect nursing practice.

K.L.V. : I have gone through the training needed in order for me to fully gain the skill to use new technologies provided in the clinical setting in

providing care for the clients. For example, the use of the computer with documenting and accessing a clients file, I have gain the knowledge of being

able to retrieve information i need throughout my day, also gaining the knowledge and skill i needed in using the medication administration process

with the new technology provided at hand.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Student consistently sought knowledge and provided evidence based rational for decisions. Student was able to use acquired knowledge
and apply it to practice. Student increased ability to organize and prioritize related to client care.

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

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

care.

K.L.V. : With the knowledge I have learned and practiced all through my first hand second year of nursing school I am able to comprehend different

situations and come up with a plan on how to tackle them effectively. I am able to come up with a solution when I come across situations that may be

problematic. For example, when a client refuses to take their medication I know how to try to encourage them and inform them why they would need

to take them rather than going straight to my head nurse and making them responsible for solving a simple problem. I encourage independence for

my client in order to help them with their wellness and to help them gain their confidence with doing things on their own.
 Satisfactory Satisfactory
8. 2 Use critical thinking, problem-solving and decision-making skills to assess clients and to

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

K.L.V. : I am now more comfortable with making a concept plan in order to provide the best care for my client. Being well informed with how different

diagnosis affects patients, I know which aspects of my clients situation needs to be prioritized in order to provide the most effective care. For example,

for my client who had a very limited mobility I had to make sure to re-position and them every couple hours in order to keep their skin intact, I also

make sure to clean them up in order to avoid long exposure to moisture which also helps to prevent skin breakdown.

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

improve

these.

K.L.V. : I have been able to react on my feet during unexpected situations and incorporated the knowledge that I have of the client into the decisions

that must be made during the process of plan of care and was able to come up with the most effective solution to a problem. I have reflected on areas

I needed to improve and practiced skills that worked best for me and did not in order to come up with a plan on how to better myself the next time I

attend the clinical setting. I practice skills that needs improvements such as administering SC injections and taking manual blood pressure in order to

perform better while caring for my clients.

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

provide safe and competent care.

K.L.V. : Being aware of my clients capabilities I am able to provide a safe and competent care by not forcing myself beyond my limits, I often ask for

assistance when doing procedures I know I can't do alone. Using appropriate restraints only if needed in order to reserve my clients dignity and not to

make them feel incapable of doing things on their own, this also helps build a therapeutic relationship by allowing the trust between us grow by

reassuring them that I am capable of taking good care of them.

Satisfactory Satisfactory
8. 5 Prioritize effectively.

K.L.V. : As the weeks went by in our clinical setting, I have learned how to plan my day according to the priority of what my client needs most in their

plan of care. Working with clients from different age groups, checking their vitals and doing proper assessments gave me enough information as to

what to prioritize with my care. As most of our client had weakness or pain of some sort which caused some immobility, skin integrity and pain

management were mostly my priority. Administering medications on time in order to follow the doctors regimen and also to control pain, if needed,

was a strategic skill I needed to develop in order to provide the best care for my client. Knowing to re position and turn my client every 2 hours, as well

as to encourage ambulation was also a priority in terms of client care in order to promote more independence.

Satisfactory Satisfactory
8. 6 Demonstrate professionalism and accountability.

K.L.V. : I have learned how to mange my time wisely and effectively therefore I am now capable of keeping a more professional and accountable

stature in our clinical setting. I know how to take responsibility for my actions and I also know how to improve on skills I need to improve on. I take my

instructors comments as a learning experience in order to better myself as a health care provider and to continue to demonstrate professionalism and

accountability as a member of the hospital staff.

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

guide practice.

K.L.V. : I incorporate the 3 aspects of decision-making as I do my care plan, I focus on the clients well-being and consider factors to keep them safe

also while thinking about my safety. I decide based on the plan of care and my clients preferences in order to achieve the clients well-being in the

most effective way.

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

Student successfully cared for 2 clients for several weeks. Student was able to apply analytical, interpersonal, and technical skills to
implement a safe effective plan of care.

Student Final Summary with Strategies for Continued Growth

I have demonstrated adequate skills during our clinical (days), however I will continue to develop and improve my critical thinking skills, my
communication skills as well as to practice my medication administration techniques in order to avoid medication errors. I will continue to practice my
assessments in order to continue to attain accurate information regarding my patient's conditions during my hours of practice.

Teacher Final Summary with Strategies for Continued Growth

Congratulations in finishing your clinical! You did a great job in meeting your objectives and presenting yourself in a professional manner. I suggest
you continue to focus on your documentation, communication, critical thinking, and nursing skills. All of these take time but, the more you are
prepared and exposed to different situations you will become proficient in these areas. Good Luck for next semester!

You have outstanding work from HESI with Sandra Cop. Therefore, I need to refer you to CEC. Grace

Student's References

CNO Guidelines, Humber College's Clinical Setting Policy and Regulation, Oakville Trafalgar Memorial Hospital (Halton Hospital)'s contract policy

Grade Satisfactory Unsatisfactory

Submitted Date: 17-Dec-2016 12:08