Professional Documents
Culture Documents
Nurs 151 K4y Final
Nurs 151 K4y Final
Danna Gonzalez
Yeu Yin Hwang
John Stone
Sunnybrook Veterans Centre
Agency
K3E
27-Feb-2015 To 23-Apr-2015
168
168
156
Student Rating
Teacher Rating
1. COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK
1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies
Satisfactory
Satisfactory
and procedures.
D.G. : I have continued to comply with regulatory standards to the practice settings, such as keeping food and beverages only in the
dining room, as well as calling for a registered nurse to obtain narcotics for medication administration.
Satisfactory
Satisfactory
D.G. : I have practiced my responsibilities as a practical nursing student by acting in an ethical and accountable manner. I ensure that any
procedures I have any concerns about in terms of caring for my patients are clarified with my supervising nurse before actually providing
care.
1. 3 Determine strengths and limitations and when to consult and seek assistance from other
Satisfactory
Satisfactory
professionals.
D.G. : Throughout this clinical experience, I have been able to confidently approach my peers and other staff nurses to seek for assistance
in providing care for my patients. Most of the time I have been asking for assistance in providing bed baths to the patients whose weight I
was not able to safely bear on my own.
Satisfactory
Satisfactory
D.G. : I was able to use evidence informed practice and a theory-based approach to care by attending clinical shifts prepared. For example,
I researched the medications and diagnoses for the patients to abide by the rights to medication administration (Lilley et al, 2011, p.12). I
also look into the Kardex that lists the tasks and patient preferences so that I can provide care that is consistent with routine care.
Satisfactory
Satisfactory
D.G. : I have ensured the safety of client by ensuring that they are eating in the proper position to prevent aspiration or choking. At times
when one of my clients is agitated, I make sure that there are no objects nearby that can be used to harm himself and other health care
providers.
1. 6 Ask relevant questions to clarify understanding of the plan of care and whenever
Satisfactory
Satisfactory
uncertain.
D.G. : One of the ways I clarified my understanding of the plan of care for one of my patients was ask the supervising nurse how one of my
patients liked to eat their meals so that I can mix their medications safely and in the proper foods.
1. 7 Identify ethical and unsafe situations and seek appropriate assistance to resolve these.
Satisfactory
Satisfactory
D.G. : I was able to ask my supervising nurse for assistance when providing bed bath to one of my agitated patients. Fortunately, she knew
the patient well and therefore knew how to handle the situation properly in order to reduce the risk of anyone getting hurt.
Satisfactory
Satisfactory
D.G. : I have been able to demonstrate my understanding of the role as a student nurse. I know when to ask for assistance in, for example,
obtaining narcotics for medication administration as well as clarify any procedures that need to be done for my patients.
Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Consistently responsible and accountable with attendance, meeting deadlines and being prepared for clinical. Practised within the scope
of a PN student and followed rules outlined by the Humber handbook and Sunnybrook.
Satisfactory
Satisfactory
D.G. : I have been able to improve on my learning goal by accomplishing my initiative to become a better leader. This included
participating in team discussions, which helped me improve my confidence in speaking with other team members and allowed me to learn
from their feedback.
2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic
Satisfactory
Satisfactory
methods.
D.G. : Documenting in a timely and accurate manner was one of the areas of I felt I needed to work on since my first time I was assigned
my own patient. I have been able to improve so much on my time management and ensuring that my documentation has been completed
on time.
Satisfactory
Satisfactory
D.G. : I always maintain communication between my supervising nurse and I when it comes to providing certain care that is scheduled for
my patients such as fleet enemas and bed baths. I also inform them when I will have my breaks throughout the day so that they know when
I will be available to help them or not.
2. 4 Utilize communication techniques with the client and inter-professional health care team.
Satisfactory
Satisfactory
D.G. : I have been able to improve my communication techniques with my clients by closely observing their behaviours and seeking for
assistance from my supervising nurse when I
Satisfactory
Satisfactory
2. 6 Use technology to retrieve information including research, data and other information.
Satisfactory
Satisfactory
D.G. : I have been able to use technology throughout my whole clinical experience to retrieve patient information for providing care,
research on medications to administer, and other patient information that may be of use when constructing my health care plan.
Satisfactory
Satisfactory
D.G. : I have been able to improve on effective communication techniques by participating in group discussions during post-conferences,
as well as talking about patient-related information to my supervising nurse.
Satisfactory
Satisfactory
3. 3 Apply knowledge of therapeutic use of self and identify its effect on client well-being.
Satisfactory
Satisfactory
D.G. : I have been able to improve on my ability to provide care to my clients by knowing my limits and areas of improvement. For
example, I know when to seek assistance from staff if I feel like I cannot safely provide care for my patient on my own.
3. 4 Use self-awareness to identify the effects that beliefs, values, and personal experiences
Satisfactory
Satisfactory
3. 5 Interact with clients and members of the inter-professional health care team; and, consult
Satisfactory
Satisfactory
appropriately.
D.G. : When I first stared my clinical experience at Sunnybrook, I had very little experience with interacting with other health care
professionals. Throughout the semester I have been able to meet cardiologists and other therapists that have scheduled visits for my
patients. For example, a therapist came by to see one of my patients for their music therapy.
3. 6 Apply knowledge of practices and systems that support the diversity of clients and the
inter-professional health care team.
Satisfactory
Satisfactory
D.G. : I have been able to support the diversity of my clients by always looking over their scheduled tasks so that I can carefully plan out
and organize my day. When I was not entirely sure of how music therapy was implemented for one of my patients, I personally asked the
therapist to better understanding on how it affects my patient.
3. 7 Apply knowledge of clients cultural, religious, and other beliefs and values as these
Satisfactory
Satisfactory
Satisfactory
Satisfactory
D.G. : I have been able to improve on providing client education to my patients, especially when they are reluctant on receiving certain
care that makes them uncomfortable. One of my recent patients did not want to have their scheduled fleet enemas. I told her that her fleet
enema would help her stomach feel better as she was suffering from constipation. When she was better informed on what kind of
therapeutic effect the fleet enema will have on her, she agreed on letting me give her the enema.
Satisfactory
Satisfactory
D.G. : I have been able to improve on my resolving conflicts in a timely manner. For example, two of my patients were scheduled for care
around the same time after breakfast. One had to get a rectal suppository, while the other needed a fleet enema. I had to figure out which
patient to attend to first, and because my supervising nurse, who told me would help me give the rectal suppository, was busy with another
patient, I had my clinical teacher help me give the fleet enema to my other patient in the meantime.
4. 2 Demonstrate leadership skills that foster group work and a positive learning environment.
Satisfactory
Satisfactory
D.G. : I have been able to improve my leadership skills by maintaining a positive environment by seeing for assistance and providing
feedback to my peers when I am asked to.
Satisfactory
Satisfactory
4. 4 Provide feedback to peers and accept feedback from peers and members of the interprofessional health care team.
Satisfactory
Satisfactory
D.G. : Throughout my clinical experience I have received feed back not only from my peers, but also from the health care team who have
been able to supervise me in caring for my patients. For example, I have been told what certain things need to be prioritized specific to my
patients because of the certain medication and care schedule that they have.
Satisfactory
Satisfactory
D.G. : I have supported my clients' rights for self-determination and choice by allowing them to voice their concerns and opinions about
any care that I should be giving them. For example, one of my patients did not self-administer all of her medications at once during
breakfast. I supported her choice to take her medications in the manner that she wanted, but also monitored her to ensure that she had
taken them within the right time frame.
Satisfactory
Satisfactory
D.G. : I have been able to experience unsafe and unacceptable behaviours from my patients, but I have also been able to respond to them
in a professional manner. Instead of becoming emotionally involved by getting angry to a patient who was physically and verbally
aggressive, I maintained a safe environment and ensured that no one else would get hurt.
4. 7 Consult and collaborate when carrying out health care and nursing practices that are in
Satisfactory
Satisfactory
the best interests of the public and protect the public through collaboration and consultation.
D.G. : I have been able to consult and collaborate in carrying out health care and nursing practices with my supervising nurses. I do this
by ensuring that I speak with my supervising nurses while they are by themselves to ensure that the public or any other health care
provider outside of the patient's care is not exposed to any of the information we disclose.
5. PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES
5. 1 Incorporate the unique needs and expected outcomes into individual clients plans of
Satisfactory
Satisfactory
care.
D.G. : I have been able to improve on my patient care plans by prioritizing which problems need tending to at the moment. For example,
one of my patients complained of itching and persistently asked for lotion throughout the day, which made managing his skin integrity my
priority.
5. 2 Develop theory-based plans of care that are holistic and client centered and are
Satisfactory
Satisfactory
5. 3 Use knowledge, skill and judgment to assess clients, prioritize needs and outcomes.
Satisfactory
Satisfactory
D.G. : I have used my knowledge, skill and judgment to assess my clients, prioritize their needs and outcomes more often these past few
weeks in the clinical setting. Being assigned more than one patient has allowed me to become more vigilant in monitoring my patients, as
well as ensuring I was giving the right medications to the right people. Using what I knew about my patients' diagnoses and what their
medications were for, I knew the kinds of signs and symptoms I needed to expect after giving them their medications.
5. 4 Provide information that contributes to the evaluation and refinement of plans of care.
Unsatisfactory
Satisfactory
D.G. : Because I am assigned a different patient every week, I found it difficult to evaluated and refine my care plans for each of my
patients.
Y.Y.H. : You showed evaluation and plan for care refinement through your care plan (part 2).Even though you didn't get a chance to carry
out the interventions/goal, you were still able to critically identify them for further patient care improvement.
5. 5 Safely and competently carry out nursing assessments and nursing interventions that are
Satisfactory
Satisfactory
5. 6 Carry out nursing care that reflects the practice decision-making framework.
Satisfactory
Satisfactory
D.G. : I was able to carry out nursing care that reflected the practice decision-making framework through my assessment of one of my
patients. My supervising nurse asked me to take the vitals of my patients in the morning and when I did, I found that some of his vitals were
lower than the normal values I learned from textbooks. However, instead of reporting to my nurse of abnormal findings, I looked through
his information in the database and noticed that my findings were around the same values as his baseline data.
Satisfactory
Satisfactory
timely manner.
D.G. : I found that it took me a little longer than I wanted to improve on managing my nursing care responsibilities in a timely manner, but I
have been improving. Now that I have gotten used to the schedules that the facility has for report, breakfast, lunch, and dinner, I was able
to determine what should be done in between those meals other than medication administrations.
Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
You consistently took initiative with organizing and managing your patients care. You took every opportunity to practice your assessment
skills when you were able to. You improved your time management and prioritizing skills over the term and it showed when you took care
of two full patient assignments.
6. 1 Work with clients and members of the inter-professional health care team to assess
Satisfactory
Satisfactory
clients, determine health needs, and to achieve mutually agreed expected outcomes.
D.G. : I have been able to work more with my supervising nurses than the inter-professional health care team when caring for my clients.
We collaborate to decide on the best time for both of us to assist each other in providing care to a specific patient, to ensure that while they
are receiving help, I am also learning from the experience. An example would be speaking to my supervising nurse about anything other
care I should provide while my patient and I waited for him to finish providing care for another patient before helping me transfer my
patient.
Satisfactory
Satisfactory
6. 3 Seek out assistance and consult with members of the inter-professional health care team.
Satisfactory
Satisfactory
D.G. : Because I have been able to identify my physical limitations when caring for my patients, I know when to ask my peers or nurses for
assistance so that I can safely carry out my nursing care in a timely and efficient manner.
Satisfactory
Satisfactory
D.G. : I have used teamwork, consensus building, and conflict resolution skills to provide efficient care to my patients. For example, when
one of my patients did not have an appetite for any food on her breakfast menu, my peer and I worked as a team to help encourage her
since my peer had the chance to care for her the week before. When we both decided that maybe trying to urge the patient was only
irritating her, we decided to give her time to herself to let her know that we respected her decision and tried to offer her other nutritious
foods later.
6. 5 Describe effective, collaborative, and consultative strategies to meet clients needs within
Unsatisfactory
Satisfactory
a changing environment.
D.G. : I feel I can still improve on demonstrating collaborative and consultative strategies to accommodate my client's needs within a
changing environment. The unit at my placement doesn't often change, but when it does, it is usually a scheduled appointment. In my
opinion, I think that the unit receiving student nurses poses as a changing environment to the patients in the unit because we are
unfamiliar faces to them compared to the nurses they usually see. I have been able to help the patients get used to us by introducing
myself as a student nurse every morning before I provide care for them.
Y.Y.H. : Despite the fact that the patients in the clinical setting didn't change, I think you collaborated well with staff and patient caregivers
well when called upon. Such as collaborating with a caregiver to learn feeding strategies for a patient that had difficulty swallowing.
6. 6 Interact with members of the health care team respecting their unique role and
Satisfactory
Satisfactory
competencies.
D.G. : I have been able to interact with the health care team members more often ever since I started getting assigned two patients to care
for. This allowed me to want to communicate with my supervising nurses more because I knew I was not going to be able to give my full
time and attention to only one patient for the day.
7. 1 Act in the best interests of clients and protect clients from harm through collaboration
Satisfactory
Satisfactory
and consultation with members of the inter-professional health care team and through
competent and safe practice.
D.G. : I collaborate with my peers and other nurses to protect my patients from harm, especially when I have to transfer them from the bed
to the wheelchair. This not only allows me to safely transfer my patients, but it also gives me the opportunity to familiarize myself with the
mechanical lifts provided for each patient in the unit.
Satisfactory
Satisfactory
D.G. : I often use a lot of self-reflection to identify my strengths, and areas of improvement after every clinical shift so that I can prepare
myself for the next clinical shift and know what I should keep in mind to improve on. For example, I have learned that a couple of the
patients I was assigned to provide care for became agitated, especially whenever they were given a bed bath. Knowing this, I always
assess my patients on their moods and behaviour before providing them a bed bath just in case I may need to provide a safer environment
or seek for more assistance from my peers and nurses.
7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance
Satisfactory
Satisfactory
program (CNO).
D.G. : This semester I have been given the opportunity to implement and evaluate my learning plan that I created last semester. Based on
my clinical experience from these past few months, I have been able to see where I should put more time and effort to improve on to
become a more competent nurse for the next year to come.
7. 4 Seek out learning opportunities and feedback that foster professional development; and,
Satisfactory
Satisfactory
7. 5 Utilize nursing, health and other theory and literature to improve nursing practice.
Satisfactory
Satisfactory
D.G. : I use nursing, health and other theory and literature to improve my nursing practice to help me prepare for my clinical experiences.
For example, when I found out that the patient I was assigned to had a catheter, I watched online videos provided for us as well as the
checklists from one of the textbooks.
Satisfactory
Satisfactory
D.G. : I have used a theory-based approach and evidence-informed practice by always considering the rights of medication of
administration when I prepare the medications for my patients.
8. 1 Utilize problem-solving skills to inform decision making in all aspects of nursing care.
Satisfactory
Satisfactory
D.G. : I was able to use my problem-solving skills to include in my nursing care, especially with one of my patients. Many times during the
day he asked me to apply lotion on the dry areas of his skin. Instead of just continuously applying lotion onto his skin, I assessed in fluid
intake and output to ensure that he was well hydrated.
Satisfactory
Satisfactory
Satisfactory
Satisfactory
skills.
D.G. : I designed a plan on improving my problem-solving and decision-making skills in my self-reflection for this semester. One of the
areas of improvement was to be consistent in time management because I noticed on some clinical days I was more organized than other
days.
8. 4 Utilize knowledge from variety of nursing, health, and other theory into nursing practice
Satisfactory
Satisfactory
Satisfactory
Satisfactory
D.G. : I always try to prioritize the types of care I need to provide my patients for the day. Besides medication administration, I try to
manage my time wisely so that I can give them a bath before lunchtime.
Satisfactory
Satisfactory
D.G. : I demonstrate professionalism and accountability by first introducing myself to not only my patients, but also the supervising nurse
assigned to my patient. This allows me to inform the nurse that I will be responsible for providing most of the care to my patient, such as
medication administration, bed baths, and feeding.
8. 6 Recognize strengths and limitations and seek appropriate assistance and support.
Satisfactory
Satisfactory
D.G. : I know my strengths and limitations when it comes to providing care for my patients, such as repositioning and transferring patients
on and from their bed. I know that I am too small and unable to safely bear the patient's weight on my own, so I seek for assistance from my
peers or other nurses.
Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING EFFECTIVELY :
Improved prioritization, problem solving and decision-making skills throughout the term. Able to care for 2 patients with confidence.
Consistently was professional and accountable for own learning and completing assigned work on time.
Student's References
Lilley, L.L., Harrington, S., Snyder, J.S. (2011). Pharmacology for Canadian Health Practice (2nd ed.). Toronto, ON: Elsevier Canada Ltd.
Grade
Satisfactory
Unsatisfactory
Grade
Satisfactory
Yes
No
Yes
No
Yes
No
Student Comment
I enjoyed my first clinical experience at Sunnybrook, and I look forward to my future placements to further enhance my nursing skills.