Professional Documents
Culture Documents
Selfassessment Nurs 208
Selfassessment Nurs 208
I declare that this is my original work and the sources used are acknowledged.
1. COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK
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1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies and
procedures.
M.D.L. : I have reviewed Michael Garron policies and procedures regarding patient care. I have carefully followed any special procedures that have
been mentioned during report, as well as double check with assigned nurse and/or clinical instructor.
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1. 2 Act in a responsible, ethical and accountable manner.
M.D.L. : I understand that as a student nurse I am still accountable for the nursing actions I have done towards a patient. I know that I have to always
act in a responsible and professional manner in the nursing setting. During medication administration, it is my responsibility as a nurse to research
information regarding the drug, when it is to be administered, whom it should be administered to, indications, contraindications, risks to clients, and
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1. 3 Determine how the three factor and practice decision-making frameworks influence client care.
M.D.L. : During nursing care, my patient was experiencing a fever, low blood pressure, and was hyperglycemic. My assigned nurse and I
administered her dose of Acetaminophen; however, we still had to find the source of the fever. Therefore, we collaborated with the RN who decided to
get a blood culture. In this situation, the RPN and I were able to relieve the patient of pain and fever symptoms, but incorporated the RN since the
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1. 4 Use evidence informed practice and a theory-based approach to care.
M.D.L. : I have used my clinical lab practices and modules and have applied this knowledge towards my patients at Michael Garron Hospital. These
procedures include bed bath, head-to-toe assessments, medication dosage and calculations, GI tube feedings, wound care, and catheter insertion.
safe environment.
M.D.L. : I ensure that all risk management procedures are always done such as lowering the bed a the lowest position for the clients, bed rails are up
at all times, wearing appropriate PPE, doing hand hygiene, using 6 rights of medication. (College of Nurses of Ontario, 2014) Client safety was also
met by reviewing the ekardex and following certain and special procedures that were required for the patient.
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1. 6 Ask questions and clarify the plan of care, unclear orders or directions, and whenever uncertain.
M.D.L. : Before patient care, I always make sure to listen to report and attend to my assigned nurse for regarding patient care and ekardex. I always
try to clarify procedures and/or be supervised in order to provide the best possible care for my patient. This was evident when one of my patient's had
a low blood pressure and hypoglycemia, that I had to collaborate with the RN on what steps to take for patient care.
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1. 7 Demonstrate professional behavior by seeking assistance in situations in which there is unsafe,
M.D.L. : I ensure that I talk to my clinical teacher with anything that an RPN or RPN has done that I felt was unacceptable or unprofessional behavior
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1. 8 Demonstrate understanding about the role of the nurse within health care.
M.D.L. : I understand that as a student nurse I have to attend to my patients, and give them the best possible care. Although we may be limited to a
certain number of patients, it is not about the number of patients we have but how we use our nursing knowledge and put it into use of our patient
care.
Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Mikkel has an understanding of what a nurses role entails, he acts in a responsible, ethical and accountable manner as he will clarify his
care plan or if he is uncertain of what to do, he practices according to the hospitals policies and procedures or by following best practice
guidelines. He realizes that the Three factor and decision making frameworks play an important part of influencing his client care. When
providing care to his clients he is diligent ensuring that he has the bed in the lowest position for the safety of his client
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2. 1 Participate in team sharing and discussions.
M.D.L. : I try to contribute as much as I can during group discussions to help benefit the team. I give appropriate peer feedback when working with
colleagues, as well as accept feedback from members of the team. I try to share and listen to my colleagues and instructor to share my experiences
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2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic methods.
M.D.L. : I have gone over documenting with nursing staff and clinical instructor to provide clear and accurate information regarding patient care. I
have also reviewed the poly and procedures provided by the CNO to know remind me the importance of documenting any relevant information
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2. 3 Report relevant information to the appropriate personnel.
M.D.L. : I have been able to document and report findings that needed to be brought to attention by the primary nurse. For example, after taking
routine vital signs, my patient was experiencing a fever and low blood pressure. This was immediately reported to the nurse in order to find the cause
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2. 4 Use communication techniques with the client and the inter-professional health care team.
M.D.L. : I communicate with the primary nurse with patient care and procedures, as well as provide information regarding patient status. I always
inform my client the procedures I will be doing towards them to reduce anxiety and for their own knowledge.
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2. 5 Ensure privacy and confidentiality according to the Personal Health Information Protection Act
(PHIPA).
M.D.L. : I always maintain privacy during patient care by closing the curtains/door when necessary. I also maintain patient confidentiality with
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2. 6 Use technology to retrieve and share information including research, data and other information.
M.D.L. : I have been able to use Evolve modules to refer to tasks, Mosby's nursing drug guidebook for medical drug information and assessment
checklist to use in the clinical setting. I have also been able to use Michael Garron's Powerchart program to retrieve information regarding information
Mikkel participates in team building by sharing information about his clients with other members of the health team, he researches
information that he is unsure about by using technology and also shares it with the health team, he documents care provided in the
computer charting system. He ensures his clients privacy by pulling the curtain when providing care, he ensures that he puts papers with
the clients information in the confidential waste. He has discovered that there are many ways to communicate with clients, although there
are times that he will not be able to communicate with them.
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3. 1 Use effective communication techniques.
M.D.L. : In order to give my patients the best possible care, I always make sure to inform my primary nurse and any other members in the circle of
care for that patient. When I'm with the patient I make sure to avoid the use of any jargon words that the patient may not understand or misinterpret.
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3. 2 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and
M.D.L. : I always try to have a trusting relationship with both my patients and other team members in the circle of care. I keep in mind the patient's
culture, gender, and needs because patients still need to be respected. (Potter, P., Perry, A., 2014)
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3. 3 Demonstrate therapeutic use of self to foster client well-being.
M.D.L. : I feel that the presence of a nurse brings hope towards the client. It helps them feel as if we are there to help and support them in order to
bring them back to their optimal health, which is exactly what we try to do and achieve as a nurse.
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3. 4 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on
relational practice.
M.D.L. : I know that every individual has different beliefs, values, and personal experiences. In order to give the best possible care towards patients, I
try to respect their own beliefs, values, and personal experiences and find a point where both the client and I can agree on in order to provide the best
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3. 5 Collaborate with clients and members of the inter-professional health care team and consult
appropriately.
M.D.L. : I am able to interact with patients and health care team at a professional level. I constantly check on my patient to see if there is any
assistance needed for their ADL's. I also constantly consult with the primary nurse, clinical instructor, and colleagues for relevant information about my
patient.
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3. 6 Support the diversity of clients and the inter-professional health care team.
M.D.L. : I always try to take into account my client's culture, gender, and special needs when giving care. My patient care always needs to be
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3. 7 Display sensitivity and respect for clients cultural, religious, and other beliefs and values
M.D.L. : Examples of when I respected a client's choice and decisions is when they ask for privacy during religious prayers and during bed baths.
Sometimes the client's like to be left alone to carry out their own needs and in order to build that trusting relationship with the client and I, I need to
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3. 8 Provide effective client education.
M.D.L. : I always communicate with my client as much as I can so that they understand and are aware of what nursing procedures I will be doing for
them in order for them to get better. I have also been able to communicate with the patient's family members regarding care to relieve anxiety
Mikkel has learnt that there are different ways to communicate with the clients, he uses communication techniques such as listening, being
attentive and acknowledging what he has heard. He develops caring and compassionate relationships with the clients that he has cared
for, he ensures that they have everything they require prior to leaving the room. He has realized that his beliefs, values and personal
experiences can aid in his building relationships with his clients and that clients are diverse in many ways (culture, ethnicity, religion etc.).
Mikkel has learnt how to interact with members of the interdisciplinary health team.
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4. 1 Apply appropriate conflict resolution skills in therapeutic client and other interactions.
M.D.L. : When providing patient care I have always forgotten to implement proper body mechanics, and I know in the long run that it will affect my
body even though it does not seem like it currently. However, I have been able to constantly remind myself to raise the bed to my appropriate level,
and I also seek assistance for patients that are too heavy for me to move
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4. 2 Evaluate and refine leadership skills to develop solutions and create a positive work
environment.
M.D.L. : I have given a lot of encouragement and positive attitude towards my colleagues to help them improve their nursing care. I always try to
communicate with colleagues regarding patient care and give them good feedback to boost their confidence
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4. 3 Provide feedback to peers and accept feedback from peers and members of the inter-
M.D.L. : I constantly try to have the primary nurse, clinical instructor, and colleagues supervise my patient care to receive feedback. I use this
feedback for upcoming patient interactions to improve my nursing skills and interventions. For example, my primary nurse and colleagues had
mentioned to me to try to boost my confidence during communication and patient care, so that my patient will not feel worried or scared about my
nursing actions
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4. 4 Advocate for clients, self, others, and quality practice environment.
M.D.L. : I have been able to provide verbal feedback to colleagues regarding nursing practice to help improve their nursing skills. I also have been
discussing my nursing actions to my client's in order to reduce anxiety and for their own knowledge as well.
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4. 5 Support clients rights for self-determination and choice.
M.D.L. : I respected a client's choice and decision when they ask for privacy during religious prayers and/or during bed baths. Sometimes the client's
like to be left alone to carry out their own needs and in order to build that trusting relationship with the client and I, I need to respect their choices and
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4. 6 Respond appropriately to unsafe, unacceptable, and unprofessional behaviours.
M.D.L. : There was a situation where client information was being discussed between the RPN and I regarding a patient; however, there were family
members in the same room attending to a different patient. So I ensured that we provided client confidentiality by leaving the room and discussing
elsewhere.
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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.
M.D.L. : I constantly refer to my primary nurse and clinical nurse to find the best way to carry out nursing procedures and practices for the best
nursing care. I have been told to manage my time and be much more organized with the way I prioritize my tasks to be more efficient.
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4. 8 Contribute to the creation of quality practice solutions and strategies.
M.D.L. : I try to provide positive feedback or help out with colleagues to provide the best care. For example, I had helped a colleague who was
completely new with doing a bed bath, and I helped guide my colleague through it.
Mikkel has developed his leadership role by taking charge of his clients care, he plans their care and will collaborate or consult with other
members of the health team to ensure that he is following nursing best practices or the policies of the facility. He plans the clients care
and will alter it based on the clients choices. Mikkel completed a peer review and submitted one for his peer as well,
5. PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES
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5. 1 Incorporate the clients unique needs and expected outcomes into holistic and client-centred
plans of
care.
M.D.L. : I had experienced quite a few different patients both with very different needs. One of my patients required attention with their hypertension.
Their level of consciousness was altered and feeling dizzy. They were able to ambulate themselves to the washroom; however, at risk for falls based
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5. 2 Develop theory-based plans of care that are holistic and client centered and are articulated
M.D.L. : I was able to develop a concept care-plan that would give the best possible outcome for my patient. I used interventions that were
reasonable that would help benefit the patient in staying in the best shape possible. For example, the patient had an increased chance of developing a
pressure ulcer due to lack of mobility, so my nursing intervention was to reposition the client every 2 hours. (Jarvis, C., 2014)
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5. 3 Use knowledge, skill and judgment to assess clients, prioritize needs and outcomes.
M.D.L. : I constantly assessed the patient's skin during hygiene care and checked the patient's facial expression for any pain. I try to achieve a
response during procedures to ensure that the patient is doing okay. I try to comfort the patient to the best of my ability and give the patient their daily
needs such as hygiene care, food, and social interaction.(Jarvis, C., 2014)
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5. 4 Collaborate in the evaluation and modification of plans of care.
M.D.L. : One of my patients had a lack of mobility, nursing assistance, and was incontinent; therefore, I had stated that he was at risk for pressure
ulcer. I was able to identify factors that contribute to developing a pressure ulcer to identify a nursing diagnosis and used the nursing diagnosis to
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5. 5 Safely and competently implement and evaluate nursing assessments and nursing interventions
M.D.L. : I was able to identify factors that could put my patient at risk for pressure ulcers from low mobility, nursing assistance, and incontinent. From
there I was able to come up with interventions that could prevent pressure ulcers like repositioning, management of incontinence, and skin
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5. 6 Use the Three-Factor and practice decision-making frameworks to guide practice.
M.D.L. : I have been able to do proper care for my patient because the complexity of the patient was at a reasonable level. I have recently become
more efficient with the way I prioritize my tasks to have the patient carry on with their ADL's. Such as deciding whether to give a bed bath before or
after breakfast and identifying the amount of time it takes to complete daily nursing tasks.
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5. 7 Prioritize nursing care and nursing interventions in order to manage workload, time, and physical
resources.
M.D.L. : I have progressed very well in completing and organizing my nursing care responsibilities in a timely manner. The amount of time it takes to
complete nursing tasks has significantly reduced due to familiarity of equipment, experience and time it takes to complete individual tasks.
Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Mikkel includes his clients unique needs when planning their care and incorporates the Three Factor and decision making frameworks
when looking at the client as a whole to guide his practice. He uses knowledge and skills learnt in school when assessing his clients,
prioritizing needs and outcomes and to help him to prioritize care and interventions in order to manage workloads and his time efficiently,
(gathering all equipment required to provide care to a client on isolation precautions prior to entering the room, organizing care so that he
can provide care equally to his clients.
6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM
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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.
M.D.L. : I have been continuously working with colleagues, clinical instructor, and primary nurses to discuss my patients' status. One of my patients
were experiencing hypertension; however, the antihypertensive medications were not helping lower the patient's blood pressure.
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6. 2 Contribute as a member of the inter-professional health care team to respond to the changing
M.D.L. : One of my recent patients were undergoing a lot of problems such as hyperglycemia, low blood pressure, not eating, and a fever. Although
we were able to handle some of those problems, we were unable to immediately get them to eat due to low level of consciousness.
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6. 3 Seek out assistance and consult with members of the inter-professional health care team.
M.D.L. : I have been seeking assistance during any situations where I do not feel strong or confident in. I also seek assistance during patient
transferring or repositioning because sometimes I may not be able to handle the patient's weight by myself. I have also asked for assistance during
procedures I have not yet done to ensure that I am doing the procedure correctly.
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6. 4 Use teamwork, consensus building, and conflict resolution skills to meet expected client
outcomes.
M.D.L. : I used teamwork with colleagues in order to help complete hygiene for patients that required total dependence and more than one person
assist. Some patients were very heavy, especially for my colleague so I had to assist with keeping the patients calm and roll over to get to the hard to
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6. 5 Use effective, collaborative, and consultative strategies to meet clients needs within a changing
environment.
M.D.L. : I try to thoroughly explain procedures that will be done with clients to help relieve any stress and anxiety that the patient may be
experiencing. Also, it is important that the patient has insight and knowledge based on the care I do, which in turn builds a stronger nurse-client
relationship.
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6. 6 Interact with members of the health care team respecting their unique role and competencies.
M.D.L. : I ensure that I allow my colleagues, primary nurse, and clinical instructors do their jobs at the placement. I consult about patient preferences,
and certain procedures with the primary nurse and fellow colleagues. I allow clinical instructor to provide constructive criticism about my nursing care,
Mikkel has interacted with members of the health team such as physiotherapy, occupational therapist, pharmacy other nursing members
and the physician and he has worked with his peers and buddy nurses as part of the team in providing care to his and other clients, he will
assess and collaborate his client, seek assistance when he needs help, to achieve the expected outcomes that were agreed upon.
consultation with members of the inter-professional health care team and through competent and safe
practice.
M.D.L. : I ensure that I maintain client privacy and confidentiality, communicate with members of the team about patient status, seek assistance and
guidance when needed. I always ensure that safety precautions are taken whether it be putting on PPE, putting up bed rails, and be height.
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7. 2 Engage in ongoing reflective practice to identify strengths, areas for improvement; and, integrate
M.D.L. : I have taken time to identify my areas of weakness, such as proper documentation, time management, and body mechanics. I was able to
improve my time-management and organization slightly, but I have yet to remind myself and improve in proper body mechanics
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7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance program
(CNO).
M.D.L. : I have reviewed with colleagues, clinical teacher, and primary nurses with my weaknesses during clinical placement, and I have discussed
ways to improve my nursing skills and care based on the Quality Assurance program provided by CNO. (College of Nurse of Ontario, 2009)
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7. 4 Seek out learning opportunities and feedback that foster professional development; and,
M.D.L. : I always try to observe some nursing skills that I have not yet performed through colleagues and/or primary in order to enhance my own
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7. 5 Use nursing research to foster professional development.
M.D.L. : I have been able to research information through the use of Jarvis textbooks provided by Humber College, and in-class nursing simulations
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7. 6 Use a theory-based approach and evidence-informed practice.
M.D.L. : I try my best to use a concept care plan to help with specific patient care. For example, one of my patients had little to no mobility on their
right side and required nursing assistance with skin care and bed bathing. Based on those issues, that patient was at risk for developing a pressure
ulcer; however, with proper care such as applying lotion, doing skin assessments, and being aware of the patients skin integrity, the patient was less
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7. 7 Apply knowledge of changes to the health care system, technology, and in society as these
M.D.L. : I take into account the policy and procedures that Michael Garron has prior to doing my nursing care
Mikkel bases his care on a theory based and evidence informed practice (monitor blood sugars prior to administering insulin, having the
client in an upright position if has a feed infusing via N/G, check N/G placement prior to infusing medications). Mikkel advised the
instructor of areas of learning that he required improvement or wanted experience in. He would research the medications prior to
administering them to improve his professional development. If he heard about a procedure or skill occurring on the unit he would ask to
observe or participate in the skill. He submitted his self reflection and developed concept maps for his clients.
8. USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING
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8. 1 Use critical thinking and problem-solving skills to inform decision-making in all aspects of nursing
care.
M.D.L. : Each patient is different in ways that they have different preferences, some require more attention depending on their condition, and patient
outcomes vary from other patients. I have been able to identify the appropriate procedures and type of care that needs to be done based on
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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.
M.D.L. : I have been able to complete concept care maps relating to my assigned patients. This was done be collecting and providing information to
support my nursing diagnosis, in one case, a patient had hyperglycemia and a fever and required immediate attention by the RN. Both the RN and I
were able to collaborate in the steps required to care for this patient.
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8. 3 Evaluate critical thinking, problem-solving, and decision-making skills and design a plan to
improve
these.
M.D.L. : I have been able to come up with nursing interventions to help provide the best care for my clients based on the information collected during
head-to-toe assessments. Also, I have been able to create care plans for each patient based on their needs and their conditions.
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8. 4 Integrate knowledge from a variety of nursing, health, and other theory into nursing practice to
M.D.L. : I have used my knowledge from my Jarvis textbook to help me with my nursing care. An example of this is paying attention to specific
assessments based on the client's medical diagnosis. One of my patient's was experiencing hypertension, so I focused mainly on neurological
assessment and cardiovascular assessment. Based on the information gathered during assessments, I was able to provide the proper nursing care
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8. 5 Prioritize effectively.
M.D.L. : I have been able to organize my priorities during nursing care in order to complete all nursing tasks that is required for every shift. This was
done by recording the amount of time it took me to complete my regular tasks, and I used that information the organize the way I complete my nursing
tasks.
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8. 6 Demonstrate professionalism and accountability.
M.D.L. : I always arrive before the morning shift starts, with full uniform and prepared with readings/modules required for the week. I am also aware
that I am accountable and take full responsibility for my nursing actions towards my patient.
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8. 7 Use the practice decision-making and the nurse-client-environment frameworks to inform and
guide practice.
M.D.L. : I have implemented the decision-making and nurse-client-environment frameworks in my nursing care as outlined in the CNO (College of
I feel that overall, my nursing skills have greatly improved over the course of the clinical placement. I was able to learn and experience much more
procedures that was not available in my previous clinical. I was also able to be more involved in patient care and have been able to enhance my skills
with teamwork and communication.
Mikkel has been a pleasure to work with, he is always eager to learn new skills or knowledge to aid with his professional development. I encourage
him to continue researching his medications, diagnoses and practicing the skills he has been taught, to continue working as a team and to reflect on
the care that he provides, to seek peer feedback in order to continuously improve.
If student was absent one clinical day then the hours should be 184 total clinical hours.
Student's References
College of Nurses of Ontario (CNO). (2009). Practice Standard: Confidentiality and Privacy - Personal Health Information - retrieved from
http://cno.org/en/learn-about-standards-guidelines/standards-and-guidelines/
Jarvis, C., Browne, A., MacDonald-Jenkins, J., Luctkar-Flude, M. (2014). Physical Examination and Health Assessment, Canadian Edition, 2nd
Edition. [VitalSource Bookshelf Online]. Retrieved from https://pageburstls.elsevier.com/books/9781926648729
College of Nurses of Ontario (CNO). (2009) Practice Standard: Infection Prevention and Control - Retrieved from http://cno.org/en/learn-
aboutstandards-guidelines/standards-and-guidelines/
College of Nurses of Ontario (CNO). (2009) Practice Standard: Professional Standards -Retrieved from http://cno.org/en/learn-about-
standardsguidelines/standards-and-guidelines/
College of Nurses of Ontario (CNO). (2009). Practice Standard: Ethics. Retrieved from http://cno.org/en/learn-about-standards-
guidelines/standardsand-guidelines/
Potter, P., Perry, A., Ross-Kerr, J., Wood, M., Astle, B., Duggleby, W. (2014). Canadian Fundamentals of Nursing, 5th Edition. [VitalSource Bookshelf
Online.] Retrieved from https://pageburstls.elsevier.com/books/978-1-926648-53-8
College of Nurses of Ontario (CNO). (2009) Practice Standard: Medication - Retrieved from http://cno.org/en/learn-about-
standardsguidelines/standards-and-guidelines/