Clinical Evaluation Process for the Trent Fleming School ...



Clinical Evaluation Process Nursing 3020Instructions The Mid-Term Evaluation will be completed by students at the mid-point of the clinical placement to assist students to take inventory of their current development and assist them to make plans for future clinical practice. The student will use a reflective process to help assess progress in meeting established program, year, and course objectives. The student will submit an electronic copy of the Mid-Term Evaluation document to the clinical instructor prior to the formal mid-term student evaluation. Because the document is to be completed electronically, the student and instructor can take as much space as they need to provide appropriate evidence and feedback.After receiving the student’s Mid-Term Evaluation, the clinical instructor will complete the comment section providing feedback and evaluation of the student’s progress. The clinical instructor will provide suggestions for improvement. The instructor will place a check in the “S” column if progress is satisfactory, and in the “U” column if progress is unsatisfactory. If a student demonstrates unsatisfactory progress at mid-term, the student and instructor will develop a Learning Plan outlining strategies in which the student will engage, along with clear expectations that must be met for the successful completion of the course. The course professor may be involved in developing the learning plan. The student and instructor should save and print a copy of the mid-term evaluation. Printed copies must be submitted to the course professor within a week of completion. At the end of the rotation, students will complete a Final Evaluation. Students will use a new copy of the evaluation template to archive their achievements and areas for future development. The student will submit an electronic copy of their final evaluation to the instructor; this will help the instructor complete an assessment of the student. In order to complete the final evaluation, the clinical instructor will provide additional evidence by completing the comment section, providing feedback and evaluating the student’s progress. The clinical instructor will collect evidence in the form of the student self-assessment, comments of the health care team members, patient input, student submissions (including portfolios) and observations. A summary of achievement as well as implications for future learning should be included in this document. The attendance section and record of completed hours is to be filled in completely. The completed document is to be printed, shared with the student and signed. The signed copy must be returned to the TFSON within 10 days. The Year Lead, lab instructor, and/or course professor will assess the completion of the Learning Center Component, if applicable.Students and instructors will complete both the mid-term and final clinical evaluation documents electronically. An electronic copy of the completed (student and instructor) final evaluation should be submitted to the course professor within 48 hours of the final evaluation delivery. A printed and signed copy should follow within 10 days of the evaluation meeting.yNURS 3020HClinical Evaluation (Check one) Midterm __________ Final ??????????Student Name: Catherine Martin Clinical Instructor: Jan Scott Missed Clinical Hours: ______ Missed Lab Hours: ______Program GoalsGraduates are generalists entering a self-regulating profession in situations of health and illness.Graduates are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a variety of settings. Graduates continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their practice.Graduates will demonstrate leadership in professional nursing practice in diverse health care contexts.Graduates will contribute to a culture of safety by demonstrating safety in their own practice, and by identifying, and mitigating risk for patients and other health care providersGraduates will establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based upon relational boundaries and respect.Graduates will be able to enact advocacy in their work based on the philosophy of social justice.Graduates will effectively utilize communications and informational technologies to improve client outcomes.Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed interventions and outcome measures.ObjectivesProgressIndicators/EvidenceSU1Explain the experience of acute illness in individuals receiving care in acute setting One of the patients I had been assigned to was very kind and pleasant to work with. He had been admitted to the hospital multiple times between PRHC and hospitals in the GTA. This time that he was admitted he was on isolation. He explained to me that once he hit 70, everything went to crap for him. Although he was grateful for the care he received, it was clear that he wanted to be at home. One patient that I had was very nice and never had any problems with me when I needed to take his vitals or do an assessment. He was more than compliant. He told me multiple times how great the nurses were on this floor and how much he appreciated all that they did for him. This showed that this patient had a positive, experience in the acute care setting. 2Interpret critical aspects of the person’s experience of acute illness in relation to common signs and symptoms, responses to treatment, patterns of coping, and impact on individual and family relationships One of the patients that I was assigned to was diagnosed with syncope. The syncope was d/t a mass found in his lower GI tract. When seeing him, he seemed okay, other than being a little weak. He and his family were told that there was a chance that this mass was cancerous. This had a very big impact on the family and individual relationship. This patient’s wife and daughter were at the hospital all day and evening with him. They were constantly asking his nurse questions and they were very concerned and scared. The patient however, brushed this news off and acted as if he hadn’t heard it. I assume that, that was his way of coping. One of my patients had a diagnosis of a fall and new confusion. His comorbidities included Parkinson’s, UTI’s, falls and Lewy Body Dementia. The first day I went in to meet this patient, he was very kind. He had a hard time with speaking clearly but I was able to make sense of the things he was saying. He was very upset because he was on a tube feed and had just failed the swallowing test that morning. I met his wife later that afternoon, when this patient was sitting up in his chair. The next day he had a meeting early in the morning where all of his kids came to with this patient’s wife. After the meeting they went home and came back later as this patient was tired and needed to rest. This shows a very strong family relationship, as everyone wanted to be a part of this individual’s health and needs.3Identify common medical treatments and potential consequences/complications of selected acute illnesses One of the patients I was assigned to was diagnosed with sepsis. A common treatment for this is an antibiotic. A broad-spectrum antibiotic is usually used initially if the infectious agent has not yet to be identified. Later once blood test results are back, the physician may decide to switch to a different antibiotic that is more appropriate to fight off the particular bacteria causing the infection. A complication of this acute illness is that if it worsens, blood flow to vital organs becomes impaired. It may also cause blood clots to form, leading to various degrees of organ and tissue death. One of the patients I had was diagnosed with CHF. A treatment for this is the use of Beta-Blockers. This medication is used to slow heart rate and decrease blood pressure. This medication also limits or reverses some of the damage to the heart if the patient has systolic heart failure. A complication of this acute illness is kidney damage or failure. Heart failure reduces the blood flow to the kidneys, which can eventually cause kidney failure. 4Demonstrate selected nursing and collaborative interventions related to clinical pathways, peri-operative care, IV medication administration, cardiac assessment and rhythm strips, neurological assessment, wound care, blood component therapy, TPN and central lines, pulmonary care including chest tubes and tracheotomy, initiating IVs, rapidly changing conditions, and resuscitation While administering medications for a patient, I was able to reconstitute one of his medications and hang this IV medication for him. It was a very good experience for me as I was able to put my lab skills to use in a clinical setting. One of my patients had a TPN and a PICC line. I was able to see the lipids and nutrients hung on the IV pole that was given to this patient. It was very similar to what we were shown in lab. I was also able to observe my clinical instructor flushing a PICC line. 5Under the supervision of a Registered Nurse, demonstrate safe, competent, evidence-based, holistic nursing practice with clients with acute illness Apply relevant nursing models, philosophical frameworks, theories and evidence Demonstrate therapeutic use of selfEngage with patients in an ethical and culturally safe mannerUnderstand and anticipate emerging bio-psycho-social needs of persons with acute illness and apply this knowledge to care:Plan appropriate nursing carePredict outcomes of nursing care Evaluate client response to nursing care Demonstrate health promotion and illness prevention practicesEngage with patients and families to identify health-related situational challenges Work with patients and families to create reasonable and effective solutionsDemonstrate patient advocacyDemonstrate accountabilityDemonstrate reliability I show accountability during this placement as I always show up to placement on time with my notebook, pens, stethoscope, nursing badge, and preclinical worksheet. I demonstrated health-promotion and illness prevention practices while discharging a patient. With the assistance of my clinical instructor, I explained the exercises that should be avoided while at home, and that they are to come to emerge if any similar signs or symptoms emerge. 6Critically appraise own practice in relation to nurse-client/family interactions and as a member of the health care team One day when I came into placement and was getting rapport from a fellow nursing student, she had told me that this patient was very rude to her that morning and would not let her do his vitals or assessment. When I went in to introduce myself I made sure to take the chance to talk to him and get to know him before starting any assessments or vitals. By doing so he was very friendly and talkative with me and had no problem with me taking his vitals or doing his assessment. This showed me that building a therapeutic relationship with a patient is very important. Although I was not assigned to this patient I answered a few of his call bells. This patient had many visitors constantly in visiting him. While assisting him, I asked the family to step outside, as this patient needed assistance in the washroom. While assisting him back into bed and talking with him for a bit during this process, I was able to get to know the patient better. After helping him I went out and got the family and explained that I assisted him in getting back to bed. I chatted with them for a few minutes and they seemed very appreciative. The next week, this patient was still in the hospital and the family remembered who I was. 7Participate in professional development based on reflective practice and critical inquiry I feel that I participate in professional development because I work as a team with the other nursing students and nurses on the floor. I do this by assisting them when help is needed. This skill is important, as it is critical to work as a team in the field of nursing. I participate in reflective practice and critical inquiry during post-clinical while discussing each other’s days to one another. This allows each of us to participate and voice our opinions on different situations that occurred during our shifts. This allows for each of us to work together to come up with the best approaches, in regards to the situations faced that day. Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)Signature of Instructor___________________________________________________Date _____________________________Signature of Student_____________________________________________________Date ______________________________ (Final Evaluation Only)Student Areas of Strength1. I feel that I have improved my basic nursing care skills over the course of this placement.2. I feel that I work well as an individual and as a team player, with my peers as while as other nursing staff when they or I need assistance. 3. I feel that I use communication well, as I communicate with my fellow classmates, other nurses, and my clinical instructor on what I have done or am doing, and communicate while helping patients (i.e. sliding someone up in bed and telling patients what I am going to do).Student Areas for Future Development1. I feel that I need to work on planning my days ahead as soon as I get on the floor. 2. I feel that I need further development with acute care skills, such as catheterization, wound care, etc. as I feel I have not had enough experiences in these areas outside of labs. 3. I feel that I need more practice on writing progress notes. Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)AttendanceThursFriThursFriWeek 1Week 6Week 2Week 7Week 3Week 8Week 4Week 9Week 5Week 10Total number of clinical hours completed_____________Clinical ComponentSatisfactory Unsatisfactory (Please circle the appropriate outcome)Clinical Learning Center CompletedNot completedSignature of Instructor____________________________________Date_______________________________Signature of Student______________________________________Date________________________________ ................
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