Clinical Evaluation Process for the Trent Fleming School ...



Clinical Evaluation Process for the Trent Fleming School of NursingInstructions for useThe Mid-Term Evaluation document will be completed at the mid-point of the clinical placement to assist the student in taking inventory of their current development and assist them to make plans for future clinical practice. Reflection will be used to assist the student in measuring their progress against their established program, year, and course objectives. The student will submit the Mid-Term Evaluation document to the clinical instructor prior to the formal mid-term student evaluation. After receiving the student’s Self Mid-Term Evaluation, the clinical instructor will add to the evidence of progress and complete the comment section providing feedback and evaluation of the student’s progress. The clinical instructor will provide suggestions for improvement. If a student is in a failing position at mid-term, the student and instructor will develop a Learning Plan outlining strategies the student will engage in, along with clear expectations that must be met, for the successful completion of this clinical course.At the end of the rotation, the Final Evaluation document is to be completed by the student to archive their achievements and areas for future development. It will assist the clinical instructor in their assessment of the student. The clinical instructor will add to the evidence of progress and complete the comment section providing feedback and evaluation of 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 portfolio) and observations to complete Final Evaluation. A summary of achievement as well as implications for future learning shapes the outcome of this document. The attendance section and record of completed hours is to be filled in completely. The completed document is to be shared with the student and signed. The signed copy must be returned to the TFSON within 10 days. The Year Lead will assess the completion of the Learning Center Component, if applicable. An electronic copy of the student’s completed final evaluation must be uploaded by both the student and by the clinical instructor within 48 hours of the final evaluation delivery. . NURS 3020H Clinical Course EvaluationEvaluation Student: Emily PerryClinical Instructor: ____________________________Missed Clinical Hours: ______ Missed Lab Hours: ______NURS 3020H Clinical Course Mid-Term Evaluation Program GoalsThird Year OutcomesStudents graduating from this program are prepared as generalists entering a self-regulating profession in situations of health and illness.To be developedStudents graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a variety of settings. Students graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a variety of settings. Graduates will learn to continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their practice.Students graduating from this program will be prepared to demonstrate leadership in professional nursing practice in diverse health care contexts.Graduates will be prepared to 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 providersStudents will demonstrate the ability to establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based upon relational boundaries and respect.Graduates of this program 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.NURS 3020H Clinical Course Mid-Term Evaluation ProgressCourse ObjectiveEvidence/IndicatorsSatisfactoryUnsatisfactoryExplain the experience of chronic illness in individuals in chronic care settingsThe first patient I had suffered from hypercalcemia and had a history of breast cancer and rheumatoid arthritis. The HCP’s were not able to figure out why her calcium levels continued to rise and she was frustrated with not knowing what was going on. I was able to listen to both her and her son and answer as many questions as I could, and sat with her for a long period of time when she needed to talk about what her next steps were. I cared for a patient who was recently diagnosed with lymphoma and in the middle of treatment. His reason for being at the hospital was an infection. He had a procedure the morning I was with him and he was unaware of what procedure he was having. I was lucky enough to go down with him while he had a transesophageal echocardiogram and once we found out what the procedure was I was able to talk to him about his concerns and why he was nervous. He also told me about his journey with cancer and opened up about his family and the burdens his illness had on him and his family. My third patient was also a cancer patient and the doctors were investigating possibly her original cancer had spread to her lungs. I was able to be with my patient from start to finish through her bronchoscopy and throughout the day to help her with ADL’s. Although she was able to get up and move around she struggled with coping with her new onset of generalized weakness.Interpret critical aspects of the person’s experience of chronic illness in relation to common signs and symptoms, responses to treatment, patterns of coping, and impact on individual and family relationships. I make sure that with each clinical day and each new patient I have I try and get a good understanding of the diagnosis and the treatment options. I am sure to put time and effort into my pre-clinical assignments and find them extremely helpful when I need a better understanding of the pathophysiology, important assessments and top priorities. I was able to get a better understanding of hypercalcemia, possibly causes (bone cancer), treatment options (calcitonin), and I was also able to witness what should have been a simple explanation turn into a much more complicated one. When the expected cause was not easily found, more specialized tests needed to be conducted (ultrasounds and daily lab tests)I was also able to gain a better understanding of Birkitt’s lymphoma and the treatment options available. My patient was being treated for an infection but also informed me of the blood transfusions if his hemoglobin was in the 7’s. He also was undergoing 5 rounds of chemotherapy injected directly into his spinal cord. I was informed that his family had been there for him through day 1 but he felt that he was taking up so much of their time and energy that he was feeling bad. It made me realize how much of a commitment for not just the patient but the patients support group and families fighting cancer is. I also had a conversation with my patient and her son about her options for after the hospital. I was able to sit with my patient for a long time and just listen to her thoughts and her concerns about her illness and what was next for her. Identify common medical treatments of selected chronic illnesses I make sure to understand the top priorities with my assigned patients and if I have questions I am sure to ask my clinical instructor or primary nurse. I was able to see the process of investigating if an infection from a central line had caused an infection in the heart by witnessing a transesophageal echocardiogram and by understanding why cloxocillin was being administered (for a possible blood infection). When doing my assessment I did not find any abnormal other than the patient being a little tired from the illness and his lymphoma. I cared for a patient with hypercalcemia and rheumatoid arthritis and was able to assist with morning care as well as helping the patient eat. Due to the RA she had limited function of her hands and fingers and had a lot of joint stiffness in the morning. She was on bed-rest because she had limited use of her legs due to arthritic pain. Her pedal pulses were present but very faint due to poor circulation and she had a wound on her foot and some skin breakdown from being in the bed for so long. I applied moon boots to her feet to assist with minimizing skin breakdown. Demonstrate selected nursing and collaborative interventions related to caring for the person with chronic illness, such as medication administration, physical and chemical restraints, enteral feedings, residual volumes, NG tube insertion, wound care, colorectal screening, patient-controlled administration pumps, neurological assessmentI was able to do a sterile wound dressing in my first week of clinical on my patient who was on bed-rest and had skin breakdown on the back of her heel and a wound on the front on her foot. Assisting patients with ADL’s in each week of clinical has been an important aspect in chronic care for my patients. It is important to help patients with their ADL’s while still supporting them in their attempt for self-care. For example assisting with feeding when the patient is too tired to continue on their own, or to assist with feeding by making sure there is not too much or too little food on the utensil, so they are getting adequate nutrition. In week three I was able to administer medications to my patient, medications included flagyl, ferrous gluconate, vitamin B12 and docusate sodium. I did my patient checks before administering and gave medications under the supervision of my clinical instructor. I safely administered a PRN puffer to my patient after recognizing she was very wheezy. Demonstrate 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. I was able to witness the pre-op and recovery from a bronchoscopy in week three. The patient had to be NPO for 6 hours before the procedure and NPO for one hour after. I was able to see what occurs when a patient is unable to take their medication in the morning due to a procedure, the daily medications were given when she was no longer NPO but her novorapid was held in the morning. I was able to participate in a simulation code blue in my third week where my clinical partners and I worked as a team to run through what a code blue might be like. We successfully revived our patient. My patient who went for a bronchoscopy had a change in condition when she came back from the procedure. When I did my initial assessment her chest was clear and she had no trouble breathing. When she returned she was wheezing as she breathed and I safely administered a PRN puffer and documented my findings. Identify potential consequences/complications of chronic illness The patient who had hypercalcemia could have mant potential side effects if they HCP’s can’t find out the underlying reason for the increased calcium. The patient may not be able to absorb other important nutrients like iron and magnesium. The patient could also develop arrhythmias because of the role calcium plays in heart muscle contraction. My patient who was being treated for an infection from his central line, if left untreated could have went septic and then into shock and possibly arrest. A central line is a a venous catheter that is inserted directly into the blood stream to get to the heart as quickly as possible. An infection that begins in a central line can be harmful in itself because of the close proximity to a patients heart. This is why the patient underwent the transesophageal echocardiogram because a complication could have been an infection in the heart. The same patient was also undergoing chemotherapy for his Birkitt’s lymphoma. Chemotherapy can cause many different reactions, nausea, vomiting, fatigue, loss of energy. His Birkitt’s lymphoma could also cause complications like metastasis and if in end-stage possible death. Under the supervision of a Registered Nurse, demonstrate safe, competent, evidence-based, holistic nursing practice with clients with chronic illness Apply nursing models and theoriesDemonstrate therapeutic use of selfEngage with patients in an ethical and culturally sensitive mannerDemonstrate health promotion and illness prevention practicesDemonstrate patient advocacyPredict outcomes of nursing care Evaluate client response to nursing care Demonstrate accountability and reliabilityI engage with each and everyone of my patients in an ethical and culturally sensitive manner. For example my patient in week one was Catholic and asked me to pray for her to let God decide her future. I am Catholic yes, but not religious at all. I just let her talk to me about her beliefs and her experiences without judgment and in a comfortable safe setting. I am sure to use all of the resources I have to complete my pre-clinical instead of using the internet which can be unreliable I use my pathophysiology, pharmacology, and acute care text books. I have had patients who were on precautions each week I have been at clinical. The first week they were on cytotoxic drug precautions, the second week was contact as well as droplet and the third week was contact. I used my knowledge of disease spread and my knowledge of infection control to prevent the spread of infectious disease to others in the hospital and in the community. Critically appraise own practice in relation to nurse-client/family interactions and as a member of the health care teamIn my first week of clinical I was able to listen to part of a discharge meeting for one of my patients. It was an experience for me because I did not realize how many different decisions and options patients have. My patient was very overwhelmed with all of the options they gave her and I was able to listen to her and reassure her that we all want what is best for her and that the health care team is there to answer any questions she has. I have also been able to observe rounds at 0900 in week one and week three where the different members of the healthcare team discuss each patients case and decide what resources the patient needs to be successful in their recovery. Participate in professional development based on reflective practice and critical inquiry I participate in professional development by researching anything that I don’t quite understand. I did not know what Birkitt’s lymphoma was so I went home and researched it and now have a better understanding of it. I make sure to review medications as often as I can at home and in the clinical setting. I have handed in my first reflective journal as well and I think as a group we show professional development in our post-conference. We all reflect on our days and even help each other to critically think through some tough cases and feelings we have had. Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)Signature of Instructor___________________________________________________Date _____________________________Signature of Student_____________________________________________________Date ______________________________ NURS 3021H Clinical Course Evaluation Final Evaluation Student: __________________________________Clinical Instructor: ____________________________Missed Clinical Hours: ______ Missed Lab Hours: ______Satisfactory Unsatisfactory Please circle the appropriate outcomeNURS 3021H Clinical Course Final Evaluation Program GoalsYear OutcomesStudents graduating from this program are prepared as generalists entering a self-regulating profession in situations of health and illness.To be developedStudents graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a variety of settings. Students graduating from this program are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a variety of settings. Graduates will learn to continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their practice.Students graduating from this program will be prepared to demonstrate leadership in professional nursing practice in diverse health care contexts.Graduates will be prepared to 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 providers.Students will demonstrate the ability to establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based upon relational boundaries and respect.Graduates of this program 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.NURS 3020H Clinical Course Final Evaluation ProgressCourse ObjectiveEvidence/IndicatorsSatisfactoryUnsatisfactoryExplain the experience of chronic illness in individuals receiving care in chronic care settingsInterpret critical aspects of the person’s experience of chronic illness in relation to common signs and symptoms, responses to treatment, patterns of coping, and impact on individual and family relationshipsIdentify common medical treatments of selected chronic illnesses Demonstrate selected nursing and collaborative interventions related. to caring for the person with chronic illness, such as medication administration, physical and chemical restraints, enteral feedings, residual volumes, NG tube insertion, wound care, colorectal screening, patient-controlled administration pumps, neurological assessmentIdentify potential consequences/complications of chronic illness Under the supervision of a Registered Nurse, demonstrate safe, competent, evidence-based, holistic nursing practice with clients with chronic illness Apply nursing models and theoriesDemonstrate therapeutic use of selfEngage with patients in an ethical and culturally sensitive mannerDemonstrate health promotion and illness prevention practicesDemonstrate patient advocacyPredict outcomes of nursing care Evaluate client response to nursing care Critically appraise own practice in relation to nurse-client/family interactions and as a member of the health care teamParticipate in professional development based on reflective practice and critical inquiry Student Areas of Strength1.2.3.Student Areas for Future Development1.2.3.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 outcomeClinical Learning Center Completed (if applicable)______________Signature of Instructor____________________________________Date_______________________________Signature of Student______________________________________Date________________________________ ................
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