Practical Nursing Diploma Program HUMBER School of Health Sciences Final Clinical Evaluation Form Student: Courtney Braithwaite Student Number. _ 823-144-563, Course: _Nurs*264 Section __05. Dates: March 12" to April 15° 2014 as Final grade: Satisfactory ‘Summary of Areas of ‘Student Comments: Faculty Comments: Practice Summary of clinical ‘Summary of cl ‘experience Experience ‘Competent and safe practice S (i through vil) in a professional, legal and | agree with your comments: ethical framework ii, Acted in a responsible and othical manner Courtney has developed her throughout the placement. | sxils throughout the semester Ensured | took ‘and is able to provide safe, responsibility for all ofmy | competent care for one complex aE ar meade sure $0 | patient atthe WOHS Brampton eek whet Weeiasiaaate) Civic site. She followed the how to do something (bed | acc ward policies and alarms, dressings; ocean a cespomsle and positioning etc.). Peet Soi ‘always looked after my | 2¢Countable manner. Courtney pationte to the bost of my” | ‘arfied her plan of care Ability, and wasn't afraid to | frequently with the clinical ask for assistance. [helped | teacher and staff when others with repositioning —_| uncertain, Safety was a priority because | had more for her and she made sure bed strength, and rail and bed position were documentation because! —_| correct and that her clients were was efficient at it Imade | comfortable and safe at all times. sure to spend time Courtney practiced good body improving my assessments | mechanics by raising the bed to and | have recognized ! need | her ievel while giving care to practice sterile dressings and suctioning. viii. | have demonstrated understanding about the Tocopnizing an we PY | infection contol standards responsible for my patients | (™sks, hand cleaning, waste Care and checking on them, | “sposal etc) were consistently but that I still depend on the | ™et during patient care. staff for assistance with the hoyer lif, suctioning and | Courtney completed the required yxis machine medications. | medica diagnoses and medication research plus she «reated medication ue cards for easy reference while giving medications. She was always able ‘She was present and punctual for all 14 weeks of clinical practice.to state the drug action and possible side effects when ‘questioned. Courtney was always careful to administer her ‘medications using the MAR, Identifying her client and asking ‘or checking for allergies. Courtney planned her day by Using an organizational plan. She was consistently able to provide all care for her clients within a reasonable time frame. Communication Ss: |. | always participated in team sharing, attempting to provide tips and feedback for my peers wherever possible. | took part in discussions with the interprofessional team, fellow students and clinical instructor. ii. did my best to document clearly and accurately in a timely matter. | aways made sure to document a minimum of 3-4 times throughout the shift and tried to do it asap afler providing care. | also assisted my fellow classmates as often as needed. ii, | reported relevant information to appropriate personnel, such as when my Patient needed to be suctioned, when | needed help with the bed alarms, when there was conflict or miscommunication between staff and myself, | ensured to involve my clinical instructor. iv, lused a variety of ‘communication techniques throughout placement. Using sign language and yes no sentences for my patient who was aphasic and using a calm ‘and soothing voice. I also made sure to communicate professionally with staff and my clinical instructor. 'S (ithrough vi) | agree with your comments. Over the semester Courtney was able to acquire the skills needed to provide accurate documentation using the ‘Meditech system for her clients. ‘This required practice and asking staff members for assistance. Courtney received staff, clinical teacher, and peer support so that the required details were documented correctly and by the end of the semester she was helping her peers. Courtney consistently charted all medications administered clearly and promptly in the MAR. She always identified her client first ‘and asked for allergies, as a safety precaution, Courtney communicated well ‘with all staff, peers, and clinical ‘teacher. She was responsible for receiving and verbally giving a report on her patient throughout the day, at shift changes, and when leaving the ward for breaks. Courtney maintained the confidentiality of her clients at all times, She spoke to RZ. and Mr. A. frequently even though one hhad aphasia and severe ‘neurological impairment and the other did not speak English. Courtney participated well in post conferences and groupdiscussions. She was always upbeat and bubbly with enthusiasm and a positive attitude. Caring relational practice i made sure to talk to my pateints when in their room {and providing care. Always informing them of what I am doing and making sure to use a soothing environment. | also made sure to check base with my patients and always ask if they were okay. ii, | demonstrated therapeutic and compassionate care for my patients. | made sure to moisturize and massage their skin during a bath, spend time doing their hair and holding their hand or rubbing their back. | also played games with one of my clients ensuring to engage him and encourage him to be active and enjoy our time together. v. Linteracted with clients and the inter-professional team in a respectful manner, always ensuring that | was patient and professional vil. I respected that my first client was a young generation and chose her entertainment to stimulate her accordingly, With my second client, | recognized that he was religious and played his music, took him to the bathroom to wash his hands and face after praying (according to his religious values) and made sure the room was quiet and | did not speak while he was listening and praying out of respect for his culture. S (ithrough | agree with your comments. Courtney demonstrated caring, and compassion in the therapeutic relationships she developed with her clients. She regularly spoke with kindness to her non-verbal client despite a severe neurological impairment. ‘She was patient and kind to her other client who often had negative behavior and refused care. She would play therapeutic ‘games and take him for walks in his wheelchair. Courtney communicated and interacted ‘well with peers, staff, and clinical teacher. She respected the diversity and religious practices of her clients and shared some of her own practices with her clinical group in one of the labs. Leadership and advocacy cy Worked to recognize contficts when my client was being diffcult and not co-operating S (ithrough vil) | agree with your comments. Courtney advocated for her patients and performed all carewhile providing assistance with | his ADLs. In moments where | was frustrated or feeling stressed, | took a deep breath, and recuperated myself to ensure that | didn't react. ii, Demonstrated leadership skills that foster group work by encouraging my coworkers to take part in discussions and involve them in dialogue. Was Tot afraid to take the initiative to communicate with the staff members and ask questions during in-services, ili | identified opportunities to improve my clients care by ‘engaging him in games and by taking him for waiks to stimulate him. | identified his need for activity and attention 8 an intervention to relax him and engage him, v. I supported my clients right for choice by always asking before feeding him, asking what he wants to eat, what he wants to wear, what games he | wants to play etc. | wanted to ‘ensure that even though he ‘cannot communicate his ‘opinions on his own, he could atleast make a choice for his preference. in their best interest and to the best of her ability. she offered her client Mr. A choices, respecting him as an individual with rights. She was observed to be polite and approachable in all staff and peer interactions throughout the semester. Courtney isa pleasant student and always willing to help her peers and staff She gave and received peer feedback well. Courtney showed leadership skills in her ability to lead discussions, offer suggestions, and approach the staff for guidance regarding patient care. All assignments were done well and as requested. Plans of care: Meeting Clients Needs and Mutually Agreed Expected Outcomes i. incorporated unique needs and expected outcomes into my patients plans of care. | realized that my frst patient needed to be given affection and enjoyed having her hair done and her head massaged to relax her and comfort her. realized that my second client needed to be encouraged to eat and that he needed to be offered food throughout the day to maintain his blood glucose, therefore | would check in on him periodically and always offer snacks throughout the day multiple times a day. S (ithrough vi | agree with your comments. Courtney submitted two excellent nursing care plans using Roy's Model. She was able to gather data, analyze it to find the problems, prioritize and then create three Step 2 nursing diagnoses with appropriate ‘outcomes and interventions. She performed several nursing assessments. Time management and organizational skills have developed well during the semester as Courtney became familiar with the ward routines.Ti. Tassessed that my client needs to be engaged in activity to calm him and keep him quiet. l ensured I was able to keep him company and socialized with him whether by speaking or playing games whenever possible. recognized games he enjoyed playing more, that used his fine motor skills, judgement abilities and his cognitive function. | made the executive decision that smaller puzzies were better, and that I would only step in to assist him after he tried on his own and had received my guidance. vii. Completed all nursing care responsibilities and interventions in an organized and timely manner. | made ‘sure my patient was always up and ready before breakfast, and that I fed him his dinner while it was hot before giving hhim his evening medications. | finished my care with enough time to always be able to socialize and interact with my client because | realized that interaction is an important part to his experience of care. All care was completed in a timely fashion and Courtney was always helping her peers after her care was completed. She used a daily organizational plan. Assessment skills have improved throughout the semester. | Courtney had clients that required daily abdominal, skin, respiratory and neurological ‘assessments. She was able to ‘complete and document these as required. Courtney performed many skills for the first time including subcutaneous injections, tracheostomy suctioning, sterile dressing changes (trach, Gtube ), enteral feed management, bathing and hygiene, 42 hr repositioning, bed making , accurate taking of vital signs ‘manually plus many more. She safely administered the correct ‘medications with clinical teacher supervision, identifying her client, and inquiring about allergies, Collaborative Practice S: ii. worked with my aphasic client fo learn to communicate hhow to check on him and his ‘needs without being able to talk. I learned how to assess his needs by pointing, using thumbs up, bringing food to him, the commode to him etc. il. Thelped staff members with other patients and their care to take the opportunity to learn and see new things. | helped with blood work on a patient, MRSA swabs, and pressure ulcer wound care. ‘S(ithrough vij | agree with your comments. Courtney worked on a nursing ‘team that included RNs, RPNs, and PSWS. She often worked with 2 student partner as her ‘assignment included complex nursing care on a client with a severe neurological condition. Courtney assisted other students with the care of their patients when asked. ‘She was present for several inter- professional in-service sessions ‘and learned about the roles of other professionals involved in the care of her clients, mainly recreation therapy, respiratory therapy and infection controlpractices. Quality Assurance i. acted in the best interest of my clients to protect them from harm by always taking safety measures into place when Patients are in bed (bed rails up and in lowest positiong) when in wheelchair (seat belt ‘on). | made sure that | always had the wheelchair close by when transferring my Patientand always had a pillow beside the bedrail when turning my patients to prevent them from hurting themselves, il. have participated in many self reflections throughout the semester and have worked hard to reflect on my strengths and weaknesses and determine where | could improve. | made sure to reflect after each day at clinical and determine what | was happy about and what | should have done differently. iv. | tied to seek out learning ‘opportunities and encouraged both my peers, staff and instructor to provide me with feedback on my progress and give me guidance for ways to improve. | want to ensure that | can be the best that I can be, and | recognize that S (through vi) | agree with your comments. ‘There was much learning for you ‘with your fist patients, and self- reflection was a good method to ‘see your strengths and. developmental needs. You are a self-reflective student and write excellent reflections. Courtney submitted several reflective journals including a ‘midterm and final evaluation. ‘She participated in peer review and submitted a self-evaluation and learning plan for next semester. Her learning plan needs include improvement with sterile technique, tracheal suctioning, and repositioning and turning patients. These will come with practice and experience. Courtney researched her clients! medical diagnoses and medications, which were 2 clinical requirement. She attended 3 Clinical Simulation labs at the College. Critical Thinking, Problem ‘Solving and Decision Making S ji, Use problem-solving and decision making skills to determine which activities were best for my patient to boost his self esteem and encourage involvement. 1 ‘made the decision of when to stop playing games or give hhim alone time based on his state of attitude. ¥. | prioritized patient care ‘accordingly. | made sure that my patient was tolleted and cared for before meals. | made ‘sure to check on my peers to S (through vii) agree with your comments, Courtney has shown development in critical thinking skills over the course of this semester. All skills performed hhave required this. ‘She has created two nursing care plans with data, problem Identification, nursing diagnosis, and interventions for patient ‘eave, She has learned how to prioritize care especially whenoffer assistance only after my dlients have to be up in the chair patient was looked after and | by a certain time (Mr.A) in the settled. morning, I did my best to ensure that his teeth were brushed after meals to prevent thrush and | always encouraged him to eat and drink Courtney showed accountability bby completing all assigned work such as medication and diagnoses research as requested Post lab Blackboard quizzes in week9 were completed with passing grades. ‘Attendance: No days absent Punctuality: Good Courtney, you have done a super job this semester! You have succeeded in every way. Your bubbly personality has made it a pleasure to be your first clinical teacher. | wish you all the best in your future studies. Ihave read and understand this form and its contents Student Signature: _ Courtney Braithwaite Date: April 15" 2014 Facult