Student Name __________Tiffany Ching___________ Date ________4/10/17________

N360 Weekly Self Evaluation #5

1. Considering your patients current status, list potential complications and strategies for prevention and early
recognition.
This week, I had the opportunity to care for an elderly adult with a right hip hemiarthroplasty.
Some potential complication of having this procedure may include fracture of the femur, dislocation, infection,
loosening of the implant, and pain. Strategies for prevention consists of mild-moderate exercise, proper diet, proper
body mechanics, and reporting to HCP if pain in joints occur.

2. Am I getting more comfortable with the use of the nursing process to plan and evaluate nursing care? (Give
examples of how it is better now or problems that still bother you).
During our 5th week of clinical, I realize that I am becoming more comfortable with using the nursing process to plan
and evaluate my care for my patients. As we near the end portion of clinical rotation, I feel that I have improved a long
way and coming up with a plan of care is not as complicated as how I thought it was before.

3. Were my nursing diagnosis and plan of care individualized for my patients? (Give examples of how you did this.) Do I
have difficulty in this area? (Explain).
This week, I focused more on the patients overall health versus just looking at his diagnosis. Since this patient had a
right hip hemiarthroplasty I focused on range of motion exercises while he was in bed. I also educated him on how to
prevent further complications by encouraging him to ambulate to the bathroom instead of using the urinal. I feel that I
am improving in this area of plan of care as we move on during this rotation.

4. How are my assessment skills developing? Am I being as thorough as I need to be? What areas are still difficult for
me and what am I doing to improve? (Be specific).
My assessment skills are improving because the nurse I followed allowed me to do more hands-on skills with her
patient load. The assessment skills have been getting better each week, however I feel that making time for DAR
charting is something I need to work on.

5. What new skills did I implement this week? How did I do? What could have helped me to improve? Did I ask for help
when I needed it?
This week, I felt more independent in giving care to my nurses patient load of 4. She allowed me to think for myself
and try to plan out the day by giving whose meds first and what to do afterwards. It almost felt like having my own load
with her supervision. There was a lot of skills to learn such as time management and giving report to the physician
during rounds and hopefully by the end of this rotation I will be more comfortable with it.

6. How is my time management progressing? What areas of difficulty have I found and what can I do to improve? How
do I monitor my time management while in the clinical area?
My time management is improving as I assisted the nurse and her patient load during the 5th week. However, I still
feel that time management is something I will improve on even after this rotation. The nurse I followed told me that
anything could happen and to be able to adapt to the situation is important or youll drown in your work. I managed my
time in the clinical area by planning on seeing the most stable patient first then work my way down.

7. Was I involved in making referrals for my client in any way? How could the nursing role in this process have been
strengthened?
This week, I was not involved to make any referrals for my client in any way but I offered asking the nurse if after
discharge the patient is able to have physical therapy at home or a home health aide assist him until hes able to
ambulate on his own.

8. List the specific interventions, in order of priority, for two of your clients and explain how you determined which
interventions took precedent.
a. Assess skin/incision color, temperature, and integrity; note presence of erythema or inflammation, loss of wound
approximation.
b. Promote good hand washing by staff and patient.
c. Postural drainage and percussion PRN - mobilizes secretion.
d. Turn on unoperated side using adequate number of personnel and maintaining operated extremity in prescribed
alignment. Support position with pillows and/or wedges.
e. Medicate before procedures and activities.
f. Total hip PT: Quadriceps and gluteal muscle setting, isometrics, leg lifts, dorsiflexion, plantar flexion of the foot.
g. Palpate pulses on both sides. Evaluate capillary refill and skin color and temperature. Compare with non-operated
limb.
h. Assess reports of pain, noting intensity (scale of 010), duration, and location.