3020 Midterm Evaluation

1. a) Interpret critical aspects of the person’s experience of acute illness in relation to

common signs and symptoms, responses to treatment, patterns of coping, and impacts on
individual and family relationships 

 Recognizing signs of infection – redness, heat, pain, fever, swelling, diaphoresis

 Recognizing signs of failure to cope – confusion, anxiety, immobility, not adhering to
care plan or goals, not meeting pathway requirements
 Impacts on individual and family – anxiety, ensuring the client is understanding pre and
post-operative care through

1. b) Demonstrate selected nursing and collaborative interventions related to caring for

adult patients with acute illness. Pre and Post-op care, IV medication, physical assessments,
wound care, rapidly changing conditions, and resuscitation.

 Pre-op care – collecting a patient’s baseline vitals and mobility

 Post-op care – encouraging coughing and deep breathing after anesthetics, calf pumping,
patient education on weight bearing and proper positioning in bed
 IV medication – assessing IV site, spiking new bags, programming IV pumps with my
instructor
 Physical assessments – head-to-toe assessments
 Wound care – cleaning wounds with NS, changing dressings, documenting findings,
irrigating wounds
 Rapidly changing conditions – frequents vitals, collaboration with MRN and instructor on
best next steps

1. c) Identify common medical treatments and potential consequences/complications of

selected acute illnesses

 Common orthopedic medical treatments are as followed:

o Total knee replacements – infection, improper positioning leading to altered
healing, ambulating according to the pathway
o Total hip replacements – infections, confusion, consequences of bending hips
more than 90 degrees, fusion

1. d) While engaging with patients and families, demonstrate health promotion and illness
prevention practices specific to their health-related and/or situational challenges.

 Health promotion – education on clean dressing changes after discharge, hand hygiene,
adequate nutrition
 Illness prevention – coughing and deep breathing to dry up secretions, calf pumping to
avoid DVT
2. Establish and maintains therapeutic, caring and culturally safe relationships through
effective communication.

 Introducing self to patient, asking about themselves, their family and home situation
 Finding common interests to (professionally) bond over
 Making myself available to the patient to answer any questions of concerns
 Using therapeutic techniques such as appropriate comforting touch, maintaining eye
contact, having a friendly and positive approach

2. b) Demonstrate therapeutic use of self and patient advocacy

Therapeutic use of self – sitting with patients in emotional distress, holding their hands and
incorporating therapeutic touch, encouraging patients to voice any concerns or fears they have
about pre or post-op
Patient advocacy – consulting my MRN and instructor with any change to the plan of care I
believe would be appropriate (e.g. putting a patient on oxygen or changing a patient’s ambulation
status from X1 assistance to X2)

2. c) Understand and anticipate emerging bio-psycho-social needs of persons with acute

illness and apply this knowledge to care: Plan appropriate nursing care, predict outcomes
of nursing care, evaluate client response to nursing care.

A common emerging need of a person with acute illness on the orthopedic surgery unit is pain
management. Appropriate nursing care includes administering analgesic medications including
opioids. Predicted outcomes of said nursing care include decreased pain, pain management and
prevention of break-through pain. Response to nursing care should be a score of 3/10 or below
on the pain scale.

3. Apply the ways of knowing and informational technologies to effectively care for diverse,
acutely ill patients.

 Empirical way of knowing – interpreting vital signs

 Personal way of knowing – recognizing anxiety in patients pre and post-op, providing
compassion for patients in distress
 Aesthetic way of knowing – recognizing signs of boredom or loneliness, confusion or
delirium

3. a) Apply relevant nursing models, philosophical frameworks, theories and evidence

(including best practice guidelines).

The nursing metaparadigm consist of concepts such as person, health, environment and nursing. I
always take these concepts into consideration during my nursing practice.
Person – practicing patient-centered care
Health – health promotion, illness prevention, patient history, diagnosis
Environment – conscious of patient privacy, clean environment
Nursing – nursing interventions (dressing changes, administering medications), pain
management, proper documentation, compassion, therapeutic relationships

3. b) Adhere to policies and practice of the institution.

 Administering medications with my clinical instructor (3 checks)

 Providing education from the PRHC surgery booklets
 Hourly rounds, timely documentation
 Following proper PPE

3. c) Use knowledge gained in theory and labs to support patient care decisions.

Through lab and theory courses, I have gained knowledge in wound care, IV pumps and
medications, documentation, neuro assessments, acute care interventions, leadership theories

3. d) Uses best practice guidelines.

I use best practice guidelines while administering medications (performing my 3 checks),

transfers of patients in and out of bed (lowering bed, putting down head and bedrail), and pain
management.

4. Adhere to professional practice standards and organizational polices to contribute to a

culture of safety.

 Proper use of PPE

 Using the sharps bin after
 Reporting any threats to safety (aggressive behaviors from patients)
 Proper disposing of bio hazardous materials

4. a) Critically appraise own practice in relation to nurse-client/family interactions and as a

member of the health care team

I believe I have demonstrated the ability to develop therapeutic relationships with client’s and
their family members. My friendly demeanor makes it easier to facilitate conversation with the
patient and interact with their family. I have also included myself in change of shift reports and
attended meetings with the physicians.

4. b) Engage with patients in an ethical and culturally safe manner

 Always embracing patient-centered care

 Frequently asking the patients opinion on plan of care
 Encouraging questions
 Using good communication with other members of care team, especially MRN and
instructor
4. c) Demonstrates accountability and reliability

 Arriving on time with a professional appearance

 Signing hourly rounds, proper documentation and descriptive documentation
 Having basic knowledge on drugs I will be administering during the shift

5. Exercise leadership to enhance patient care, and support professionalism in practice.

 Demonstrating basic skills to peers who needed a refresher of certain areas of care such
as bed baths, changing briefs, emptying catheter bags and repositioning patients in bed.
 Encouraging peers to answer call bells

5. a) Participate in professional development based on reflective practice and critical

inquiry.

 Completing weekly care plans

 Frequently asking questions to MRN and instructor
 Reviewing patient history, medications and care plans
 Participating in post-conference discussion


5. b) Support peers.

I frequently offer my support to peers who may need assistance with tasks such as dressing or
brief changes. I also offer my assistance in charting and documentation whenever possible.

3 areas of strength

 Good communication skills

 Making myself useful – answering call bells, offering help to my assigned nurses as well
as other nurses on the unit
 Time management

3 areas of development

 Remembering all relevant information to assess during daily head-to-toe’s

 Providing patient education as much as possible
 My confidence in giving injections (hand placement)