Carroll Community College

Division of STEM, Nursing and Allied Health

Department of Nursing
NURS 133 – Nursing Concepts 1
SUMMATIVE Student Clinical Performance Evaluation

Student Hanna Lowman Date 11-29-2018 Week # Faculty Prof Combs

S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not applicable (*) Critical behavior
Students who meet any of the following criteria will be given a remediation plan and may be placed on probation.
Failure to progress in these areas may result in failure of the course.
-One unsatisfactory grade in a critical behavior -Two needs improvements in a critical behavior
-Two unsatisfactory grades in a non-critical behavior -Four needs improvements
Student Instructor
Self- Eval of
Outcome 1 Eval Student
Use the components of the nursing process when creating a plan of care (CO1) S/N/U S/N/U
1. *Prioritizes patient care based on assessment with coaching S S
2. Demonstrates accurate patient assessment skills with coaching S S
3. Gathers data from the patient’s medical record to provide patient care S S
4. Uses patient assessment data to develop individualized plan of care with coaching S N
5. Establishes appropriate nursing priority list based on collected evidence and patient S
assessment with coaching S
6. Establishes measurable patient outcomes based on nursing priorities with coaching S S
7. Establishes appropriate nursing interventions based on assessment with coaching S S
8. Evaluates patient response to care and revises plan as needed with coaching S S
Student Instructor
Self- Eval of
Outcome 2 Eval Student
Develop an awareness of opportunities that promote professional growth (CO2) S/N/U S/N/U
9. Demonstrates professional behavior and appearance S S
10. Seeks input from patient, instructor, and healthcare team in the delivery of patient- N
centered care N
11. *Demonstrates accountability and accepts responsibility for own actions and attitudes S S
12. *Adheres to attendance policy S S
13. Participates actively in all clinical experiences S S
14. Engages in self-reflection and communicates learning needs to instructor S S
15. Completes assignments as required and submits on time S S
Student Instructor
Self- Eval of
Outcome 3 Eval Student
Provide patient-centered care with coaching (CO3) S/N/U S/N/U
16. *Implements appropriate infection control precautions S S
17. Provides culturally sensitive care with coaching S S
18. Documents patient care accurately with coaching S S
19. Uses beginning therapeutic communication skills S S
20. Follows through with all patient care with coaching S S
21. Verbalizes knowledge of medications for assigned patients S S
22. Demonstrates caring behaviors S S
23. Uses SBAR to communicate patient status to instructor with coaching S S
24. Identifies issues needing advocacy for assigned patients S S
25. *Demonstrates physical and mental competence S S
26. *Identifies safety concerns and notifies instructor and appropriate healthcare team S S
Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18
 Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 133 – Nursing Concepts 1
SUMMATIVE Student Clinical Performance Evaluation

members
27. Identifies ways to spend clinical time more efficiently S S
28. Identifies patient and family health education needs S S
29. *Updates instructor and healthcare team regarding changes in the patient’s condition S S
30. *Provides nursing care based on the policies and procedures of the facility S S
31. *Provides nursing care in accordance with the Maryland Nurse Practice Act S S
32. *Adheres to HIPAA guidelines S S
33. *Provides care according to ANA Scope and Standards of Nursing Practice S S
Student Instructor
Self- Eval of
Outcome 4 Eval Student
Explore the scientific evidence that supports the patient’s plan of care (CO4) S/N/U S/N/U
34. Identifies evidence-based rationale that supports the patient’s plan of care S S
Student Reflection (Thoroughly answer all questions)
How has this clinical rotation helped to define your role as a nurse? Please explain.
This clinical rotation helped me to understand what a hospital setting is like, as I only have experience in long
term care. This clinical rotation helped me to “think like a nurse” and identify priorities and how to reach a goal
with a patient.

Which objective did you accomplish during this rotation? How did you do it?

I began to think like a nurse, to evaluate a patient, identify priorities, implement interventions.

What are your goals for your next clinical rotation?

For next clinical rotation, I want to gain more confidence in the clinical setting. Most patients will look at a
nursing student as incompetent and are not as receptive to care from a nursing student. I want to get more
comfortable in the hospital setting.

Faculty Comments/ Student Learning Goals (Goals must be established even if performance is satisfactory.
If an item was identified as N or U, narrative comments are necessary to clarify student performance along
with goals to improve performance).

Hannah, great week 4. You did a wonderful job caring for a patient who not only has much experience being
around the medical field, but with two family members also being physicians/surgeons. I can imagine being in
nursing school and caring for this patient could be stressful, but you did a wonderful job.

Your week 4 paperwork looks great! Assessment is solid and med list looks good. Awesome job incorporating
the feedback throughout the past 4 clinical experiences. I don’t want you to feel incompetent when you are in
clinical. You are in clinical to learn and that is exactly what you’re doing. Your confidence will rise, and it will
Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18
 Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 133 – Nursing Concepts 1
SUMMATIVE Student Clinical Performance Evaluation

get easier. Keep advocating for your patients and paying attention to detail and it will get easier as the
semesters progress. Learning to think like a nurse is the reason we have clinical.

When you mention “Most patients will look at a nursing student as incompetent and are not as receptive to
care from a nursing student”, in my experience this isn’t always true. I think this is more of an attitude we take
on when we come into clinical. Attitude is everything. Patients will often appreciate nursing students and enjoy
their company and support which I think you’ll see in your next hospital rotation (not on ortho). Going into the
next semester, continue working on assessment skills and how to think like a nurse!

Awesome job this semester, feel free to reach out if you ever have questions and I wish you the best of luck
throughout the rest of the program!!

Best,
Prof. Combs

Student Signature: Hanna Lowman Date: 11/29/18

Instructor Signature: Date:

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18