Carroll Community College

Division of STEM, Nursing and Allied Health

Department of Nursing
NURS 233 – Nursing Concepts 3
WEEKLY Student Clinical Performance Evaluation

Student Katelyn Patterson Date 12/3/2020 Week # 5 Faculty Prof. Schroeder

Criteria: S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not (*) Critical
(Meets) (Requires assistance) (Unable) applicable 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
Instructor
Student Eval of
Course Goal 1 Self-Eval Student
Analyze the effectiveness of the plan of care (PG1) S/N/U S/N/U
Using faculty as a resource:
1. Prioritizes and completes daily nursing tasks S S
2. Completes assessments accurately S S
3. Uses EMR/MAR, patient charts, handoff report to provide care S S
4. *Establishes appropriate nursing priority list S S
5. Creates measurable patient outcomes S S
6. Establishes appropriate nursing interventions S S
7. Evaluates patient response to care and revises plan as needed S S
Instructor
Student Eval of
Course Goal 2 Self-Eval Student
Seek opportunities that promote professional growth (PG2) S/N/U S/N/U
Using faculty as a resource:
8. Adheres to dress code S S
9. Seeks input from patient, instructor, and healthcare team when providing care S S
10. *Demonstrates accountability and accepts responsibility for own actions and attitudes S S
11. Actively participates in all clinical experiences S S
12. Communicates learning needs to instructor S S
13. Completes assignments/evaluations as required S S
Instructor
Student Eval of
Course Goal 3 Self-Eval Student
Provide patient-centered care with faculty as resource (PG3) S/N/U S/N/U
Using faculty as a resource:
14. *Implements appropriate infection control precautions S S
15. Identifies client’s cultural needs S S
16. Accurately documents patient care S S
17. Communicates appropriately with patient, family, healthcare team, and instructor S S
18. Explains the actions, side effects, and nursing implications of medications S S
19. *Administers medication using the six rights S S
20. Demonstrates concern, compassion and empathy with patients S S
21. *Demonstrates physical and mental competence S S
22. *Notifies instructor and appropriate healthcare team members with safety concerns and changes
in the patient’s condition S S
23. Identifies patient and family health education needs S S
24. Provides nursing care in accordance with the Maryland Nurse Practice Act and the ANA Scope &
Standards of Nursing Practice S S
25. *Adheres to HIPAA guidelines S S
Criteria: S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not (*) Critical
(Meets) (Requires assistance) (Unable) applicable behavior

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18, 1/2020

 Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 233 – Nursing Concepts 3
WEEKLY Student Clinical Performance Evaluation

Instructor
Student Eval of
Course Goal 4 Self-Eval Student
Implement nursing care based on scientific evidence (PG4) S/N/U S/N/U
Using faculty as a resource:
26. Incorporates evidence-based rationales that support the patient plan of care S
S
Student Reflection (Thoroughly answer all questions)
What did you learn this week that has contributed to your growth as a nurse? Please explain.
This week was amazing for me. I accomplished a lot of firsts and got to witness a lot as well. I got to watch a PICC line insert, a NG
removal and an attempt to replace.
MY growth this week started at the beginning of my day when I got to help with a bipap patient who in the end I could not have
but the knowledge I learned really helped me.
Later, I got to provide stable and consistent care to my patients and the staff and continually be on assistance as a team member.
My male patient was getting irritable at the amount of attentiveness he needed but I managed to keep his spirits high and
hopefully kept him happy.

Which objective did you accomplish this week? How did you do it?
This week I accomplished IV confidence. I managed to properly change IV tubing twice and attached it to a brand new inserted PICC
line with no machine error. I also drew my fist heparin injection and did not waste any of the capsule and gave a SQ in which my
male patient complimented my execution. I also emptied my first ostomy bag and was able to observe two in the abdomen.
I gained more confidence in giving medications and delegation to the technicians.
By giving multiple IVs – I am now comfortable looking up compatibilities and I feel that is a very important (not always talked
about) skill.
Overall, this week was a busy day but in the end, I learned a lot and was in constant communication with the primary nurses and
CNAS.

Do you have any concerns about your performance? If so, what are your plans for improvement? Please explain.

The one thing I need to work on is being a bit more assertive, instead of apologizing for my continuous attentiveness to the
patients. I say sorry a lot for bothering them and need to work on that,

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).

Katelyn,
This week you demonstrated flexibility and the ability to change directions at a moments notice. This skill is a tool on a nurse’s
toolbelt which will serve you well. You had an opportunity for a sick and interesting patient but due to COVID we had to reassign
you. Then you had meds due early and had to get going. As you move forward please try to keep the IV hubs and tips of the IV
tubing clean. You did well hanging all those lines but seemed to struggle a bit with sterility of the ends. It can be a challenge with a
patient who had as many lines as your guy did. But I am sure you see how important it is to prevent infection.
The man you were assigned was a challenge as well as the lady in 23. You did a fine job and kept things light but were respectful at
the same time. Way to go!
Now you have had a chance to think about what I said about transitioning from student nurse to nurse and the phrase “I’m sorry”.
What will be your replacement phrase you plan to use when you enter a room and encounter the patient? We spoke about
substituting a different phrase. I was looking forward to seeing you interact this week but clinical was cancelled.
Since you had 2 patients with “big nurse meds” you were jumping, and documentation had to wait until later in the day. Then you
isolated yourself and got the work done. Excellent job!
Positive take aways from our clinical together include your personality is pleasant and you start each day with a positive attitude.

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18, 1/2020

 Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 233 – Nursing Concepts 3
WEEKLY Student Clinical Performance Evaluation

Your appearance is professional, and your body language portrays interest in the patient. Your actions portray true caring and this
builds trust with the patients. Due to your work experience you were able to take the grumpiness in stride and not take it
personally. This paid off with the gentleman in 13 for he perked up and was even trying to make a few jokes at the end.
You have the knowledge to make connections and were consistently able to answer the Socratic questions. I appreciate that you
are willing to ask questions and try to figure it out on your own first.
I see great promise in your nursing abilities.
This is our summative evaluation for our last clinical day was cancelled. You are meeting all the outcomes, so I am not concerned
about missing one day.
Congratulations Katelyn. It has been a pleasure having you in clinical at CHC. I wish you the best as you move forward.

Student Signature: Katelyn Patterson Date:12/3/2020

Instructor Signature: Jane Schroeder, MSN, RN Date: 12/10/2020

Definitions:
Coaching – Faculty guides student to define objectives, set goals, and develop action plans through collaboration in the decision-making process
Assistance – Student unable to perform task independently; needs some aid or minimal direction from faculty to complete tasks. Not autonomous but does not
require coaching.
Resource - Faculty serves as a facilitator but student is capable of completing self-directed tasks.

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18, 1/2020