NURS 3020H Clinical Practice Focused on Acute Care

Fall Midterm Evaluation X      Fall Final Evaluation      

Student:    Weiga Chen  

Clinical Instructor:   Martina McDowell   

Clinical Placement Hospital:   Lakeridge Oshawa 

Date:      

Missed Clinical Hours: 0      Missed CLC Lab Hours: 0     

 NURS 3020H Clinical Practice Evaluation
Program Goals
Students graduating from this program will be:
1. Prepared as generalists entering a self-regulating
profession in situations of health and illness.
2. Prepared to work with people of all ages and genders
(individuals, families, groups, communities and
populations) in a variety of settings.
3. Expected to have an enhanced knowledge of the program
foci: indigenous, women's and environmental health and
aging and rural populations.
4. Prepared to learn to continuously use critical and scientific
inquiry and other ways of knowing to develop and apply
nursing knowledge in their practice.
5. Prepared to demonstrate leadership in professional nursing
practice in diverse health care contexts.
6. Prepared to contribute to a culture of safety by
demonstrating safety in their own practice, and by
identifying, and mitigating risk for patients and other
health care providers
7. Able to establish and maintain therapeutic, caring and
culturally safe relationships with clients and health care
team members based upon relational boundaries and
respect.
8. Able to enact advocacy in their work based on the
philosophy of social justice.
9. Able to effectively utilize communications and
informational technologies to improve client outcomes.
10. Prepared to provide nursing care that includes
comprehensive, collaborative assessment, evidence-
informed interventions and outcome measures.
3000 Level Outcomes
On completion of 3000 level courses students will be
able to:
Fully understand how to practice in a self-regulating
profession.
Analyze clinical situations and reflect on individual roles of the
nurse as it impacts upon patients and the nursing profession.
Rationalize the link between health and illness.
Understand the complexity adults, of all genders, to achieve
optimal health.
Use a critical perspective in applying the foci to nursing
knowledge and practice.
Integrate critical reflective evidence-informed care using
multiple ways of knowing.
Develop and embody leadership at the point of care.
Expand awareness of leadership in nursing.
Identify strategies to develop leadership potential.
Anticipate, identify and manage risk situations.
Demonstrate awareness of resources related to risk
management.
Engages in deliberative personal centred relational practice to
assist individuals, families and communities to achieve health.
Acknowledge own potential to contribute to effective
collaborative team function.
Advocate for individuals, families, and communities
recognizing the influence of public policy on health.
Recognize contextual influences on persons lived experiences
within the health care system.
Integrates and applies critical thinking to the use of
information technology and dissemination strategies as related
to clinical outcomes.
Critically assess the individuals, family and community health
status.
Collaborate to identify priority health needs.
Identify evidence informed interventions and health outcome
evaluation in complex care situations.
Before completing the evaluation form, students and preceptors should review the objectives and sub-objectives. While
students and preceptors should comment on each of the seven course objectives, it is not necessary to write comments about
each sub-objective. It is better to provide specific and detailed comments about a few sub-objectives than to write broadly
about many.

Each objective should be awarded one of the following ratings:

Midterm:
Satisfactory Progress (SP): The student consistently demonstrates sufficient knowledge, and skill and ability to safely practice
or achieve the objective with an average level of teaching support and guidance; or the level of performance is what the
instructor would expect of an average student at that level and point in time; and  the instructor reasonably anticipates that if
the student continues at the current pace of practice and achievement, the student should be able to fully meet the objective
at the end of the course. 
 
Needs Development(ND): The student demonstrates sufficient knowledge and ability to safely practice or achieve the
objective,  but requires more teaching support and guidance; or the student demonstrates knowledge but needs more
practice to achieve the competency; or the level of performance is below what the instructor would expect of the average
student at that level and point in time; and the instructor reasonably anticipates that if the student focuses his/her learning in
the required area, and gains sufficient practice, the student has the potential to meet the objective at the end of the course.

Unsatisfactory Progress (UP): The student does not consistently demonstrate sufficient knowledge, or skill, or ability to safely
practice or achieve the objective, even with constant, intensive teaching support and guidance;  or the level of performance is
far below what the instructor would expect of the average student at that level and point in time; and the instructor
reasonably anticipates that if the student continues at the current pace of practice and achievement, the student is not likely
to  meet the objective at the end of the course. 
Final:
Satisfactory (S): The student consistently demonstrates sufficient knowledge, and skill and ability to safely practice or achieve
the objective with an average level of teaching support and guidance; or the level of performance is what the instructor would
expect of an average student at that level.

Unsatisfactory (U): The student does not consistently demonstrate sufficient knowledge, or skill, or ability to safely practice or
achieve expected objectives, even with constant or intensive teaching support and guidance; or the level of performance is far
below what the instructor would expect of the average student at that level.

Course Objective
1. Provide nursing care that
includes
comprehensive, collaborative
assessment, analysis, planning,  we begin, the patient
evidence-informed interventions
and outcome measures.
● 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
● Demonstrate selected
nursing and collaborative
interventions related to
caring for adult patients with
acute illness, preoperative
and postoperative care, IV
medication
administration, cardiac
assessment and rhythm
strips, neurological
assessment, wound
care, blood component
therapy, TPN, central
venous devices, pulmonary
care including chest
tubes, rapidly changing
conditions, and
resuscitation.   ● When doing the
●  Identify common medical
treatments and potential
consequences/complications
NURS 3020H Clinical Practice Evaluation
Progress
Evidence/Indicators Evidence/Indicators
Fall 2021 –Midterm Fall 2021 - Final
Student: Student:
● I learned about how to
do wound care. Before ● I learned about the importance of doing a comprehensive
assessment on a patient who was burned because multiple
may need pain systems could be affected e.g. pulmonary system,
medication to manage neurological system, integumentary system etc.
the pain during the ● I learned about IV, IM, and subcutaneous medication
wound dressing change. administration in lab
During the procedure, ● I learned about signs and symptoms of pneumothorax and
we first carefully take off treatments for pneumothorax such as using chest tube
the dirty dressings. If the
innermost layer is
attached to the skin, we
can use saline to rinse it
to make it easier to peel Clinical Instructor:
off. Next, we use gauzes
to dry the area to
prevent infection. If
necessary, apply inadine
dressings. We can cut
the pads according to
the size of the wounds.
Then we wrap up the
wounds with clean, dry
dressings, and make
sure the patient is
comfortable before we
leave the room.
subcutaneous infusion,
we first clean the skin
 of selected acute illnesses   with an alcohol wipe,
●  Demonstrate health
promotion and illness
prevention practices.
●  Engage with patients and
families to identify health-
related situational challenges
● Work with patients and
families to create reasonable
and effective solutions.
Progress Midterm
X SP
◻ ND
◻ UP
insert the needle bevel
up at a small angle,
attach a bandaid onto
the site, take out the
needle, attach the
medication to the port,
and flush the tube (as
per Lakeridge’s policy).
The kit should be
changed every two days.
● I learned from the lab
that we should be
careful when removing
sutures because doing it
wrong may lead to
infection. We should
first use the forceps to
hold the notch. Instead
of cutting the middle
portion of the string
that’s exposed to the
outside, we should cut
the end of the string.
This is because if we cut
in the middle, when we
try to pull out the string,
part of the string that’s
exposed to the
environment would need
to go underneath the
skin, and this may result
in infection.
Progress Final
◻ S
◻ U
2. Establish and maintains
therapeutic, caring and
culturally safe relationships
through effective
communication
● Explain the experience of
acute illness in individuals
receiving care in acute
setting
● Demonstrate therapeutic use
of self
● Understand and anticipate
emerging bio-psycho-social
needs of persons with acute
illness and apply this
knowledge to care:
o Plan appropriate
nursing care
o Predict outcomes of
nursing care
o Evaluate client
response to nursing
care
o Demonstrate patient
advocacy
Student: Student:
● Before starting to
measure patients’ vitals, ● I consider my patients’ bio-psycho-social needs when
I will introduce myself preparing the care plan. For example, I identified that a
first and indicate what I patient was at risk for situational low self-esteem related to
am going to do. diarrhea and wearing of a brief, and I planned to support
● When the patient the patient in her attempts to secure autonomy and sense
accidentally exposes of capability.
body parts, I help them ● If the patient is having pneumothorax, I understand that I
cover them up to need to evaluate his or her response to nursing care by
protect their dignity and conducting assessments. For example, has the patient’
privacy. breathing rate decreased to the normal range? Is the
● I encountered a patient patient’s SpO2 within the normal range? Is the patient still
who is not fluent in anxious and restless?
English. I made sure to ● I always ensure patients’ privacy by closing the curtains and
communicate with him only exposing necessary body parts.
patiently and use easy to
understand language.
● After studying the
simulation case study, I
made a care plan Clinical Instructor:
addressing some of the
priority issues such as
respiratory distress, fluid
volume deficit, and
acute confusion. Some
of the interventions I
planned for include
delivering oxygen as
prescribed, monitoring
patients’ breathing and
O2 saturation regularly,
monitoring patient’s
intake and output daily,
and so on.
Progress Midterm
X SP
◻ ND
◻ UP
3. Apply the ways of knowing and
informational technologies to
effectively care for
diverse, acutely ill patients
● Apply relevant nursing
models, philosophical
frameworks, theories and
evidence   vital sign and so I can
● Adhere to policies and
practice of the institution.
● Use knowledge gained in
theory and labs to support
patient care decisions
● Uses best practice guidelines
Progress Final
◻ S
◻ U
Student: Student:
● I utilized my knowledge and skills learned in labs to
● I learned about the administer medication and perform subcutaneous
normal values of vital injection.
signs at the labs, it helps ● I used my knowledge gained in theory courses and labs to
me to see if the patient perform cardiovascular assessment and pulmonary
is having an abnormal assessment e.g. recognizing abnormal signs
● I learned to use the best practice guideline for
inform the health care administering medication i.e. check MAR against
team if that happens. order→check medication (name, dosage, expiry date)
● I also learned from the against MAR upon taking it out of the cart →check
nurse to check the medication against MAR again at the patient’s bedside.
patient’s vital signs
before administering
medications. For
example, if the patient is
having low blood
pressure in the morning, Clinical Instructor:
nurses should hold the
hypertension
medications and inform
the physician first.
● I learned from the lab
that when inserting the
nasal gastric tube, we
should first assess if the
patient can cough and if
their gagging reflex is
intact. Then during the
procedure, if the patient
is coughing vigorously

Progress Midterm
X SP
◻ ND
◻ UP
4. Adhere to professional practice
standards and organizational
polices to contribute to a culture
of safety.
● Critically appraise own
practice in relation to nurse-
client/family interactions
and as a member of the
health care team
● Engage with patients in an
ethical and culturally safe
manner
● Demonstrates accountability
● Demonstrates reliability
and the SpO2 is
dropping, we should
retreat the tube because
it likely goes into the
trachea and will lead to
respiratory distress.
Progress Final
◻ S
◻ U
Student: Student:
● I maintain patients’ ● I arrived at all labs and clinical placement on time. I had to
privacy and uphold their miss a lab due to an extreme weather condition, but I made
dignity by remembering sure to email the course coordinator first.
to close the curtains ● I asked for the patients’ consent before performing any
when I help to wash the procedure on them e.g. bathing the patient, feeding the
patient, and by only patient, administering the medication
exposing the necessary ● Sometimes patients would ask me questions regarding
body part during any their care (e.g. about the medication or the treatment). If I
procedure. did not have the answer, I would tell them that I did not
● I encountered a patient have an answer for them at the moment but I would go
who is not fluent in figure it out, and I made sure I returned to the patient with
English. I made sure to an answer.
communicate with him
patiently and use easy to
understand language.
● When I tell the patients I
will assist them doing
something or bring them Clinical Instructor:
something, I always
remember what I have
promised and do what I
have told them.
 ● I arrive at the hospital
and labs on time.
Progress Midterm Progress Final

X SP ◻ S
◻ ND ◻ U
◻ UP

5. Exercise leadership to enhance Student: Student:

patient care, and support
professionalism in practice
● Participate in professional
development based on
reflective practice and
critical inquiry   ● I reflect on my practice
● Support peers
● I exercise leadership by
giving proper
instructions to patients’
families regarding how
to feed the patients.
and learning after each
shift and lab, and I
document what I have
learned so that I do not
forget.
● I support my peers’
learning during the first
shift by showing them
how to do vitals
● When my peers were not able to perform the procedure by
themselves, I went to assist and support them in
performing the task.
● I learned about transformational leadership theory in NURS
3004. In an assignment, I reflected on my past experiences
using the theory and I developed an action plan to improve
my leadership skills. For example, I planned to closely
observe how experienced nurses on the floor convey their
message and influence others.
● I supported my peers by sharing with them how I perform
head-to-toe assessment.

Clinical Instructor:

Progress Midterm Progress Final

X SP ◻ S
◻ ND ◻ U
◻ UP

This section to be filled out Student Areas of Strength Student Areas of Strength
by the student.
1. Willingness to learn 1. I am reliable, I live up to my promise
 2. I took notes after 2. I am more confident in interacting with patients
each week of clinical and performing assessments on them now
so that I do not
forget the skills that I 3. I am supportive, I am willing to help my peers out
learned when they need it

3. I always keep the Student Areas for Future

patients in mind and Development
I will try my best to
make sure they are 1. Still not proficient enough in bathing the patient
as comfortable as and performing peri care
possible
2. Need to be more familiar with the names and
Student Areas for Future functions of different medical supplies
Development
3. Need to improve on empathetic communication
1. The ability to use skills
medical terminology
needs development

2. The ability to
conduct a thorough
head-to-toe
assessment needs
development

3. The ability to
smoothly clean the
patient needs
development
 (bedbath, brief
change, and shower).

Clinical Instructor Summative Comments:

Weiga is progressing well in this course. Despite the regional challenges of this semester with not having access to Epic, Weiga continues to
work on meeting course objectives. Weiga has had four 8-hour clinical shifts on the Cardiology Unit at the Lakeridge Health Oshawa
Hospital thus far and though she has not physically been in the clinical environment due to the ongoing pandemic, she is functioning quite
well. On her first day she had a shadow shift to orientate to the unit and the routines of the Cardiology Unit and also to establish her
comfort of being in the clinical environment and caring for real people. Despite some trepidation Weiga displays an eagerness to learn,
seeks out learning opportunities around the unit, and is not afraid to ask questions or ask for help. She also helps her colleagues and other
nurses when she is available. Weiga has not been able to perform certain crucial aspects of nursing such as assuming care for a patient,
documenting assessments and cares, and administering medications to patients as yet due to the challenges of the semester. However, she
has been able to perform vital signs assessments and performed ADLs for multiple patients over these 4 shifts and this has allowed her to
become more confident and competent in these aspects of care. She has communicated any assessments and cares provided to the primary
care nurses for documentation in to Epic. Weiga has had the opportunity to observe the process of medication administration with nurses
on the unit and is encouraged to reflect on the process of medication administration including the recommendations of CNO regarding the
checks and rights of medication administration. Weiga participates fully in post conferences sharing experiences and enhancing overall
group learnings. She has also attended a wound care presentation with our clinical group and the wound care specialist at Lakeridge
Health. She has a great attitude towards nursing and this will benefit her as she progresses in this career. She conducts herself
professionally and communicates effectively with clients, colleagues and clinical instructor. I am confident that Weiga will become more
competent and confident as the semester progresses and as she is able to do more with having access to Epic. Keep up the great work.
End of Term Clinical Practice Outcome (completed by Clinical Instructor): Satisfactory X Unsatisfactory ☐

Clinical Learning Centre

Attended mandatory skills workshop       Attended practice OSCE session      

Total number of unfolding case studies completed in the HUB       4 / 4

OSCE (S/U):      

Clinical Learning Centre Outcome (completed by Course Lead): Satisfactory ☐ Unsatisfactory ☐

Signature of Course Lead: __________________________________Date: _____________________

Signature of Clinical Instructor: _____ __________Date: _March 4, 2022________________

Signature of Student: _______ _________________Date: ___Mar 21, 2022__________