NURS 3020H Clinical Practice Focused on Acute Care

Winter Midterm Evaluation       Winter Final Evaluation      

Student: Erin Collins

Clinical Instructor: Jennifer Roesler

Clinical Placement Hospital: PRHC Unit A5

Date: March 20, 2022

Missed Clinical Hours: 16 hours 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.
 NURS 3020H Clinical Practice Evaluation

Course Objective
1. Provide nursing care that includes
comprehensive, collaborative
assessment, analysis, planning, 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 have interpreted critical aspects of the
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.   on a heel and a coccyx and preventative
  Identify common medical treatments and
potential consequences/complications of
selected acute illnesses   Many of the patients that I worked with
  Demonstrate health promotion and illness
prevention practices.
  Engage with patients and families to identify dementia, so I was completing
health-related situational challenges
 Work with patients and families to create
reasonable and effective solutions.
Progress Midterm Progress Final
 SP  S
 ND  U
 UP
Progress
Evidence/Indicators
Fall 2021 –Midterm
Student:
Throughout the clinical term so far, I
have provided nursing care that includes
comprehensive, collaborative
assessment, analysis, planning,
evidence-informed interventions, and
outcome measures in multiple ways. I
patient’s experience of acute illness by
completing comprehensive assessments
of numerous patients (i.e., completing
head to toe assessments). During
clinical, I witnessed numerous wound
care dressing changes, as well as
completed some on my own. Some of
the dressings included a sterile wound
packing, pressure ulcer wound dressing
wound dressings on pressure points.
during my time on the unit had some
sort of cognitive decline or a form of
neurological assessments as I went
throughout the shifts. I was constantly
assessing my patients when providing
any care (i.e., providing an
integumentary assessment when
providing HS care, toileting or bathing
the patient, pain assessments, assessing
the patients’ outputs, etc.). I
Evidence/Indicators
Fall 2021 - Final
Student:
Throughout the clinical term, I have
effectively provided nursing care that
includes comprehensive, collaborative,
assessment, analysis, planning, evidence-
informed interventions, and outcome
measures. I was able to interpret critical
aspects of the person’s experience of acute
illness. For example, many of the patients I
cared for were recovering from a hip or
knee replacement surgery, so I was
assessing for pain, effective pain
management, signs of infection at wound
site, adequate healing, and so on. I
demonstrated nursing interventions related
to caring for caring for adult patients with
acute illnesses such as providing post-
operative care for multiple hip and knee
replacement surgeries. Some of the nursing
interventions that I provided surrounding
post-op care included analgesic medication
administration, wound care, removal of
staples and stitches, and assistance with
ambulating, transferring, and repositioning
of affected limb. I practiced numerous IV
nursing skills, including practice in
hanging/changing IV bags, priming lines,
changing IV tubing, assessing IV sites, and
removing locks. I demonstrated health
promotion and illness prevention practices
by practicing good hand hygiene techniques
demonstrated health promotion and throughout my shifts, using sterile
illness prevention practices by technique when providing wound care, and
promoting independence in ADLs (e.g., by following good infection control
when toileting and encouraging procedures.
independent feeding). I also ensured
that I was repositioning my patients
regularly when in bed, transferring them
into their chairs, when possible,
between meals, and applying any
preventative wound care measures or
appropriate measures to prevent any
skin breakdown. I engaged with my
patients to identify health-related
situational challenges by using
therapeutic communication techniques
to help assess the situation at hand and
ways to overcome them. For example, I
redirected many patients with dementia
by using therapeutic communication,
building a therapeutic relationship, and
assessing what they were upset about in
that moment, and working with the
patient to find a solution. For example,
there was a patient on the unit with
dementia who consistently was going
around the unit crying and visibly upset.
We found that talking with the patient
did not help, as anything you said would
make them cry more. But, after forming
more of a therapeutic relationship with
the patient and speaking to the other
nurses on the unit, we found other ways
to redirect the patient (i.e., giving them
a task to complete and focus on like
gathering supplies from the linen cart).

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
Progress Midterm Progress Final
X SP  S
 ND  U
 UP
Clinical Instructor:
Erin has demonstrated a successful head
to toe assessment. She was able to
perform a complex dressing change with
assistance. She helped multiple patients
with feeding and ADL’s.
I look forward to more opportunities for
skills and learning with Erin.
Progressing well.
Student:
I established and maintained
therapeutic, caring and culturally safe
relationships with multiple patients
throughout my clinical shifts. I ensured
that I was using effective communication
techniques such as maintaining eye
contact, actively listening, and actively
engaging in the conversations. I
understand that there will be different
biopsychosocial needs with each
individual patient and that it is
important to assess not only the physical
aspects/needs, but the psychological
and social ones of each patient as well. I
also understand that these needs will
help to determine the proper plan of
care, outcomes, and client response of
each patient. I will also use my
knowledge and my power to advocate
for my patients whenever possible. On
the unit that I was on for my first two
shifts, many of the patients had
cognitive decline or dementia, making it
Student:
I both established and maintained
therapeutic and caring relationships with
the patients that I cared for throughout my
clinical term. When I was caring for the
patients on the floor, I ensured that I was
using effective communication techniques
such as maintaining eye contact, actively
listening, and engaging in conversations,
and therapeutic touch when appropriate. I
can understand and anticipate emerging
bio-psycho-social needs of persons with
acute illness and apply it to care. For
example, I can plan appropriate nursing
care, predict outcomes of the care
provided, and evaluate the patients’
response to the nursing care that I
provided. I also demonstrated patient
advocacy, by advocating for my patients
needs. For example, one of the patients I
was caring for during this rotation had an
NG tube with low intermittent suction. They
were NPO as they had a bowel obstruction.
The patient was not receiving any

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   always using empirics and science to
 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 Midterm Progress Final
X SP  S
 ND  U
very important that they have somebody
there to properly advocate for them and
their care.
Clinical Instructor: Came to clinical
prepared to work and learn. She planned
out the needed care for patients and
performed accordingly. She was able to
recognize the patient’s cognitive status
and help out as needed and advocate for
their care.
Progressing well.
Student:
I used the ways of knowing (i.e.,
empirics, esthetics, personal knowledge, practicing throughout this clinical term in
and ethics) when practicing this clinical numerous ways. I used empirics and
semester so far in multiple ways. I am
inform any decisions or tasks that I
complete. I use esthetics by perceiving
and evaluation other aspects of a
situation other than empirics to guide
any clinical decisions I may make. For
example, empirically, to redirect a
patient with dementia we are taught
that speaking with them and talking
about different things will help to
replacement fluids to account for the
electrolyte imbalances, as they were only
receiving normal saline. The patient’s
potassium levels were on the lower end in
the normal range. So, to advocate for the
patient in this scenario, I voiced to the
nurse about what I had noticed and
questioned why the patient was not
receiving anything else to help
maintain/correct any electrolyte
imbalances. This demonstrated patient
Student:
I effectively used the ways of knowing when
evidence-based practice guidelines when
making any decisions or performing any
nursing interventions. I was able to use
esthetics by evaluating and perceiving
aspects of the situation other than
empirics, using it to guide my clinical
decisions and judgement. I used my past
personal knowledge to guide and foster my
clinical judgement/decision making skills.
Both from past clinical semesters working
on a chronic unit and from working in a
 UP redirect them. This was not the case for
one of the patients I worked with. So, I
had to use my esthetic way of knowing,
which entails a lot of perception and
empathy to decide other than what we
were empirically taught. I used my
personal knowledge from my past
experiences at work or in other clinical
rotations to guide many of my decisions
and care for my patients as well. For
example, when completing any wound
care, a lot of the supplies I was familiar
with solely because of working in a
retirement home with assisted living for
a couple years now. So, I was able to use
my personal knowledge to provide care
more effectively to the patient, knowing
what supplies have worked for similar
situations in the past. Lastly, I used the retirement home, I have gained valuable
ethical way of knowing by using my experience that I used throughout this
moral knowledge to ensure that I was clinical term. For example, I have prior
always making the ethical and right knowledge in basic wound care, so I was
decision for the patient. I adhered to all able to apply this to more advanced wound
best practice guidelines, ensuring that I care dressings within the hospital. I also had
was keeping the nurses on the unit up to personal knowledge about providing ADLs
date with everything I had completed and medication administration as well. This
and any assessment data that I noted. helped me form a base of knowledge with
which I then built from within the clinical
Clinical Instructor: term. I used the ethical way of knowing to
Adheres to the policies and procedures always make ethical and sound decisions
set out by PRHC. Has shown good best for the patients’ needs. I ensured that I was
practice guidelines while performing providing care to the best of my ability and
tasks. Was able to use what she was adhering to best practice guidelines.
taught in class and labs and bring it into
the clinical setting when dealing with her
patients.
4. Adhere to professional practice standards and Student:
organizational polices to contribute to a culture I ensured that I was adhering to
of safety. professional practice standards and
organizational policies to contribute to a
 Critically appraise own practice in relation to culture of safety in multiple ways. I
nurse-client/family interactions and as a
member of the health care team ensure that I am always critically
 Engage with patients in an ethical and appraising my own practice, reflecting
culturally safe manner on ways I could always improve in the
 Demonstrates accountability future to become a better nurse overall.
 Demonstrates reliability I am aware of my own beliefs and
values, to ensure that I am not bias in
Progress Midterm Progress Final any way. I am always educating myself
and open minded to all cultures,
X SP  S
ensuring that I am working in a culturally
 ND  U
safe manner. I demonstrated
 UP
accountability by always letting my
clinical instructor and/or another nurse
know what I was doing and updated
them afterwards. For example,
whenever I would toilet a patient, I
would let their nurse know so that they
can be aware and properly document
the situation (as we had no access to
EPIC). I demonstrated reliability by
always doing what I said I was going to
do. For example, if a patient asked for a
glass of water, I would ensure that I
followed through with that, establishing
trust between the patient and myself.
Furthermore, if a nurse asked me to do
something, I always made sure that I
completed that task and reported back
to them when it was completed.
Clinical Instructor:
Demonstrates practice reflection thus
Student:
Throughout this clinical term, I ensured that
I was adhering to professional practice
standards and organizational policies to
contribute to a culture of safety in
numerous ways. I critically appraised my
personal practice regularly, always
reflecting on aspects that I could improve
upon to better my practice overall. I always
engage with patients in an ethical and
culturally safe manner. I am always learning
and educating myself about different
cultures, practices, beliefs, and viewpoints,
so that I can provide culturally safe and
competent care to my patients. I
demonstrated accountability throughout
the term by always remaining accountable
for my own actions, ensuring that I am
keeping all the nurses that I work alongside,
and my clinical instructor know what I am
doing/the outcome of the intervention. I
also demonstrated accountability by
documenting nursing interventions
completed (when able to access EPIC) or
telling the assigned nurse the proper
information so that they could properly
document it. I demonstrated reliability by
continuing to always do what I said I was
going to do. For example, if the patient
asked me to come back in one hour and
transfer them to their bed, I would ensure
that I was honoring that and returning in an
hour. Also, if a nurse asked me to complete
a task, I would ensure that I completed
what they asked me to, and followed up
with them regarding the completion of the
 far. Participates in post discussions. Very
reliable and follows through on what she
is asked. Often updates me on what she
is doing and has done and asks questions
task and/or the outcome.
when needed. Shows accountability
thus far.
5. Exercise leadership to enhance patient Student:
care, and support professionalism in practice I exercised leadership while in clinical by
stepping up and helping whenever I
 Participate in professional development could. For example, some of my
based on reflective practice and critical
inquiry   colleagues in my clinical group have not
 Support peers had any in person placements due to the
pandemic. So, even though it is not their
Progress Midterm Progress Final fault, they have no experience working
with patients in general or experience
X SP  S doing the basic skills of nursing (i.e.,
 ND  U changing briefs, transferring, etc.). I was
 UP privileged enough to work in a
retirement home with assisted living and
have thus, gained more experience with
the basics. I tried to help my peers
whenever possible and tried to make
sure that they got the most out of their
experience there as well. I also worked
on my own professional development by
reflecting on what I could have done
better or changed next time, to
ultimately improve my nursing skills and
practice overall. There is still, and always
will be, so much to learn, so I ensure
that I am always asking questions and
observing other nurses, when possible,
to continue to improve as much as I can.
I ensured that I was working
collaboratively with others, supporting,
Student:
I participated in professional development
by regularly reflecting and critically
inquiring on my own practice and how I
could improve. For example, one of the
things that I would like to continue to
improve on is time management. So, I
would reflect on ways that I could improve
this aspect daily and try to enact those
improvements. Reflective practice is a
major aspect to nursing, so I will continue
to use this to keep improving and
developing my practice and skills overall. I
supported my peers by always assisting
them in ways whenever I could. For
example, if somebody needed assistance
with a wound dressing change, I would help
them to the best of my ability.
Furthermore, if I had the opportunity to
witness or perform a nursing skill that I
believe they would also benefit from or
would be interested in watching, I ensured
that I found my peers and opened the
opportunities to them as well. Nursing is a
team effort, so I always try to support my
peers wherever I can, as they do with me as
well. Overall, I had great peers to work with
this semester that made the semester such
a good learning experience.

This section to be filled out by the
student.
and working with my peers as a team.
Clinical Instructor:
Has shown to be a great peer and helper
to the other students. Shares her
knowledge and learns from theirs as
well. Able to reflect and learn from
others.
Student Areas of Strength
1. Communication
2. Organization
3. Working collaboratively
Student Areas for Future
Development
1. Time management
2. Focused assessments
3. Practicing more acute skills
(i.e., advanced wound care, IV
maintenance and care, and so
on)
Student Areas of Strength
1. Communication
2. Organization
3. Working collaboratively
Student Areas for Future
Development
1. Time management – I believed I
improved on this aspect, but I
want to improve more with time
and practice
2. Using EPIC charting – D/t not
having complete EPIC access for
most of the time at clinical, this is
something I need to
practice/improve on
3. IV medication administration
skills – I improved/practiced this
 aspect, but I would like to keep
learning and practicing as I
continue my education to
become an RN

Clinical Instructor Summative Comments:

Midterm: look forward to more time with you in the clinical setting. Progressing well

End of Term Clinical Practice Outcome (completed by Clinical Instructor): Satisfactory Unsatisfactory

Clinical Learning Centre

Attended mandatory skills workshop       Attended practice OSCE session      

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

OSCE (S/U):      

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

Signature of Course Lead: __________________________________Date: _____________________

Signature of Clinical Instructor: Jen Roesler Date: 2/9/22

Signature of Student: ______________________________________Date: March 20, 2022