Carroll Community College

Division of STEM, Nursing and Allied Health

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

Student Hannah Durkin Date 11/19/19 Week # 4 Faculty Carroll Hospital

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 S
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- S
centered care S
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 N/A NA
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 N
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 form me into a better nurse. These first few weeks of clinicals allowed me to put
into practice what I have been learning in school. I now feel that I am ready to deal with real healthcare
situations and real patients. Clinicals were the first real place for me to practice and show my skills that I will be
using as a nurse in the future. Now for the next semesters to come, I will use everything that I have learned
this semester on new patients and possibly a new hospital. I was very nervous on the first day of clinicals, now
next semester I know what it’s like and will be much more comfortable.

Which objective did you accomplish during this rotation? How did you do it?
I feel as though I accomplished a bunch of objectives during this rotation. I learned how to communicate
effectively with not only patients but staff as well. I learned how to create SBAR’s and read over patient
information both online and paper form. I learned how to take vital signs on patients electronically. I assessed
patients from head to toe, including listening to the lungs, heart, and abdomen. Something simple I wasn’t
taught before clinicals but learned over the past few weeks was how to make a hospital bed. I now know the
steps involving AM care including bed baths, brushing teeth, changing briefs, feeding breakfast, etc. I basically
am now able to perform all of the basic care needed for patients.

What are your goals for your next clinical rotation?

My goals for my next clinical rotation involve becoming more confident in caring for patients. Do I know this
skills… yes, but I want to be able to perform them on patients without second guessing myself or having to
look off of a cheat sheet telling me what to do. I also want to become better at making concept maps. I want to
learn more advanced nursing skills that allow me to become a better/improved nurse.

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).
You did indeed grow as a student nurse during this rotation, becoming more confident in what needed to
happen sequentially and working well with the staff of 4 S and also your peers. This growth will continue
throughout your time as a student and does not stop when you are the “nurse”
Knowledge of medications will continue with time and exposure. Continue your goal of knowing the normal to
recognize the abnormal.
Likewise, you will surely have more opportunities to complete concept maps- hopefully this will enable you to
apply the knowledge and begin to think in this manner to complete/implement the nursing process.

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

Student Signature: Hannah Durkin Date: 11/19/19

Instructor Signature: Carol Palmer, RN,BSN,MA Date: 11/25/19

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