MN 561 Midterm Clinical Evaluation Discussion

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MN 561 Midterm Clinical Evaluation Discussion

MN 561 Midterm Clinical Evaluation Discussion

 

 

For the Midterm Clinical Evaluation in Week 5 you will be
required to schedule a preceptor call with your instructor and preceptor
utilizing the faculty directions in the course Announcements. Failure to
schedule or complete this preceptor call could result in failure of the course.

Grading will follow the rubric and will be a collaboration
between your faculty and preceptor. Any area of clinical concern will require
faculty and student conference as well as implementation of an individual
learning plan.

You can find the rubric located in Course Resources.

Clinical Evaluation Process Nursing 3020
Instructions
The Mid-Term Evaluation will be completed by students at the mid-point of the clinical placement to assist students to take inventory of their current
development and assist them to make plans for future clinical practice. The student will use a reflective process to help assess progress in meeting
established program, year, and course objectives. The student will submit an electronic copy of the Mid-Term Evaluation document to the clinical
instructor prior to the formal mid-term student evaluation. Because the document is to be completed electronically, the student and instructor can take
as much space as they need to provide appropriate evidence and feedback.
After receiving the student’s Mid-Term Evaluation, the clinical instructor will complete the comment section providing feedback and evaluation of
the student’s progress. The clinical instructor will provide suggestions for improvement. The instructor will place a check in the “S” column if
progress is satisfactory, and in the “U” column if progress is unsatisfactory. If a student demonstrates unsatisfactory progress at mid-term, the student
and instructor will develop a Learning Plan outlining strategies in which the student will engage, along with clear expectations that must be met for
the successful completion of the course. The course professor may be involved in developing the learning plan.
The student and instructor should save and print a copy of the mid-term evaluation. Printed copies must be submitted to the course professor within a
week of completion.
At the end of the rotation, students will complete a Final Evaluation. Students will use a new copy of the evaluation template to archive their
achievements and areas for future development. The student will submit an electronic copy of their final evaluation to the instructor; this will help the
instructor complete an assessment of the student.
In order to complete the final evaluation, the clinical instructor will provide additional evidence by completing the comment section, providing
feedback and evaluating the student’s progress. The clinical instructor will collect evidence in the form of the student self-assessment, comments of
the health care team members, patient input, student submissions (including portfolios) and observations. A summary of achievement as well as
implications for future learning should be included in this document. The attendance section and record of completed hours is to be filled in
completely. The completed document is to be printed, shared with the student and signed. The signed copy must be returned to the TFSON within 10
days.
The Year Lead, lab instructor, and/or course professor will assess the completion of the Learning Center Component, if applicable.
Students and instructors will complete both the mid-term and final clinical evaluation documents electronically. An electronic copy of the completed
(student and instructor) final evaluation should be submitted to the course professor within 48 hours of the final evaluation delivery. A printed and
signed copy should follow within 10 days of the evaluation meeting

ical Evaluation
3
Program Goals
Graduates are generalists entering a self-regulating profession in situations of health and illness.
Graduates are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a variety
of settings.
Graduates continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their
practice.
Graduates will demonstrate leadership in professional nursing practice in diverse health care contexts.
Graduates will 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
Graduates will establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based
upon relational boundaries and respect.
Graduates will be able to enact advocacy in their work based on the philosophy of social justice.
Graduates will effectively utilize communications and informational technologies to improve client outcomes.
Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed interventions
and outcome measures.
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Objectives Progress
Indicators/Evidence S U
1 Explain the experience of acute illness in individuals
receiving care in acute setting
During my acute clinical experience, I believe that I now understand the
experience of acute illness in individuals who are receiving care. Three
example of my understanding are as follows:
1. I had the opportunity to shadow a nurse on the surgical constant
care unit for a day during clinical. When we went into the patient’s
room, he was standing next to his bed with a blood-spattered sheet
on top of him. We had realized that the patient had pulled out both
of his IVs, his NG tube, and was attempting to pull out his JP drain.
In this situation, the patient was confused and did not understand
why he was in the hospital. It was important for us to explain to the
patient why he was there and why he needed to stay in bed with his
equipment hooked up. I could imagine how difficult it would be to
be in a hospital and not understand why.
2. On March 6th I received an orthopedic patient who had recently had
her right hip replaced. I was told that my patient had not urinated
since her surgery and that she was too afraid to have a catheter put
in. I could understand her hesitation, but my co-assigned nurse and
I knew that it would be much easier for the patient and us if she had
a catheter. I listened to the nurse explain to the patient why it would
be easier and that it will not hurt. She seemed nervous at first but
then understood that it would be more painful to move to the
bathroom than it would be to have a catheter. When we finished the
procedure she was much more relaxed and happy with her choice.
3. During the week where I was team leader, I was able to watch my
peer do a wound packing on her patient’s foot. When we entered
the room to start the procedure, the patient said that she was
nervous and that she was not ready to see her foot. We told the
patient that if she was not ready that she could lay her bed flat and
look up at the ceiling. She seemed to appreciate our idea and was
happy that she did not have to look. The wound looked well, so we
comforted her by telling her how well she is healing. In this
situation, I can understand why the patient did not want to see.
Many patients need time before they can cope with their situation.
Throughout this placement, Megan has developed and demonstrated
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understanding of acute illness in the acute care setting. Megan
understands patient specific needs and can tailor her care to meet those
needs. Megan is strengthening her professional presence in patient care.
Megan had the opportunity to spend a day with a nurse in the Surgical
Constant Care unit. The nurse communicated to me that he was very
impressed with Megan’s knowledge base and willingness to learn.
2 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 impact on
individual and family relationships
1. On February 27th I was assigned a patient who had Wagner’s
granulomatosis. He had already been in the hospital for a number of
weeks and was receiving a hazardous medication (Rituximib) the
following Monday. Although he was in the hospital, the patient was
very independent and did not need help with anything. He was
excited to receive his medication so that he could go home soon.
The patient was coping very well with his diagnosis and was always
in a happy mood. His wife was at his bedside constantly, which he
said helped the process become easier. During one assessment, I
heard the patient tell his wife not to be worried and that he would
be going home soon. Overall, this was a good way of coping as he
had motivation to leave.
2. While shadowing a nursing on the surgical constant care unit, we
had a 40-year-old patient who was ill but had yet to have a
diagnosis. During an exploratory surgery, the surgeon’s opened up
his abdominal cavity and found unknown grey liquid. Afraid that it
was contagious, the surgeon close to them up and sent him to the
surgical constant care unit. The patient was having trouble coping
with his situation, as he still did not know what was wrong with
him. His wife was at the bedside and she seemed very distraught. In
this scenario there was a huge impact on both the individual and his
family.
3. During the week where I was team leader, our clinical group was
notified that someone on the surgical constant care unit had passed
away. Over the next hour I watched the man’s family pass by the
nurse’s station to go and visit him. I felt very sorry for the wife and
family because I can imagine how much they will miss him. This
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result had a huge impact on many people and I am sure they had a
difficult time coping.
Megan is able to use information obtained through her research and her
assessments to understand the patient’s experience of acute illness. Megan
is able to advocate for her patients while maintaining professional
presence. Megan easily develops therapeutic communication and
relationships.
3 Identify common medical treatments and potential
consequences/complications of selected acute illnesses
During this semester, I have seen many medical treatments and have
witnessed their potential consequences.

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1. On March 5th, I received a diabetic patient with bilateral leg
infection. I was told that she had recently had a debridement done
on her left heel. A debridement is the removal of damaged tissue, in
this case, caused by the infection. Unfortunately, the treatment was
unsuccessful for the patient and they had to do a left below knee
amputation to fix the issue. When a debridement of the infected
tissue is not successful, many times an amputation must be done to
stop the spread of the infection.
2. On March 5th, I also received at patient who had been previously
diagnosed with colon cancer and received an open right
hemicolectomy. This is the standard surgical treatment for
malignant neoplasms on the colon. The patient was constipated for
a few days after the surgery. Constipation is common in individuals
with colon cancer and common after a hemicolectomy is
performed. Laxatives can be given to treat the constipation. When
the patient finally had a bowel movement 4 days after the surgery,
small amounts of sang appeared in his stool. Usually after a colon
resection, there may be some blood with the first 1-2 bowel
movements. However, if there are large amounts of blood, a doctor
is to be notified.
3. On March 26th, I was given a patient who had been diagnosed with
a femoral-tibial artery block. Here, the patient had a blocked artery
in his leg, which stops blood flow from passing through the leg and
into the foot. When blood cannot carry oxygen to these parts, the
patient can develop critical limb ischemia. This causes pain and
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eventually the tissue begins to die (gangrene). The treatment for this
blockage is a femoral popliteal bypass surgery. Here, blood is
redirected through a graft, which is either made from a transplanted
blood vessel or one from man made material. . The graft is sewn
above and below the blocked artery so that the blood flows through
the graft and around the diseased part. Although this is a common
surgery, risks can still occur such as an infection, bleeding, swelling
and a failed or blocked graft.
Megan uses her clinical knowledge to understand rationale for common
medical treatments. She is able to recognize the impact these treatments
can have on the patient as well as their family. Using her knowledge base,
Megan understands potential complications for different treatments.
4 Demonstrate selected nursing and collaborative
interventions related to clinical pathways, peri-operative
care, IV medication administration, cardiac assessment and
rhythm strips, neurological assessment, wound care, blood
component therapy, TPN and central lines, pulmonary care
including chest tubes and tracheotomy, initiating IVs,
rapidly changing conditions, and resuscitation
Throughout the semester, I have learned and demonstrated many new
nursing interventions related to acute illness. For example:
1. On March 6th I received an orthopedic patient who had recently had
her right hip replaced. As stated earlier, my co-assigned nurse and I
convinced her to receive a catheter, it’s it would be easier for her to
void through this mechanism. Since I had never inserted a catheter
before, the nurse allowed me to do this under her supervision. The
previous day, I had watched my peer insert a catheter, therefore, I
knew how to prepare the sterile field and ready my supplies. Once I
did this, I inserted the catheter. The patient told me that it did not
hurt as much as she had anticipated and my co-assigned nurse told
me that I did a good job. I now feel comfortable doing this
procedure on my own.
2. This semester, I was able to spend a few days administering
medication for my patients. I was also able to watch an IV be put in
and was taught how to find the right vein. On my medication day, I
learned how to look the medication up in the MAR and take the
correct medication out of the med cart. That week, I was able to
give a subcutaneous injection of enoxaparin. I now understand that
I am supposed to ask the patient their name, date of birth and
possible allergies before I give the medication, as well as go over
the 10 rights to medication administration. This semester I also had
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the change to administer oral medications to my patients. Lastly, I
was able to watch a nurse administer Epimorph through an epidural.
I feel more comfortable with medications at this point and am
excited to do more next semester.
3. This semester I had the opportunity to work on the surgical constant
care unit for a day. Here, my co-assigned nurse and I had a patient
who was tachycardic and had a heart rate of 160. I was able to look
at the electrocardiogram that was done for the patient and the nurse
taught me how to read the rhythm strips. We could then tell that the
heartbeat was irregular as well as tachycardic. We also noticed that
the patient’s P and T wave collided frequently and we notified the
doctor of this issue.
Megan uses her nursing knowledge to understand nursing interventions.
She has become confident in her abilities and skills. Megan is efficient in
her care, and is able to prioritize accordingly. Megan provides safe care,
working within her scope of practice.
5 Under the supervision of a Registered Nurse, demonstrate
safe, competent, evidence-based, holistic nursing practice
with clients with acute illness
1. Apply relevant nursing models, philosophical
frameworks, theories and evidence
2. Demonstrate therapeutic use of self
3. Engage with patients in an ethical and culturally
safe manner
4. Understand and anticipate emerging bio-psychosocial needs of persons with acute illness and apply
this knowledge to care:
a. Plan appropriate nursing care
b. Predict outcomes of nursing care
c. Evaluate client response to nursing care
5. Demonstrate health promotion and illness
prevention practices
a. Engage with patients and families to identify
1. This semester, I was taught how to chart my assessments properly.
This includes doing tick charting and writing detailed progress
notes. I feel comfortable writing my assessments on my own
without having my preceptor look them over. I make sure to include
everything that I have done and nothing that I didn’t do. I now
understand how important charting is and it is a skill that I am glad
I was able to learn this semester. By performing proper charting for
both of my patients on time, I believe that I have demonstrated both
accountability and reliability.
2. Under supervision of my preceptor, I had the opportunity to give
my patients meds for two days. First, I checked my patient’s MARs
and then looked up any medication that I was not familiar with.
This shows accountability, as I wanted to understand which
medications I was giving my patients. I also demonstrated patient
advocacy this day when my patient asked me if he could have his
pain meds. I checked his MAR to make sure his pain meds were
PRN and I delivered them to him with help from my preceptor.
3. During my clinical experience, I received a patient who was very
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health-related situational challenges
b. Work with patients and families to create
reasonable and effective solutions
6. Demonstrate patient advocacy
7. Demonstrate accountability
8. Demonstrate reliability
confused to as why she was in the hospital. When I went into her
room after lunch, I noticed that the patient had a cup of pills in front
of her. She did not understand why the pills were there and I
noticed that she was sucking on one of them. Clearly, she should
not have been left alone with the pills and a nurse should be
watching her take them to make sure they are all taken properly. I
tried to explain to the patient how to take the pills, however, she
had a hard time swallowing them all with water. I then when to get
applesauce for the patient to help her get the medication down. I sat
with the patient to feed her and made sure she took every pill
properly. I believe that I demonstrated patient advocacy in this
instance, as the patient could not take the pills on her own. I also
demonstrated accountability, as I noticed that the patient needed
help and took the time to make sure she took all of her prescribed
medication.
Megan has always come to clinical prepared, demonstrating her
accountability and reliability. Megan develops therapeutic relationships
with ease. She communicates well with other members of the health care
team. Megan advocates for her patients, and understands patient specific
needs. Megan has developed her documentation skills, and consistently
charts with detail and accuracy.
6 Critically appraise own practice in relation to nurseclient/family interactions and as a member of the health
care team
1. During my clinical experience, I had the opportunity to be the team
leader for two days. Here, I was able to help my peers with their
tasks and make sure everyone was getting things done in time. I
enjoyed being team leader because I like to be organized. I also
enjoyed being able to help others with their daily activities and got
to see many different procedures that I haven’t seen before. From
this experience I learned how important it is to be apart of a health
care team and also know that is important to be organized.
2. As a member of a heath care team, I understand that I will
sometimes need help and others may sometimes need my help.
During the semester, there was a day that one of my peers had a
patient with c. difficile. I have never had any experience with this
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diagnosis but I have heard many stories about it. My peer asked if
someone would help her with a brief change. Although I was
nervous and did not know what to expect, I offered to help her. I
believe that an important part of being a team member is to help
with things that you do not always want to do. I ended up helping
my peer multiple times throughout the day and she was very
grateful for my assistance. I also feel more confident now that the
next time I need help with something, she will offer.
3. I believe that it is important to take the time to get to know my
patients. This semester I have made sure to introduce myself and
build rapport with my patients before I begin my assessments. I
understand that I will be with my patients all day long and they
need to trust me and feel comfortable telling me about how they
feel. I believe it is also important to earn each patient’s trust. At the
end of my shift, I make sure to give good rapport to the next student
nurse and introduce them to the patient. This way, the patient
knows that I am leaving and knows who is taking my place.
Overall, I believe that by doing this I am showing responsibility.
Throughout the placement, Megan has critically appraised her own
practice. She receives feedback well, and incorporates this into her patient
care. She is helpful to other students as well as staff.
7 Participate in professional development based on reflective
practice and critical inquiry
During this semester I believe that I have participated in professional
development based on both reflective practice and critical inquiry.
1. Each week, I come to clinical on time and prepared for the day. I
come with my completed pre-clinical assignment and hand it in to
the team leader. The pre-clinical assignment includes looking up
my patient’s surgery and understanding any areas that I am unsure
of. I also have handed in my post-clinical reflections on time. This
consist of my reflection of the week and what new skills I have
learned. I believe that these reflections allow me to review my week
and provide deeper learning by looking at my experiences in a
different context.
2. On March 26th, I had the opportunity to give my patients their
medications. I looked up their meds in the MAR and made sure to
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Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)
Megan is satisfactory at completing all course objectives. She has improved throughout the term, and is confident with her assessments,
documentation, communication and skills. Megan uses knowledge to understand medical interventions and complications. She is becoming confident
with health teaching and promotion. Megan provides safe and competent care, and works within her scope of practice. She is able to develop
therapeutic relationships easily with patients and their families. Megan has progressed well throughout the placement.
Signature of Instructor___________________________________________________ Date _____________________________
Signature of Student_____________________________________________________ Date ______________________________
look up any medications that I have not heard of before. This
allowed me to understand what medications I was giving to my
patients. By looking up the medications and understanding what
they do, I believe I participated in professional development.
3. During a clinical shift, I had extra time to look through my patients
MAR. I noticed that she was to receive enoxaparin at bedtime. I
asked my co-assigned nurse if I could give my patient the subcut
injection because I had never done one before. I believe that this
shows my willingness to learn and ask questions. I was able to give
the injection and not feel more comfortable with subcut injections. I
am excited to develop further when it comes to medications.
Megan has demonstrated continued professional development throughout
the term, as evidenced by interactions in clinical time, as well as in her
post clinical journals and reflections. She is developing her portfolio with
this placement. Her portfolio is professional and very well done.
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(Final Evaluation Only)
Student Areas of Strength
1. Head to toe assessments, tick charting and progress notes
2. Communicating and developing a nurse-patient therapeutic relationship
3. Being emotionally stable
Student Areas for Future Development
1. Knowledge about certain medications
2. Confidence when initially meeting a patient
3. Asking more questions on a regular basis to further my learning
Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment

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