NURSE 3021 Summer2013 Clinical Practice Focused on Chronic Care. Self-Evaluation Form-Midterm Page _1_ of 10

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1 NURSE 3021 Summer2013 Clinical Practice Focused on Chronic Care Self-Evaluation Form-Midterm Page _1_ of 10 Student Name: Scott Wight Designated Hospital and Unit: PRHC A2 Competency Category (Circle one) Professional Responsibility, Knowledge-based Practice, Ethical Practice, Service to the Public, Self-Regulation Goals Short Term: I will present a seminar which focuses on the nature of professionalism in nursing with a focus on team collaboration, communication, and nursing leadership. This will be accomplished by May 16 th. Long Term: I will ensure that, over the course of the entire clinical and by its completion, that will I seek help from my instructor, other nursing colleagues, and peers when presented with an activity or skill with which I am uncomfortable or need guidance. Activities, necessary resources and timeframes (What do I need to do to achieve my goals? What do I need to help me achieve my goals? When will I achieve my goals?) Short Term: I will research through the library and CNO/RNAO websites to find articles, studies, and best practices regarding the establishment and details of maintaining good team communication and nursing professionalism. I will also find information at PRHC which may discuss these issues and their own recommendations for success. On May 16 th I will present my findings to my clinical group for discussion. Long Term: Although every encounter is different and presents its own problems, I will critically analyze each with the intention to act with the proper knowledge skill and judgment to complete my tasks appropriately. If I feel uncomfortable or unsure, I will seek the help of those that do (specifically my clinical instructor) to gain the knowledge I require. Resources (both goals):

2 My peers, clinical faculty, nursing school faculty and members of the health care team Books : High-Acuity Nursing (Wagner, 2010), The New Leadership Challenge (Grossman, 2013), Nursing Theory: Utilization and Application (Alligood, 2006), Pathophysiology: A clinical approach (Lippincott, 2011), Medical-Surgical Nursing in Canada (Lewis, 2010), Fundamental of Canadian Nursing (Kozier, 2010), and Clinical Drug Therapy for Canadian Practice (Brophy, 2011) Trent University Website/Library Internet PRHC resources - Policies Evaluation Am I achieving my goals where is the evidence? Short: I had the opportunity to present a seminar on the CNO s entry to practice competencies and the importance of maintaining the tenets of our profession on May 17 th. I felt I was able to give some examples and foster some discussion regarding professionalism and areas in which students who are soon to enter the nursing profession, as well as those already working, could re-evaluate and understand. I provided the clinical group with a set of CNO competencies on transparent cards which they could use to identify and become more familiar with. I felt this goal was a success and am pleased with the outcome. Long: I feel this goal has been a success thus far. I ve been able to participate in a number of elements of practice which I was either uncomfortable or unfamiliar with and requested/required the help from my instructor or other nurses. Such activities which I asked for help and participated have been: Participating in SubQ injections, insulin administration, general medication admin (ADU s etc), utilizing slider boards and other devices, admitted and d/c patients, charting and others. What goals or learning activities will I be carrying into the rest of the rotation? I will be continuing to be proactive in my learning and ask questions to ensure I m providing the best and most professional care possible. I ll attempt to keep the CNO competencies in my mind when on the floor and analyze my experiences to become a better nurse. Participated in on-going enhancement of portfolio -continue to update my online portfolio when necessary Signature_Scott Wight Date May 17, 2013

3 Nursing 3021 Clinical Practice Focused on Caring for Patients with Chronic Illness Learning Plan Page 3 of _10 Student Name: Scott Wight Designated Hospital and Unit: PRHC A2 Competency Category (Circle one) Professional Responsibility, Knowledge-based Practice, Ethical Practice, Service to the Public, Self-Regulation Goals From the CNO National Competencies, (2008), Knowledge-Based Practice # 37 Uses appropriate assessment tools and techniques in consultation with clients and other health care team members From the CNO National Competencies, (2008), Knowledge-Based Practice # 44 Engages clients in identifying their health needs, strengths, capacities and goals (e.g. the use of community development and empowerment principles, networking strategies, understanding of relational power and community capacity assessment) Short Term: I will find at least one practice/tool which the nurses/practitioners utilize to assess aid their clients recovery as it pertains to a particular disease/condition. Long Term: Over the course of the entire semester, ending in June, I will use literature and best practices to develop and strengthen my relationships with my clients to help them feel empowered, both mentally and physically, as they go through their daily routines on the Unit. I will attempt to make my relationship with them sincere attempt to find out more about them so that I can quicken their recovery and personal wellbeing.

4 Activities, necessary resources and timeframes (What do I need to do to achieve my goals? What do I need to help me achieve my goals? When will I achieve my goals?) Short Term: During each day on the floor I will write down at least one practice which I have found useful and/or standard for my particular client. By May 18 th I will have established a suitable list of interventions that are used and can refer to them when I contend clients who contend with those illnesses. Long Term: I will research one article which pertains to a particular element of rehabilitation and may aid my clients. I will utilize this information to help myself as a student nurse and colleagues as well During one post-conference, if there is an opportunity, I will discuss the findings with my colleagues. Resources (both goals): My peers, clinical faculty, nursing school faculty and members of the health care team Books : High-Acuity Nursing (Wagner, 2010), Nursing Theory: Utilization and Application (Alligood, 2006), Pathophysiology: A clinical approach (Lippincott, 2011), Medical-Surgical Nursing in Canada (Lewis, 2010), Fundamental of Canadian Nursing (Kozier, 2010), and Clinical Drug Therapy for Canadian Practice (Brophy, 2011) Trent University Website/Library Internet Evaluation How will I know that I have achieved my goal? Short: I have found numerous tools in which rehab nurses/practitioners utilize to help their patients. This list has included: Using the Moto-med to improve circulation, strength, and balance; slider boards for transfer, special belts to support clients, communication techniques to speak to stroke patients, charting protocols (ie: pathways); precautionary protocols (ie: stickers (R,Y,G) on boards, lifting techniques, types of dressings and benefits of certain types (mepilex s, tagaderms etc), and others I feel this goal has been a success as I have accumulated a list and continue to document my activities and learning. Long: I have yet to research an article re: this goal, however, there is time and will hope to inform my colleagues at a future post-conference. What goals or learning activities will I be carrying into the rest of the rotation? I will continue to document my activities and different techniques used on the Unit. I will research an article for future learning. Participated in on-going enhancement of portfolio -continue to update my online portfolio as necessary Signature_Scott Wight Date May 17, 2013

5 Nursing 3021 Clinical Practice Focused on Caring for Patients with Chronic Illness Midterm Page _5_ of _10 Student Name: Scott Wight Designated Hospital and Unit: PRHC A2 Competency Category (Circle one) Professional Responsibility, Knowledge-based Practice, Ethical Practice, Service to the Public, Self-Regulation From the CNO National Competencies, (2008), Ethical Practice # 98 Advocates for clients or their representative especially when they are unable to advocate for themselves. From the CNO National Competencies, (2008), Ethical Practice # 96 Accepts and provides care for all clients being respectful of diverse health status, diagnosis, experiences, beliefs, and health practices. Short Term: I will ensure that every encounter is met with the notion that the client s needs are paramount in their ability to heal and recover, and will ensure to look for signals or communicate with them to establish if they have needs which are not being addressed. Long Term: Every encounter will be met with an open mind and from a very neutral perspective, as each patient experiences life different from the next. I will be respectful and cognizant of their own needs regarding each patient until the end of the semester. Activities, necessary resources and timeframes (What do I need to do to achieve my goals? What do I need to help me achieve my goals? When will I achieve my goals?) Short Term: I will develop a checklist for myself regarding my goals, and ensure that before I go into each encounter I am reminded of the client s needs and factors which may inhibit their recovery. I will advocate for them immediately (by the end of the day at the latest) if I recognize that they may need something which is not being acquired. The checklist may be reviewed by the midterm evaluation. Long Term: I will be open-minded and understanding as possible regarding each patient. I will keep a list of some situations which I felt were difficult or ways in which I might have learned from a particular event. I

6 will ensure the ethical safety of other patients as well to ensure that they are also given the same treatment and advocate for them if needed. This will occur over the entire semester. Resources (both goals): My peers, clinical faculty, nursing school faculty and members of the health care team Trent University Library Evaluation How will I know that I have achieved my goal? Short: I have generated a chart which indicates all of my goals I had set for myself during my clinical. I have used this as a way to remind myself and ensure that I am able to get the most of my clinical placement. I feel I have succeeded in this manner and will attach the checklist for my midterm evaluation. Long: I believe I have been progressing fairly well so far. Although I have had some good discussions regarding different situations on the unit with other nurses and colleagues, I feel I need to do more to evaluate this goal. I will aim to improve this following the midterm. What goals or learning activities will I be carrying into the rest of the rotation? I will concentrate on communicating more with my instructor regarding my thoughts with patients where I demonstrate (or have problems demonstrating) open minded-ness and ethical care as it pertains to specific situations. Participated in on-going enhancement of portfolio -continue to update my online portfolio as necessary Signature_Scott Wight Date May 17, 2013

7 Nursing 3021 Clinical Practice Focused on Caring for Patients with Chronic Illness Midterm Page _7_ of _10 Student Name: Scott Wight Designated Hospital and Unit: PRHC A2 Competency Category (Circle one) Professional Responsibility, Knowledge-based Practice, Ethical Practice, Service to the Public, Self-Regulation Goals From the CNO National Competencies, (2008), # 107 Uses established communication protocols within and across health care agencies, and with other service sectors. From the CNO National Competencies, (2008), # 101 Enacts the principle that the primary purpose of the registered nurse is to practice in the best interests of the public and to protect the public from harm. Short Term: I will find out more about the procedures in place which communicates with other health care agencies such as CCAC, family doctors, or specialists as it pertains to the rehabilitation floor at PRHC. This will be completed by May 18 th. Long Term: To work within my scope and ability to ensure that I provide my patient(s) with the best possible care while acting in their best interests. This will occur over the course of the semester.

8 Activities, necessary resources and timeframes (What do I need to do to achieve my goals? What do I need to help me achieve my goals? When will I achieve my goals?) Short Term: I will talk to my clinical advisor, nurses, and use PRHC policies to determine how communication is disseminated to other Health Care providers. I will document these so that I understand the process involved Long Term: This task will also be completed with the help of my peers, research which I have done, and communication with my colleagues. I will communicate as much as possible and ask questions with my preceptor and research articles or best practices on my own to establish the proper ways to accomplish tasks.. If I am unsure of a task or skill to always seek guidance from my clinical faculty or other health care team members. Resources (both goals): My peers, clinical faculty, nursing school faculty and members of the health care team Books : High-Acuity Nursing (Wagner, 2010), Nursing Theory: Utilization and Application (Alligood, 2006), Pathophysiology: A clinical approach (Lippincott, 2011), Medical-Surgical Nursing in Canada (Lewis, 2010), Fundamental of Canadian Nursing (Kozier, 2010), and Clinical Drug Therapy for Canadian Practice (Brophy, 2011) Trent University Website/Library Internet PRHC resources - Policies Evaluation How will I know that I have achieved my goal? Short: This goal, for the most part, has been a success. I had a lengthy conversation with the P.T., Amanda, who was able to give me some good information re: the inter-professional communication involved at the rehab unit. I was able to get information about the CCAC and the details involved in how they integrate all of the professional assessments/recommendations to establish an appropriate home care plan. I gathered other information about how the PT/OT communicates and develops plans for patients, the types of services available for patients and how they communicate with the CCAC and how there are other details, such as finances and living conditions, pertains to their level of care following A2 therapy (ie: RN s 2 hrs/wk etc ). I was also able to speak to my clinical advisor about these services to gain more knowledge as well. Long: This goal has been going well so far. I never accomplish any tasks in which I am not familiar with and seek my clinical advisor or another nurse if required. I usually take the time to research the pathophysiology and common treatment regimens for my patients in order to understand what may be needed. I have used my textbooks and the Web to find most of the information, but will try to use research articles in the future to enhance my learning. Signature_Scott Wight Date May 17, 2013

9 Nursing 3021 Clinical Practice Focused on Caring for Patients with Chronic Illness Midterm Page _9_ of _10 Student Name: Scott Wight Designated Hospital and Unit: PRHC A2 Competency Category (Circle one) Professional Responsibility, Knowledge-based Practice, Ethical Practice, Service to the Public, Self-Regulation Goals From the CNO National Competencies, (2008), # 117 Distinguishes between the legislated scope of practice and the registered nurses individual scope of practice based on own level of competence. From the CNO National Competencies, (2008), Self-Regulation # 123 Demonstrates continuing competence by (c) obtaining feedback from peers and other sources to augment one s assessment and develop a learning plan. Short Term: I will research an article which demonstrates the difference between a nurse s legislated scope of practice and individual scope. During my time as a student nurse I will practice safely and ensure that I practice with the knowledge, skill, and judgment of a particular task, regardless of legislated or nursing school learning objectives. Long Term: I will always welcome insight and feedback on my practice skills and communication techniques from clinical faculty, peers and health care team members and encourage communication in this vein.

10 Activities, necessary resources and timeframes (What do I need to do to achieve my goals? What do I need to help me achieve my goals? When will I achieve my goals?) Short Term: As stated, by May 18 th I will research one article which discusses the problems in adhering strictly to legislated practices and ignoring one s one scope of practice. Long Term: I will ask for feedback from my peers, health care team members, and my clinical advisor. I will be self-reflective after every clinical to assess my weakness and find areas which need improving. I will ask my peers and clinical faculty for advice and insight on how to strengthen my weaknesses. In my communications with others I will always look for new or different ways to complete tasks and skills. I will always look to enhance my practice through the feedback of others. Resources (both goals): My peers, clinical faculty, nursing school faculty and members of the health care team Books : High-Acuity Nursing (Wagner, 2010), Nursing Theory: Pathophysiology: A clinical approach (Lippincott, 2011), Medical-Surgical Nursing in Canada (Lewis, 2010), Fundamental of Canadian Nursing (Kozier, 2010), and Clinical Drug Therapy for Canadian Practice (Brophy, 2011) Trent University Website/Library Internet Evaluation How will I know that I have achieved my goal? Short: This goal has yet to be fully completed. I have always practiced within my own knowledge and scope and practice, however, I have yet to research an article regarding this competency. I feel I ve been doing well with many of my goals and hope to complete this by the end of the term. Long: This ongoing goal has been going well. I often request feedback and receive it from both my preceptor, colleagues, and other nurses. I ve been able to evaluate my skills accordingly ie: med skills and where I can improve, sterile/clean technique, and others. Signature_Scott Wight Date May 17, 2013

11 Professional Responsibility Scott your seminar was educational and resourceful great job. Scott you come to clinical prepared with pre clinical information completed. You recognize your limitations by asking questions and seek help as necessary. You are a team member who can be relied upon to accept responsibility and accountability for your practice. You are also knowledgeable about your patient s and you report and document care in a clear, concise and timely manner. Course objectives number 6 met: 6. Under the supervision of a Registered Nurse, demonstrate safe, competent, evidencebased, holistic nursing practice with clients with chronic illness: -Demonstrate therapeutic use of self -Engage with patients in an ethical and culturally sensitive manner Knowledge-based Practice Scott you are able to apply your knowledge and use critical inquiry to support your decisions on patient care. When questioned about patient care and outcomes you are knowledgeable about your patient s Hx, data and outcomes. Your knew knowledge of the different types of tools used on rehab will enhance your practice. This clinical placement has also given you a strong base in nursing knowledge related to pathophysiology, pharmacology and the ADU, nutrition such as thick fluids, minced foods ect. Objective # 5 met: Demonstrate selected nursing and collaborative interventions related to caring for the person with chronic illness, such as medication administration, wound care, neurological assessment. I do suggest you take your time and not rush through procedures ie. Medication administration, new dressing changes many errors are made when nurses rush to complete tasks. Ethical Scott your ethical practice to date has demonstrated honesty, compassion and respect for those you care for. You ensure safety and privacy for your patients and other member of the health care team. -Meets course objective #6 c Scott you are very personable and therefore it makes it easy for people to like you and to communicate with you. Service to the Public/ Self-Regulation Scott you practice safely and report any unsafe practices to you clinical instructor or health team member to minimize harm to the patient. Your confidence, and self-awareness in taking responsibility for your practice and decisions is evident. You have created therapeutic relationship with your patients this term and you have been a resource for your peers. You seek opportunities to meet you learning goals. Keep up the good work Satisfactory Kelly