Guide for 3 Way Conversation with MRN, student and instructor The course outlines Consolidated Practice Experiences (CPE) listed as N370, 470, 475, 491 in the University calendar describe two criterion to successfully pass the course; evidence of meeting course expectations obtained through three way meetings and student check ins. In a registered nursing student check in, the instructor seeks out information about how the registered nursing student self reflects about their practice. In a three way meeting, the instructor seeks out information about how health care team members perceive the registered nursing student s practice. The following document provides a guide for instructors to gather evidence from which to assess a registered nursing student s progression through CPE and determine a pass/fail. Questions that might be asked of registered nursing students are in italicized font. Questions that might be asked of preceptors, CLU nurses or other health professionals about registered nursing students are in red font. HEALTH AND HEALING DOMAIN Demonstrate caring relationships with individuals and families experiencing episodic health challenges. Demonstrate that you would consider the patient/client as a member of a family, group and community. Explain how you would attend to the individual and collective needs of patients/clients, including physical, emotional, mental, and spiritual dimensions. Describe how you would be with and relate to patients/clients and families. How do you know when you have demonstrated caring? To your patient? To their family? What acts have you witnessed that suggest to you (student) is a caring nurse? How do you prepare yourself to be caring in a challenging situation such as when a client and family is experiencing suffering, loss, or life threatening conditions? It is our expectation at the School of Nursing that registered nursing students take on challenging patients as part of their learning in CPE. Have you noticed this with (student)? Can you think of a situation where (student) demonstrated caring in the face of complex challenging patient care?
What do you think are some of the factors about the nurse client relationships that have promoted healing for someone experiencing complex health challenges? For the family? How do you adapt to different developmental needs? What impact has your use of technology had on your developing and maintaining a caring relationship? How do you identify and access resources/support systems in the hospital or community for the care of your client or their family? When planning daily activities with patients how does (student) identify and access resources to support patients? How has your knowledge of pain theory been helpful to a client with health challenges? TEACHING AND LEARNING DOMAIN Describe how you collaboratively meet the patient/client learning needs about their health and healing concerns. Identify how you explore with patients/ clients and their families to discover their learning needs and readiness to learn. Show how you work with patients/clients and families to provide accurate and appropriate information. Evaluate effectiveness of health education with patients/clients and families. How does patient education fit into your plan of care of clients? How do you assess the individual learning needs of patients and families? What obstacles and challenges have affected your ability to provide effective patient education? How do you identify and access resources for patients and families health education? How do you evaluate the effectiveness of health education? What kinds of patient education opportunities
are usual practices on your unit? How do you evaluate the effectiveness of patient education? Can you tell me about (student) patient education practices? What have you noticed about (student) knowledge prior to a teaching session? What resources does (student) access and utilize? DECISION MAKING FOR NURSING PRACTICE DOMAIN Demonstrate competent decision making in the performance of safe nursing skills. Demonstrate thorough health assessment. Show how you systematically monitor patient/client health status. Identify changes in the patient's/client's condition and how you would initiate appropriate actions. Demonstrate an increasing ability to set priorities, plan, and organize nursing care. Describe how you would report and document assessment data, nursing care provided, and patient/client response. Utilize correct principles in the performance of psychomotor skills and all nursing actions. Apply the principles of safety in all nursing actions. What theoretical knowledge (from nursing, biological, pharmacological, social, or other sciences) contributes to the decisions you make about your nursing practice with clients? Is (student) able to provide you with a rationale for patient care? How do you adapt your assessments to the individual patient and their needs? Have you noted (student) assessments to be thorough? Do you find you need to prompt? Recheck? Whom do you include in making clinical decisions? How is (student) communicating with the nursing team and other health care professionals when planning patient care? How does current research inform your decision making? How do you organize your work with clients and staff? Is (student) organized during shift? Are nursing tasks completed in a timely manner? What is your normal workload? How do you organize a typical day?
When there are constraints with time and tasks, how do you determine what you do first? Is (student) able to prioritize and balance required nursing care during a shift? What kinds of things do you do to complete your work assignment and meet the needs of your client? What psycho motor skills can you perform independently, which do you seek assistance with, and which skills have you not yet practiced? We recognize, at the School of Nursing, that due to varied practice placements some students may be providing skilled care on a real patient for the first time. Have you any concerns about (student) preparedness and ability to seek supervision safely? How do you describe your competence, knowledge, safety and efficiency in psychomotor skills that you include in your normal practice as an undergraduate? Medication administration, all routes Advanced lines Sterile procedures e.g. complex dressing, catheterizations Tube and drains e.g. chest tubes, tube feeding Do you have any concerns about (student) ability to safely deliver psychomotor skills to patients? What do you do when you come across a new psychomotor skill or technology that you are unfamiliar with? How do you handle a situation when a patient s condition changes and an emergency develops? How do you determine if nursing care is effective and how do you use this information?
PROFESSIONAL RESPONSIBILITY DOMAIN Explain own nursing practice and how changes are incorporated to improve practice. Explain how the CNA Code of Ethics and the CRNBC Professional Standards for Registered Nurses are incorporated in your practice Explain how you practice within the parameters of agency and University College philosophies, policies, procedures and guidelines Describe how you stay current with knowledge and skills Demonstrate how your practice has changed based upon critical examination and analysis of your own nursing practice Identify examples of situations in which you advocated for patients/clients and families What resources do you utilize to verify current and safe practices? How do you know when your practice may need to be changed to meet a standard? What practices demonstrate that you have adhered to each of the values of the nursing profession s code of ethics? What do you do when you are asked to perform a skill or care for a patient outside of your scope of practice? What has been your experience in advocating for clients and/or their family? How do you reflect on your own practice in order to improve and modify your care? What do you do when you observe practice that you consider unprofessional or unethical? Would you consider (student) to be professionally responsible for nursing practice? Can you give examples? COLLABORATIVE/LEADERSHIP DOMAIN Explain your ability to work within the health care team. Demonstrate how you effectively communicate with health care team members. How do you communicate: With physicians? With RNs working beside you? With other health professionals? What role do you play when working with
Describe how you participate actively as a responsible health team member. Identify ways in which you are beginning to take a leadership role in patient/client care. LPNs? How do you handle a conflict that arises between you and a team member? When and how do you question the status quo and taken for granted practices that you encounter? What role do you take when changes are occurring in the health care setting? What role do you take on the nursing team? Does (student) effectively communicate with health team members? Examples. Does (student) actively participate as a responsible health team member? Examples. Can you think of some examples that you noted (student) demonstrating leadership in practice?