UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
Student Name: Rajvir Saini
Instructor: Madonna Martin
Clinical Area: Brampton Civic Hospital
Dates: February 24, 2014
Clinical Hours Missed: 0
Nature of Experience: Acute Health Care (Neurology)
Legend (S = Satisfactory, ND = Needs Development, U = Unsatisfactory)
Ability
Student Instructor
S
1. Knowledge and its Application
Outcomes:
1.1 Draws from multiple forms and sources of knowledge when providing nursing care with clients and families experiencing
acute health challenges.
Student: I used Kardex to gather information for my assigned patient regarding his/her health history, diagnosis, immediate
problem, diet, and ADL status, code, and physician order and progress notes. To gather information regarding pathophysiology
of diseases and nursing care, I used Lewis et al (2009), Potter & Perry(2009),BCH policies, BCH library, and Taber’s medical
dictionary(2010). I used patient MAR to know about his/her medications and I used Mosby’s nursing drug reference book(
2010) to search the mechanism and compatibility of all the medications patient receiving. I reviewed Jarvi’s health assessment
book and Mosby’s nursing skill videos to refresh my assessment skills. I attended labs to practice my nursing skills and
continuously attending Simulation labs to sharpen my skills to handle acute challenges. I referred CNO (2009) practice
guidelines and standards to promote optimal well being of my patients.
S
and
ongo
ing
1.2 Uses an holistic approach that considers knowledge from nursing and the social sciences when planning and implementing
nursing care with clients experiencing acute health challenges.
Student: While providing care to a particular person, I always consider his/her physical, psychological, social, cultural,
spiritual and environmental context to plan my nursing care. I use CNO (2009) practice guidelines, RNAO best practice
guidelines, CNA standards, Humber-UNB curriculum, BCH policies and protocols to guide my knowledge to plan and
implement nursing care. I use different evidence based assessment tools to identify the issue, for example pain assessment tool,
Mini mental status examination etc. I am impressed from Nightingale Theoretical Model and use the same in my practice to
meet my patient’s needs.
1
S
and
ongo
ing
UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
Instructor comments for Knowledge and its Application Ability:
I admire your ability to research information for client care. You are able to incorporate relevant resources and research to
practice and you are diligent in providing safe care.
S
2. Communication
Outcomes:
2.1 Reports and documents information effectively in a concise and defendable manner according to policies of the practice
setting.
Student: At the start of my shift, I always participated in “Shift Report process” to get information regarding the current status
of my patient to ensure continuity and safety of patient care. I communicated effectively with the previous shift nurse and my
mentor nurse to provide client centered care to promote his/ her well being. Throughout my day, I document my every
assessment and observation in a timely manner to ensure its accuracy and legibility as per hospital policies. I also share my
every observation to my mentor nurse to ensure continuity of care. I always use hospital approved appropriate abbreviations in
my documentations to give comprehensive, accurate and clear picture of resident’s needs, interventions and response to care
received. I avoid opinions and always document specifically and objectively what I observe, smell or hear.
S
and
ongo
ing
2.2 Provides appropriate teaching to clients and families in the acute care setting.
Student: I always assess my patients and families educational level and knowledge regarding their diagnosis and treatment
plans. I act accordingly and incorporate my teachings in my nursing care at appropriate time. For example while administering
medication I tell them about the medication action, side effects and the methods to prevent those side effects. I also evaluate
patients hearing and vision senses to present my teaching in best effective manner. For example, for hearing deficit patients I
guided them with written instructions.
S
and
ongo
ing
2.3 Begins to incorporate developmentally appropriate communication techniques within a counseling framework to facilitate
therapeutic and caring relationships in anticipated acute health care situations.
Student: I use Motivational way to change my patient’s behavior if he/she is resistant to required regimen. I always respond
empathetically to meet my clients’ needs. I always remains non judgmental and aware of my personal feelings and beliefs. I
use CNO(2009) practice guidelines to establish a therapeutic professional relationship with my patients.
2
S
and
ongo
UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
ing
2.5 Uses appropriate technology to retrieve, manage and interpret relevant information related to client care.
Student: I use patient Kardex and hospital computers to retrieve and interpret patient information regarding their care plans,
lab reports and diagnostic tests to get up to date information to ensure client centered care that meets their current specific
needs. I always protect my patient information by secured password.
S
and
ongo
ing
Instructor comments for Communication Ability:
You understand the importance of communication. This is demonstrated through your communication with staff, patient and
also through your charting. Good job so far
S
3. Critical Thinking/Skills of Analysis
Outcomes:
3.1 With direction, analyzes data and considers perspectives and ways of knowing to make connections, formulate clinical
decisions and plans for care.
Student: Before providing care or administering any medication, I always consider patient’s current situation in my mind. I
review his/her chart to see history, old and new lab values, diagnostic tests and old & current vitals. I recall my knowledge
from pathophysiology and pharmacology to analyze the existing data to recognize any inconsistency. With the guidance of my
teacher or mentor nurse I synthesize existing information to formulate a plan of care.
S
and
ongo
ing
3.4 Reflects on previous experiences determining the meaning and relevance to current nursing care.
Student: I use reflective tool to assess my strengths and weaknesses by using Gibbs model (1988). At the end of each day I S
always analyzed the work I performed that day. Each situation gave me a new idea to perform the same work in a more and
3
UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
proficient way next time. My instructor always provided me with a constructive feedback to enhance my practice. I am ongo
continuously working to gain more practice to enhance my research skills, social determinant assessment and communication ing
to get more accurate results.
Through continuous learning, I have improved my research skills and I utilized my knowledge to make sustainable ties with
patients, other health professional and community resources. I enhance patient awareness by providing them appropriate
teachings to make informed choices regarding their treatment plans.
Instructor comments for Critical Thinking/Skills of Analysis Ability:
Critical thinking is a process which involves experience, independent thinking and specific knowledge. This comes through
observing, sensing and reflection. I believe that you are well on the way with critical thinking abilities because you understand
patient diagnosis and are able to develop a pertinent care plan of action for your client.
4. Professional Identity/Ethics
Outcomes:
4.1 Integrates applicable legal, ethical and professional standards when providing nursing care with clients and families in
complex situations.
S
Student: I follow CHNC standards of practice and CNO (2009) to deliver safe and effective ethical care to my patients. I
and
maintain my professional relationships with clients by providing care during my clinical hours. I deliver quality care to clients
ongo
by providing them all the information they need in their acute health condition. I promote equality by connecting my patients to ing
the support groups and resources, thus reorienting the family to existing services. This aligns well with the nursing practice
standard to facilitate access and equity to promote health of population (CNO, 2009), as well as the Ottawa Charter (WHO,
2002).
4
S
UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
4.2 Reflects on knowledge of nursing theories to deepen one’s philosophy of nursing care and guide practice.
Student: Nightingale theory is a foundation of my nursing practice. I believe that nursing is a combination of both science and
art. I provide holistic patient care, by not only taking person’s concern into consideration but also how that concern is affecting
that person as a whole. The concepts of nursing, person, environment and health are the fundamental constituents of the
nursing paradigm. My personal philosophy of nursing is strongly related to these constituents. Each of these concepts has their
own importance in my life. Exposure to Nightingale theory provided me a great knowledge and understanding of holistic
care.While Nightingale addressed the technical skills associated with the care of the sick, she also discussed attending to their
psychological, social, and emotional well-being as important in the overall plan of care.
S
and
ongo
ing
4.3 Begins to develop leadership skills to advocate for clients and families with other health professionals.
Student: I assumed leadership roles at various occasions to provide client centered care. I volunteered myself for the role of an
assistant whenever my colleague or my mentor nurse needs help. I voiced my patient’s preferences to appropriate person to
ensure and promote patient’s respect and dignity. For example, one day my patient Mr. X requested for shower and my mentor
nurse refused his wish by saying that she is very busy today, and requested me to give Mr. X a bed bath. I advocated for my
client’s wish and changed my mentor nurse’s mind to give Mr. X a full bath by saying that I will help her in her other
assignments to compensate her time.
S
and
ongo
ing
4.5 Identifies learning needs and formulates a plan to develop professional competence.
Student: : My theoretical knowledge provides me a rationale for collecting valid and reliable data about the health status of my
patient, which is essential to develop effective plan and interventions. It also provides me a framework to generate knowledge
and new ideas. My theoretical knowledge assists me to predict my personal nursing experience and to establish criteria to
assess the quality of my nursing care. The combination of my knowledge and daily experience helps me to deliver quality care.
I empower my patients and family members by involving them actively in the process to determine their health needs and to
understand the determinants of health. I help my mentor nurse to educate patients about the local resources and facilitated their
interaction with the resources by fixing an appointment (CHNC, 2008).
I use reflective tool to assess my strengths and weaknesses by using Gibbs model (1988). At the end of each day I always
analyzed the work I performed that day. Each situation gave me a new idea to perform the same work in a more proficient way
next time. My instructor always provided me with a constructive feedback to enhance my practice. I am continuously working
to gain more practice to enhance my research skills, social determinant assessment and communication to get more accurate
5
S
and
ongo
ing
UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
results.
Through continuous learning, I have improved my research skills and I utilized my knowledge to make sustainable ties with
patients, other health professional and community resources. I enhance patient awareness by providing them appropriate
teachings to make informed choices regarding their treatment plans.
4.7 Considers personal wellness in individual health practices.
Student: I always use proper body mechanic techniques to prevent back injury during transferring or repositioning the client. I
always bend my knees and keep my back straight to maintain proper body posture. I never used mechanical lift alone to
transfer my patient, always ask for assistance from my mentor nurse during transfer process. I always follow infection control
protocol to protect myself. I wash my hands before, in between and after client contact. I always use PPE’s wherever
applicable. My immunization status is up to date.
S
and
ongo
ing
Instructor comments for Professional Identity/Ethics Ability:
Your actions and positive attitude as nurse, coupled with self reflection, have contributed to your professionalism keep up the
good work.
S
5. Social Justice/Effective Citizenship
Outcomes:
5.2 Applies the principles of primary health care and recognizes the impact of the determinants of health on the hospitalization
of patients and families and engages in culturally safe nursing practice.
Student: I follow CHNC (2008) standards, Primary Health Care (PHC) principles, and the Ottawa Charter (WHO, 2013)
strategies to ensure equity in health services. During patient assessment, I assessed the physical, social and economical
environment of my patient or his community to identify health disparities. I also remain nonjudgmental to my client’s beliefs
and values in order to deliver culturally sensitive care.
5.5 Critically examines personal bias, scientific evidence and cultural knowledge in decision making.
Student: I remain nonjudgmental to my client’s beliefs and values in order to deliver culturally sensitive care to diverse or
multicultural population which aligns well with standards. I engage in self reflection by discussing and sharing my clinical
experience with my professor and my peers. I also self reflect on my own cultural beliefs and practices when I interact
with patients of varying cultural background, which aligns well with practice standards of CNO (2009). Wherever possible, I
6
S
and
ongo
ing
S
and
ongo
ing
UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
incorporate generic care to my professional care to promote patient well being. Combination of generic care to professional
care is an essential component of cultural sensitive care (Alligood, 2014).
Instructor comments for Social Justice/Effective Citizenship Ability:
You are practicing according to standards and you are effective in your practice and diligent in providing competent and
culturally sensitive nursing care. Keep up the good work.
Midway Summary with Strategies for Continued Growth:
Student Comments: I use Nightingale’s holistic approach to assess my patient. I supported this assessment information with research articles to
prove its reliability and validity. To gather this information, I use variety of sources such as patient Kardex, potter & Perry (2009), Lewis et al
(2010), World health Organization website (2013), CNO website (2009), journal articles, BCH policies, Ottawa Charter, Canada Health Act and
internet websites. I work independently and collaboratively with my team members to determine the needs of population by studying their social
determinants. I communicate effectively to gather and share information with physicians and other health care professionals. I follow CNO
standards of practice and federal &provincial professional standards to deliver safe and effective ethical care to my patients. I assess the
physical, social and economical environment of my patient to identify health disparities. I promote social justice by assisting and connecting the
patients to appropriate supports services. I also remain nonjudgmental to my patient’s beliefs and values in order to deliver cultural based safe
care. I perform leadership role at various occasions to advocate my patient’s concerns. I incorporate my theoretical knowledge into my practice
to deliver quality care. I always complete my assignment within a defined timeframe and help my fellow students if they need any assistance. I
am enjoying every moment of my clinical placement. It provides me the opportunities to establish and foster my learning skills. This placement
helps me to realize the impact that nurses can have on a patient in their vulnerable condition. This course also helped me to grow professionally
to a point where I can advocate for my client anywhere regardless of my work setting.
7
UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
Instructor’s Response:
Rajvir, You have the opportunity to obtain a wonderful learning experience and you took that opportunity with grace and always a smile on your
face. I can tell that you really like what you do. You were able to incorporate the necessary resources and research to practice. You applied
previous knowledge into your present practice to ensure patient safety. You are competent and diligent in providing nursing care to the clients.
Keep up the good work.
Instructor: Madonna Martin
Student: ____________________________
Date: __________________
References:
Alligood, M. R. (2014). Nursing theory: Utilization and application (5th ed.) Mariland Heights, MO: Elsevier Mosby
Community Health Nurses Association of Canada, ( CHNAC, 2008). Canadian community
health nursing standards of practice.Ottawa, ON.
8
UNB Faculty of Nursing
Midway Collaborative Assessment of Student Abilities (CASA) for NRS.323 (NURS 3073)
College of Nurses of Ontario, (2009).CNO Nursing Standards of Practice. Retrieved on
Feb.23, 2014 from www.cno.org/Global/docs/prac/41006_ProfStds.pdf
Mosby (2013). Mosby’s dictionary of medicine, nursing and health professions ( 9th ed.) . Toronto.
World Health Organization, (2013).Social determinants of health. Retrieved from
WHO website: http://www.who.int/social_determinants/en/
9