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UNB-Humber Collaborative BN Program

Final Collaborative Assessment of Student Abilities (CASA) for NRS.215


Student Name: Ruckman Ghotra
Instructor:
Clinical Hours Missed: 0 hours
Nature of Experience :( type of experience, length of time, etc.)

Clinical Area:

Dates: January 9, 2014- April 11, 2014

Working on a Rehab unit and applying theoretical knowledge and practical skills.
Legend (S = Satisfactory, U = Unsatisfactory)

Ability

student/Instructor
S
S

1. Knowledge and its Application


Outcomes:
1.1 With guidance, incorporates relevant information when caring for individuals within the context of their family.
Student: The concepts learned in chronic health challenges and the readings from Potter & Perry helped

1.2 Applies knowledge and skills gleaned from year I and year II when assessing, planning, providing, and evaluating safe, competent nursing
care. (e.g. therapeutic communication techniques; nursing problem solving process; vital signs; basic comfort and hygiene; Code of Ethics;
individual wellness health promotion strategies like nutrition, sleep hygiene, stress management; suicide crisis intervention techniques; family
developmental theory in relation to transition, etc.)
Student: I applied the skills learned in year 1 such as checking Vital signs which is part of daily routine and then planning

me put together all


the theoretical knowledge and apply it on the Rehab Unit. I provided the information regarding clients health status to
their families using the skills and knowledge that I developed during the placement. I always provided information that is
at my level of understanding and did not perform any activity that was beyond my current role and skills.

interventions accordingly. I provided comfort and privacy by drawing curtains when performing an activity on the client.
For example whenever I was assigned to a client who has cardiac issues I always checked their blood pressure and made
sure it is within the range that I can administer medications to them. I asked clients whether they are stressed over
something and I tried to talk to them to understand their emotional status and emotionally supported them when needed. I
also checked upon them during breakfast, lunch and dinner and made sure they are eating enough to keep up with their
levels of blood glucose. I wore gloves when administering injections and taking the client to the washroom and performed
hand hygiene. I used therapeutic communication techniques by being professional.
1.3 With guidance utilizes course resource material (e.g. texts, electronic databases like CINHAL, Psych Info, and Medline) and a philosophy of
caring to provide safe nursing care to clients and their families.
Student: I meet this outcome as I used different resources such as CINAHL to find scholarly articles to support my

reflection. I used Medline and Canadian Health resources to search for articles and research about the medications. I used
the drug guide to find the classification of drugs, generic and trade name and to understand the effect of that particular
drug on the body. The clinical instructor also showed resources that we can use to find information about clients health
related issues. I also incorporated and followed my philosophy of nursing and provided care in safe and ethical manner to
the clients and their families.
1.4 With guidance incorporates into practice relevant standards of care (Best Practice Guidelines and federal/provincial legislation) within the
context of primary health care, while recognizing ones own developing nursing role and the role of the interdisciplinary team.
Student: I meet this outcome as I provided safe and competent care according to CNO standards. I administered injection

under the supervision of clinical instructor. I provided care in way that helped me develop on my professional skills and
ability to make judgments about clients health status. I performed activities that were at my current level of knowledge
and I did not perform anything that was beyond my level of practice. I asked for recommendations and guidance from
nurses on the unit that helped me made decisions regarding clients health and what is best for them.
1. Knowledge and its Application
Instructor

Student
S

Instructor
S

Ruckman has come prepared to clinical each week, and has easily integrated knowledge from multiple reliable sources
including theory from textbooks as well as scholarly research articles while caring for her diverse patients. If unsure, Ruckman
always asked questions in order to deliver the best possible care. In performing nursing interventions, and patient teaching at
the bedside, Ruckman was able to discuss and apply relevant standards of care such as RNAOs BPGs.

Ability
2. Communication
Outcomes:
2.1 With guidance, documents in a clear, comprehensive manner using clinical terms appropriately.
Student: I documented in a clear and comprehensive manner and used clinical terms and

student/Instructor
S
S
S S

terms that are used by the agency. I


documented vital signs, ADLs, Braden Scale, Insulin and wound dressing on the Meditech. I made sure to sign the
MARs and gave the reports to the nurse before leaving the unit. I documented as per CNO guidelines and did not share
and let anyone document under my name. I completed the documentation under the supervision of the clinical instructor
and asked her to guide me while documenting for activities that I performed such as wound dressing, catheterization.
2.2 Uses elements of effective oral communication appropriately incorporating educational aids to enhance client learning.
Student: I have developed greatly on my communication skills and it is a gradual progress and will continue

to develop as I
move onto next clinical placements. I tried to simplify the scientific terminology and communicated with the client in way
that will help them understand about their health. I kept on communicating with the client as I perform an activity on them
and inform them about certain parts that will be painful.

2.3(a) Communicates with clients/families intentionally utilizing therapeutic communication techniques.

(b)Provides clients/families with informal teaching in timely manner at a level understood by them and appropriate to their current need.
Student: I educated the client and family members about the medication. For example, when the clients went home for the

2.4 Engages in inter-professional relationships in an accountable and clear manner.


Student: I meet this outcome as I followed the hospital schedule of giving

2.5 With guidance uses available technologies to support professional communication.


Student: I use internet and Medline to search for the drugs generic and trade

Student: I meet this outcome as I communicated with family members on a professional level and explained them my
roles as a student nurse. I responded effectively to the client and the family members questions and if there was something
that was beyond my understanding or I did not know how to explain I asked the clinical instructor and the nurses on the
unit. I used therapeutic communication techniques by understanding verbal and non-verbal clues. I will continue to
develop on this skill as I will be encountering patients and their family members with different personalities.

weekend I reviewed all the medications with the family members and explained them how to read the instructions in a
manner that is understood by them. I informed the clients and their family members before performing a certain activity.
As, I am moving onto clinical placements I will continue to improve and develop more on this component and learn how
to meet clients need that is appropriate for their current state.
reports. I made the nurse informed about the vital
signs, about the medication administered and anything unusual with the clients health. I always informed the nurse before
time to perform blood glucose level on the client which helped me prepare and make interpretations about how much
insulin to administer or not. I always asked the nurses on the unit to clarify my doubts about the clients charts and why
certain medication is discontinued. I followed the process of being in a team and was able to answer questions about
clients health when asked by other health professionals on the unit.
name. For example, on the clients MARs the
name of the insulin was Lantus and I searched the other name in which the insulin in supplied as Humalog. I will continue
to develop on this skill as I move into different clinical placements and practice at different units.
2. Communication
Instructor
Although shy in the beginning, Ruckman opened up and easily integrated herself in the clinical setting, and
communicated openly with PSWs, nurses, doctors, allied health, as well as patients and families and her
colleagues. By being clear, and accountable for her work, Ruckman was able to engage in therapeutic
relationships with her assigned patients as well as to document her findings on Meditech.

Student Instructor
S
S

Ability

student/Instructor
S S
S S

3. Critical Thinking/Skills of Analysis

Outcomes:
3.1
(a) With guidance, articulates a variety of best nursing practice strategies and clinical information to develop a safe plan of care with assigned clients
and families.
Student: I meet this outcome as I always checked patients Kardex for health history and diagnosis. I also looked up on

Meditech to check lab values, health history and notes made by the doctors to get a better understanding about the clients
health. I kept note of things I need to be aware of the client I am assigned to such as their mobility sticker red needing full
assistance, yellow needs one person assistance and green as fully independent. With the help of my clinical instructor I made
diagnosis and planned care accordingly.
(b) With guidance, is able to articulate rationale (evidence-based) for planned interventions with clients and families. At a beginning level, critiques
and reflects on different approaches and possible health care strategies.
Student: I meet this outcome as I planned evidence based interventions for the clients and families. Before performing any

3.3 With guidance, modifies the plan of care in accordance with the clients response to the previous nursing interventions.
Student: I meet this outcome as I always asked the client how they are feeling before intervening. I involved

3.4 With guidance, engages in self-evaluation in manner that identifies personal strengths and areas for improvement.
Student: I meet this outcome as I reflect on my practice and figure out what went wrong and what

activity on the client I always informed the client about the procedure and provided reasons for the intervention to the family
members. I always explained the client why I am performing certain activity and how it can affect and bring improvement in
their health. If there was anything that I was unable to handle I asked the clinical instructor and the nurses on the unit to assist
me in performing task.
the clients in the
treatment and asked for their advice about what is best for them at current state. I asked them whether they are ready or not to
perform the activity. One of the clients informed me that he does not want to take the eye drops because his eyes are getting
better. I respected their choice and did not force him to take it.
areas I developed and
improved on. The positive experience helped me develop on my strengths. The errors that were made during the practice
helped me recognize my weakness. The clinical instructors response and comments encouraged me to be confident of my
work. The errors made during the practice helped me learn to manage my time and provide care in a timely manner. The self
reflections are helping me understand and recognize my personal feelings and emotions. Through that I learned how as nurses
we have to put aside our personal issues and not let it interfere with our practice and the care we are providing.
3. Critical Thinking/Skills of Analysis
Student Instructor
Instructor
S
S
Ruckmans critical thinking skills developed greatly this term, and she was able to question, and understand
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orders, medications, and decision-making that was done based on the context of her patients. By analyzing
abnormal test results and lab values, Ruckman was able to advocate for changes in the patients care plan in
order to provide the best care.

Ability

Student/Instructor
S S
S S

4. Professional Identity/Ethics

Outcomes:
4.1 With guidance, integrates use of Canadian Nurses Association CNA Code of Ethics and CNO guidelines in nursing care and able to highlight the
intent behind their actions.
Student: I meet this outcome as I followed the CNA code of ethics and CNO guidelines while providing the care.

I respected clients choice regarding food, medications and activities. I also use RNAO best practice guidelines for my
reflections. CNA and CNO guidelines are helping me to build on my professional skills and how to work in a professional
manner. I came to clinical on time in uniform and the equipments needed such as stethoscope, BP cuff and ID card.
4.2Begins to analyze personal and societal beliefs, values, and determines ones own philosophy of nursing practice.
Student: As I am moving into different clinical placements and encountering different situations

4.3 Begins to articulate personal leadership attributes and relevant past leadership experience.
Student: I have developed on my leadership skills and it is a gradual process and

4.4 With guidance, modifies plan of care based on clients cultural context and populations diverse uniqueness.
Student: I provided care within the clients cultural context. For example, one of the clients I

4.5 Recognizes gaps in ones knowledge of nursing and related fields, and with guidance, develops and uses strategies to address learning needs.
Student: I kept note of things that I need to figure out such as diagnosis and the use of medications. I also asked the nurses

I am developing on my
personal definition of nursing. The clinical settings and the real life scenarios is improving my knowledge about nursing
profession. Reflections are helping me to recognize my inner strengths and recognize my emotions and feelings. This
clinical placement has greatly influenced my personal definition of nursing as nursing is more than administering
medications and it is about being with people.
I will continue to develop on them as I
move into other clinical placements. The hospital setting has taught me how to work in a team and actively participate in
decision making with other health professionals. I took the responsibility of taking vital signs, providing basic care and
administering medications and reported the nurse about clients health status. I also gave report to the nurse and
immediately reported anything unusual.
was assigned to asked me to
leave as he wanted privacy when changing. I respected clients choice whenever they refused me to perform a procedure on
them. I asked for permission before entering into the washroom. As nurses it is important for us to be culturally aware and
culturally knowledgeable and respect others decisions that are culturally based.

and the clinical instructor to help me understand certain issues regarding clients health. I used internet and other sources
such as textbooks to look up for the various things that were beyond my current level of knowledge. I always asked the
nurses about how one thing is affecting and the way it is interfering and limiting clients performance.
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4.6 Begins to recognize behaviors that enhance professional identity.


Student: As a nursing student I am learning to recognize behaviours

4.7 Identifies individual health practices that maintain balance and wellness in ones life.
Student: As I am learning and understanding how our body works and how

that are not acceptable in the clinical setting and should


be avoided. I have developed greatly on my professional identity of being able to perform and work in a professional
manner. I maintained therapeutic relationship boundaries by not sharing my personal opinions and stories with the client. I
reported any errors or issues that arose during the practice. I documented and provided care in a professional manner.
certain medications and foods affect out health, I
am trying to follow health habits that maintain balance and wellness. I recommended clients about certain foods and
exercises that they can add into their daily life to release stress.

4. Professional Identity/ Ethics


Instructor
Ruckman has been punctual and accountable, and she has recognized the importance of these behaviours.
By maintaining professionalism in the clinical setting, Ruckman has evidently practiced according to the
CNA code of ethics as well as the CNO guidelines.

Ability
5. Social Justice/Effective Citizenship
Outcomes:
5.1 Has a beginning awareness of personal values and biases and how they may affect their nursing practice.
Student: I kept all of my personal values and biases aside and did not let it interfere with my

Student Instructor
S
S

student/Instructor
S
S
S S

practice. I involved the client


and family members in the decision making and did not put my personal opinion. The clinical placements helped me learn
that we can not judge a client because their views and ideas are different than us and it should not affect the care we are
providing.
5.2 With guidance, collaborates with others in unfamiliar contexts, considering perspectives of social justice, to begin to provide culturally
competent and safe nursing practice in the context of primary health care.
Student: I treated the clients equally regardless of their gender, race and ethnicity. I followed the context of primary

5.3 With guidance, compares and contrasts differences in health outcomes based on a beginning understanding of the determinants of health and
relationship to the environment (ecological, economic, global, etc.) for individuals and families.
Student: I meet this outcome as I did the health teaching at a level that is understood by the client. I also asked clients who

health
care and social justice as learned in year 1. I did not judge clients culture and not let it interfere in my practice. One of the
clients I encountered wanted to pray before eating and I respected their choice.

will take care of them when they are discharged and if they have access to health services such as a family doctor for
regular checkup. I asked them about their social networks and their work whether they can support themselves financially
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and seek support and assistance from their social networks.


5.4 Begins to recognize disparities and power dynamics within the health care system
Student: As nursing student I can give recommendations and do not have

5.5 Articulates a basic understanding of culture, society and history to engage with clients/families and consider different approaches to nursing
care that are culturally sensitive.
Student: I understand how each culture is different and the way people respond is different which depends on their ethnicity

the power to make decisions about clients health.


I have learned that health professionals such as doctors, nurses and pharmacists they all work together and make decisions
regarding clients condition. I also recognized that nurses can not make decisions about clients medications and whether to
discontinue certain treatment. The doctor has the power and nurse has to report the doctor as he/she will instruct which
treatment to follow up next.

and previous life history. During week 11, I was assigned to a client and it was his shower day and I asked the clients wife
and wanted to do it alone and did not want me to be there. I respected their choice and did not judge, which helped me,
learn that as nurses we have to be aware and accept other cultures.
5. Social Justice/Effective Citizenship
Instructor

Student Instructor
S
S

Ruckman has provided culturally sensitive care to her patients. By taking initiative to discuss her patients illness experience, and
their recovery, she has been able to value the unique experience of each of her patients, and ensure that the care that she provides
fulfills their specific needs. Thus, Ruckman has also been able to promote a sense of equity among her patients.

Midterm Summary with Strategies for Continued Growth:

Student comments: It was a learning experience and this placement has greatly increased my theoretical knowledge and practical skills. I
learned how to work in a hospital environment and work in a team with other health professionals. It has increased my confidence level from
where I started and motivated me to keep on practicing. I have developed on administering oral medications and injections. I also learned that I
will be dealing with more than one patient in the hospital and I need to manage my time and provide care in a timely manner. I have encountered
different patients with different personalities and values. This experience has helped me improve on my communication skills of how to interact
with clients. I provided the care by maintaining personal zones and therapeutic boundaries by not sharing person opinions. The clinical
instructor kept on encouraging and provided positive feedback on my performance which has increased my confidence level. I will take these
skills and move forward into next clinical setting and I feel motivated as I have the knowledge and skills to practice in a health care setting. In
the beginning I felt nervous and scared whether I will be able to fit and understand the unit. As I progressed and encountered different situations
I feel I have improved. I learned how to look back at my mistakes and learn from it. The hospital environment has made me aware of the real
life scenarios that I will be facing in my coming placements. I will continue to build on my leadership skills of working in a team.
Instructors Response:

It has been a pleasure to teach Ruckman this semester, and I wish her continued success in the rest of her studies!
Satisfactory

Instructor:

"Unsatisfactory

Student:

Date: