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Preview Assessment - Multi Rater Competency Assessment

20152016NURS253PracticalNursingPregraduateExperie
MRAMid(201508)
NURS253PracticalNursingPregraduateexperience(PN,18
201607May2016)
MidTermAssessment

Student:
MahletYizengaw
StudentID:
N01031719
ClinicalTeacher/Preceptor:
RitaPoonoly
Advisor:
RamandeepSasrao
ProgramCoordinator:
JudyMartin
Location:
WilliamOslerHealthCentre/EtobicokeGeneralHospital
Placement:
Agency
Unit:
L7WNM
Period:
18Jan2016to07May2016
RequiredHours:
200
Studenthours:
228
Validatedhours:
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228

Ideclarethatthisismyoriginalworkandthesourcesusedareacknowledged.

Iagree
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1. Model safe, competent, and ethical practice in compl

and regulatory frameworks and the policies and proced
practice setting.
1.1Complywithregulatorystandards,relevantlegislationandthepracticesettingspolicies
andprocedures.
M.Y.

Icomplywiththepolicyoftheorganizationbyarrivingontime,bywearingclean
uniforminaccordancewiththepolicyoftheorganization.

R.P.

punctualandalwaysinwelldressed

1.2Actinaprofessional,responsible,ethicalandaccountablemanner.
M.Y.

R.P.

Iassumeresponsibilitybytakingbedsidereport,usingthreeidentifierstocheck
rightclient,notifyingmypreceptoranydeviationsfromtheclient'susualvital
signs,andabnormalconditionoftheclient.
questionaskedifnecessary

1.3Usethethreefactoranddecisionmakingframeworkstodeterminestrengthsand
limitationsandwhentocollaborateandconsultwithotherprofessionals.
M.Y.

R.P.

Iidentifytheclient'scomplexissues,andalertmypreceptorforexamplewhen
client'sfastingbloodistoolow.IworkwiththeRNsandRTsforbetter
managementofCOPDpatientwhoseoxygensaturationisin70'swith5ltof
consultappropriatelywithrtandphysio

1.4Integrateevidenceinformedpracticeandatheorybasedapproachintonursingcare.
M.Y.

Havingagoodunderstandingofthediseaseshelpedmetoperformafocused
assessment,andtoplanandimplementeffectivenursinginterventions

R.P.

hasgoodplanning

1.5Assesspracticesandriskmanagementprinciplesandtakeactiontoensuresafetyof
clients,self,andothers.
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M.Y.

Iassessclientsconditionandinformtomypreceptorforfurtherintervention,for
exampleifthepatientbloodpressureishighorlow,oxygensaturationisbelow

R.P.

wellactonmedicalsafty

1.6Questionandclarifyunclearordersordirectionsandwhenuncertain.
M.Y.

R.P.

Ihadthechancetoaskrelevantquestionsespeciallyifitisrelatedwiththepolicy
oftheorganization.Forinstancerestrainusedinthefacility,thepre
requirements,whoisthemostresponsibletoaskconcent,andespecialnursing
referpolicyreferances

1.7Question,clarifyorchallengequestionableorders,decisionsoractionsbyothers.
M.Y.

R.P.

Ihadapatientwithlowfastingbloodsugarandheisonmultipleoral
hypoglycaemicdrugs.Therefore,IinformedmyclinicalteacherandtheMRPand
wewereabletomaintainthebloodsugarintheacceptablerange
sheperfomedwithpreceptor

1.8Respondinaprofessionalmannertosituationsinwhichthereisunsafe,unacceptableor
unprofessionalbehavior.
M.Y.

R.P.

Ihadaclientwhoshowedunacceptableorinappropriatebehaviourwhile
providingpersonalcare,thereforeIwasabletoremindhimthistypeofbehaviour
istotallyunacceptableandintolerable.Ialsoinformedmyclinicalpreceptor,and
satisfactoryappropriate

1.9Demonstrateunderstandingabouttheroleofthenursewithinhealthcare.
M.Y.

R.P.

Iunderstandmyroleasastudentnurse.Iunderstandclientsmedicaldiagnosis,
andthetreatmenttheyarereceiving.Iusethenursingprocesstoprovidea
completecare,thatwillhelpmetoassistclientstoachieveoptimalhealth
goodteamwork

Teacher comments for Model safe, competent, and ethi

compliance with legal and regulatory frameworks and t
procedures of the practice setting. ability:
R.P.

2. Communicate using strategies and technology to ee

timely information sharing including data, research, an
information.
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2.1Contributetoteamsharinganddiscussions.
M.Y.

R.P.

Iaminvolvedasactivememberofthemyteamandpracticeteamwork.In
addition,Iattendmorninghuddles,giveandtakereport,attendspecialtraining
forinstanceaboutnewTelemetrytraining.
attendshuddlesandbulletrounds

2.2Documentclearly,accurately,conciselyinatimelymannerusingwrittenandelectronic
methods.
M.Y.

R.P.

Atthebeginning,Ihadsomedifficultyinunderstandingthewayhowtodocument
usingelectronicdocumentationmethod.However,throughtimeIamableto
manageontimeandproperdocumentation.
goodinelectronicdocumentation

2.3Useeffectivecommunicationtechniqueswhenreportingrelevantinformationand
providingfeedbacktotheappropriatemembersoftheinterprofessionalheathcareteam.
M.Y.

R.P.

IhavethechancetoworkwithotherRPNs,RNs,socialworkers,physiotherapists,
occupationaltherapists,anddischargeplanners,Iamabletocommunicatewellin
ordertoaddresstheproposedgoalsintheclientshealthintervention
abletocommunicatewelltheteams

2.4Evaluateandrefinetechniquesusedtocommunicateandshareinformationwithclients
andtheinterprofessionalhealthcareteam.
M.Y.

IbelievemycommunicationskillneedsdevelopmentintermsoffollowingFDAR,
andgivingandtakingreport,documentationinthecommunicationbookwithMRP

R.P.

wedoatdailyrounds

2.5Ensureprivacyandconfidentiality.
M.Y.

Beforestartingprovidingpatientcare,Imakesurethatcurtains,andwashroom
doorsareclosed.Ialsomaintaingconfidentailltyofmyclient'smedical,andhealth

R.P.

privacyandcofidentailiyprovided

2.6Usetechnologytoretrieveinformationincludingresearchandotherdateandtoobtainand
forwardinformationbothwithinandoutsidethepracticesetting.
M.Y.

Ihavethechancetousetheonlinemedicalandsurgicalbooks,medicationandIV
compatabilityLexicome,andwatchvideosregardingthecertainprocedures.

R.P.

databaseandlexicomeavailablityininternet

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Teacher comments for Communicate using strategies a

eect accurate and timely information sharing includin
and other information. ability:
R.P.

3. Engage in relational practice that is caring, compassio

respectful.
3.1Establishtherapeuticcaring,compassionate,andculturallysaferelationshipswithclients
andhealthcareteammembers.
M.Y.

R.P.

Inmyclinicalsetting,Ihavethechancetocareforclientsfromdifferentcultural
background.Iunderstandtheirvalues,andincorporateintheirplanofcare.
IncludingthefamilymemberhelpsmetoknowaboutthepatientADL,andmeans
verycaring

3.2Establishacaringenvironmentthatsupportsclientsinmeetingtheirneedsandoutcomes,
managingtheirillness,orexperiencingapeacefuldeath.
M.Y.

Iassistclientstoachieveandmaintaintheiroptimalhealth.Iassistinperforming
theclient'sADL.

R.P.

ADLperfomeddaily

3.3Demonstratetherapeuticuseofselftofosterclientwellbeing.
M.Y.

R.P.

IhavethechancetocareforaclientwhoisnewlydiagnosedwithDMandhada
depthdiscussionaboutdiabeticdiets.Frommypersonalexperience,diabetic
familymember,helpedmetounderstandwellaboutsomeofthechallengesthese
discusswithclients

3.4Utilizerelationalknowledgeandskills,andethicalprinciplestosupportclientsandto
interactwithhealthcareproviders.
M.Y.

R.P.

Mostofthemedicaldiagnosisinmyclinicalsettinghavealotofsimilarities,
therefore,Ihavethechancetosharethesespecialexperiencesfromoneto
another.Inaddition,havingagoodunderstanding,knowledgeaboutthedisease
polceyandproceduresareused

3.5Useselfawarenesstoidentifytheeffectsthatbeliefs,values,andpersonalexperiences
haveonrelationalpractice.
M.Y.

Iamwellawareofmypersonalvalues,whichintermhelpsmetorespect,and
understandothersvaluestoo.ForinstanceIrespectclientsdecisionwhentheydo
noteatspecialtypeoffoodduetoreligion.Andsomeclientsarefastingdueto

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R.P.

respecttheirpersonalbelieves

3.6Collaboratewithclients,membersoftheinterprofessionalandhealthcareteamsand,
consultappropriately.
M.Y.

R.P.

IhavethechancetoworkwithotherRPNs,RNs,socialworkers,physiotherapists,
occupationaltherapists,anddischargeplanners,Iamabletocommunicatewellin
ordertoaddresstheproposedgoalsintheclientshealthintervention
colabreateeithotherteams

3.7Upholdpracticesandsystemsthatsupportthediversityofclientsandofthe
interprofessionalhealthcareteam.
M.Y.

R.P.

Mostoftheclientsneedmultipleinterprofessionalhealthmanagement.Ihave
thechancetoworkwithPT,OT,dieticiandischargeplannerinordertoprovide
comprehensivehealthcare
workwithd/cot,pt

3.8Provideeffectiveclienteducation.

M.Y.

R.P.

Ihavethechancetohealthteachaboutadvantages,andtechniquesoflippursed
breathingformanyofmyclientswhowerediagnosedwithCOPD.Healthteaching
abouttheadvantageofsittingattheedgeofthebedanddanglingfeetpriorto
standingandwalkingtopreventposturalhypotension.Therelevancyoforal
sheattendstheinservicesofferedonthefloor

Teacher comments for Engage in relational practice tha

compassionate and respectful. ability:
R.P.

4. Act as a leader and an advocate to empower clients, s

interprofessional health care team and to further the p
4.1Evaluateandrefineleadershipskillstodevelopsolutions,resolveconflict,createa
positiveworkenvironmentandorganizationalculture,andtostrengthenadvocacyrole.
M.Y.

Ishowedleadershipskillwithotherstudentnurseswhileprovidingpatientcare.I
alsoworkwithothernursesintheunittoprovidequalityofnursingcare

R.P.

workswithotherstudentswhenevertheyarehere

4.2Providefeedbacktopeersandacceptfeedbackfrompeersandmembersofthe
interprofessionalhealthcareteam.

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M.Y.

IhavethechancetoworkwithPTtoassistmyclienttogetoutofbedforthefirst
timeafterlongperiodofstayinICU,andbedboundhospitalization.Ialsohave
thechancetoworkwithdieticiantocareforaclientdiagnosedwithciliatic

R.P.

takesfeedbackwellfromotherteams

4.3Advocateforclients,self,others,andqualitypracticeenvironment.

M.Y.

R.P.

IbelieveasastudentnurseIamprovidingqualityofnursingcare,andadvocateto
myclient,myselfandthequalityofnursingcare,andtheworkingplace.However,
sometimesIwouldliketoverbalizemydisagreementwhenIobserve
incompetentpractices,andthatdoesnotmeetstandardofnursingcareFor
welldone

4.4Supportclientsrightsforselfdeterminationandchoice.
M.Y.

R.P.

Iactivelyinvolvemyclientsinthetheirdailycareplan.Afterperformingnursing
assessmentanddiagnosis,Iwithmyclientcomeupwithbetterintervention.For
exampleforaclientwithnobowelmovementfordays,duetomedicationsside
supportsclientsandassesswithinterventions

4.5Respondappropriatelytounsafe,unacceptable,andunprofessionalbehaviors.
M.Y.

R.P.

hadapatientwhoisdiagnosedwithCOPDwithexacerbation,wasonoxygen5lt.
Whenmyclientwantedtogotothewashroom,hesimplyremovedthenasal
prongs.Thiswasunsafeforhisconditionsincehighlydependentonoxygen.
neddstobestrongwhenclientmisbehaved.

4.6Demonstratepublicprotectionandactingintheinterestsofthepublicthrough
collaborationandconsultationwithothermembersoftheinterprofessionalhealthcareteams.
M.Y.

R.P.

IhavethechancetocareformultipleclientswhohaveMRSAandothermedical
conditions.Iwaspracticingbasedonthestandardguidelines,andactively
providedhealtheducationtothepatientandfamilymembers
isolationtechnicsfolowed

4.7Contributetothecreationofqualitypracticestrategiesandsolutions.

M.Y.

R.P.

Iequallyparticipatealongwithothernursestoprovidequalityofnursingcareand
comeupwithcertainsolutionstoaddresscertainissues.Forinstance,Imostly
collectthemostcommonmaterialsthatthenursesuseforthedayandsetatable
priortostartingourshift.Inthiswaywecanminimizethebackandforth,and
verygoodteamworker

4.8Assign,supervise,teachasappropriate,andprovidefeedbacktounregulatedcare
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providers(UCPs)incollaborationwiththeinterprofessionalhealthcareteam.
M.Y.

R.P.

IworkedwithUCPsandotherstudentnurses,Ihadachancetoteachtoinorder
toincreasecompetencyofthecare.ForexampleIhadthechancetoteachanother
studentnursethereasonwhyisitnecessarytoprickapatient'sfingersidewhile
colabrationwithotherteams

Teacher comments for Act as a leader and an advocate

clients, self, the interprofessional health care team and
profession. ability:
R.P.

5. Integrate the nursing process into all aspects of nursi

across diverse practice settings.
5.1Formulatesclinicaljudgmentsthatmeetclientsuniqueandchanginghealthneedsand
priorities,outcomes,andoverallconditionandincorporatestheseintoevolvingplansofcare.
M.Y.

R.P.

AsastudentnurseIbelieveInoticechangesandreporttothemostresponsible
nurseorclinicalpreceptor.Forexamplewhenmyclient'sbloodpressure
unpredictablydecreaseafteradministeringofanyhypertensivemedication,I
needtodevelop

5.2Deviseevidenceinformedplansofcarethatareholisticandclientcentred.
M.Y.

R.P.

Ireferevidencebasedplansofcareinordertoprovidequalityofcare.For
examplewhenapatienttransfersweperformMRSAscreening,anddependingon
theresultweuseappropriateprecautions
sheprovidequalityofcareastheyneedit

5.3Useclinicaljudgmenttoassessclients,prioritizeneeds,outcomes,andnursing
interventions.
M.Y.

R.P.

Ihavethechancetocarefordifferentpatientswithrespiratoryandcardiac
problems,Ihavethechancetoperformprioritizedsystemicassessmentandstart
interventionaccordingly
careisastheyneedit

5.4Collaborateintheevaluation,refinementandmodificationofplansofcare.
M.Y.

Ihavethechancetocareforaclientwithciliaicdiseasewhosedietmustbe
monitored.Iwiththedieticiansworkedwelltohealtheducateaboutthedisease
condition,andtheappropriatediet

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R.P.

planofcareastheyrequire

5.5Safelyandcompetentlyperformtreatmentsandusetechniques,andtechnology
autonomouslyandincollaborationwithclientsandmembersoftheinterprofessionalhealth
careteam.
M.Y.

R.P.

Idemonstratedthisskillwithmedicationadministrationpump.Mostofmyclients
haveIVmedication,Ihavethechancetousethepumprepeatedly,anddevelop
theskill.Currently,IbelieveIcancompetentlyusemedicationadministration
saftyisprovidedaccordingtothierneeds

5.6Collaboratewiththeclientsacrossthelifespanandwithmembersoftheinterprofessional
healthcareteamtocreateaclientcenteredplanofcarethatisarticulatedwithcompetence
bothinwritingandorally.
M.Y.

R.P.

IhavethechancetoassesstheclientsabilityforADL.Nurses,OT,PTdiscussabout
hteclientscondition,asanurseIencouragesandassisttoperformtheirADL's
whiletheOT,&PTprovidewithwrittennotestoreenforce
communicateverbalyandinwritting

5.7Useawarenessofownknowledgeandskills,thethreefactorsofnurse,clientand
environmentandthepracticedecisionmakingframeworktoguidepractice.
M.Y.

R.P.

Iunderstandthatwhentheclient'sconditionisnotasthecareplanned,Iinform
mypreceptor.Forexample,whenaclientwithCOPDhasSPO2OF7982%,WITH
5ltofoxygen.Iimmediatelyreportittomypreceptor.Duetotheabove
sheapproavchesmeastheyneedtogetherwegivecare

5.8Manageworkload,time,andphysicalresourcestoprovideeffective,efficientandethical
care.
M.Y.

R.P.

Myclincalsetteingandmyplacmentisanacutemedicin,Ihadmanageddifferent
levelsofworkloads.However,therearesomedaysthattheworkloadhas
affectedthequalityofthenursingcare.
worktogetherwhenincreasedworkload

Teacher comments for Integrate the nursing process in

nursing care and across diverse practice settings. ability
R.P.

6. Collaborate and consult with clients and the interpro

care team to provide comprehensive and holistic health
complex and changing environment.
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6.1Collaboratewithclientstodetermineneeds,mutuallyagreedhealthoutcomes,
approachestocare,andtoevaluatecare.
M.Y.

R.P.

Idemonstratethisskillsatisfactorily.Iprovideclientcenteredcarebyproviding
informationandgivingthechancetomakedecisions.Forexamplewhensome
clientwouldliketotaketheirmedicationtoswallowaswholeorcrashed
workasclienterequirement

6.2Contributeasamemberoftheinterprofessionalandhealthcareteamstorespondto
changingclientneedsandoutcomes.
M.Y.

R.P.

Iworkwithmanyhealthprofession,forexampletherearemanytimesthatI
workedwithdieticianwhowereinminceddietbutareunabletotolerateitand
changethembacktopureeddiet.IbelieveIamcontributingtothesettinghealth
dealswithcareandcontributewithotherteams

6.3Consultwithandseekoutassistancefrommembersoftheinterprofessionalhealthcare
team.
M.Y.

R.P.

Ihaveconsultedandseektheassistanceofmanyinterprofessionals,workedwith
respiratorytherapistforCOPDpatients,OT,PTformanyofthestrokepatients,
withspeechpathologistforpatientswithdysphagia
consultandseekassisstantswithotherteam

6.4Useteamwork,consensusbuilding,andconflictresolutionandleadershipskillstomeet
expectedclientoutcomes.
M.Y.

R.P.

IIhavelearnedagreatteamworkskillinthisdepartment.Mydesiretolearn
helpedmetoseeothersdoingit,assistandworkwithotherstaffs.Similarly,I
demonstratedmyleadershipskillforstudent(studentsfromHumberorother
shetakesleadershipandgoodteam

6.5Integrateeffective,collaborative,andconsultativestrategiestomeetclientsneedswithin
achangingenvironment.
M.Y.

R.P.

Insomedayswhenthemedicalwardidfull,weadmitpatientstothehallway.In
thesesituationIhavehandledmanypatientswithcomplexmedicalcondition.I
havemanageddifferentpatientsinsituationwhereisunderstaffed,agency
workeffectiveandtogetherwithotherteam

6.6Respecttheuniqueroleandcompetenciesofallmembersoftheinterprofessionalhealth
careteam.
M.Y.

Toprovidequalitynursingcare,Iseektheassistanceofmanyinterprofessions,
thatdemonstratemyappreciationandrespecttotheotherdepartmentmembers

R.P.

dealswellwithinterprofessionlas

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6.7Collaborateasamemberoftheinterprofessionalhealthcareteamtorespondtochanges
innursingknowledgeandpracticeandinthehealthcareenvironment.
M.Y.

IdemonstratedthisskilltoUCP.Whileprovidingcaretopatientwithdecreased
swallowingability,Iexplainedtheprecautionstotakeandsomesafelyhealth

R.P.

wellwithchanges

Teacher comments for Collaborate and consult with clie

interprofessional health care team to provide compreh
holistic health care in a complex and changing environm
R.P.

7. Engage in Quality Assurance consistent with the regu

framework.
7.1Actinthebestinterestsofclientsandprotectclientsfromharmthroughcollaborationand
consultationwithothermembersoftheinterprofessionalandhealthcareteamsandby
throughcompetentandsafepractice.
M.Y.

R.P.

IhavethechancetocareformultiplepatientswhoarediagnosedwithCVA,andI
havethechancetoworkwithspeechpathologistinordertoassesstheclients'
swallowingability.Followingtheassessment,Iobservedandprovidedspecial
actwellwithchanges

7.2CommittoQualityAssurancepracticetoidentifystrengthsandareasforprofessional
growthandinaccordancewiththeregulatoryframework(CNO).
M.Y.

Iidentifiedmyweaknessesandstrengths,however,Ineverhavethechancetouse
CNO'sQAforfurtheridentifyandcommittotheprofession

R.P.

needstoidentifyqa

7.3Create,implement,andevaluatealearningplanconsistentwiththeQualityAssurance
program(CNO).

M.Y.

R.P.

IhavedevelopedalearningplanaccordingtoQualityAssuranceprogram(CNO).
Forexample,Imadeaplantobfullycompetentinusingthemedication
administrationpump,bytheendoftheclinicalplacement.Ihadthechancetosee
manyonlinevideos,seekassistancefromthenurseeducator,andrepeatedthe
herlearningplanisdealwithpump

7.4Assumeresponsibilitytoseekoutfeedbackforcolleaguesandpeersandlearning
opportunitiesthatfosterprofessionaldevelopment.
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M.Y.

R.P.

WheneverIhavethechance,Ifrequentlyaskthenursestoassistthemwithany
nursingprocedures.AndIftheyhaveIamwillingtoperformit.ForexampleIhave
thechancetocatheterizeapatientwiththepermissionoftheothernurse.Ihave
lookfornewlearningoppurtunities

7.5Consistentlyreviewnursingresearchandinformationabouthealthcaretoimprove
competenceandtosupportclients.
M.Y.

R.P.

Idemonstratethisskillbyreadingthepatient'smedicalhistorypriortoadmission,
Identifyingthepriorityassessmentandinterventions.Usingrecentmedical
articlesandbooks,identifyingactualandpotentioncomplicationstheplanning
identifiesassessmentandinterventions

7.6Developprofessionalresponsestohealthcaresystemchangesresultingfromadvances
inresearch,technology,andchangesinsocietalandpoliticalforces.
M.Y.

R.P.

Intheclinicalsetting,thereisachancetologinusingmyclinicalaccountand
checkmedicalresearchesandarticles.Ihavethechancetoreadaboutmostofmy
clientsmedicalcondition,medicationsandplanofcare
sheusesandchancestouseinternets

Teacher comments for Engage in Quality Assurance con

regulatory framework. ability:
R.P.

8. Use critical thinking, problem solving and decision ma

meet the health care needs and expected outcomes of c
8.1Usecriticalthinkingtoinformdecisionmakinginallaspectsofnursingcare.

M.Y.

R.P.

IbelieveIhaveagoodunderstandingofthemostcommondiseaseconditions,and
basedonthatIcanmakeaprioritizedassessmentandinterventions.Forexample
Ihadapatientwhoishypoglycaemic,andtotreattheproblemIadministereda
cupoforangejuice.Irecheckedandreportedthereturnofthebloodsugartothe
normalvaluetomypreceptor.However,theclientisstilltakingahigherdoseof
incriticaltimesthinksappropriatleyandtreatclients

8.2Useclinicaljudgmenttoassessandrefineassessmentsincollaborationwiththe
interprofessionalhealthcareteam,formulatenursingdiagnoses,plannursinginterventions,
andoutlineevaluativecriteria.

M.Y.

Understandingoftheclients'diseaseconditionhelpedmetoidentifyandwork
withmultipleinterdisciplinaryteams.Forexample,IworkwithOT,andPTfora
betterevaluationsofanewlyadmittedpatientwithCVA.Andforthoseclients
whohavecertainpsychosocialsupport,Ihavethechancetofacilitateandwork

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R.P.

colabratewithother

8.3Evaluateandrefinecriticalthinking,problemsolving,anddecisionmakingskills.

M.Y.

R.P.

Ascomparedtothebeginningmypregradclinicalexperience,IbelieveIhave
improvedabetterunderstandingandskillsofprioritization,anddecisionmaking.
Forexample,atthetimeofmedicationadministrationtimetomultiplepatients,
basedonthemedialconditionandthetypeofmedication,Iprioritizewhoshould
getthetreatmentfirst.Ialsohavedevelopedtheskillofidentifyingactualand
sheiscapablecriticalthinking

8.4Integrateknowledgefromvarietyofnursing,health,andothertheoryintonursingpractice
toprovidesafeandcompetentcare.
IbelieveIhaveagoodunderstandingofthepathphysiologyofthemostcommon

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