NURS1020 Clinical Course Evaluation

Mid-term Evaluation

Student: Leah Will

Clinical Instructor: Anne V.

Missed Clinical Hours: ______ Missed Lab Hours: ______

NURS 1020 Course Learning
objectives
Objective
Established therapeutic nurse-resident
relationships in residential /long-term care
settings.
Performed skills relevant to situating an
individual within his/her personal, familial
and community context
Evidence/Indicators of Progress: (The student has ...) Progress
Satisfactory Unsatisfac-
tory
Mrs. V is an older resident with cognitive impairments. I was able to
establish trust with her while feeding, and despite her lack of words she
was able to take my hand and take me around the home, showing me her
belongings. She recognizes me week to week.
Meeting Mr. R in the retirement home was my first interaction with a
resident as a nursing student. I felt empathy for him as he is a 90 year old
independent man who is caring for his 95 year old fully dependent wife
who is confined to a wheelchair. He is slowly adapting to their new life
in the retirement home, even though he regrets the decision to not hire
home care so they could stay at home.
Patient X needed assistance with her daily bath. Another student and I
demonstrated professional intimacy while doing a bed bath for the first
time together.
As a group, we all observed the admissions process for a new resident in
the long term care home. We stood in the room with the patient while her
two daughters were also present. It was beneficial for us to be able to
listen to the kinds of questions that the RPN was asking as part of the
admissions process. The daughters commented that the resident was very
happy when she saw all of our smiling faces in the room with her. This
made us feel like we really welcomed her into her new home.
During the meeting with Mr. R in the retirement home, I demonstrated
skills relevant to situating him with his personal and familial context. I

Developed and demonstrated skills in
basic assessment techniques relevant to
the long-term care population
Demonstrated skills in providing resident-
centered support for activities of daily
living
asked a number of open-ended questions regarding his thoughts and
feelings about his experience in the home, and why he made the decision
to move into a home with his wife. His wife had cancer many years ago
and is now confined to a wheelchair due to complications with the
radiation treatment. He no longer has to worry about cooking, cleaning or
getting around due to the care they both receive in the retirement home.
I personally have not had the opportunity yet to do a full set of vitals on a
resident. I am looking to get this chance in weeks to come.
While bathing a resident, I am consciously aware of the integrity of their
skin. I have noticed the thinness and tearing of skin while preforming a
bed bath as well as within the shower.
While feeding a resident, Mrs. A, I noticed that there is significant skin
breakdown on her hands due to a habit she has of constantly having her
fingers in her mouth due to a past stroke. I let the nurse know and her
hand was bandaged again.
I have fed multiple residents that require assistance for meals. I have
demonstrated patience, with some residents who are very agitated while
feeling, and need constant encouragement and remainders to eat, chew
and swallow. One resident, Mrs. A, had a stroke and now constantly tries
to eat her hands and put her fingers in her mouth, even when she is not
being fed. This makes it challenging, as I have to keep her hand out of
the way while feeding her. She also gets quite agitated and sometimes
will have sudden outbursts.
I have also assisted the nurses and PSW’s with getting residents out of
bed, bathed and dressed for the day. I have also been able to do this on
my own a few times with residences who only require a 1-person assist. I
found this challenging because I wanted to make sure I did everything
correctly while keeping the resident comfortable. I would also help the

Developed knowledge about the
experience of residents living in a long-
term care setting
resident select her outfit for the day, I took her to the bathroom, provided
pericare and helped her brush her hair, wash her face and brush her teeth.
During this process I encouraged her to do as much as she could on her
own, while engaging in conversation to keep the process as comfortable
as possible.
I was paired with the RN for the floor and we went around getting
multiple residents up for the day. A resident was a 2-person assist, and
required a mechanical lift to get out of bed. I have used mechanical lifts
all the time at the hospital during my part time job, but these were a little
different so it was a good experience to know how to work multiple lifts
with different lift sheets than I was used to.
In the retirement home, Mr. R told me that they do not have many
activities to do outside of the home. He told me that the location of their
old retirement home had a park and little shops around it, but there is
nothing to do at this one. I was surprised to hear this, as I never thought
about the surroundings around the home.
In the retirement home, I learned about the activities that were available
in the home. While I was waiting for instruction on the first day of
placement, I was across the room from a fitness class going on. It was
nice to see that there are these types of activities provided for the
residents.
Once I was finished my conversation with Mr. R in the retirement home,
he offered to play a game of pool with me. This made me feel happy
because he is still quite active and he was explaining that there are not
many people still able to actively play a game of pool. We finished our
conversation over a game.
Demonstrated safe and ethical clinical When entering a room, I always check to see if there are any special
practice at the level appropriate for a year instructions, such as the level of assist or any feeding restrictions while in
one nursing student the dining room. I was working with a resident who was quite
independent, but I still made sure to check if there were any changes.

While working with the RN at the long term care facility, we were
helping a palliative patient out of bed and into a chair. She was asking
me how comfortable I am with mechanical lifts, because she knew I
work at a hospital. I told her that even though I work with lifts and lift
sheets quite often, that the lifts they use in this facility are a little bit
different than the ones I am used to. I asked to explain the process to me
as if it was my first time using them to ensure I was practicing
appropriately for this facility.

I have not yet had the opportunity to shadow the RPN while
administering medication. It would be useful to know what we are, and
are not allowed to do as first year nursing students.

Participated in professional development Before our clinical placement, we were required to complete online
based on reflective practice and clinical modules regarding common topics we will see during our placement in a
inquiry long term care facility.

In regards to reflective practice, I wrote my first reflection journal. I

focused the reflection on my first experiences in a retirement home and
in a long term care facility. I focused my response on a resident that was
highly confused in the bathing process. It must have been extremely
frustrating for her to be in such a vulnerable state and to not have the
cognitive ability to fully understand what is happening to her.

In the long term care home, I got the opportunity to look at a chart of one
of the residents and understand how the chart is set up and what all goes
into it. This demonstrated clinical inquiry as I was understanding the
process of charting.
 Examined personal attitudes regarding the
elderly and other residents of long-term
care homes
Developed a basic knowledge of the
clinical manifestations and relevant
nursing interventions of chronic diseases
Clinical Instructor Comments (Please include strengths as well as needs for improvement. There must be comments to
elaborate on any
objective marked “unsatisfactory”.
As I have been experiencing the long term care environment for a few
weeks now, I have developed an understanding of how complex the
elderly is from a medical perspective. There is a lot of chronic illnesses
as well as acute illnesses as well. It is interesting to learn.
I have come into contact with many of the resident’s families during the
times where I am feeding in the dining room. It is encouraging to hear
the positive feedback they have about the care that their family members
are receiving in the long term care facility.
I have also noticed that there is a wide range of residents living in the
long term care home. There was one resident who was in her 30’s while
several are over the age of 100. It makes me have respect for the RN’s,
RPN’s and PSW’s along with all the supporting staff who work here
because of the high complexity and variety of people under their care.
Mrs. A was a stroke patient who also has dysphagia. She is on an entirely
pureed diet as a nursing intervention to prevent choking.
In lab, we learned about the risk of bed sores and pressure ulcers. While
making a bed at the long term care facility, I pay special attention to
make sure I am preventing the risk of this occurring.
While looking at the charts of the residents, I can see the medications
they are on and what kind of conditions they have. This allows me to
make connections between the medications and what they are used to
treat. This opens my eyes to various nursing interventions used.
Signature of Instructor___________________________________________________ Date____________________

Signature of Student_____________________________________________________ Date____________________