1. ANRS 311, 2014
RNRS 311 Clinical Evaluation Tool
Student: Emily Tarrell Instructor: Barb Gallogy
Advisor: Katie Selle Semester: Fall Session II
Course Description: Clinical course focused on nursing care of adult clients in an acute care setting. The course is designed to further develop the necessary skills for
baccalaureate generalist nursing practice including an introduction to patient safety, quality improvement, and information management. Continued development and
application of professional practice standards are addressed.
Student Signature: ______________________________________________
I am willing to have subsequent clinical instructors review this evaluation for the purpose of promoting my learning in future clinical experiences.
Course assignments are designed to allow students to demonstrate the knowledge and behaviors essential to meet each clinical objective and succeed
in the course. The interdependent nature of the objectives precludes having any one assignment sufficiently correlate with or measure student progress.
Instructor ratings and comments on the various assignments, do however serve to document the student’s growth and areas for development. Ratings of – or +
should be supported with comments.
Each critical behavior is considered essential and must be satisfactorily demonstrated to pass the course. Passing the course includes satisfactory
completion of all the assignments.
Midterm Rating Key: Progressing (√) Needs Improvement (NI) Failing (-)
Final Rating Key: Pass Fail
Evaluation Standards
Meets the standard Fails to meet the standard
• Demonstrates expected behavior consistently.
• Initiates expected behaviors constantly.
• Requests assistance as needed and appropriate.
• Rarely requires reminders to demonstrate expected behavior.
• Demonstrates competence in expected behavior.
• Performance improves with practice and experience.
• Consistently solves routine problems.
• Makes accurate clinical decisions in routine situations.
• Demonstrates expected behavior only occasionally or inconsistently.
• Requires promoting or reminders from others to initiate executed
behaviors.
• Requires assistance from others to demonstrate the behavior.
• Seldom initiates expected behavior.
• Performs expected behavior inaccurately or incompletely.
• Makes errors in performance and/or judgment, or would make errors
without the intervention of others.
• Does not recognize need for assistance and/or does not request assistance
when needed.
• Performance is not significantly improved with practice and experience.
• Often fails to solve simple problems or make routine clinical decisions.

2. ANRS 311, 2014
Essential I. Integrate the liberal
arts into the practice of nursing
Competency: Use skills of inquiry, analysis and information literacy to address practice issues.
Evaluated by: Date Rating Instructor and Student Comments
Weekly writing assignments and journal entries
demonstrate increasing analytical skills and
increasing depth of inquiry.
Throughout √  Each week, my written assignments are becoming easier due to an
increase knowledge of nursing care, as well as an improvement of
critical thinking skills. I believe I always show my desire to learn and
observe procedures.
 My preps are becoming more in depth with less prompts and
corrections. After more practice, I am able to sort of the differences
between major medical diagnoses and symptoms with less guidance.
 I am able to successfully complete my charting in Epic by a reasonable
time throughout each work day. My SBAR notes are well-detailed and
applicable to each patient as well as the interdisciplinary team.
 My journal entries are thorough and well-thought out. I try to focus on
several areas of the clinical experience instead of the skills alone. I am
becoming more confident with my skills, therapeutic communication,
and critical thinking abilities.
 I have completed all of the written assignments prior to my alternate
experiences, coming up with situational specific questions to inquire
about that particular unit.
 During post-conference, I follow up with concepts assigned in
preconference that require further investigation.
 I view each day as a learning experience, and I utilize the care team to
answer my inquiries. For example, I made a trip to 9 Tower to request
more information regarding urology concerns and CBI.

3. ANRS 311, 2014
Essential II. Apply skills in
leadership, quality improvement,
and patient safety to provide
high quality health care in a
systems environment.
Competencies:
1) Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including
nurse sensitive indicators, in the microsystem of care.
2) Promote adherence to the evidence-based practice of providing restraint-free care (both physical & chemical restraints)
3) Implement & monitor strategies to prevent risk & promote quality & safety (falls, medication mismanagement, pressure ulcers) in the
nursing care of older adults with physical & cognitive needs.
Evaluated by: Date Rating Instructor Comments
Competency 1
As demonstrated by collaborative concept maps
in clinical setting.
Student will participate in organizational
initiatives for quality improvement.
Competency 2
Adheres to organizational safety and comfort
assessments as evidenced by charting
observations
Competency 3
Utilize and demonstrate use of Braden Scale, fall
prevention, restraint free protocols and other
patient safety organizational protocols.
11-2
11-9
11-23
Throughout
Throughout
√
√
√
 I have been attempting to make each week’s concept map as
detailed as possible. My first attempt flowed nicely, but could have
had a bit more detail. My second attempt seemed more thorough,
but lacked flow in the last page of nursing interventions. My third
week was very detailed and my best work so far.
 I am improving each week with my charting, getting my assessments
done systematically methodically in order to complete my first
charting as early as possible in the shift.
 I am comfortable with the organizational machines to assess VS, and I
accurately document these findings in Epic.
 I try to complete most charting in the patient’s room immediately
after assessments in order to assure accurate timing of care is noted.
 I successfully log out of Epic to safeguard the privacy of my patients,
as well as other people within the database.
 I try to carefully assess each patient, utilizing the Braden Scale, FPP,
and using a lack of restraints to ensure safety.
 I use the Braden scale for each patient, and take extra precaution
with our older adult patients, who may be at a higher risk for skin
breakdown.
 I implement the use of the red FPP socks, gait belts, and assistance
whenever ambulating my patients to provide safety.
 Fortunately, my patients have not needed to be placed in restraints.
During my alternate experience in the ICU, I was able to observe two
sets of restraints, and I was mindful of observing these sites for the
possibility of pressure sores.

4. ANRS 311, 2014
Essential III: Translate current
evidence into the practice of
nursing.
Competency: Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing
and evaluating outcomes of care. *
Evaluated by: Date Rating Instructor Comments
Address in weekly journal entries,
hand- off report, weekly clinical preps.
Shared information in pre and post conference
discussions.
Students demonstrate this through the teaching
and learning project, researching evidence-based
nursing interventions from the current literature
with a focus on management of the acute care of
the patient.
Incorporate evidence- based practice for
underlying pathology on individual plan of care
11-9
10-26
Throughout
12-4
10-25
11-23
√
√
Rate
NI
√
 I have begun to be able to communicate easier with medical jargon
when needed between staff/Epic/preps. However, I am also making
progress using lay terms with patients. Critical thinking is becoming
easier with each week.
 Each day, I have been present at the bedside report between the night
shift nurse and the RN that I will be following. I have been able to share
additional information due to my preps and early morning Epic checks.
 During our first patient care day, I was able to share information related
to my case. I came prepared to discuss my POC with my classmates, as
well as other pertinent information.
 I have continued to come prepared to each conference, and I have
check back when I needed to gather more information throughout the
day.
 Teaching Learning project submitted after methodical research
regarding discharge education. I believe the essay was thoroughly
written and well-detailed.
 My first prep went well for an initial attempt, but I know I have a lot to
improve on as the session progresses. I hope to become efficient at
writing NCPs.
 I am becoming more and more confident with my prep assignments. I
was able to show our graduate student helper my work and the
constructive criticism on my sheets.

5. ANRS 311, 2014
Essential IV: Demonstrate
knowledge and skills in
information management and
patient care technology
Competencies:
1) Demonstrate skills in using patient care technologies, information systems & communication devices that support safe nursing
practice.*
2) Apply safeguards & decision making support tools embedded in patient care technologies & information systems to support a safe
practice environment for both patients & healthcare workers.*
3) Understand the use of CIS systems to document interventions related to achieving nurse sensitive outcomes.
4) Recognize the role of information technology in improving patient care outcomes and creating a safe care environment.
5) Implement & monitor strategies to prevent risk & promote quality & safety in the nursing care of older adults with physical & cognitive
needs.*
Evaluated by: Date Rating Instructor Comments
Competency 1
Complete clinical organization Electronic Medical
Record training class.
Uphold HIPPA policies regarding use of a
patient’s electronic medical record.
Competent use and appropriate application of all
bedside technology systems (blood glucose
meter, pulse oximetry, bladder scan, volumetric
IV pumps, secured drug dispensation system).
Competency 2
Use of patient’s medical record to retrieve
relevant information for planning,
implementation, and evaluation of clinical data to
develop a safe and specific action plan of care.
Competency 3
Engages in appropriate professional care during
simulated scenarios.
Competency 4
Comprehension of the unique health care needs
of an older adult and national safety concerns
regarding appropriate care of the older adult
within a technological health care setting.
10-24
11-9
11-23
Throughout
12-6
10-25
11-23
11-9
11-2
√
√
√
√
√
NI
√
√
√
 I had all of my training and paperwork successfully accomplished before
the beginning of clinicals.
 We reviewed HIPPA and performed blood glucose monitoring with
partners during our orientation training day.
 This marked the end of our third week of clinicals. So far, I have
completed BGM, pulse oximetry, and the secured drug dispensation
system.
 I have validated the intravenous Alaris pump system.
 I competently obtain pulse oximetry levels daily.
 My patient required the bladder scanner, and I completed the scan and
straight catheterization.
 I am able to log into Epic, gather a patient’s information, and apply that
to my prep. I will improve my critical thinking skills as I practice writing
more NCPs.
 I am proud of the two preps from this weekend. I think they have been
the most thorough and clearest to date.
 At the CNE, I maintain a professional attitude as I would in the hospital
setting. For that time, the mannequin is just as a real patient would be
for me.
 I worked with two older adult patients this weekend, and it was
necessary to pay special attention to the FPP required for each one,
adequate nutrition, encourage hydration, and assess neuro changes.

6. ANRS 311, 2014
 Attended the Geriatric seminar in the Meriter conference room, where
we discussed needs specific to the older adult. These include adequate
nutrition, hydration, mobility/repositioning/rehabilitation.
Essential VI. Perform
communication and collaboration
skills consistent with professional
standards when working in
interprofessional settings to
improve health services
Competencies:
1) Use inter-and intraprofessional communication skills to deliver evidence-based, patient-centered care.*
2) Incorporate effective communication techniques, including negotiation and conflict resolution to produce positive professional
working relationships.*
Evaluated by: Date Rating Instructor Comments
Competency 1
Initiates relationship building with client, unit staff
and other health care professionals
Appropriately documents in computerized
information system.
Demonstrates individual accountability through
weekly journals.
Participates in interprofessional collaboration
through shift-shift report.
Competency 2
Accurately interprets communication techniques
based on communication discussion in post-
conference.
Arrives at resolutions to conflict through
brainstorming, questioning, active listening or
negotiation.
Communicates effectively using verbal and
nonverbal techniques.
Involves the client in decision-making.
10-25
10-26
11-9
11-9
11-16
11-2
10-26
11-22
√
√
√
√
√
√
√
√
 During the shadowing experience, I immediately started to build a
professional relationship with the 8 Tower staff.
 During our first patient day, I worked hard throughout the day in order
to document appropriately.
 I am striving to make each day with patients individualized to their needs
and connect with them in their own necessary way.
 I have attended bedside report and always check out with my RN and
NA, as well as relaying important information throught the day.
 Improved on therapeutic communication techniques from the first
portion of the project through the second. I was able to utilize more
communication techniques with my patient DH.
 At the end of the shift, I was struggling because my Pt’s IV line was not
flushed at any point over the course of the day. I questioned the MAR,
and my RN was impressed by my observation and contacted the MD.
 During our first patient day, I established rapport and communicated
effectively with my patient.
 I was able to discharge my patient SF. During this process, I was able to
complete discharge teaching, which included instruction about two new
medical prescriptions, care at home, and methods to prevent/observe
signs concerning this condition in the future.

7. ANRS 311, 2014
Essential VIII: 1) Integrate
professional standards of moral,
ethical and legal conduct in
nursing practice.
2) Formulate a personal
professional practice model that
addresses accountability,
continuous professional
engagement & lifelong learning.
Competencies:
1) Promote the image of nursing by modeling the values & articulating the knowledge, skills & attitudes of the nursing profession.*
2) Protect patient privacy & confidentiality of patient records & other privileged communications.*
3) Act to prevent unsafe, illegal, or unethical care practices.
Evaluated by: Date Rating Instructor Comments
Competency 1
Review the ANA Nursing Code of Ethics. Discuss
how each statement applies to current practice at
the 311 level.
Review and discuss the Edgewood College SON
Code of Professional Conduct, as it applies to the
clinical unit, during clinical orientation. Provide
examples of violation and consequences through
discussion and reflection.
Competency 2
Review institution’s Patient Confidentiality
policies and procedures.
Attend Lab; “Reporting and Documentation”
Student signs confidentiality contract.
Review policies and procedures for computer
access to client records.
Monitor student performance during clinical
practice and provide feedback.
Competency 3
Use of simulated vignettes that address ethical,
legal and moral patient care situations.
Or attendance at an interdisciplinary ethics
committee meeting.
10-24
10-24
10-24
10-25
10-24
10-24
Throughout
11-9
N/A
√
√
√
√
√
√
√
√
N/A
 In our orientation and training day, we reviewed these ethical standards
and applied them to our situation as nursing students.
 I am aware of the Edgewood Code and I strive to act as a model for the
Edgewood community. I dress appropriately and use appropriate
language throughout my clinical environment.
 I am mindful of the Edgewood values and strive to incorporate them
into my experience at Meriter.
 I come to the clinical setting is freshly washed and pressed scrubs
according to the dress code, and I do not wear additionally clothing that
is not a part of this policy.
 These were completed by the clinical rotation began through the
Meriter training modules.
 The rest of these were completed prior to orientation, and we reviewed
them as a class in the Meriter conference room.
 I hope to give my classmates constructive criticism. I provide a lot of
moral support and encouragement for my peers, and I am always
willing to help others.
 I played the role of handoff nurse to set up the CNE Simulation for
three following scenarios.
 The ethics committee meets on Thursdays during other course time, so
I am unable to attend.

8. ANRS 311, 2014
Essential IX. Demonstrate
knowledge & skills in the care of
patients, including individuals,
families, groups, communities,
and populations across the
lifespan and across the
continuum of healthcare
environments.
Competencies:
1) Deliver compassionate, patient-centered, evidence-based care that respects patient & family preferences. *
2) Implement evidence-based nursing interventions as appropriate for managing the acute & chronic care of patients & promoting health
across the life-span.*
3) Monitor client outcomes to evaluate the effectiveness of psychobiological interventions.
4) Facilitate patient-centered transitions of care, including discharge planning & ensuring the caregiver’s knowledge of care requirements
to promote safe care.
5) Provide nursing care based on evidence that contributes to safe & high quality patient outcomes within healthcare microsystems.*
6) Revise the plan of care based on an ongoing evaluation of patient outcomes.*
Evaluated by: Date Rating Instructor Comments
Competency 1
The student demonstrates compassion through
listening, empathy and reflection of patient’s
preferences as shown through their self-
evaluation and conversations shared in clinical
conference. Weekly clinical encounters observed
by the instructor and weekly nursing diagnosis.
Competency 2
Students demonstrate their evaluation of the
effectiveness of psychobiological interventions
through enacting the nursing process in the
clinical setting, through direct observation by the
clinical instructor, and nursing diagnosis of their
assigned patients, and sharing their evaluation of
the outcomes that spans both psychobiological
interventions in post-conference discussions.
Competency 3
Anticipate discharge needs of patient, family and
caregivers. Include discussion of discharge needs
with interdisciplinary team members to promote
safe care.
11-2
11-16
11-9
11-10
11-8
11-22
NI
√
√
NI
√
√
 My Therapeutic Communication Part I was not as clear as I had hoped.
I wish to improve for Parts II and III.
 Part II was greatly improved. My patient was so thankful for my care,
and I knew that I had connected with her.
 Nursing diagnosis are becoming easier, as I write concept maps, as
opposed to writing medical diagnosis.
 I am working on improving the flow of my concept maps in order to
show the activities that may benefit the patient’s condition and why.
These concept maps allow me to think through the nursing process and
actively participate in these activities to improve the patient’s health.
DH was diagnosed with pneumonia. Throughout my concept map, I
showed how CDB, ambulation, and increased fluid intake could improve
her condition by eliminating excess secretions and improving lung
expansion.
 I was able to prep a patient and his daughter for an upcoming
discharge, by teaching them about things to expect that afternoon
before discharge and upon return to their home.
 I helped SF and her husband prepare for discharge, planning the
discharge teaching, and answering their questions. I accompanied SF to
the lobby via wheelchair, and the NA helped me to position her safely in
her car.

9. ANRS 311, 2014
Competency 4
Incorporate knowledge of pharmacology and
diagnostic tests when planning and providing
patient care.
Student’s ability to provide a plan of care that
includes safety and quality care outcomes for
weekly assigned patient.
Competency 5
Demonstrates ability to consider alternate
interventions for identified nursing diagnosis.
Shares in clinical discussions reevaluation of
patient outcomes based on assessment data.
Ability to be make adjustments in plan of care
based on changes in patient status.
Throughout
10-26
11-16
11-23
11-16
11-8
NI
NI
√
NI
√
 Pharmacology is not second nature to me, so I need to continue
applying the course work from lecture to clinical.
 I am beginning to form NCPs, but I would like to improve as I complete
more preps.
 I think that my preps are becoming more in depth, and I am beginning
to be able to form a better CP for each day to include beneficial
activities.
 I am proud of the flow I had this weekend. Besides a flub in
communication with my RN, I successfully accomplished all of my
hourly rounds, assessments, and charting.
 I am trying to consider alternate interventions and recommendations
for the interdisciplinary team. I wanted to encourage more PT sessions
for DH to improve the strength and mobility in her left side.
 I am flexible to new appointments and cares that are scheduled last-
minute for my patients. I was able to switch around my POC to
accompany my patient to his stress test and reevaluate our schedule for
the afternoon.
n*Competency begins in NRS 311 and continues throughout entire program

10. ANRS 311, 2014
Midterm Evaluation
Student Comments: Date: 11-17
1. Strengths with supporting examples:
o I always volunteer to help Professor, the other students, and the hospital staff. After I complete my cares, I always try to check in with each
student to see if they are in need of any assistance.
o I am capable of showing an emotional connection to patients in an appropriate manner. I try to check in on past patients (my admission JS is
an example) to show emotional support.
2. Areas of knowledge or skill that require further development:
o I need to improve my dexterity with certain medications. I have trouble ripping IV bags and turning off injection caps, which tends to make me
nervous.
o I want to improve my knowledge from our Pharmacology course and apply it to my patients. I enjoy looking up each medication for prep each
week. However, I cannot always remember what the medications are for without my notes. I hope to improve my knowledge, and be able to
communicate each medication and its effects efficiently to my patients.
3. Realistic and measurable learning goals for the remainder of the semester.
o I enjoyed working with a fairly complex patient this weekend. I would like to continue this in order to improve my time management skills,
complete in depth preparatory forms, and provide as much care as possible. If possible, I would like to challenge myself to prep for two
patients if I was demonstrating quality care and expertise as the session continues.
o I would like to incorporate more communication with the interdisciplinary team. I learned so much from my cardiac short stay experience, as
well as my trip to the stress test. I want to continue meeting as many care team members as possible. I always try to have a few solid
questions to address in order to learn as much as possible.
Midterm Rating and Instructor Comments Date:
Essential I: Integrate the liberal arts into the practice of nursing. (Needs Improvement) Preps have consistently shown good data collection and
plans of care. Emily does struggle with determining the major medical diagnosis vs. symptoms, which must be researched for a good
understaning of the patient care situation. For example, on 11/15-16 she researched hypoxia, obtundation, and loss of consciousness rather than
the medical diagnosis of opiate overdose, pneumonia, and rhabdomyolosis. I discussed this with Emily during clinical as well as on the phone
after the clinical was completed. A goal for Emily is to be able to better disaggregate a vast amount of medical information and focus on the acute
problems the patient is experiencing and being treated for. Being able to identify the key diagnosis will enable her to better understand the
interventions being provided (e.g. medications), the diagnostics (abnormal lab values), and the overall plan of care. It is
important that Emily is able to put all of these pieces together before moving on to the next level. I suggest she call me while prepping, so that I
can understand her thinking and provide guidance as necessary.

11. ANRS 311, 2014
She is demonstrating consistent improvement in accurately identifying the reasons why patients were prescribed the medications she was passing
with and without the use of the prep sheet. She asks questions and problem solves as necessary. Her work is methodical and thorough and
demonstrates good manual dexterity while performing skills.
She is beginning to show confidence while conferring with other members of the health care team r/t plans of care. She has had the opportunity to
work with OT, PT, RNs, CNAs, and members of Care Coordination. She is not afraid to ask questions and act as patient advocate.
Journal entries provided adequate reflection on the clinical day – she discusses challenges and successes of the clinical day. She consistently
shows good insight into her strengths and areas needing improvement.
Essential II. Apply skills in leadership, quality improvement, and patient safety to provide high quality health care in a systems environment.
Emily has completed three concept maps. She needs to work on writing a complete Nursing Diagnosis statement and focus on one specific
subsystem. Feedback has been provided and I suggest that Emily bring the latest submission to her midterm conference on 11/20/14, for
continued instruction on Concept Mapping.
Emily ensures a safe environment by adhering to the 8 Tower standards of care such as implementing the Fall Prevention protocol and assessing
patients using the Braden scale. She has been very conscientious in ensuring a safe environment for her clients.
She accurately documents assessments, interventions and evaluations on the Epic documentation system. As the weeks progressed, she required
less prompting to complete all fields of the EMR.
Essential III: Translate current evidence into the practice of nursing.
Emily’s plans of care (written on prep and discussed during pre-conference) for her assigned patients are well organized and thorough. She
requires less prompting from the clinical instructor to include all essential data in her reports. She has been very flexible in reorganizing care as
priorities shifted.
Essential IV: Demonstrate knowledge and skills in information management and patient care technology.
Emily is comfortable navigating the Epic documentation system and utilizes the electronic resources to access information to facilitate
comprehensive patient care (e.g.teaching materials, discharge).
She appears comfortable with other 8 Tower technology resources such as the glucometer, bladder scanner, and Alaris IV pumps (improving with
practice and experience). She has cared for four older adult patients – her preps have addressed assessments and interventions specific to this
patient population. She is very sensitive to the care needs of the older adult and works extremely well with this patient population.

12. ANRS 311, 2014
Essential VI. Perform communication and collaboration skills consistent with professional standards when working in interprofessional settings
to improve health services.
Emily is showing growth in this area. She has become more confident in communications with members of the IDT as well as with patient and
family interactions.
She has completed the Therapeutic Communication assignment, Parts I and II. Part I (written portion) did not demonstrate a good understanding
of therapeutic communication (as written). Communication techniques were discussed but there were missed opportunities for more in-depth
communication to occur. Feedback was given. Emily demonstrated improvement in Part II (post clinical discussion). With this experience she
gained insights into her abilities as a therapeutic communicator. She now has a better understanding of the purpose of therapeutic communication
and the nurses role as facilitator.
Emily provides client-centered care, accommodating their needs and wishes over a nurse driven schedule. Patients and families respond positively
to Emily’s attentiveness and caring presence.
Essential VIII: 1) Integrate professional standards of moral, ethical and legal conduct in nursing practice.
2) Formulate a personal professional practice model that addresses accountability, continuous professional engagement & lifelong learning.
Emily has provided excellent examples of how she has met this Essential and the competencies. I concur with her self-assessment.
The ANA Nursing Code of Ethics was discussed during clinical orientation. The discussion focused on the students’ interpretation of each
provision and how they can apply them to their current practice.
Essential IX. Demonstrate knowledge & skills in the care of patients, including individuals, families, groups, communities, and populations
across the lifespan and across the continuum of healthcare environments.
Emily has demonstrated progress in this area. She has consistently provided client and family centered care. She developed plans of care that
took into account patient and family preferences. I concur with her self-assessment.
Emily will complete the required Teaching/Learning project in the next few weeks. She does provide patient teaching on a daily basis, which
includes addressing understanding of medications, safety precautions, and general plans of care. This activity is documented on the patient’s
EMR.
Emily has become increasingly efficient with care planning and delivery. Initially, she was unable to complete the baseline assessments before 9
am, but as the session has progressed she has been able to meet this goal. She anticipates care needs and follows through with assessments and

13. ANRS 311, 2014
evalations. She strives to be “on top of things” as observed by the clinical instructor. She is able to prioritize her work and and asks questions if
unsure of how to proceed. On 11/15-16 she cared for a complex patient with many medical issues, medications of varying routes,
blood glucose monitoring, IV fluid infusion, voiding trials after removal of a Foley catheter, changing trach ties, etc. She was able to provide
systematic care with good attention to detail as she accomplished the tasks of the day.
Emily has been present, on time, and prepared for the clinical day. She has been Care Team Leader on one day and demonstrated excellent
organizational, leadership, communication, and delegation skills. This experience provided a brief glimpse into the work flow and complexity of
care needs on 8 Tower and those of her peers. She will have another opportunity to act in this role on 12/8.
Emily is gaining confidence, but needs to share her fears more readily with the instructor when she is feeling unsure of herself. She fears she is not
keeping up with her peers (some have lots of CNA experiences in acute care), which I think she finds intimidating. In a phone conversation with
Emily (11/17/14) I stressed that everyone has different learning needs and is on their own path. I told her that it is my job to ascertain each
students learning needs and provide education accordingly, however it is important that she be more confident and communicative in sharing her
learning needs with me. I assured her that at this point in the session she is meeting objectives – with some areas needing improvement – but with
continued diligence on her part and support by me, she should be able to meet the objectives of the course.

14. ANRS 311, 2014
Final Evaluation
Student Comments: Date: 12-12
Identify your growth over the semester in relationship to each of the six course objectives. Provide clear examples to support your assertions.
I. Apply the nursing process to meet health needs of adults with a focus on secondary prevention.
a. Each week my written work expanded in medical knowledge and awareness. It became easier for me to find specific diagnoses by utilizing
physician’s notes. My preps were submitted with concrete information, as well as appropriate citations. I composed my journals after ample
consideration time, in order to ensure thorough reflection on my weekly work.
II. Incorporate individual differences of clients into nursing care within an acute care setting.
a. As I wrote in my final journal, in the beginning I was focusing so much on each condition as a separate entity. After this clinical, I have been
able to develop a broader sense of care for each patient as an individual, realizing that the patients with the same comorbidities will have
different symptoms, methods of treatment, and reactions to medication. I have established a new way to critically think through each prep in
order to provide the best care for each of the individual differences of clients.
III. Communicate therapeutically with clients to promote their personal integrity.
a. I developed many communication skills that needed improvement over the course of the semester. I began to employ new techniques, and
those that were uncomfortable in the beginning of the semester progressed throughout each weekend. I had a few patients that needed me
to explain each process, medication, reason for care. Others needed silence in order to voice their own concerns. My last patient required
therapeutic touch throughout the entire hospitalization.
IV. Analyze the acute care environment to promote and protect the health of clients.
a. Each week I employed patient safety more accurately than the week prior. I made sure that my patients always had the correct number of
aides/SNs to ambulate. I adamantly attempt to clean patients’ rooms in order to free the walkways from any obstacles. I administered the
correct medications while knowing the reason and action; I held medications when the patient was not in the correct state to receive them
(low blood glucose, low blood pressure), and I quickly put the remaining medications back in the safety lock box.
V. Apply knowledge from nursing, the humanities, and the natural and behavioral sciences to nursing practice with adults.
a. The nursing process genuinely utilizes so many areas of expertise. I attempted to bring in all of the knowledge from our courses thus far, as
well as personal experience while caring for each client. As our pharmacology course progressed, I was able to apply that education to my
medication preparations. I used anatomy and physiology when researching comorbidities. However, I always maintained an ethical standpoint
throughout the entire process. As an Edgewood alum, and returning student, I placed the Edgewood values at the forefront of my care.
VI. Demonstrate professional accountability when providing care with adult clients.
a. The older adult population may require more thorough assessments during their hospitalization due to a greater chance of functional decline. I
listened intently during our presentation on functional decline in the hospitalized older adult, and I truly began to bring those considerations
into my nursing process. I accurately used the Braden scale for this population, attempting to prevent any risk of shearing or possible pressure
ulcer formation. I tried to promote suitable nutrition and hydration for each individual. I incorporated their families as much as to promote a
supportive atmosphere for healthy living after discharge.

15. ANRS 311, 2014
Final Rating and Instructor Comments Date: 12/11/14
Essential I: Integrate liberal arts into the practice of nursing.
Preps showed steady improvement through out the term. Emily has incorporated Instructor feedback and since midterm has shown drastic improvement in
the prep work. Emily continues to develop her critical thinking and clinical reasoning skills. She is beginning to sort out large amounts of patient data so that
priorities can be developed. This is a huge improvement from the beginning of the term when it was difficult for her to disaggregate large amounts of patient
data. She has become more fluid with medication knowledge and passes. It is evident that she is utilizing new knowledge gained in the concurrent
Pharmacology course into everyday practice. She is also demonstrating increased confidence in her knowledge both in her written work and clinical
performance.
Emily continues to share candid insights in her journal entries. She knows her strengths and areas needing growth. Since midterm, she readily confers with
the instructor when she needs feedback on performance. A goal for Emily in her future clinical courses, will be to be more confident in her knowledge.
Essential II: Apply skills in leadership, quality improvement and patient safety to provide high quality health care in a systems environment.
With practice and feedback, the concept maps have become more fluid with good logic and flow. Emily is able to identify priority nursing diagnosis, write a
cohesive ND statement, and identify appropriate goals and interventions for each patient she has cared for. She follows the nursing process by evaluating the
interventions provided.
Emily continues to show great attention to safety with her patients on fall precautions, remaining present for patient and consistently reinforcing teaching. She
is attentive to ensuring safety by supporting and facilitating organizational initiatives for quality improvement. She utilizes the 5 R’s consistently with med
passes.
She has been Care Team Leader on one occasion and was excellent in this role. She demonstrated effective leadership skills, work flow management, and
support for her peers.
Essential III: Translate current evidence into the practice of nursing
Emily has been consistent in using evidence-based research in her written work. She is able to apply this theorectical work into practice by discussing how this
information applies to her patient’s health condition. Plans of Care (POC) are discussed during pre-clinical conference and over time she has required less
instructor support in establishing priorities for care. Reports have been thorough with few instructor cues required. Even though established POCs require
alterations as the day progresses, Emily has demonstrated flexibility in doing so. She has cared for several complex patients where shifting priorities occurred.
She required support for reorganizing the POC, but was receptive to the assistance and learned from these experiences.
She has shown improvement in “thinking like a nurse”, that is following the nursing process in it’s entirety (e.g. has become more efficient at re-evaluating
pain status after prn administration).
She is engaged in her learning during pre and post clinical conferences. She shares her knowledge regarding her patient care experience as well as contributes
knowledge related to her peers’ patient care issues. She asks appropriate questions and seems to have a great thirst for knowledge.
A score of 43/50 was received on the Teaching and Learning project. Most points were deducted for APA and Scholarly format. I will discuss the paper with
Emily at her final conference (12-11-14).

16. ANRS 311, 2014
Essential IV: Demonstrate knowledge and skills in information management and patient care technology.
Emily has become much more confident and fluid with navigating the EMR. She is able to retrieve relevant data to safely care for her client.
To the best of my knowledge, she upholds confidentiality polices. She has become more adept at using 8 Tower technology such as the glucometer, Alaris IV
pump, bladder scanner, etc.
Emily participated in a Simulation experience (older adult s/p hip arthroplasty requiring a blood transfusion). She was very prepared for the experience
(completed all written work and contributed to the pre-Simulation discussion). She acted out her role in a professional manner. She provided constructive
criticism to her peers in an atmosphere of mutual trust.
Emily has cared for four older adult patients. She provides information about assessments and interventions required for each patient on her clinical prep. She
has a solid knowledge base in this area. She has continued to be very cognizant and sensitive to the care needs of this growing patient population. She
attended an inservice on “The Hospitalized Older Adult” on 11/21 which further facilitated her knowledge development in this area.
Essential VI. Perform communication and collaboration skills consistent with professional standards when working in interprofessional settings to
improve health services.
This is one of Emily’s greatest areas of growth. She has become more confident in her use of effective therapeutic communication strategies, based on
individual needs.
She has become more confident while conferring with members of the interprofessional team. She recently conferred with an off-unit nurse (9T) regarding the
documentation for CBI, which isn’t typically performed on 8 Tower. With this experience, Emily learned that we need our team members (can’t know
everything) in order to facilitate quality care delivery for our patients.
She has participated in am and pm shift to shift report.
The Therapeutic Communication assignments were completed. The Part III was discussed on 12/7/14. Emily discussed how her skills have improved over
time. She utilized effective strategies (touch, silence, presence) which facilitated accomplishment of the goal (providing comfort). All criteria was met for this
assignment. Emily stated that her growth has centered on understanding the importance of individualizing communication with each patient care situation –
using silence is a technique she is becoming more comfortable with.
Throughout the term, patient centered care was provided. She was very willing and accommodating to their needs and requests.
Essential VIII: 1) Integrate professional standards of moral, ethical and legal conduct in nursing practice.
2) Formulate a personal professional practice model that addresses accountability, continuous professional engagement & lifelong learning.
Continues to have excellent self reflection and assessment of personal strengths and needs. She continues to demonstrates learning from all patient care
experiences. She continues to be very open and honest about her strengths and areas needing growth.
To the best of my knowledge, Emily upholds the moral, ethical, and legal standards of nursing practice.

17. ANRS 311, 2014
Essential IX. Demonstrate knowledge & skills in the care of patients, including individuals, families, groups, communities, and populations across the
lifespan and across the continuum of healthcare environments.
Emily became much more efficient with care planning and delivery toward the end of the term. She required less support from the clinical instructor over
time. She developed excellent rapport with her patients and families through her ability to develop trusting relationships. Patients greatly appreciated her
care and concern. Emily took the initiative to call her pateint’s daughter (12/7/14) to update her on his status – the daughter was very upset the day prior about
her father’s condition.
Emily has been aware of discharge/transitional care. She reads the Care Coordination notes as well as documents daily on the discharge plans (standard of
care). She has actively participated in the discharge process. She was able to witness the complexity of this process. She saw first hand the importance of
communication – both written and verbal- for smooth transitions to occur.
She has been present, on time, and prepared for all clinical days.
It has been a pleasure having Emily in the clinical group. She is persistant in her quest for learning and understanding. She takes responsibility for her
learning. She brings a positive energy to the work group, and does not let challenges impact her level of professionalism. She has handled the stress of caring
for high acuity patients, long, back to back work days, and lots of homework well. These attributes are very important to the academic challenges ahead of her.
She is very sensitive/emotional, but has maintained a professional demeanor while caring for patients.
Keep up the hard work and things will come together for you. Your caring presence will make you a great nurse!
Instructor Signature:__________________________________________Date:_______
Student Signature: ___________________________________________Date:_______