Multi Rater Competency Assessment

2015 - 2016 - NURS 253 Practical Nursing Pre-graduate Experience MRA Final (201508)
NURS 253 Practical Nursing Pregraduate experience (PN, 18-Jan-2016 - 07-May-2016)
Student :
Clinical Teacher/Preceptor :
Advisor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Kristina Milaniak
Ingrid Zicari
Melissa Morgan
Judy Martin
Holland Bloorview Kids Rehabilitation Hospital
Agency
3W SODR - Specialized Orthopedic & Development
18-Jan-2016 To 15-Apr-2016
456
448
456

I declare that this is my original work and the sources used are acknowledged.

Abilities and Outcomes / Learning Outcomes

Student Rating

Teacher Rating

1. Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and procedures of the
practice setting.

1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies and

Satisfactory

Satisfactory

procedures.
K.M. : I believer I have followed all policies and procedures within the Nursing scope that are enforced at Holland Bloorview Kids Rehabilitation
hospital. For example, certain procedures are only allowed to be done by RNs versus RPNs. I believe I have also applied the College of Nurses of
Ontario (2010) regulatory standards including privacy and confidentiality, ethics, documentation, medication administration, while encompassing the
therapeutic nurse-client relationship within all these professional standards.

1. 2 Act in a professional, responsible, ethical and accountable manner.

Satisfactory

Satisfactory

K.M. : I believe I have upheld my clinical practice thus far that has been accountable and responsible, with examples such as, following plan of care
appropriately for all clients, transferring of accountability during shift change over, bedside reports, and covering for breaks during the assigned shift.
The CNO (2009) ethical values that must be upheld while giving nursing care as well. They are: client well-being; client choice; privacy and
confidentiality; respect for life; maintaining commitments; truthfulness; and fairness. I believe I have upheld all these ethical values thus far to my
patients and my colleagues.

1. 3 Use the three factor and decision making frameworks to determine strengths and limitations and

Satisfactory

Satisfactory

when to collaborate and consult with other professionals.

K.M. : The three factor framework that is outlined by the CNO consists of the nurse, client, and the environment. These three components are
essential in the practice of nursing. I believe that I have integrated all aspects of the framework within my clinical setting up to date. When noticing my
limitations, I always consult with the clinical nursing staff (primarily preceptor), and ask questions to ensure that patient safety.

1. 4 Integrate evidence-informed practice and a theory based approach into nursing care.

Satisfactory

Satisfactory

K.M. : Evidence-informed practice and theoretical approaches to care are integral to the health care system. I have used technologies and resources
that are available to further my practice and ensure optimal patient care. For example, I have used Lexicomp as a medication- tool resource to
research medications that I am unfamiliar with. Also, knowledge learned through in-services and the Humber PN curriculum support evidence-based
practice.

1. 5 Assess practices and risk management principles and take action to ensure safety of clients,

Satisfactory

Satisfactory

self, and others.

K.M. : Safety is important to the client, just as much as it is to the nurse. Infection and control practices are integral to provide safe patient care. Hand
hygiene is the number one defense against spreading disease. Using PPE equipment and following precaution of isolation guidelines outlined by the
agencies policies protects all factors within the multidisciplinary health care team. I have complied with these standard by taking seminar, and
enforcing these practices in clinical always. Doing my 4 moments of truth of hand hygiene protects my clients and myself. Also being up to date with
agency immunization policies also reinforced safety-based practices. I have also participated in a Workplace safety seminar (WSIB tutorial) that was
provided by the agency, Holland Bloorview.

1. 6 Question and clarify unclear orders or directions and when uncertain.

Satisfactory

Satisfactory

K.M. : Within this competency, I believe I have been satisfactory. With my preceptor, Ingrid, I have clarified all questions and taken direction
accordingly when necessary. Examples include: clarifying orders/ care plan when reading an order is difficult, asked questions and asked for
demonstration when I need help performing a clinical skills, i.e., intermittent catheterizations and suctioning. I think whenever my capacity or
knowledge is being questioned, I always ask my preceptor before doing any sort of care to maintain the safety of the patient.

1. 7 Question, clarify or challenge questionable orders, decisions or actions by others.

Satisfactory

Satisfactory

K.M. : When questioning orders, actions, or decisions made by other health care providers, I always clarify with the health care team within the
patient's circle of care. I have not yet had the opportunity to challenge an order, but have consulted with the team as a group to what the best pathway
of care would be. For example: working with the NP, primary nurse, and doctor during an admission to determine the best plan of care.

1. 8 Respond in a professional manner to situations in which there is unsafe, unacceptable or

Satisfactory

Satisfactory

unprofessional behavior.
K.M. : Within this competency, I believe I have been satisfactory in regards to responding in a professional manner in situations that may hinder CNO
clinical standards. I have not encountered any of these situations in my pregrad setting fortunately, as the team at Holland Bloorview is amazing with
there care and clients. I know that acting in a professional manner within the multidisciplinary team is best practice. I know that if any of these
behaviours are witnessed they must be reported and documented.

1. 9 Demonstrate understanding about the role of the nurse within health care.

Satisfactory

Satisfactory

K.M. : The role of the nurse is integral to the health care team. By being a part of the multidisciplinary team as a student, I have learned how
important the nurse is within our health care system. Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore
health, and to alleviate suffering. The need for nursing care is universal, and are imperative to client care within the interdisciplinary team.

Teacher comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies
and procedures of the practice setting. :
Kristina has demonstrated full competence in this area of practice. I have recommended that she participate in an Interpersonal education session on
Ethics offered by the hospital.

2. Communicate using strategies and technology to effect accurate and timely information sharing including data, research, and other
information.

2. 1 Contribute to team sharing and discussions.

Satisfactory

Satisfactory

K.M. : I believe that I have contributed to team sharing discussions as best as I could throughout my consolidation. I have participated in clinical
rounds and family team meetings. I will continue to develop my confidence in speaking up and contributing effectively.

2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic methods.

Satisfactory

Satisfactory

K.M. : I have used the following technologies and communication tools that are provided to staff at Holland Bloorview such as Meditech, eMAR,
patient charting, and doctors notes. These are all avenues to which I have documented clearly, accurately and in a timely manner. The electronic and
paper methods available at Holland Bloorview are all for open and effective communication amongst the multidisciplinary team.

2. 3 Use effective communication techniques when reporting relevant information and providing

Satisfactory

Satisfactory

feedback to the appropriate members of the interprofessional heath care team.

K.M. : Effective communication is imperative to providing appropriate patient care. During consolidation, the effective communication techniques
including SOAP nurse notes, TL (team lead) binder notes, and patient daily communication folders. I believe that I have provided feedback to the
appropriate inter-professional health care member when client information needs to be discussed/ reviewed/ recorded. Examples: body system
assessments, respiratory assessment and suctioning to RT, and appropriate mobility transfers/ modalities based on OT/PT and surgeon protocol. I
have also abided by all patient seizure protocols and have documented clearly those events.

2. 4 Evaluate and refine techniques used to communicate and share information with clients and the

Satisfactory

Satisfactory

interprofessional health care team.

K.M. : Due to the fact that I still have a student-nurse status, I believe I have upheld this competency to the standard. Although, I have evaluated and
used communication techniques effectively that are in place at Holland Bloorview. However, I have not been involved in refining any techniques to
communicate more effectively with clients and the team because the ones in place I believe work effectively to meet patient demands.

2. 5 Ensure privacy and confidentiality.

Satisfactory

Satisfactory

K.M. : I ensure that the privacy and confidentiality standards are upheld for my practice. It is integral as health care team members to maintain that
privacy for all patients, as it is a client's right. The competency is a CNO standard and must be met always. Examples include: I have only discussed
client information to the appropriate inter-disciplinary individuals that are within the client's circle of care; also when providing care I ensure that doors
are closed or curtains are drawn to promote privacy.

2. 6 Use technology to retrieve information including research and other date and to obtain and

Satisfactory

Satisfactory

forward information both within and outside the practice setting.

K.M. : As stated above, I have used the appropriate techniques and researched relevant information pertaining to the client care provided. This has
been done to further my knowledge for within and outside the practice setting of Holland Bloorview.

Teacher comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Kristina has developed confidence in clearly communicating with the multidisciplinary team on an individual basis.

3. Engage in relational practice that is caring, compassionate and respectful.

3. 1 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and

Satisfactory

Satisfactory

health care team members.

K.M. : Working in health care, the setting is predisposed to coming across families and clients that are of different ethnicities and cultures. I believe
that within my consolidation and novice practice, I have been caring and compassionate to all clients and families at Holland Bloorview, and have
developed a good rapport with the clinical staff as well.

3. 2 Establish a caring environment that supports clients in meeting their needs and outcomes,

Satisfactory

Satisfactory

managing their illness, or experiencing a peaceful death.

K.M. : Although I have not encountered any clients at Holland Bloorview in the palliative stages, I have provided an nursing practice environment that
supports clients meeting their needs and managing the illnesses they have.

3. 3 Demonstrate therapeutic use of self to foster client well-being.

Satisfactory

Satisfactory

K.M. : I believe I have demonstrated my therapeutic use of self by being supportive of the families and clients that are at Holland Bloorview. The
organizations family- centred care approach allows me to be a supportive measure to the clients and their families during this stressful time.

3. 4 Utilize relational knowledge and skills, and ethical principles to support clients and to interact

Satisfactory

Satisfactory

with health care providers.

K.M. : Although I have still much to learn from my superiors and from future experiences, I believe that as a novice nurse I have used relational
knowledge to the best of my abilities truthfully and ethically. I am also participating in a IPE in-service on April 12th, to contribute to this competency.

3. 5 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on

Satisfactory

Satisfactory

relational practice.
K.M. : Although I have still much practice and knowledge to learn about communication, I believe that I have been self-aware with my beliefs and
values, and making sure I am respectful of client's choices and cultural practices. I use relational practice from client to client, however, I still know to
give the individualized plan of care the client needs.

3. 6 Collaborate with clients, members of the interprofessional and health care teams; and, consult

Satisfactory

Satisfactory

appropriately.
K.M. : I believe that I have been open and honest with the clients at Holland Bloorview and team in regards to what/ who needs to be communicated
about the client. I believe I have been satisfactory in this competency, and have consulted my preceptor and appropriate health care team members
when needed.

3. 7 Uphold practices and systems that support the diversity of clients and of the interprofessional

Satisfactory

Satisfactory

health care team.

K.M. : I believe that I have upheld the practices and policies that are outlined for RPNs from the College of Nurses (CNO) and from Holland
Bloorview. I respect and appreciate learning from my peers and clients about their diversities in cultures, beliefs and values.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

K.M. : I have done some client education throughout my placement at Holland Bloorview but I do feel this will be an ongoing competency that I will
learn throughout my practice. Experience will only contribute to the ability to provide effective communication, and I know that will come with time.
Some examples include: teaching clients to do self-catheterization, educating clients/ families on medications when they are leaving on a leave of
absences. I answer client's questions to the best of my knowledge. and consult with my preceptor for further education.

Teacher comments for Engage in relational practice that is caring, compassionate and respectful. :
Kristina has demonstrated full competence in this area of practice by receiving positive feedback from the client, families and staff on numerous
occasions .

4. Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the profession.

4. 1 Evaluate and refine leadership skills to develop solutions, resolve conflict, create a positive work

Satisfactory

Satisfactory

environment and organizational culture, and to strengthen advocacy role.

K.M. : I believe that it takes years of practice to develop an expertise in leadership. I believe that I support all my peers and collaborate to foster a
positive work environment, however, my leadership skills always need developing. However, I do believe my competency is up to standard within my
novice status.

4. 2 Provide feedback to peers and accept feedback from peers and members of the

Satisfactory

Satisfactory

interprofessional health care team.

K.M. : I believe that I have developed my leadership skills, and given reinforced positive feedback to my peers. Therefore, I believe that I have been
satisfactory within this competency. I am always looking for feedback for improvements as well.There are many students at Holland Bloorview,
therefore peer mentorship and collaboration is enhanced within this teaching hospital setting.

4. 3 Advocate for clients, self, others, and quality practice environment.

Satisfactory

Satisfactory

K.M. : I believe that I have advocated for my clients, self, and the environment I work in to foster the safest clinical practice possible. The critical
thinking skills I have developed throughout my practice thus far, allows to foster skills that allow nurses to advocate for their client and themselves.

4. 4 Support clients rights for self-determination and choice.

Satisfactory

Satisfactory

K.M. : I agree that I have supported client's to the best of my abilities and allowed the paediatric clients to be in control and self-determine their care if
they have the capacity to do so.

4. 5 Respond appropriately to unsafe, unacceptable, and unprofessional behaviors.

Satisfactory

Satisfactory

K.M. : As stated above in the previous section, with regards to relational practice, I believe that I have abided and responded appropriately to any
unsafe behaviour within the practice setting.

4. 6 Demonstrate public protection and acting in the interests of the public through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional health care teams.

K.M. : I have protected the public and the acting interests of the public throughout my practice thus far to the best of my abilities. Through doing hang
hygiene, specimen collection in-services with Holland Bloorview, and overall PPE infection control practices, are all examples of how I have
incorporated protection of the public.

4. 7 Contribute to the creation of quality practice strategies and solutions.

Satisfactory

Satisfactory

K.M. : I contribute to the quality practice strategies and solutions by enforcing reflection and peer review after every nursing shift with my preceptor. I
ask for solutions/ strategies to strengthen my weaknesses whenever appropriate.

4. 8 Assign, supervise, teach as appropriate, and provide feedback to unregulated care providers

Satisfactory

Satisfactory

(UCPs) in collaboration with the interprofessional health care team.

K.M. : I have not worked with many UCPs at Holland Bloorview directly, therefore I am unable to evaluate my competency on this. From previous
practice settings I have complied accordingly to these expectations to the best of my ability. In this facility I have been able to work with 1:1 PSWs and
collectively collaborate with them to provide optimal care to the client.

Teacher comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :
Kristina has demonstrated full competence in this area of practice. She continues to provide positive feedback and strong leadership skills to other
students on the unit. She responded appropriately to a potentially unsafe behavior of a family member by reporting it promptly to the assigned nurse.

5. Integrate the nursing process into all aspects of nursing care and across diverse practice settings.

5. 1 Formulates clinical judgments that meet clients unique and changing health needs and priorities,

Satisfactory

Satisfactory

outcomes, and overall condition and incorporates these into evolving plans of care.
K.M. : From the clinical knowledge that I have acquired and developed thus far. I believe that I have met client's needs and identified/ consulted with
appropriate care providers to ensure all needs are met.

5. 2 Devise evidence-informed plans of care that are holistic and client-centred.

Satisfactory

Satisfactory

K.M. : The therapeutic client-nurse relationship framework requires nurses to provide holistic care. Holistic nursing integrates
complementary/alternative modalities into clinical practice to treat peoples physiological, psychological, and spiritual needs. If client's family has
certain requests to accommodate cultural preferences, I do so accordingly.

5. 3 Use clinical judgment to assess clients, prioritize needs, outcomes, and nursing interventions.

Satisfactory

Satisfactory

K.M. : Every clinical shift I take vitals, and make required assessment head- to-toe to determine clients needs and prioritize relevant interventions. I
review all care plans and patient safety tools on Meditech, along with receiving bedside shift change over reports to evaluate my priorities and
organize my day.

5. 4 Collaborate in the evaluation, refinement and modification of plans of care.

Satisfactory

Satisfactory

K.M. : Along with the primary nurse, physician, PT/OTs, etc., every assessment and clinical day I make evaluations and modifications to plan of care
when necessary. When unsure if modifications should be done I ask my peers for a second opinion which foster collaborative work ethics.

5. 5 Safely and competently perform treatments and use techniques, and technology autonomously

Satisfactory

Satisfactory

and in collaboration with clients and members of the interprofessional health care team.
K.M. : I promote safety and competent nursing skills that are based on critical thinking and decision making frameworks at the level of the individual
client: assessing health status, selecting nursing interventions, and evaluating care outcomes. When unsure of nursing skill procedures, I always ask
for clarification or assistance.

5. 6 Collaborate with the clients across the lifespan and with members of the interprofessional health

Satisfactory

Satisfactory

care team to create a client centered plan of care that is articulated with competence both in writing
and orally.
K.M. : This practice setting especially, paediatrics, I have learned and developed to collaborate plans of care that carry across a lifespan and with the
members of the family. This family-centred approach is definitely something I can carry throughout my future years as an RPN.

5. 7 Use awareness of own knowledge and skills, the three factors of nurse, client and environment

Satisfactory

Satisfactory

and the practice decision-making framework to guide practice.

K.M. : I believe I am very aware of my limitations and strengths, and are aware to make sure the client's care is safe and appropriate.

5. 8 Manage workload, time, and physical resources to provide effective, efficient and ethical care.

Satisfactory

Unsatisfactory

K.M. : I believe that my critical thinking skills allow for appropriate prioritization of nursing care to the patient assignments given. I have been able to
uphold a full patient assignment and organize my time effectively to make sure care is done appropriately. I collaborate with both the primary nurse
and nursing preceptor (Ingrid) to ensure that my workload and management of time is appropriate. I am able to assess if hoyer lifts, 2 person lifts or
other mobility device is needed if patient needs transfer or re-positioning.

Teacher comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
Kristina has demonstrated full competence in this area of practice . She is able to manage a 3 client workload in a organized and timely manner and
will seek assistance when needed.

6. Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and holistic health care in a
complex and changing environment.

6. 1 Collaborate with clients to determine needs, mutually agreed health outcomes, approaches to

Satisfactory

Satisfactory

care, and to evaluate care.

K.M. : I have collaborated with the health care team to ensure all needs and mutual outcomes are met. As stated before, I am able to evaluate the
appropriate care necessary. I have been able to update care plans, and patient safety tools, plus status boards, to ensure that care is appropriate.

6. 2 Contribute as a member of the interprofessional and health care teams to respond to changing

Satisfactory

Satisfactory

client needs and outcomes.

K.M. : I have actively sought mentor-ship from the inter-professional team by including the client as a partner in care because the client/ family is the
expert on his/her life, and identifying the clients goals, wishes and preferences and making them the basis of the care plan.

6. 3 Consult with and seek out assistance from members of the interprofessional health care team.

Satisfactory

Satisfactory

K.M. : Within this competency I have been satisfactory and I have consulted and sought out assistance from members and nurses of the interprofessional health care team.

6. 4 Use teamwork, consensus building, and conflict resolution and leadership skills to meet
expected client outcomes.

Satisfactory

Satisfactory

K.M. : I think I have helped out my peers and fellow nurses at every chance I have. I have actively tried to be as hands on as possible to ensure that
all members of the team are working together. I believe that I strive in the team work environment and offer help and assistance wherever necessary. I
coordinate with the team to solve conflict and resolve the problem to meet the client's expected outcome.

6. 5 Integrate effective, collaborative, and consultative strategies to meet clients needs within a

Satisfactory

Satisfactory

Satisfactory

Satisfactory

changing environment.
K.M. : As discussed earlier, I agree with this statement and believe I am satisfactory in this competency.

6. 6 Respect the unique role and competencies of all members of the interprofessional health care
team.

K.M. : The client population at Holland Bloorview requires the nurse to be respectful of the client's wishes, and families preferences. I have been
respectful and truthful to my fellow nursing peers.

6. 7 Collaborate as a member of the interprofessional health care team to respond to changes in

Satisfactory

Satisfactory

nursing knowledge and practice and in the health care environment.

K.M. : By collaborating with other health care professionals allows for further growth in my practice and enforces further learning. Gaining knowledge
from my peers is one of the strongest learning avenues that I cherish in the clinical practice setting. For example: one clinical shift Ingrid and I were
placed in the Complex Care unit and had to adjust our day accordingly and adapt to the new environment.

Teacher comments for Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and
holistic health care in a complex and changing environment. :
Kristina has demonstrated full competence in this area of practice. She has developed more confidence in collaborating with other disciplines
regarding client's needs and outcomes.

7. Engage in Quality Assurance consistent with the regulatory framework.

7. 1 Act in the best interests of clients and protect clients from harm through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional and health care teams and by through
competent and safe practice.
K.M. : I believe the practices and standards that I uphold that are set out for nurses by CNO are done in the best interests of the client. I provide
competent care the reinforces the safety of the patient by effective nursing practice.

7. 2 Commit to Quality Assurance practice to identify strengths and areas for professional growth and

Satisfactory

Satisfactory

in accordance with the regulatory framework (CNO).

K.M. : In terms of my QA and reflection, I have achieved my goals within this consolidation setting. I have complied to the Quality Assurance
practices of the CNO to foster growth and development.

7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance program

Satisfactory

(CNO).
K.M. : I have created a learning plan and achieved my goals in order to be satisfactory to the guidelines set out by the CNO.

Satisfactory

7. 4 Assume responsibility to seek out feedback for colleagues and peers and learning opportunities

Satisfactory

Unsatisfactory

that foster professional development.

K.M. : I have sought for feedback from my peers, colleagues, and have had the opportunities to sit in in-services that foster professional
development.

7. 5 Consistently review nursing research and information about health care to improve competence

Satisfactory

Satisfactory

and to support clients.

K.M. : Reflective practice such as getting nursing assessments weekly from the clinical instructor, along with post-conference reflections and peer
reflections allows for effective ongoing identity of strengths and areas of improvement that I need to focus on. Feedback is integral within the nursing
practice because it promotes growth. I appreciate all the feedback I get from my preceptor and the opportunities of strengthening it offers.

7. 6 Develop professional responses to health care system changes resulting from advances in

Satisfactory

Satisfactory

research, technology, and changes in societal and political forces.

K.M. : All developments in the health care system and policies that are enforced affect my nursing practice and are adhered to accordingly. I will
source professional resources and adhere to technological advances within the health care system.

Teacher comments for Engage in Quality Assurance consistent with the regulatory framework. :
Kristina has demonstrated full competence in this area of practice by always seeking new learning opportunities offered by the hospital and has
shown an interest to participate in a IPE on Ethics.

8. Use critical thinking, problem solving and decision making skills to meet the health care needs and expected outcomes of clients.

8. 1 Use critical thinking to inform decision making in all aspects of nursing care.

Satisfactory

Satisfactory

K.M. : I continue to grow each day with my critical thinking skills. I believe I have definitely improved throughout my time at Holland Bloorview. My
critical thinking has been central to my professional nursing practice because it allows test and refine my nursing approaches, learn from successes
and failures, apply new knowledge (e.g., nursing research findings), and this ensure holistic patient-centred care with the clinical setting. I have made
informed decisions within my placement.

8. 2 Use clinical judgment to assess and refine assessments in collaboration with the

Satisfactory

Satisfactory

interprofessional health care team, formulate nursing diagnoses, plan nursing interventions, and
outline evaluative criteria.
K.M. : I agree that I have used my clinical judgement to assess and refine my nursing plan. I have also collaborate with Ingrid (my nursing preceptor)
and my peers to make appropriate decisions to clients care.

8. 3 Evaluate and refine critical thinking, problem solving, and decision-making skills.

Satisfactory

Unsatisfactory

K.M. : I seek and ask questions when necessary, and like to always be well informed, to be honest in facing personal biases, and to always be willing
to reconsider and think differently about issues. I believe I use this to improve and incorporate the plan of care.I have used my acquired cognitive
skills, such as interpretation, analysis, inference, evaluation, explanation, and self-regulation to develop my critical nursing thinking.

8. 4 Integrate knowledge from variety of nursing, health, and other theory into nursing practice to
provide safe and competent care.

Satisfactory

Satisfactory

K.M. : Using textbooks, CNO, and other peer-reviewed research allows me to use those theories and info in my nursing practice.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

K.M. : I believe I prioritize my time and nursing interventions effectively to provide the best care possible to foster the expected outcome outlined by
the patient care plan.

8. 6 Demonstrate professionalism, responsibility, and accountability.

Satisfactory

Unsatisfactory

K.M. : I have been professional and accountable to all areas of my nursing practice. I interact with peers, colleagues, and others professionally. I am
accountable by informing my nursing instructor of all situations that may hinder my nursing practice. I am accountable within my scope of practice by
being able to appropriately receive bedside report and transfer accountability accordingly.

8. 7 Use critical thinking, the practice decision-making framework and the nurse-client-environment

Satisfactory

Satisfactory

framework to inform clinical judgments and practice.

K.M. : From my mid-term assessment, I have been diligent to continue to practice and enhance my critical thinking skills. I have continued to become
diligent in assessing client's care plan and organizing my time appropriately to prioritize certain needs over others. I believe that I have improved and
continue to grow each day.

Teacher comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Kristina has demonstrated more confidence and independence in critical thinking and problem solving especially in prioritizing in her client workload.
She conducts herself in a very professional and conscientious manner .

9. Final Exam Results

9. 1 Final Exam Results

Satisfactory

Teacher comments for Final Exam Results :

Satisfactory for consolidation hours component. Writing pregrad exam on March 28th.

Student Final Summary with Strategies for Continued Growth

This has been one of the most rewarding and knowledge enhancing practice setting. I cannot thank Holland Bloorview enough for this amazing
opportunity. The learning and mentorship I have received from Ingrid has been so useful and will contribute to my practice for years to come. I believe
that I have acquired immense knowledge when it comes to the paediatric client population. This is where I want to specialize in and participate in the
family-centered approach given to these clients. There are many nursing skills I have developed with nursing assessments, catheter care, respiratory/
suctioning care, wound care, and ambulatory device knowledge. Holland Bloorview embodies collaborative care, and being involved in client's family
team meetings has encompassed and fostered my team-work skills. I have learned so much from my preceptor, Ingrid Zicari, and look forward to
developing my novice practice further. For the last 3 months of my consolidation, I have grown as a nurse and am confident that I can start my
practice once I have completed my licensing. I have acquired more knowledge on skills, and continue to learn more about different medications,
Cerebral Palsy, Acquired Brain Injuries, Seizures, etc and all the complex disorders that affect Holland Bloorview's client population.
Note: I will be completing my last week of hours by picking up shifts as my preceptor is leaving Holland Bloorview after 29 years of service. The
commitment to her clients embodies the true essence of nursing care and it has been a pleasure to be mentored by such an amazing role model.
Thank you Holland Bloorview, and Ingrid especially, I cannot wait to continue to my novice practice.

Teacher Final Summary with Strategies for Continued Growth

Kristina has successfully completed her consolidation. She has established a strong and conscientious work ethic. She has proved to be a positive
role model to other students .She continues to strive for new learning opportunities and has established a passion for working with children with
disabilities. I wish her a very successful career and with no doubt will be an asset to the Nursing profession.

Advisor Final Summary with Strategies for Continued Growth

Kristina has performed exceptionally as a student nurse, she has taken the opportunity provided to her by Holland Bloorview kids Rehab and
developed many new skills and searched out as many educational opportunities as possible.
When meeting and speaking with her preceptor I was advised that the student was encouraged to apply to the facility because they felt she would be
a great addition to the team. Kristina developed professional and caring relationships with patients that allowed her to provide exceptional care
because the patient and their family trusted her.
Kristina successfully upheld the CNO practice guidelines and learned to incorporate them into her normal practice and routines.
I encourage Kristina to continue to search for educational opportunities that will allow her to expand her skills and professional relationships.

Student's References
College of Nurses of Ontario. (2012). Fact sheet: Introduction about the college of nurses. Retrieved from
http://www.cno.org/Global/docs/general/45002_SpectrumService.pdf
College of Nurses of Ontario. (2009). Practice guideline: Culturally sensitive care. Retrieved from
http://www.cno.org/Global/docs/prac/41040_CulturallySens.pdf
College of Nurses of Ontario. (2009). Practice guideline: Consent. Retrieved from http://www.cno.org/Global/docs/policy/41020_consent.pdf
College of Nurses of Ontario. (2014). Practice standard: Decisions about procedures andauthority. Retrieved from
http://www.cno.org/Global/docs/prac/41071_Decisions.pdf
College of Nurses of Ontario. (2009). Practice standard: Disagreeing with the plan of
care.http://www.cno.org/Global/docs/prac/41017_fsDisagreeing.pdf
College of Nurses of Ontario (2009). Practice standard: Ethics. Retrieved from http://www.cno.org/Global/docs/prac/41034_Ethics.pdf
Lewis et al., (2012) Medical-Surgical Nursing in Canada Textbook
Potter & Perry (2008) Canadian Nursing Textbook

Grade

Satisfactory

Submitted Date: 26-Mar-2016 11:22

Unsatisfactory