Sheri Ogbebor

MIDTERM Y3S1

Summary of progress (Discuss concepts identified in the course, learning plan progress, skills)	At the midterm, Sheri is progressing well towards meeting the competencies and learning objectives required for NURS-3742. Sheri is a quiet but effective student and has demonstrated her ability to form appropriate therapeutic relationships with her patients on a consistent basis. She is patient, kind, and caring in all interactions that take place in the clinical setting. She has continued to attend clinical in a punctual manner, in appropriate uniform with her ID badge displayed at all times. Sheri has demonstrated an understanding of the CNO standards of practice as they relate to her scope of practice as a third-year nursing student, with particular regard to accountability, communication, ethical practice, and documentation. At the midterm, Sheri has had the opportunity to perform the following skills: – Head-to-toe assessment with cardiac/respiratory focus – Care and management of a 2 patient assignment – Documentation, including comfort rounds, DAR notes, and assessment on the acute care flowsheet – Accuchek monitoring – Simple wound care Sheri has not missed any clinical time as of the midterm. She has not yet had the opportunity to administer medication, however she was successful on her medication calculation quiz on the Mobius platform. She was also successful on subsequent medication calculation practice in the clinical setting. Sheri consistently maintains patient safety, privacy, and confidentiality in the clinical setting. She has demonstrated a knowledge and awareness of hand hygiene and PPE protocols, with particular regard to the importance of confirming which contact precautions patients fall under due to the placement on a floor where several patients are admitted for the purpose of ruling out Covid-19. She is aware of and implements patient safety interventions such as ensuring the call bell is within reach, non-slip socks are on, bed is in lowest position, and bedside is free of clutter/safety hazards. Sheri has demonstrated her ability to complete her documentation in a timely manner and appropriately in accordance with WRH policy and the CNO standards of practice for documentation. She does not require reminders to ensure that all aspects of documentation are completed. Sheri has utilized a good level of reflective practice to identify and create learning goals that are relevant and appropriate for the current clinical placement. She has created goals for herself to administer a minimum of 2 IV medications, continue to improve her documentation to ensure it is thorough and objective, and to improve her knowledge and ability to identify a normal rhythm as well as A-Fib on telemetry monitoring. She required some guidance to ensure that her goals were specific and had appropriate supportive activities and timelines for completion, however, she applied the feedback provided to her and submitted a revised learning plan that was satisfactory. She has submitted one reflective journal reflecting upon her experience when performing a dressing change on a patient admitted for sepsis, incorporating supportive research to expand her knowledge on this experience. Her clinical worksheets have been very well done with a great deal of attention to detail, inclusion of appropriate HTT assessment findings, and identification of priority systems assessments. All assignments have been submitted in a timely manner.
Strengths (Things you did well consistently):	As noted, Sheri is a quiet but effective student who has continued to demonstrate increasing levels of confidence in the clinical setting. She continues to demonstrate leadership among her peers through teamwork/collaboration, participation in post-conference, and modeling professionalism in communication and accountability among her peers. Sheri routinely forms appropriate therapeutic nurse-client relationships with ease, and has demonstrated appropriate professional and therapeutic communication in all interactions with her peers, staff, and patients. She routinely advocates for her patients and ensures that all personal care and pain management requirements are met. She is able to perform a thorough, objective HTT assessment with minimal prompting and indicate which body systems are the priority for assessment in order to tailor her assessment to her specific patient. When caring for 2 patients, Sheri has demonstrated appropriate time management and organizational skills. Sheri is able to apply nursing knowledge and theoretical concepts to the patient care she provides, answering critical thinking questions about diagnoses, past medical history, and lab values when asked. She functions well as a member of the healthcare team, as well as independently. She consistently assists her peers in the completion of nursing care as required, demonstrating her commitment to teamwork within the clinical setting.
Areas for Improvement/Growth (Things you need to work on): Must be addressed in your learning plan for the next clinical experience	– Continue to review common diagnoses and medications as needed to familiarize yourself with what you will be exposed to on the unit, as well as prepare for your medication administration opportunities. – Focus on time management as a goal as you progress towards caring for 2+ patients and administering medications to 1-2 patients. – Continue to seek new learning opportunities and advocate for your learning. Challenge your critical thinking by asking questions about your patient’s diagnosis, past medical history, pharmacology, lab values, etc. to help you expand your nursing knowledge base and skill set. – Continue to use reflective practice to help you assess how you are progressing towards meeting your goals, as well as reflecting upon the experiences you have in clinical to help you synthesize meaning for application to future practice. – Continue to practice DAR charting. – Continue to be confident in your skills and previous experience! Seek opportunities to demonstrate leadership among your peers. – Continue to utilize research in practice. – Continue to function as a member of the multidisciplinary team, engaging in conversation and patient care with these team members to better understand their role in the facilitation of positive patient outcomes.

FINAL Y2S2

Summary of progress (Discuss concepts identified in the course, learning plan progress, skills)	Sheri has successfully met all the clinical competencies of NURS2742 and completed 72 hours as a result of a disruption in the placement due to the global COVID 19 pandemic. Sheri has successfully performed vision screening using the Snellen eye chart; hearing screening using the Weber, Rinne and whisper tests; scalp assessments for head lice; oral cavity and mucosa, and height and weight using the World health organization’s growth charts. Health screenings have been conducted on children in JK, Grade 2 and Grade 3. Initially, guidance was provided to complete each of the health screening stations however with repetition and guidance she was able to perform them independently. Sheri was assigned as the clinical lead for the height/weight and oral mucosa/hygiene screening station and was responsible for being the topic ‘expert’. As clinical lead Sheri and her partner were directed to develop a learning activity for this station however on the first day of screening, nothing had been developed. She had however conducted research on these screening topics including how to complete the assessments, normal and abnormal findings. The following week Sheri and her partner had developed teaching activities the group could use for their station. Together with her peer she also developed a teaching and learning plan that future students could use to prepare for the school health clinical experience which highlighted how to perform each of the assessments, normal findings by age, abnormal findings, health teaching, referrals and community resources. Sheri has completed 2 reflective journals. One of which was a pamphlet about oral hygiene she developed with a colleague. Content presented was accurate and geared to the literacy level of the consumer. The information presented was factual and supported by evidence and referenced correctly. The other reflective journal she submitted discussed the misconceptions of head lice and the role of the nurse in addressing these. Sheri submitted a learning plan at the onset of this clinical experience identifying the following 2 goals: communication with children and identification of normal and abnormal assessment findings following health screening in the school health setting. She evaluated these goals with concrete examples to highlight how these goals were met upon conclusion of her clinical experience. Sheri has begun to integrate the social determinants of health into her health teaching. For example when discussing healthy foods she modifies delivery to include less expensive ways to incorporate fruits and vegetables into a diet such as frozen or seasonal choices. Finally, Sheri’s e portfolio was reviewed for completeness to which she is doing a great job at keeping it current with all important documents. Best of luck through the remainder of your education Sheri. It was a pleasure working with you 🙂
Strengths (Things you did well consistently):	Sheri greatest strength is her ability to enter into genuine therapeutic relationships with the children. She sits at eye level and engages children by getting to know them first asking them about their demographics such as age, school they attend, likes, dislikes etc. Sheri has a calm, non threatening approach and gains the child’s trust before moving on to more invasive health screenings. Sheri engages children in identifying their own learning needs and she uses language children understand. An example to highlight her approach occurred when she attempted to complete health screening on an extremely fearful child who would not engage in the screening. She quietly sat with the young boy, trying to engage him through distraction yet when he still did not wish to participate, she took him back to the classroom and negotiated to complete the testing the following week. The following week, she approached the child and he recognized her agreeing to participate. Sheri performed all the health screening assessments with accuracy, identifying abnormal findings (sometimes with guidance) and sought clarification appropriately or escalated abnormal findings. Sheri demonstrates satisfactory critical thinking. Sheri has begun to develop an understanding of community referrals. Health teaching is targeted to learning needs and is developmentally appropriate. Sheri has begun to integrate the social determinants of health into her health teaching. For example when discussing healthy foods she modifies delivery to include less expensive ways to incorporate fruits and vegetables into a diet such as frozen or seasonal choices. Sheri demonstrates satisfactory critical thinking. Following her assessments, she is able to identify priority problems and interventions to meet the needs of the child. She advocates for vulnerable populations by escalating abnormal findings to the teachers who can then notify caregivers. She has gained an appreciation for the impact of abnormal visual acuity, hearing etc on learning outcomes for the children. Documentation in the My Body and Me Booklet was always accurate. Sheri practices safely. Children are signed out and back into the classroom, she monitors them while they are under her care, equipment is cleaned between each child, and she disposes of any used supplies in the proper receptacle.
Areas for Improvement/Growth (Things you need to work on): Must be addressed in your learning plan for the next clinical experience	The one area Sheri needs to be cognizant about is her use of nonverbal communication. At times she appears disinterested. For example, during conference she does not always engage in direct eye contact with her peers or instructor or has been witnessed closing her eyes. Sheri has so much to offer by her insight into current health care trends and knowledge on different topics. When she is passionate about a topic she is engaged however when she is not she appears disinterested. Continue to explore community resources that promote health and wellness. Health teaching content targeted to learner needs using developmentally appropriate teaching aids Continue to expand your understanding of the interprofessional team members roles and how they can augment positive patient outcomes. Sheri’s IPE tool required 3 submissions to achieve mastery. Continue to integrate research into practice making sure to provide a comprehensive description of the study used in your reflective journals and its application in practice. Continue to explore medical diagnoses, research pathophysiology, symptomatology and management of medical conditions in preparation for consolidation. Continue to develop knowledge of atraumatic and developmental care and how to approach children of various ages and stages. Practice nursing skills in the lab in preparation for an acute care placement as your skills checklist reflects limited practical experiences Continue to develop a knowledge of medications including use, classification, action, side/adverse effects and nursing implications.

MIDTERM Y2S2

Summary of progress (Discuss concepts identified in the course, learning plan progress, skills)	In week 1- Sheri cared for a child who was 3 months with fever and ? mesenteric adinitis. She seemed to be in pain. Sheri administerd pain meds with ease. Assessments were well done. She monitored IVF hourly. She was able to review DI tests and explain importance with some assistance. Required resubmit of learning plan. Sheri cared for a 10 month old with gastro who was persistently febrile and having diarrhea. Pt was admitted for IVF which Sheri monitored houly as well as proper I&0. She encouraged po intake. She identified child was febrile and administered po and sup antipyretics. In week 3 Sheri cared for a very sick child with peritonsillar cellulius. She was able to encourage po intake and saline lock pts IV. She administered po meds with ease. In week 4- Her second pt was one with a chronic disease who was bed bound. She required prompting to change pts attends. Sheri cared for a child with pneumonia who was very tired during our shift, not getting out of bed until the afternoon despite sleeping well. The child was not drinking so encouraged to do so by Sheri. Sheri administered IV abx well. Her second pt has a seizure disorder nyd. Sheri needed reminding to monitor ivf hourly.
Strengths (Things you did well consistently):	Sheri was praised by the staff for her level of attentiveness in week 4. Sheri is caring and easily develops therapeutic relationships with pts and famiies. She contributes valuabe input and opinions in pre and post conference related to various topics regarding peds nursing Works well with other students and staff by providing assistance when not busy with her own pts.
Areas for Improvement/Growth (Things you need to work on): Must be addressed in your learning plan for the next clinical experience	Make sure to check IVF houry, especially on peds pt to prevent missing and interstitial IV. Continue to explore labs/ dx tests that you are unfamiliar with to help expand your future nursing knowledge. This will be an ongoing goal, even after graduating.

Y2S1 FINAL

Summary of progress (Discuss concepts identified in the course, learning plan progress, skills)	Sheri has passed her Fall 2019 clinical practicum on the 8 North Surgical Unit at Windsor Regional Hospital. She has completed a total of 88 clinical hours. In placement, Sheri has cared for 2 patients each clinical day and completed: head to toe assessments and the associated documentation, vital signs, accuchecks, toileting, personal care, dressing changes, as well as other nursing skills. The specific patient populations which she has been assigned to since midterm include: hematuria with urinary retention, acute bacterial prostatitis, intertrochanter fracture, query incarcerated umbilical hernia with small bowel obstruction, small bowel obstruction with perforated viscous, radical cystectomy with ileoconduit, multiple hip fractures, femur fracture, UTI with stone, acute pancreatitis. Leadership: Sheri had the opportunity to act as a “charge student nurse” within her clinical group. She assists the nurses and her student colleagues within the unit. Safety: Sheri adheres to the BScN program policies and procedures. She is beginning to understand the importance of implementing safety precautions within the areas of infection prevention and control, as well as patient fall prevention. Communication, Time Management: Sheri communicates with her nursing instructors as well as her co-assigned nurse. Sheri completes her flowsheets and relevant charting in a timely manner. Clinical Skills: Sheri has administered medications 2 times this semester through the PO and SQ route. The following are a list of skills Sheri has had the opportunity to complete since midterm: monitoring a CBI, measuring and monitoring abdominal girth, shin dressing change following the wound care orders, discontinued abdominal incision staples and applied steri-strips, completed a JP drain dressing, and a urostomy flange change.
Strengths (Things you did well consistently):	– Sheri has improved with her time management over the semester, and manages her time in providing full care to her patient assignment. – Sheri shows up to clinical understanding her patients diagnosis and presents them in a bullet round within her clinical group. – I have found that she is helpful toward the nursing staff on the unit and her clinical colleagues. – Sheri is competent in her nursing skills and medication administration. – Sheri is able to, when asked, demonstrate proper techniques (as taught in lab) of skills and forms of medication administration.
Areas for Improvement/Growth (Things you need to work on): Must be addressed in your learning plan for the next clinical experience	– Keep an open dialogue with your instructor. I feel that I had to find you in clinical to ask you how your shift was going and to get updates. I felt that I had to seek you out as I did not find you asking me many questions or approaching me with skills to perform. – Continue to ask questions to both your instructor and co-assigned nurse to better learn about patient conditions and outcomes. – Continue to seek assistance from fellow nursing students when needed, and work on delegating tasks when administering medications. – Work on familiarizing yourself with the patients medications especially during medication administration day. Continue to follow the rights of medication administration and educating the patient on each medication they are receiving. – Take more initiative in the clinical area in order to further your learning. – For you clinical assignments, take note of your instructors comments throughout as this can assist you in work. For your nursing care plan re-submission, there were minimal changes to the original document. If you would have paid attention to my comments and suggestions, you could have made the corrections instead of having to submit it back 3 times. Work on putting more effort into your clinical assignments. – Continue to apply labs, diagnostics, and pharmacology within your clinical worksheets.

Y2S1 MIDTERM

Summary of progress (Discuss concepts identified in the course, learning plan progress, skills)	Sheri is passing at midterm. Sheri has had the opportunity to care for patients within an acute care surgical setting on 8N at Met Hospital. Such patients she has cared for thus far include: left hip pinning, total thyroidectomy, right hip fracture, and peri-anal abscess. She has cared for a total of 1 patient in which she completed focused head-to-toe assessments, vital signs, personal care, toileting, and transfers. Sheri has documented her assessment findings within the Acute Care Flowsheet as well as a DAR for each of her patients. Sheri had the opportunity to administer medications via the PO and SQ route and did this while following the rights of medication administration. Nursing skills in which Sheri has assisted/witnessed nursing skills which include: monitoring the output of a jackson-pratt drain and its removal, sterile technique for wound care, assisted her co-assigned nurse with a peri-anal abscess sterile wound packing, and monitored a patient who had a colostomy including a flange change.
Strengths (Things you did well consistently):	– Communicates well with patients and staff members within the unit. Reports abnormal assessment findings, asks for help when needed, and reports on and off to her co-assigned nurse when coming on to shift, leaving for breaks, and at the end of the clinical shift. – Sheri is compassionate in the care she provides to her patients. – She documents her assessment findings in a timely manner within the Acute Care Flowsheet and DAR nursing note. Her assessments are complete in a timely manner and documented right after. – Sheri has submitted all clinical assignments on time. She has completed 2 journal, 50% of her CPE’s, weekly clinical worksheets, and a nursing care plan.
Areas for Improvement/Growth (Things you need to work on): Must be addressed in your learning plan for the next clinical experience	– Continue to familiarize yourself with patient charting, and how to obtain relevant and important data from within the charts. – Continue to assist your fellow nursing students in caring for their patients and do not be afraid to ask for help in caring for your own. – Continue to seek out new skills and opportunities to learn within the surgical unit, even if it is just shadowing. – Continue to take initiative in helping provide care to patients on the unit.

FINAL Y1S2

Summary of progress (Discuss concepts identified in the course, learning plan progress, skills)	Summary of Progress: PASS at Final 83 hours [5 hours missed clinical hours] Sheri, you have successfully met the competencies and learning outcomes for NURS-1742 during this clinical placement as Huron Lodge Long Term Care Home. You demonstrate qualities of professional behaviour in your approach to the residents and staff with an awareness of CNO Practice Standards and Guidelines and Faculty of Nursing policies. January 15, 2019: Completed Gentle Persuasive Approaches in Dementia Care: Supporting Persons with Responsive Behaviours Education Session (8 hours) Sheri, you demonstrate awareness of protecting the residents from physical and psychological harm by meeting the Universal Competencies. Continue to adhere to these. Sheri, you demonstrate a professional presence and manner in the clinical setting. Respectful communication has consistently been observed with your interactions. Your quiet demeanor and caring attitude supports the development of your nurse-client relationships and learning experience. Teamwork and self-responsibility are developing through collaboration in the clinical setting and with peers for the Health Fair. Professional communication skills and self-confidence are developing during clinical activities and the Health Fair presentation. Be conscious of engaging in clear communication so your intent is not misunderstood as you have a soft voice. You do not always clearly enunciate your words or speak directly to the person making it difficult to hear what you are saying. Your written work has developed over the semester generally meeting the assignment objectives by incorporating feedback provided. Seeking guidance and utilizing resources would ensure that you understand the assignment objectives and reduce revisions. CPE documentation is developing but requires ongoing revisions because you do not always identify a specific activity or behaviour you demonstrated to meet the competency criteria and you do not include relevant theory to validate your nursing approach. Journal reflections are developing but not always following guidelines results in revisions to meet the learning outcomes. Not paying attention to details or seeking guidance prior to completing assignments limits your understanding of the requirements and results in revisions to meet objectives. Time management strategies demonstrate an ability to achieve clinical expectations but should be reassessed so you can develop your practical skills while meeting the care needs of your client. Effective time management strategies would support you balancing your clinical workload with your other commitments. Well done presentation and creative poster board to support your group’s presentation for the Health Fair focused on the Effects of Smoking on the Lungs and Diseases of the Respiratory System. Through the development of a Bevis client-focused nursing care plan, you demonstrate a beginning ability to manage data and prioritize your client’s needs. A client health history was completed with direction and feedback by applying relevant physical assessment skills to gather data then analyzed to identify interventions to support goal achievement. Focus your assessment skills so that you can identify your client’s problems. Nursing diagnoses and SMART Goals are developing to identify achievable goals that support attainment of health promotion behaviors. More nursing interventions could have been identified to support goal achievement for the client. Weekly evaluations will support you in assessing the effectiveness of the interventions and modifying those that do not support the client to achieve the goals. Application of Pender’s Health Promotion Model, Prochaska’s Stages of Change, growth and development Theorists, CNO Practice Standards/Guidelines, RNAO BPGs and the Bevis nursing process were evident in the development of your client’s care plans. With feedback and direction, you are developing an understanding of how theory supports your clinical practice. Use relevant theory in your discussion to validate your nursing approach when documenting competencies. Journal reflections are developing but require integration of the reference to support analysis of your experience to identify what you did well in the situation and what you can improve to develop a competent nursing practice. Sheri, you demonstrate respectful and caring qualities in this clinical setting. Your pleasant, quiet demeanor and patience supports effective nurse-client interactions. You demonstrate an awareness of ethical values identified in the CNO Ethics Practice Standard when providing nursing care. You participated in discussions with peers reflecting on unethical practices identified when staff cared for the residents. This supported an understanding and development of an ethical approach when providing client care. You attended the Funeral Home Tour to learn about death and dying practices which will support your approach providing end-of-life care. You demonstrate professionalism both in your behaviour and communication. Great qualities to have as a nurse! Sheri, you demonstrate a beginning understanding of the professional Organizations that support and guide nursing practice. You have contributed to team development by building partnerships with your peers through respectful communication and collaboration both in the clinical setting and for the Health Fair. It was advised that you and your peers participate in a practice-run prior to the presentation date but your group did not arrange an appropriate time to practice the entire presentation. This would have allowed each of you to work within the assigned time frame ensuring a more cohesive presentation and retaining relevant information. This approach does not support development of effective collaborative skills. You are aware of promoting healthy public policy by following the principles of hand hygiene. You developed an awareness of the Facility’s emergency protocols with an understanding the students’ responsibilities to protect the residents from harm. Sheri, you demonstrate an understanding of working within your scope of practice. You learned the importance of seeking guidance when unsure of your ability to perform a skill and being asked to work outside your scope of practice. You have an awareness of the significance of being fit to practice nursing including the importance of self-care. Through LEARN Journal assignments and CPE documentation, you are developing reflective skills to meet the CNO QA Program requirements. You are beginning to develop an understanding of the clinical activities that support a competent nursing practice with your CPE documentation. You need to consistently document after each clinical day to demonstrate competency in your nursing practice. Identify a specific example of an activity or behaviour you demonstrated validate your nursing approach with relevant theory discussion. You demonstrate knowledge of basic skills – hand washing /PPE, communication and interviewing techniques, feeding, bed making, tub baths / bed bathing / perineal care, oral / denture care, assistive mobility devices, vital signs and safe body mechanics. You were able to identify 2 learning goals to develop your QA Program Learning Plans. For the Health Fair, you were able to identify health promotion strategies by researching and developing an informative teaching plan on the Effects of Smoking and Diseases of the Respiratory System. Well done!
Strengths (Things you did well consistently):	Professional behaviours and respectful communication demonstrated consistently. Patience, kindness, respect and caring demonstrated consistently with residents. Communication skills are developing engaging residents with varying cognitive abilities. Collaboration is evident with peers and staff which support development of your clinical skills. You are conscientious about meeting the clinical requirements by coming prepared for the weekly activities and demonstrate developing time management skills. You demonstrate an ability to incorporate feedback into your assignment revisions improving your comprehension of the learned concepts to meet the assignment learning outcomes. Taking initiative to develop clinical skills while balancing time with client to complete assessments. Creativity demonstrated developing a visually effective tri-board to present the Effects of Smoking and Diseases of the Respiratory System to Grade 5 students at the Health Fair. Well done!
Areas for Improvement/Growth (Things you need to work on): Must be addressed in your learning plan for the next clinical experience	Sheri, re-assess your time management strategies to identify approaches that will allow you to provide client-focused care while developing your clinical skills. Managing your clinical time will support you in meeting the needs of your client while developing competency with your practical nursing skills. Commit to documenting competencies after each clinical day to demonstrate how your nursing approach meets clinical learning outcomes and competencies consistently. This will support development of a competent nursing practice. Seek guidance and communicate concerns with your Instructor to ensure that all learning outcomes are met. CPE Documentation: Review the competency statements to develop an understanding of activities that support development of a competent nursing practice. Identify specific activities you have engaged in which demonstrate meeting the competency criteria: support discussion with relevant theory to validate your nursing approach. Provide adequate discussion that identifies why your nursing approach follows theory practices. Take initiative to seek clinical learning opportunities to meet the competencies consistently. Commit to documenting soon after clinical so that it is relevant and demonstrates your competency during the clinical day. LEARN Journal Reflections: Review the LEARN Journal template guide, resources provided and feedback to develop an understanding of the reflective process to analyze and develop your clinical performance. Take initiative to seek guidance prior to writing your reflection so you understand the learning objectives and can clarify your questions. Incorporate relevant theory into your Journal analysis discussion to demonstrate an understanding of how research supports clinical practice. This will support you in identifying what you did well in the situation and what you can do to improve your clinical practice. Review Appraise/Analyze and Research/Revision sections so you can clearly identify what you learned and what you can improve in your nursing approach. Review feedback to improve your reflective skills focusing on integrating the reference into the analysis to identify approaches that will support development of a competent nursing practice. Communication: Practice therapeutic communication techniques and strategies to develop confidence when interacting with clients and colleagues as well as implement active listening skills to improve client assessments. Practice adjusting your tone, projecting your voice and stand directly in front of the person when speaking to be clearly understood. Position yourself closer to the person so that you can be heard. Critical Thinking: Review theory readings to develop a competent knowledge-based practice and develop problem-solving skills. Engage in discussions to develop confidence sharing your ideas and working through approaches to provide client care. This will demonstrate how you apply theory knowledge to support your nursing approach when caring for the client. Integrate theory into your LEARN Journal analysis using appropriate resources to identify what you did well and what you can do to develop your clinical practice. Incorporate theory in your CPE documentation to demonstrate understanding of how theory supports nursing practice. Review CNO Practice Standards & Guidelines / RNAO Best Practice Guidelines to support development of your clinical practice. Nursing Care Plan: Review the Basic Concepts of Bevis to develop an understanding of its application in client care planning. Review the Bevis nursing process to understand development of the holistic client-focused care plan to support optimal wellness for your clients. Continue formulating Nursing Diagnoses and SMART Goals. Develop individualized nursing interventions that will assist the client to meet the desired goals and outcomes. Evaluate the effectiveness of the interventions daily and modify the approach if the goal has not been successfully achieved. Review RNAO BPGS to identify interventions that will support the client achieving the goals. Skills: Continue to practice vital signs, physical assessment skills and history interviewing techniques to develop confidence when assessing clients and gathering relevant client information. Take initiative to seek out opportunities to practice clinical skills to develop competency in your nursing practice. Review physical health assessments guide to focus your client assessments as this will support you in identifying client problems and developing nursing diagnoses. Self-Regulation: Review your QA Program Learning Plans to identify learning needs that will develop and support your clinical practice next Semester. Continue to develop your reflective practice to identify learning opportunities and areas to improve in your nursing practice. Self-care is important to maintain a competent nursing practice. Identify and re-evaluate your time management strategies to effectively balance your clinical workload with personal commitments as well as manage your stress levels. Identify strategies to protect your personal well-being so that you can promote healthy behaviour changes in your clients. Best of Luck Sheri in your Year II Clinical Nursing Experience!

Y1S2 MIDTERM

Summary of progress (Discuss concepts identified in the course, learning plan progress, skills)	Passing at Midterm: Sheri is meeting the Midterm expectations for NURS-1742. January 15, 2019: Completed Gentle Persuasive Approaches in Dementia Care: Supporting Persons with Responsive Behaviours Education [8 hours] Sheri, according to the Digital CPE Tool Week 5, you are Not-Passing at Midterm. You have Met 20 competencies and have 12 Unmet competencies that require improvement in your documentation. However, you are demonstrating accountable and responsible behaviours in the clinical setting that are meeting the expected competencies at Midterm. You have been observed as well as documented meeting the Universal Competencies in “Protecting the patient from physical harm” in the clinical setting. You have not documented how you are protecting the residents from psychological harm in the “U-2 Protects the patient/client and significant others from psychological harm” Universal competency. This competency must be addressed weekly with relevant examples of what you are doing to meet specific indicators in the 4 CNO documents discussed. Universal Competencies must be documented weekly to demonstrate that you are protecting the residents from physical and psychological harm consistently. Sheri, you demonstrate accountable and professional behaviours by coming generally prepared for clinical which enables you to participate in discussions and Unit activities. You take initiative to seek out learning opportunities to develop clinical skills while demonstrating collaborative skills with peers and staff. Communication skills are developing in this LTC setting with the older adults. You have a soft voice and at times do not speak directly to the person making it difficult to engage in effective conversations with those visually and hearing impaired. Through LEARN Journals, you are beginning to develop reflective skills but not following directions, utilizing resources provided or seeking guidance has resulted in revisions to meet the learning objectives. Written communication skills are developing with your CPE documentation by identifying specific activities done in clinical but your discussion is not supported with relevant rationale. While your documentation is concise, you do not support your actions with indicators from the CNO Practice documents to demonstrate your understanding that theory supports your nursing approach. We have had discussion re time management concerns and you have been asked to reassess your approaches managing clinical requirements with your other course load responsibilities. Communication skills and self-confidence will continue to develop with practice. LEARN Journal reflections are developing but you demonstrate difficulty following the template guide to focus your thoughts and analyze what you did well in the situation and what you can improve to develop your nursing practice. Not paying attention to details and following guidelines results in revisions of your work so that you can meet the learning outcomes. Review Appraise/Analysis and summarize what you learned from the reference that relates to your situation. This will help you focus your analysis on the experience utilizing data from the reference. Be specific and identify the research that supports your nursing approach and areas that you can improve to develop your nursing approach. CPE documentation continues to develop utilizing feedback to identify specific behaviours and activities you demonstrate to meet the competency criteria. You do not always support your approach with specific indicators from the CNO Practice Standards and Guidelines. You have not addressed the Universal and ongoing competencies consistently. Through interviewing and observational skills, you demonstrate beginning assessment strategies to identify your client’s needs/goals. You demonstrate a beginning knowledge of approaches to gather information to complete a Health Assessment and develop Client Care Plans. With direction, you are beginning to demonstrate application of theory to clinical experiences and assignments supported by the CNO Practice Standards and Guidelines and RNAO Best Practice Guidelines. You are beginning to utilize Bevis’ Tools in Journal analysis to support development of your care planning approach. You demonstrate patience and respect with the residents during interactions in the clinical setting. Continue to develop your communication skills when assisting a resident to eat to encourage socialization and enjoyment of the meal. You are developing an awareness of how your professional image and ethical values support the development of your nurse-client relationship which is evident when you are providing care for the residents and through discussions. You are developing an awareness of maintaining boundaries while providing care supported by the CNO Practice Standards and Guidelines. Continue to take initiative to seek out clinical activities to support development of your caring abilities and professional behaviours. Sheri, you are demonstrating beginning knowledge of feeding, vital signs, hygiene, bed making, perineal care/brief change, oral care/denture care, basic assessment skills and care planning with elderly residents. Through reflective practice, you are developing 2 learning goals for your QA Program Learning Plan to support development of your clinical skills. Continue to review the Digital CPE Tool to identify learning opportunities required to successfully meet all competencies by the end of this clinical placement. Take initiative to be involved in hands-on practice of all basic skills especially those that will support you in meeting your personal Learning Goals.
Strengths (Things you did well consistently):	You demonstrate qualities of professional behaviour in your approach to the residents and staff with an awareness of Faculty policies and CNO Practice Standards and Guidelines. You take initiative to seek learning opportunities to develop your clinical skills. Collaboration and teamwork are evident with peers and staff which support development of your clinical skills. You are conscientious about meeting the clinical requirements by generally coming prepared for the weekly activities and demonstrate developing time management skills. You actively participate in discussions that demonstrate your understanding of knowledge application to support your nursing approach. You demonstrate an ability to incorporate feedback into your assignment revisions improving your comprehension of the learned concepts to meet the assignment learning outcomes.
Areas for Improvement/Growth (Things you need to work on): Must be addressed in your learning plan for the next clinical experience	Time Management: Research and identify new time management approaches that could support you in meeting weekly expectations and managing your stress levels. Reassess your time management strategies weekly so that they can be modified to support you in meeting the weekly requirements and competencies consistently. CPE Documentation: Identify a specific activity or behaviour you demonstrated that meets the competency criteria: incorporate theory into your discussion to validate “why” you met the competency. Identify specific indicators from the CNO Practice Standards and Guidelines to demonstrate your understanding of how theory supports your nursing approach. Elaborate on your discussion so you clearly state what you did to meet the competency and identify relevant theory to support your nursing approach. Review competency statements to develop an understanding of the activities that support a competent nursing practice. LEARN Journal Reflections: Review the Journal template to develop an understanding of the reflective process and guide you in organizing your thoughts in a logical order. Pay attention to details, follow the guidelines, access resources provided and seek guidance prior to completing assignments to meet the objectives and reduce revisions. Incorporate theory into your Journal analysis discussion to demonstrate an understanding of how research supports your clinical practice. Review Bevis Tools and Strategies that support effective care planning with your client. Critical Thinking: Review the CNO Practice Standards and Guidelines and RNAO Best Practice Guidelines to develop an understanding of the indicators that support development of your nursing responsibilities. Support your nursing approach with relevant theory to demonstrate development of a competent nursing practice. Review theory to support a knowledge-based practice and develop problem-solving skills. Continually ask the question “Why?” to develop your problem-solving skills. Continue Bevis care planning with your client identifying nursing diagnoses, SMART goals and interventions to meet specific client needs. Communication: Continue to engage in conversations with different residents to develop your communication skills as well as identify strategies and techniques for effective interactions with cognitively impaired adults. Practice adjusting your tone and projecting your voice to be heard by the visual and hearing-impaired residents. Speak directly to the residents so that they can hear what you are saying. Review components of GPA Training to implement into your clinical practice. Continue to participate in discussions to develop confidence when sharing ideas in collaborative activities. Skills: Continue to practice V/S and practical clinical skills to become proficient and comfortable providing care in this setting. Continue to integrate physical assessments into daily care when appropriate with your client. Continue to take initiative to be involved to develop your clinical skills with the staff. Self-Regulation: Review Journal and CPE reflections to identify learning opportunities and areas to improve your nursing practice. Review your QA Program Learning Plan to meet your learning objectives by March 14, 2019. Assess your time management and self-care strategies regularly to identify a routine that allows you to balance your clinical requirements with your other courses as well as allow time for your personal care. Self-care is important to maintain a competent nursing practice. Identify strategies to manage your time and stress levels to look after your own health. You must be able to protect your own personal well-being before you can successfully promote healthy behaviours with your clients. A good start to your nursing career, Sheri!