Practical Nursing Diploma Program

Mid-term/Final Clinical Evaluation Form

Student:

Whitney Illsley

Student Number:

823-334-925

Course:

261

Section

05

Dates:

January 2014

S: Satisfactory

ND: Needs Development

Summary of Areas of
Practice
Competent and safe practice
in a professional, legal and
ethical framework
Communication

Caring relational practice

Leadership and advocacy

Plans of care: Meeting

Clients Needs and Mutually
Agreed Expected Outcomes

Collaborative Practice

to

March 2014

U: Unsatisfactory

Student Comments:
Summary of clinical
experience
S: X ND:
U:
- I have been professional with
my patient and practiced
safety.
S: X ND:
U:
- I have been asking relevant
questions to enhance my
learning and communicating
my findings regarding my
patient.
S: X ND:
U:
- I have been attentive to my
patients needs and have
developed a therapeutic,
client-centered relationship
with my patient.

S:
ND: X
- I have no yet had the
opportunity to show my
leadership skills.

S:
ND: X
U:
- I am currently working to
develop a plan of care for my
patient.
S: X
ND:
U:
- I have been working as a
team member and helping my
classmates in various ways
including assisting in AM care,
wound care etc.

Faculty Comments:
Summary of clinical
Experience
S:
You always act in a
professional manner.
S:
You do a great job
communicating with your
patients, the staff, your peers
and myself
S:
I have noticed that you have
definitely started to build
therapeutic relationships.

S:
I believe that you do a great
job as a leader in the group.
You dont shy away from new
skills and even successfully
catheterized a patient this
week good job!
ND:
You have started working on
your careplan and starting this
week, you should start putting
it to practice.
S:
You work well independently
and as part of the team.

Quality Assurance

Critical Thinking, Problem

Solving and Decision
Makiing

S: X ND:
U:
- I have reflected on my
strengths and weaknesses
and made a plan on how to
strengthen myself in my weak
areas
S:
ND: X U:
- I have not yet had the
opportunity to show my critical
thinking and problem solving
abilities.

S:
Reflection is the best thing you
can do to build on your
nursing skills. Good job!!

ND:
Critical thinking is something
you will always work on
even experienced nurses still
have to work on it.

It has been a pleasure having you in my clinical group. Continue to do what you do ask
questions and dont shy away from trying new skills Great job!!!
I have read and understand this form and its contents
Student Signature:

Whitney Illsley

Faculty Signature:

Liezel May RN

Date:
Date: March 1, 2014

March 2, 2014