TE TARI MĀTAURANGA HAUORA

SCHOOL OF NURSING

CLINICAL COMPETENCY SELF-ASSESSMENT TOOL:

NZ Diploma in Enrolled Nursing: Acute Care Enrolled Nursing Practice
These competencies must be demonstrated to successfully complete this course: A minimum of One example per competency is required.

Student ID Student Name

Course No 7 2 6 • 5 0 2 Paper Name Enrolled Nursing Practice: Acute Care

Date: ______/_______/______ Clinical Hours required is a minimum of 150. Total hours completed _________

INTRODUCTION—
The graduate of the NZ Diploma in EN programme undergoes a developmental process to demonstrate competence in the prescribed areas. This process culminates in
the profile of the graduate at the conclusion of the programme. It should be noted that learning is not static but a dynamic process, which continues on beyond the
programme. The intellectual capabilities of the person provide possibilities that go well beyond this diploma programme. It is anticipated that students will have their
minds opened, stimulated and extended in order to enjoy their learning experience. This enjoyment is the foundation of learning for life.

Assessment is undertaken in order to determine the ability of students in clinical practice. It is expected that at the end of eighteen months, the student will have
achieved the competencies as prescribed by Nursing Council for a registered NZ Enrolled Nurse.

The NZ Enrolled Nursing practice is defined as student actions that are showing understandings of “nursing” and “client care” knowledge and skills that are evolving at
levels working under the direction and delegation of the Registered Nurse ensuring client safety.

INSTRUCTIONS
This form is to be completed by the student and must be discussed with the lecturer at the time of the interim and final assessments. Preceptors should provide
feedback and/or examples under student examples. Lecturers may enter comments in the space provided under each competency. It may also be copied for moderation
purposes. A copy must be placed on student file.

Ward/Area ________________________________________ Lecturer Name __________________________________

 NZ Diploma in Enrolled Nursing
Student ID

DOMAIN 1: PROFESSIONAL RESPONSIBILITY

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)
Competence 1.1 Accepts responsibility for ensuring that his/her nursing practice and conduct meet the standards of the professional, Met Not Met
ethical and relevant legislated requirements.
Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Met Not Met
Competence 1.2 Demonstrates the ability to apply the principles of the Treaty of Waitangi/Te Tiriti o Waitangi to nursing practice.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Competence 1.3 Demonstrates understanding of the enrolled nurse scope of practice and the registered nurse responsibility and accountability Met Not Met
for direction and delegation of nursing care.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Met Not Met
Competence 1.4 Promotes an environment that enables client safety, independence, quality of life and health.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)

1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Met Not Met
Competence 1.5 Participates in ongoing professional and educational development

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Not
Met
Competence 1.6 Practises nursing in a manner that the health consumer determines as being culturally safe. Met

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)

1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

DOMAIN 2: MANAGEMENT OF NURSING CARE

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)
Met Not Met
Competence 2.1 Provides planned nursing care to achieve identified outcomes

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date
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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Competence 2.2 Contributes to nursing assessments by collecting and reporting information to the registered nurse. Met Not Met

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Competence 2.3 Recognises and reports changes in health and functional status to the registered nurse or directing health professional. Met Not Met

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Met Not Met
Competence 2.4 Contributes to the evaluation of health consumer care.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)

1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Met Not Met
Competence 2.5 Ensures documentation is accurate and maintains confidentiality of information

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)

1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date
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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Met Not Met
Competence 2.6 Contributes to the health education of the health consumers to maintain and promote health.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

DOMAIN 3: INTERPERSONAL RELATIONSHIPS

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)
Met Not Met
Competence 3.1 Establishes maintains and concludes therapeutic interpersonal relationships with client.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Met Not Met
Competence 3.2 Communicates effectively as part of the health care team

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Met Not Met
Competence 3.3 Uses a partnership approach to enhance health outcomes for health consumers.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)
1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

DOMAIN 4: Interprofessional Health Care & Quality Improvement

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)
Met Not Met
Competence 4.1 Collaborates and participates with colleagues and members of the health care team to deliver care.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)

1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Competence 4.2 Recognises the differences in accountability and responsibilities of registered nurses, enrolled nurses, and Met Not Met
health care assistants.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)

1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

STUDENT’S SELF-ASSESSMENT (Lecturer to tick for Competence Met or Not Met)

Competence 4.3 Demonstrates accountability and responsibility within the health care team when assisting or working under Met Not Met
the direction of a registered health professional who is not a nurse.

Indicators of achievement: (Use examples from your practice to indicate how you demonstrated competent performance in the above competence)

1.

Preceptor’s comments

Signature Date
Lecturer’s comments

Signature Date

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 NZ Diploma in Enrolled Nursing
Student ID

Overall Comments
Comments Name/signature/designation Date

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 NZ Diploma in Enrolled Nursing
Student ID

Charge Nurse Manager or equivalent of the area

Please indicate that you have cited the document.
Comments are optional.

Sample Signatures

Name & designation Signature Initials Ward/setting Dates worked with

student

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