Carroll Community College

Division of STEM, Nursing and Allied Health

Department of Nursing
NURS 242 – Nursing Concepts Clinical 4
SUMMATIVE Student Clinical Performance Evaluation

Date Faculty
3/11/ Week # Dr.
Student Natalie Clarke 2022 6 Schlaerth
Criteria: S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not (*) Critical
(Meets) (Requires assistance) (Unable) applicable behavior
Students who meet any of the following criteria will be given a remediation plan and may be placed on probation.
Failure to progress in these areas may result in failure of the course.
-One unsatisfactory grade in a critical behavior -Two needs improvements in a critical behavior
-Two unsatisfactory grades in a non-critical behavior -Four needs improvements
Instructor
Student Eval of
Course Goal 1 Self-Eval Student
Use the nursing process to optimize client health (PG1) S/N/U S/N/U
1. Prioritizes and completes daily nursing tasks S S
2. Completes assessments accurately S S
3. Uses EMR/MAR, patient charts, handoff report to provide care S S
4. *Establishes appropriate nursing priority list S S
5. Creates measurable patient outcomes S S
6. Establishes appropriate nursing interventions S S
7. Evaluates patient response to care and revises plan as needed S S
Instructor
Student Eval of
Course Goal 2 Self-Eval Student
Assimilate into the profession of nursing (PG2) S/N/U S/N/U
8. Adheres to dress code S S
9. Seeks input from patient, instructor, and healthcare team when providing care S S
10. *Demonstrates accountability and accepts responsibility for own actions and attitudes S S
11. Actively participates in all clinical experiences S S
12. Communicates learning needs to instructor S S
13. Completes assignments/evaluations as required S S
14. Demonstrates initiative in assisting peers and healthcare team members S S
Instructor
Student Eval of
Course Goal 3 Self-Eval Student
Provide patient-centered care (PG3) S/N/U S/N/U
15. *Implements appropriate infection control precautions S S
16. Identifies client’s cultural needs S S
17. Accurately documents patient care S S
18. Communicates appropriately with patient, family, healthcare team, and instructor S S
19. Explains the actions, side effects, and nursing implications of medications S S
20. *Administers medication using the six rights N N
21. Demonstrates concern, compassion and empathy with patients S S
22. *Demonstrates physical and mental competence S S
23. *Notifies instructor and appropriate healthcare team members with safety concerns and changes
in the patient’s condition S S
24. Identifies patient and family health education needs S S
25. Provides nursing care in accordance with the Maryland Nurse Practice Act and the ANA Scope &
Standards of Nursing Practice S S
26. *Adheres to HIPAA guidelines S S

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18, 1/2020

 Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 242 – Nursing Concepts Clinical 4
SUMMATIVE Student Clinical Performance Evaluation

Criteria: S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not (*) Critical

(Meets) (Requires assistance) (Unable) applicable behavior
Instructor
Student Eval of
Course Goal 4 Self-Eval Student
Engage in evidence-based practice (PG4) S/N/U S/N/U
27. Critiques current practice based on evidence S
S
Student Reflection (Thoroughly answer all questions)
How has this clinical rotation helped to define your role as a nurse? Please explain.
This clinical rotation was very memorable and an amazing learning opportunity for me. I was able to care for patients in different
stages of pregnancy. I feel that I did push myself to ask questions, learn and try new things each clinical day. I feel more
comfortable performing assessments and vitals on mom and baby and creating a care plan for my patients. At the beginning of this
clinical rotation, I struggled a bit with determining how my priorities would change from the beginning to end of shift. By the end
of this clinical I feel stronger in planning my day and all the tasks that I need to complete. I know that this clinical rotation helped
build my confidence as a student nurse and has helped me grow to be more independent.
Which objective did you accomplish during this rotation? How did you do it?
During this clinical rotation I was able to complete the objective “use the nursing process to optimize patient health.” I was able to
do this by creating a daily plan for my patients, so I knew exactly what tasks I needed to complete. I was accurately able to
complete vitals and assessments on both mom and baby. My first day of clinical I struggled with baby’s vitals and had to repeat
them but by the time I got to my 3rd clinical I felt more confident and got the same vitals as my instructor. I successfully completed
a clinical judgment plan of care on my patients and was able to identify how my assessments and interventions changed
throughout the day. I feel more confident creating a priority plan of care for my patients and I will continue to practice that
through my practicum.
What are your goals for your next clinical rotation?
My goals for my next clinical rotation are to continue to make sure that I am being a safe nurse. This involves doing my 6 rights of
medication administration and always identifying my patient and asking for allergies. I will continue to create a daily plan for what
my patient’s care involves so I do not get behind. My goal is to create a plan of care for more than 1 patient and stay on top of
documenting in the patient’s chart as I complete tasks. I want to be able to stay on top of my nursing care and cluster my care so
that I do not get behind.
Faculty Comments/ Student Learning Goals (Goals must be established even if performance is satisfactory. If an item was
identified as N or U, narrative comments are necessary to clarify student performance along with goals to improve performance).

Natalie, it was such a pleasure having you in my clinical group. You put N/A for documentation, but I measure this outcome
through evaluation of your clinical judgment plans, which have been excellent. I gave you an N for medication administration
because I had to prompt you to check your medications against the pyxis and computer on the last day. You had done a great job
of that on other days, and even later in the same day you did a great job. This was a great reminder for you of how quickly
mistakes can be made. Continue to work on that each day!

You have so many strengths! Specifically:

You organize your daily tasks well

Establish therapeutic relationship with patients
Assesses patients for changing conditions/needs
Is adaptable to changing conditions on the unit
Takes responsibility for own learning
Identifies principles underlying nursing care
Strives to improve daily

You are on your way to being an independent nurse!

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18, 1/2020

 Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 242 – Nursing Concepts Clinical 4
SUMMATIVE Student Clinical Performance Evaluation

Student Signature: Natalie Clarke Date: 3/11/2022

Instructor Signature: Date:

Definitions:
Coaching – Faculty guides student to define objectives, set goals, and develop action plans through collaboration in the decision-making process
Assistance – Student unable to perform task independently; needs some aid or minimal direction from faculty to complete tasks. Not autonomous but does not
require coaching.
Resource - Faculty serves as a facilitator but student is capable of completing self-directed tasks.

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18, 1/2020