ions Preceptor £ Performance Student Lloydea Twk Please place a checkmark (g) in th performance on the day of care. Constn ‘on areas for furure improvement. Unit: SOU, 1 of the student's clinical ide students with insight Very “Average | Needs | Poor ] N/A Please Rate: S| a | Attendance/Punctuality | yl aE Attitude | tnitiative/Self-Motivation Interpersonal Skills with patients/families, | co-workers. & providers Y Clinical Skills: 7 | | v7 7 e Assessment © Medications © Treatments © Documentation Decision-Making Skills | Productivity/Time Management Z 7 | Instruction/Client Teaching ‘ Willingness to accept responsibility Additional Comments: Hayden NOs grea improved Kis détision maxing skulls INADIMS OF BtONS ; PAL Ilia administration, Wena hover Ant, Knowleoge hy nas tanned AnUdMoLe IS eed aptritnte ord] opt ito syne a NE ao Teamned cree WE do, Vuk Why wot do He Ayrougn tomprtensie renew OF tac Total hours worked (including breaks): VA Aut WE Cor of, Nay lin nits PAY EVO ata Haas receptor Signaturestugent wame:__ Veoh, “Very SBAR Worksheet S-Situation ~ Priority #___ 7) PF Intals be | Roms TRY.0 | Admission date 3804 | Prete Arama MC 4/13/23 nie | (B= Background | Surgery / date 'solation/precautions Si Hx Chronic tlnesses Coded are m ED | Recent procedures ws othe PF hog ay mM bet Rose. poms of cok od se: No Suge ts mtd by mjimds nd ote. WARE cig Wee che cht 7 ‘A= Assessment Prk Teeget sseatmentis t swelled, FPP mocnny ate Ye pal ard nag tat only Mental status -py Ws mapol — \unt ed ae ol mbt ‘ t Va sens Cont. Yo Quin mail 4 te O2therepy& p02 | mad — gM Nk | Mehl om LOE wo | HE te 330 (P 450 IH Hol. & | yecciacore [tube feed wits gdeorbd dn het @ Wmblhe 4 She 2m Iv therapy -US hash Rey wos mb - Wak She Vien ceploemate woes Gerd) Interventions WOwent New orders Teaching | Calls to MO, ete. [100 as imeasurabe) wih ech wu ofl bo sched opal outcomes R- Recommendations | OF Spylate.) ae esl dry ty wd Dd yey ot vil common Flee oP fem a6 Bvidenee by a 2 Desired outcomes Le Cpot scary onc verse) | \palus ond 100m0g feat PRW bre fang He phe he bbe 110 keane & |\-O, prs bled grew wil men lin 109 od Swel Shack ig iy mes trmnbbaned =o, Ligeia oF loo OS wil Gl pRwsmietNine Wowie: “ladle maa GDS Transitions Daily Gcals Worksheet Instructions: Begin each shift by sharing 2 goals Wit ceptor for the day. Examples include taking on an additional patient, givin. improving prioritization skills, communicating Ww fessional tean ete. 1. “Wbmbion of Seips = vo deed, uersed Ao 9hw gain yds = Feakany| ___ 2. Aounatiny GSW te foe 2 oy Sone Shay SS Yo woke Oat Depa\ “~< ‘Student Name: Yoo Hho “Vue 4853L Nursing Transitions Log of Hours Date | Shift “Hours per Shift |Total Hours | Faculty (ie:7a-7p, 6p-6a)_| (include breaks) | (running total) | Visit (191 | TVen- 20m} VS _1B.S: Ze Qe Top 730s is 25 as | 4) 87:36 ae eee =) 9kn=7 Soe “AD Lea el DBE! ase Dg c2.$ | i {30 | opn-130qf V2.5 aly | Ail) eel SIDA Foon Siro Se ws [We ) “) pm =7 30 es loo 2 [413 | Vom 720 (XS Le *Students are required to complete 120 clinical hours with their RN preceptor. Faculty Verification of Hour Completion: | verify the above hours were completed and student visits were made as indicated. Faculty Signature: