Practical Nursing Diploma Program

Mid-term/Final Clinical Evaluation Form

Student: Whitney Illsley

Student Number: 823-334-925

Course: Practical Nursing 261

Dates: January 2014

S: Satisfactory

Section 05
to

April 2014

ND: Needs Development

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

Communication

Student Comments:
Summary of clinical
experience
S: X ND:
U:
-

S: X
-

Caring relational practice

S: X
-

Leadership and advocacy

U: Unsatisfactory

S: X
-

I have ensured that I

have practiced care
in a safe,
professional
manner.
ND:

U:

I have been open

and communicated
my findings for my
patients as well as
other patients with
whom Ive provided
any form of care for.
ND:

U:

I have been
attentive, kind and
through in respects
to my patients care. I
have developed
several therapeutic
relationships with
many patients.

ND:

U:

I have advocated for

my patients when I
feel that something
more needs to be

Faculty Comments:
Summary of clinical
Experience
S:
Youve always come to clinical
prepared and give safe
professional care.

S:
Youve always done a great
job communicating with the
staff, myself, your peers and
your patients and their
families.

S:
I have watched you interact
with your patients and can
definitely say that youve
developed quite a few
therapeutic relationships.

S:
You have definitely been a
strong advocator for your
patients and I couldnt be
prouder. Youve also remained
respectful of your patients &

done to ensure they

are getting the best
possible care.
Plans of care: Meeting
Clients Needs and Mutually
Agreed Expected Outcomes

Collaborative Practice

S: X ND:
-

S:

Quality Assurance

S: X
-

Critical Thinking, Problem

Solving and Decision Making

I have developed
thorough and
carefully thought out
plans of care for my
patients.

X ND:
-

S: X

U:

U:

I have worked as a
team member with
my peers as well as
the staff at clinical
placement.

ND:

U:

I have reflected on
my abilities and
taken steps to
improve my weak
areas.
ND:

U:

- I have shown critical

thinking when dealing with
situations that were difficult.
I will need to continue to
improve and develop this
skill.

their families wishes, whether

you agreed with them or not.
Great job!
S:
Youve been able to
successfully do up plans of
care for your patients each
week and follow through on
them.

S:
You have shown you can work
well independently and as part
of a team. Your peers know
they can always turn to you for
help.

S:
You have shown that you
reflect on the care youve
given and participated in post
conference in discussions on
how we would handle difficult
situations.
S:
You will always work on your
critical thinking, but I definitely
think you handled problem
solving and decision making.
You have always put your
patients needs first and that is
what makes you a great nurse

It was such an immense pleasure being able to be your clinical instructor this semester. You are
going to make a truly wonderful nurse and I encourage you to trust in your instincts and Im sure
you will do well. Good luck next semester!
I have read and understand this form and its contents
Student Signature:

Date:

Faculty Signature:

Date: