Learning Learning Goals/ObjectivesGoals/Objectives

NURS 4027NURS 4027

PreceptorshipPreceptorship

Pg. 39, 53-70, 139Pg. 39, 53-70, 139

ImportanceImportance

• Frame to facilitate Frame to facilitate the organization of the organization of the preceptorship the preceptorship experience.experience.

• Assists the Assists the preceptee, preceptee, preceptor, and preceptor, and faculty advisor faculty advisor throughout the throughout the rotation.rotation.

Role of FacultyRole of Faculty

• To provide To provide insights/feedback insights/feedback on how to achieve on how to achieve your goals.your goals.

How to write goalsHow to write goals

• 6-10 usually covers 6-10 usually covers the intent of the the intent of the rotation.rotation.

• Be clear and concise Be clear and concise in the writing.in the writing.

• Make the goals Make the goals attainable.attainable.

• Include a timeline Include a timeline with measurable with measurable outcomes.outcomes.

FormatFormat

• Chart: can be helpful and easy to Chart: can be helpful and easy to readread

• Sentence structure: can elaborate Sentence structure: can elaborate and expand on the goaland expand on the goal

Remember, these goals are going to be a Remember, these goals are going to be a guideline for your preceptor.guideline for your preceptor.

My Learning goals for Preceptorship Lewoh, Cameroon

GoalObjectives/Learning Resources

Strategies/Success Indicators/Target by the end of rotation

Date/ Evaluation

Develop an understanding of the population health needs of Cameroon and how they interact with the existing health care system

Make observations of health status by patient and in the general populationAsk questions of the citizens as well as the clinic staff where possible

Gather relevant data by being submerged in the processKeep notes on the existing health conditions in Cameroon and the processes involved in treatment

By the end of the 4 weeks have a fairly reasonable understanding of the population health needs and the Cameroon health care system in Lewoh

Develop a health promotion plan for the people of Lewoh (particularly in terms of malaria)

Make observations about the existing interventions for malaria prophylaxisBe knowledgeable re the existing research on health promotion in similar cultures/villages

Determine the willingness of the population to actively participate and decide what interventions would be most practicalCollaborate with peers

Upon return from Lewoh have implemented some malaria prophylaxis and other health promotion tools

Gather arm circumferences of patients in both Lewoh and the Valley Clinic in order to assess the level of malnutrition in the area

Measure as many arm measurements as possibleRecord on paper the measurements that are collectedShare this information with Dr. Gooderham and others when home

Be sure to have enough log sheets for measurementsHave reference sheets available to determine levels of malnutrition

Upon return from Lewoh have a sufficient amount of data to provide other members of the health care team

Photograph teeth of patients that I see within the Lewoh and Valley clinic to better assess the situation for a dentist who will be going to Cameroon this year.

Photograph as many mouths as possible Record this information on paper including patients age, sex and medical conditionShare this information with Dr. Gooderham, dentist and others when home

Familiarize myself with proper techniques of taking dental photos. Make sure there is adequate photography equipment and available memory.

Upon return from Lewoh have a sufficient amount of data to provide other members of the health care team

Learning Goals for Preceptorship Learner: Date :

Learning GoalsObjectives & Outcomes Resources & Strategies Due Date Evaluation

1.I will refresh and improve the skills I have already practiced in past clinical placements - medication administration, patient assessments catheterization (especially female), complex dressing changes, and drainage and suction systems. 2.I will improve my skills in IV therapy 1.Improve my task organization and time management to perform total patient care with multiple patients.2.I will participate and communicate actively and effectively as part of the health care team. I will increase my familiarity with working with other members of the health care team (respiratory therapists, physicians etc.) 1.I will increase my ability to co-create health and well being in patients2.I will continue to improve my practice of critical thinking skills in the clinical setting

1.•I will be able to safely and independently administer patient medications •I will be able to identify and describe abnormal assessment findings patients•I will be able to independently perform complex dressing care, various forms of suctioning (airway, nasogastric) and manage wound drainage systems 2.a)I will initiate a (minimum of 1) peripheral IV b)Independently program IV pumps to administer IV medications/fluids /nutrition 3.a)Complete multiple patients assessments within 1hr of scheduled time.b)All scheduled patient care is completed independently during shift in a timely, organized manner c)Will be prepared to administer medications promptly at scheduled times4.•I will better understand the protocol for getting patients access/referral to another specialty / resource•I will assist a patient in getting access to one of these resources•I will gain confidence in communicating with and approaching physicians with regard to patient care.5.•I will continue to assist patients in identifying health goals and implement appropriate health promotion strategies.•I will identify, evaluate and respond to patient learning needs appropriately and effectively.6.a)I will recognize clinical problems and identify information and strategies to solve the given problemb)I will implement and evaluate clinical strategies, revising my strategies according to the outcomes

1.a)Research all unfamiliar medications and routes of admin. in drug reference guide and hospital policies as needed. Refer to preceptor and nursing staff with additional questions.b)Take time assessing patients. Ask for assistance/input from preceptor as required when abnormal findings are expected or found. c)Review hospital policies & procedures and/or Skills manual before performing new/unfamiliar procedures. Ask for assistance/monitoring from preceptor until I feel comfortable performing the procedure independently. 2. a)Hospital policy & procedure, review IV therapy course notes, preceptor’s presence and assistance as required. b)Preceptor or other nursing staff, medication reference guide, policy & procedures manual will be available as required3.a)b) and c) Practice! Preceptor, nursing staff and other students - role modeling

•How do others ensure they are on schedule?• What techniques and tips can I include in my own nursing practice?

4.a)Preceptor, RN’s and other healthcare professionalsb)Preceptor, other nursing staff and other member of healthcare teamc)Preceptor and other nursing staff5.•Preceptor, other members of the health care team, patients and patients families•Preceptor, other members of the health care team, patients and patients families, patient education resources6.a)Preceptor and other nursing staff will be able to help me identify problems and find appropriate strategies to resolve problem effectivelyb)Preceptor will be available to help me evaluate the effectiveness of problem solving and offer alternate solutions/expertise

1.a)Wk 2b)Wk 3c)Wk 52.a)Wk 6b)Wk 23.

•Wk 2•Wk 3•Wk 2

4.a)Wk 3b)Wk 4c)Wk 45.•Wk 2•Wk 26.•Wk 3•Wk 3

1.•Preceptor will monitor medication administration until she is comfortable with my knowledge and independent performance•Preceptor may perform some assessments with me as needed. I will discuss and describe normal and abnormal assessment findings. I will identify abnormal findings correctly•I will complete nursing procedures according to hospital policy with minimal assistance. Preceptor may monitor complex dressing change until comfortable with me doing it independently. 2.•I will be able to explain the procedure to the patient and perform initiation of IV with minimal assistance •I will be able to administer IV medications via various methods and program (and troubleshoots) pump independently. Performs required assessments of IV. 3.Preceptor and I will monitor my progress with time management and organization. Preceptor will provide feedback as appropriate. 4.•I will discuss this topic with preceptor and other specialty resources as opportunity arises •I will access hospital (or community) resources for a patient with minimal assistance from preceptor•I will have the confidence to independently discuss patients planned care with appropriate physician 5.With preceptors assistance I will ensure that I identify health goals for each patient and provide the patient with education and strategies for continued health and well-being6.With preceptors assistance I will recognize and identify instances where I used effective critical thinking to evaluate and resolve clinical problems

Goal Strategy Met/Date Unmet Comments

1. Efficiently prioritize total patient care for a minimum of 4 patients.

1. Use a DOAP to organize tasks.2. Ask for assistance when needed.3. Complete documentation in intervals.

2. Individually foley catheterize a minimum of five males and five females.

1. Inform preceptor desire to practice catheterization since it is a skill I have not yet performed.2. Offer to catheterize patients that are assigned to other primary nurses.

3. Initiate 10 IVs. 1. Offer to initiate IV on patients who are new admissions to the floor.2. Offer to restart IVs on patients. 3. Familiarize self with IV equipment.

4. Effectively perform 20 IV Piggyback medication administrations.

1. Become knowledgeable of IV Protocol/Policy binder located on floor.2. Become knowledgeable about IV compatible and incompatible medications. 3. Administer all IV drugs ordered for patients assigned to my care.

5. Transcribe 5 doctor’s orders. 1. Check charts of patients who are assigned to my care of new doctor’s orders.2. Understand the role of the assigned desk nurse.

6. Administer at least 3 blood transfusions or blood products.

1. Become familiar with blood transfusion protocols/policies and equipment.2. Familiarize with proper documentation needed when giving a patient a blood product.3. Understand steps taken when patient exhibits signs/symptoms of a reaction.

7. Perform at least 5 complex wound dressings.

1. Inform preceptor desire to practice complex wound dressing changes since it is a skill I have not yet performed.2. Offer to perform dressing changes on patients that are assigned to other primary nurses.

8. Participate in at least 3 Code Blues. 1. Become familiar with items on crash cart.2. Re-familiarize self with CPR procedure.3. Look up crash cart meds (indications, side effects, nursing implications etc;)

Learning Goals

Learning Goals for Preceptorship – Neonatal Intensive Care Unit12 weeksObjective

Over the course of the 12 week rotation my overall goal is to become successful in providing safe, ethical and competent care to a variety of neonatal patients. This involves completing full neonatal assessments with a variety of infants by caring for a diversity of patients. By the end of the rotation my goal is to successfully handle a full patient workload.

Strategies and Resources

In order to accomplish this goal I will observe, assist and practice with my preceptor and other health care professionals throughout my rotation. I will also observe and participate in patient rounds and various procedures required for neonatal patients. Learning to organize and prioritize patients’ needs appropriately and effectively will assist me in obtaining this goal. Furthermore I will use multiple sources of information that contribute to the nursing care of neonates. These resources include other health care professionals, current nursing research, nursing literature and guidelines, and my previous clinical experience and knowledge.

Evaluation

To evaluate my progress I will self reflect and communicate with my preceptor. By keeping open communication between my preceptor and other health care professionals I will be able to evaluate my progress. Using daily pre and post discussions with my preceptor regarding my goals and accomplishments will help me evaluate my progress on a daily basis.

Date of completion: Student’s initials_____ Preceptor’s initials_____

Objective

Within the 12 week rotation my goal is to effectively initiate 10 IV’s in order to successfully initiate IV therapy on my own. I also strive to successfully initiate, maintain and regulate IV therapy for various patients throughout my rotation.

Strategies and Resources

To achieve this goal I will use the knowledge and practice from the IV therapy course I have completed and previous clinical experience to successfully initiate IV therapy. Furthermore I will use the resources and practice guidelines regarding initiation of IV therapy available on the unit. After review of the practice guidelines I will observe my preceptor or another health care professional initiate IV therapy to a neonate patient(s). Following both the practice guidelines and my observation(s) of initiation of IV therapy I will attempt to initiate IV therapy with assistance from my preceptor. I will use my previous experience and clinical knowledge and the knowledge of other staff members to assist me in successfully initiating IV therapy.

Evaluation

My preceptor and/or other health care professionals involved in my attempts to initiate IV therapy will provide verbal or written feedback to me regarding my attempts. A brief discussion will be held between my preceptor and I following an IV attempt. The discussion and evaluation will consist on how well my attempt was, my areas of strengths and what areas I need to improve on. After effectively initiating IV therapy the evaluation will consist on my success at maintaining and regulating my patients’ IV therapy.

Date of completion: Student’s initials_____ Preceptor’s initials_____

I will demonstrate the concept of caring in my professional practice within legislative and ethical parameters. This will be demonstrated and documented at the end of each week.

Action Plan: •Read the policy and procedure manual for nurses on the Forensic Unit at NEMHC. • Completed within 2nd week of rotation•Review the College of Nurses of Ontario Professional standards and apply to practice.• Read prior to Feb. 1 •Review PHIPA or if available re-take course offered at NEMHC. • Read manual 1st week and/or take course when it is offered. •Read the hospital policy and procedure manual for medications if available.• Read the 1st week.•Read the orientation package available for registered nurses. • Read by end of 2nd week.•The following will be demonstrated on each shift:•Ensure that my clients have a right to privacy, confidentiality, and informed consent.•Support and advocate for my client whenever needed. •I will demonstrate truthfulness and fairness when dealing with clients, their families and staff.•I will carry out verbal and written directives safely, responsibly, and consistently and will be accountable

for my actions.•I will conduct myself in a professional manner.

This goal lacks a distinct This goal lacks a distinct timeline or strategiestimeline or strategies

Preceptorship GoalsThe following paper outlines my learning goals for my preceptorship. I am hoping to take this last opportunity to make sure that I am fully prepared for the responsibility I will be taking on. I am fully aware that I will be learning for the rest of my career, but this is my chance to ensure I am ready to work at a nurse in whatever field I choose.1. Enhance Communication Skill

I have noticed in all previous clinical experiences that communication is a key skill in nursing. Nurses need to have the ability to communicate with the patients, families, members from other disciplines, and co-workers. This is to ensure effective and appropriate care. I feel that my verbal communication skills are good, but there is always room for improvement. It would be beneficial to learn how to connect with doctors in the event that I would need to. Learning how to contact important persons when required would further enable me to care correctly for my patients.