Student Nurse Analysis

Instructions:
• Review the mid-shifts report (MSR) prior to completing the first half of your clinical shifts.
• Complete this report after finishing the first half of your shifts. Answer all parts of the question. You may use the Huber (7th ed.) leadership textbook, or Stanhope & Lancaster community textbook to guide your discussions.
• Documentation reflects a graduating student nurse and goes beyond physical tasks. Consult with clinical faculty for guidance on documentation specific to specialty areas. Refer to the rubric in Canvas.
• Follow HIPAA regulations when documenting!
• Submit this report in Canvas according to the due date set by your instructor.

Question #1 (Communication; Teamwork and Collaboration)
1a. How was your professional interaction with your preceptor? What positive interactions, concerns, or challenges did you encounter?
1b. How did you or do you plan to address any concerns/challenges in the following weeks?
(Tip: Discuss concern/challenge with preceptor, notify faculty)
1c. Discuss the top quality that you found to be helpful about the way your preceptor worked with you and others. Write at least 2 sentences about that quality.
1d. Discuss a situation where you collaborated with other members of the health care team (e.g., health care provider, respiratory therapy, social work, physical therapy, pastoral care, etc.). How did the team members collaborate with other professions?
1e. How did collaboration impact patient care and team dynamics?
1f. What did you learn that you can use in future team collaboration, and do you have suggestions for improving the communication process?

Question #2 (Culturally Congruent Practice, Thinking Like a Nurse)
Select and reflect on one patient from a recent shift during this preceptorship rotation. Identify four (4) needs the patient had at the time of your assessment (either after receiving report or upon arrival for a procedure) and categorize based on the below ABCD criteria. Document your patient’s needs and your rationale thoroughly in at least 2 sentences for each of the four (4) criteria. For D (delegation), include what staff member you would delegate the task to. Each example should reflect prioritization, clinical judgment, and decision-making utilizing the nursing process. While Assessment should be a top priority, go beyond a general head-to-toe assessment for this assignment. (Tip: discuss your ideas with your preceptor and faculty during rounds)

2a. A (absolutely now)
2b. B (better get to in the first hour)
2c. C (can wait a few hours)
2d. D (delegate/collaborate – charge nurse, LPN, AUA, safety attendant)

Question #3 (Culturally Congruent Practice; Implementation; Thinking Like a Nurse) 3-4 sentences
3a. Provide an overview of what you did this week that demonstrates you are increasing your proficiency in the management of patient care as a student nurse transitioning to registered nurse.
3b. How did you demonstrate curiosity, eagerness to learn, and active involvement this week that reflects critical thinking, decision-making, and prioritizing the management of holistic care?
(Tip: I did __ this week to increase my understanding of the role of a BSN-prepared nurse in overall patient management)

Question #4 (Assessment; Environmental Health; Evaluation; Evidence-Based Practice and Research)
4a. Describe how patient and environmental assessments are performed in your specialty area.
4b. How are your assessments different? What things do you want to emulate, and what things would you not want to copy?
4c. Describe at least two (2) ways you evaluated effectiveness of nursing care provided by you and your preceptor.

Question #5 (Advocacy, Communication, Culturally Congruent Practice, Leadership)
Advocacy initiates change. Describe a situation during this preceptorship rotation where you either: (1) advocated for a patient, or 2) observed another health care professional (HCP) advocating for a patient.
5a. What was the reason why you or the HCP had to advocate for a patient?
5b. How did you or the HCP advocate for the patient?
5c. What was the outcome?

Question #6 (Ethics, Professional Practice Evaluation, Quality of Practice, Safety)
6a. Speak with your preceptor, unit staff, the supervisor, or manager/director of your unit regarding our current health care system. In their opinion, what are current challenges they have observed or experienced that impact nursing practice, the health and wellness of an individual or community, or both? What is your response to their opinions?
6b. If you were unable to speak with others regarding our current health care system, what are challenges you have experienced or observed?
6c. How do these opinions inform your practice as you transition from student nurse to registered nurse?

Question #7 (Collaboration; Communication; Professional Practice Evaluation)
7a. What encouragement or positive feedback was noted by your preceptor this week?
7b. What areas did your preceptor give you feedback for where you need to improve? What guidance did they give you? What is your plan to address this feedback?
(Tip: If your preceptor does not offer this information, you need to ask every shift. Prepare before clinical to have questions ready for your preceptor in areas where you feel you are challenged to facilitate getting more effective feedback.)

Question #8 (Culturally Congruent Practice; Education; Environmental Health)
In the community class, you focused on the social determinants of health (SDOH) through a group-based lens. For the preceptorship rotation, the lens is through your assigned health care facility and unit, and how each determinant may impact health outcomes and quality of life. Reflect on your previous shifts and write at least a 2 sentence example for each SDOH (total 5 examples), either related to the current hospitalization or upon discharge. How did you observe or experience each SDOH impacted by a patient’s health condition or situation? If not directly observed, how can each SDOH be impacted by a patient’s health condition or situation? Refer to Healthy People 2030 SDOH for further information. The examples below are reference only. (Tip: discuss your ideas with your preceptor and faculty during rounds)

8a. Economic stability (e.g., lack of insurance)
8b. Education (e.g., patient has an intellectual disability)
8c. Social and community context (e.g., a child’s parent is incarcerated)
8d. Health and health care (e.g., patient utilizes the emergency department for primary care)
8e. Neighborhood and built environment (e.g., patient was hit by a car in their neighborhood)

Question #9 (Collaboration, Communication, Professional Practice Evaluation)
9a. Have you had an opportunity to give an end-of-shift report or SBAR during your shifts? Yes or No
9b. If yes, to whom did you give end-of-shift report/SBAR to? If no, whom have you observed giving an end-of-shift report/SBAR? Describe the format and any tool used to organize the end-of-shift report/SBAR.
9c. If yes, ask your preceptor to rate your communication on a scale of 1-5, what areas were successful, and ways to improve your communication. If not performed, discuss a plan for giving an end-of-shift report/SBAR. What assistance do you need?
1 = not meeting expectations; 3 = average for a graduating student nurse; 5 = exceptional for a graduating student nurse

Question #10 (Ethics, Resource Utilization)
10a. How many hours have you completed toward the 132-hour minimum requirements?
10b. Do you currently need assistance with self-scheduling shifts for this rotation?
(Tip: Students must complete a minimum 132 hours (e.g., eleven, 12-hr shifts) for this rotation. Students may not leave a shift early, even if hours are complete. Notify your clinical faculty STAT if you are worried about completing your hours.)