Clinical Skills & Reasoning

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Nursing Tutoring Essentials is currently building a database of quality video clips and clinical skill sheets for students to watch and read to enhance their clinical skills. Nursing Tutoring Essentials does not endorse these links – these links are intended to provide guidance. It is up to you, the student, to be discerning and to adhere to your university’s recommendations on how these skills are to be performed in both an academic and clinical environment.

Please also remember that as a university student nurse, you are limited to your scope of practice according to which year you are at in your nursing degree. Therefore, please ensure before performing these skills on clients that you are practicing within your sanctioned scope as a student.

If anyone would like to add to this database, please email RN Geller with the link to the video and a description. We will thank you for your contribution on this page.


First – Some fun and controversy…


Clinical Skills & Reasoning

Below is a list of clinical skills and resources to aid in reasoning. These consider the scope of practice undergraduate students per year level. Please note that this is not an exhaustive list. In addition, scope of practice may differ per university.

Clinical Skills and Reasoning Download

 Pathology Reference Manual Download


 

Year 1

  Registered Nursing Student Novice; no patient load; continuous supervision

Overview

Resources

Communicate and collaborates appropriately with colleagues, patients & carers/ families. Informative Articles

Skill Video

 

Establish and maintain a therapeutic relationship with patients & families appropriate to the clinical setting & inclusive of psychogeriatric and cognitively impaired clients. Skill Video

 

Perform accurate, concise and appropriate recording and reporting of objective & subjective patient data using appropriate nursing and medical terminology.
  • Handover of 1 patient
  • Discuss evidence-informed rationales for implementing designated nursing care
  • Assess patients’ input/output (direct & indirect observation, fluid balance & food/diet charts)
  • Recognise & report significant fluid balance fluctuations

 

Procedures skill sheets

 

Skill Video

 

With supervision, apply the nursing process (assessment, planning, evidence-informed interventions, rationales and evaluation) in the administration of S2 oral medications.
  • Articulate knowledge of legislation, charting and e-scribe medication administration contexts
  • Discuss the pharmacokinetics & pharmacology of all medications to be administered by the student and RN
  • Discuss evidence-based rationales for safe administration and management of oral medication (S2 only).

 

Medication skill sheets

 

Skill Video

 

Use safe and effective infection control measures & standard precautions including:
  • Clean and clinical hand hygiene
  • Use of personal protective equipment
  • Appropriate disposal of waste materials

 

Infection control skill sheets

 

Skill Videos

 

Assist with admission and primary health assessment of low acuity patients including:
  • Nursing history and primary assessment Appearance/presentation
  • Weight and height
  • Ward urinalysis
  • Vital signs; TPR,BP, RR & pulse oximetry

Vital signs skill sheets

Skill Videos

 


 

Year 2

Registered Nursing Student Novice: Advanced beginner; medium level supervision (50% patient load)

Overview

Resources

Demonstrate timely & accurate communication, documentation and evidence informed decision-making which addresses cultural safety & awareness.

Informative Articles

 

Skill Videos

 

With supervision, implement nursing actions (procedures) for the low and medium acuity medical/surgical patient (50% patient load) including:

  • Perform & document a health assessment
  • Formulate nursing problem statements based on the above data and informed by evidence
  • Conduct pain assessment and associated nursing interventions
  • Monitoring patients and performing ECGs
  • Provide evidence-informed rationales for the above interventions

Procedures skill sheets

Skill Video

 

 

Assess respiratory system & function:

  • Describe the determinants of adequate oxygenation and the nurse’s role in assessment and provision of oxygen supplementation
  • Discuss different evidence-informed rationales for providing supplementary oxygen

Skill Video

 

 

With supervision, apply the nursing process (assessment, planning, evidence-informed interventions, rationales and evaluation) in the administration of S2 & S4 medications (excluding restricted S4 & S8).

  • Articulate knowledge of legislation, charting and e-scribe medication administration contexts
  • Discuss the pharmacokinetics & pharmacology of all medications to be administered by the student and RN
  • Discuss evidence-based rationales for safe administration and management of varying regimes including; oral, IM, nebulised, SC, ocular, aural, nasal, PR & PV PEG/gastrostomy, nasogastric tube
  • Intravenous therapy regimes including IV antibiotics

Medication skill sheets

Skill Video

 

Perform a physical and psychosocial assessment of the well child & family.

Informative Articles

Skill Video

Apply the nursing process (assessment, planning, evidence-informed interventions, rationales and evaluation) in the nursing care of patients with neurological deficits.

Procedures skill sheets

Skill Video

Apply the nursing process (assessment, planning, evidence-informed interventions, rationales and evaluation) in the nursing care of patients with musculoskeletal deficits, i.e. spinal precautions, neurovascular observations.

 

Skill Video

 

With constant supervision, apply the nursing process (assessment, planning, evidence-informed interventions, rationales and evaluation) for patients:

  • Exhibiting difficult / challenging behaviours such as aggression
  • Experiencing mental illness and related problems
  • Experiencing withdrawal syndrome and/or dependency behaviours (including working with AOD team)
  • Who are cognitively impaired

Skill Video

 


 

Year 3

Registered Nursing Student Advanced-beginner: Minimal cues; minimal supervision (100% patient load)

Overview

Resources

Demonstrate professional communication, conduct and evidence-informed decision-making in all aspects of nursing across a range of cultural settings & acuity levels.

Informative Articles

Skill Video

Confidently provide accurate, logical, concise and appropriate recording and reporting of patient data (oral & written) to the health care team.

Skill Video

Apply the nursing process (assessment, planning, evidence-informed intervention, rationales and evaluation) for patients requiring medication:

  • Further develop skills in the safe administration of medicines via the oral, topical and parental routes
  • Manage medication regimes for 100% patient load & across varying modalities
  • Intravenous therapy regimes including narcotic infusions, epidurals & PCAs
  • Demonstrate knowledge about the storage and use of Schedule 2, 4 and 8 medications according to facility, statutory, State and Commonwealth Law
  • Discuss the pharmacology & pharmacokinetics of medications administered by the student

Medication skill sheets

Skill Video

 

With close supervision:

Perform primary and secondary survey of respiratory, neurological, cardiac, urinary & gastrointestinal system assessments required for high acuity patients & in emergency settings

Procedures skill sheets

Skill Videos

Infection control skill sheets

Skill Videos

Resuscitation skill sheets

Skill Video

Recognise and assist with collaborative management of clients:

  • Exhibiting difficult / challenging behaviours
  • Patients with mental health illness and related problems
  • Aggressive patients
  • Withdrawal syndrome and / or dependency behaviours (including working with AOD team)
  • Cognitively impaired patients

Skill Videos

With supervision, apply the nursing process (assessment, planning, evidence-informed intervention, rationales and evaluation) for paediatric patients including assessment, pain management, medication management & family interventions.

  • Discuss the rationales for these decisions.

Skill Sheets

Skill Videos

 


  Nursing Tutoring Essentials does not endorse these links or attachments. These resources are provided here to provide guidance only; and it is up to the individual student to make a judgement as to the veracity of these.

Thank you to the following contributors:

  • G. Geller
  • C. Cristea