Student’s signature: ……………………………………Date: COMPETENCIES: PASS/FAIL OVERALL MARK ……. Sign-off mentor’s signature: ……………………………Date: Module Leader’s Comments: Signature, Print Name and Date:
ANTENATAL/POSTNATAL PLACEMENT P or Fail If is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he has the underpinning theoretical knowledge P or Fail Sign-off mentors signature Date Student Mentor Communication Domain: Effective midwifery practice Professional and ethical practice ESC: Communication Initial consultation between the woman and the midwife Initiation and continuance of breastfeeding Demonstrates effective communication skills with women and their families and always seeks to confirm understanding and gain informed consent. Is proactive and creative when encouraging women to think about their own health, and the health of their babies and families, and how this can be improved. Utilises appropriate communication skills to deal with difficult and challenging circumstances including situations women have physical, cognitive or sensory disabilities. Engages in multidisciplinary communication: face to face, telephone, in writing and electronically ensuring the woman’s needs are wishes are clear. Plans and provides health education during antenatal and postnatal periods for women, families and juniors. Diagnosis Domain: Effective midwifery practice Professional and ethical practice ESC: Communication Initial consultation between the woman and the midwife Medicines management Initiates the holistic assessment and monitoring of women throughout the antenatal period. Considers the following through the assessment of cultural and emotional wellbeing: History taking, observation, physical examination and Including social factors for example; substance misuse, domestic violence. Can provide information relating to 2 specific antenatal investigations and demonstrate an understanding of their indications: 1. 2.
ANTENATAL/POSTNATAL PLACEMENT P or Fail If there is no opportunity for the student to demonstrate a competency, enter “EV” to denote that she/he has the underpinning theoretical knowledge P or Fail Sign-off mentors signature Date Student Mentor Respecting the individual Domain: Professional and ethical practice ESC: Communication Recognises and discusses the different roles and relationships in families; reflecting religious and cultural beliefs, preferences and experiences, particularly around family planning advice. Challenges situations/others where the dignity of women may be compromised. Respects women’s autonomy and rights when making a decision even where choice may result in harm to themselves or their unborn baby, unless a court of law orders the contrary. Professional practice Domain: Professional and ethical practice Developing the individual midwife and others Achieving quality through evaluation and research ESC: Communication Initiation and continuance of breast feeding Medicines management Practices in accordance with The Code (NMC, 2015) and within the limitations of the individuals’ own competence, knowledge and sphere of professional practice. Demonstrates knowledge and application of legislation relating to rights, equal opportunities and equality and diversity; for example: informed choice. Acts professionally to ensure that personal judgements, prejudices values and beliefs do not compromise the care provided. Maintains confidentiality and security of written and verbal information acquired in a professional capacity. Critically reflects upon the need to disclose information about individuals and organisations only to those who have a right and need to know. Through reflection and evaluation demonstrates commitment to personal and professional development. Acts as an effective role model in decision making, taking action and supporting more junior staff. Maintains midwifery standards by adhering to local uniform policies, practising good time keeping, conducting yourself in a professional manner and adhering to infection control policies.
NEONATAL WARD PLACEMENT RIE ST JOHN’S BORDERS FORTH VALLEY FIFE Please circle the applicable DATE OF PLACEMENT FROM TO PLEASE PRINT NAME OF MENTORS INVOLVED IN THE ASSESSMENT SIGNATURES & INITIALS OF MENTORS DATE OF LAST MENTOR UPDATE ORIENTATION AT INITIAL MEETING The orientation to practice area must be completed during the first shift of the placement. Please indicate if you have provided the orientation information to the practice placement in relation to the following with a tick: √
Student’s comments: Student’s signature: …………………………Date: Mentor’s comments: COMPETENCIES: PASS/FAIL Mentor’s signature: ……………………………Date: Module Leader’s Comments: Signature, Print Name and Date: NEONATAL PLACEMENT
Hours worked Daily signature Mentor’s signature ____________________________________________________ Week 2 Commencing: …………………… Mon Tues Wed Thu Fri Sat Sun Start Finish Hours worked signature Mentor’s signature ____________________________________________________ Week 3 Commencing: …………………… Mon Tues Wed Thu Fri Sat Sun Total Start Finish Hours worked Daily signature Mentor’s signature ____________________________________________________ Week 4 Commencing: …………………… Mon Tues Wed Thu Fri Sat Sun Total Start Finish Hours worked Daily signature Mentor’s signature ____________________________________________________ Week 5 Commencing: …………………… Mon Tues Wed Thu Fri Sat Sun Total Start Finish Hours worked Daily signature Mentor’s signature ____________________________________________________ Week 6 Commencing: …………………… Mon Tues Wed Thu Fri Sat Sun Total Start Finish Hours worked Daily signature Mentor’s signature ____________________________________________________ Week 7 Commencing: ……………………