As of mid-clinical rotation, Joseph had received a needs improvement in \"reporting pertinent data to staff and instructor in a timely manner\". On October 27, Joseph still had not completed head-to-toe assessments when asked at 10:00 am. When Joseph reported his assessment findings to me, he documented that one of his patient\'s pedal pulses were not palpable and another patient\'s respirations were labored. Also, he had documented that his patients had reported pain and Joseph did not make his nurse aware or re-evaluate level of pain. I explained to Joseph that he would need to re-assess his patients and get a doppler pulse if a pedal pulse could not be palpated. At 11:00, when asked to see Joseph\'s assessment sheets, he had still not re-assessed his patients.   There was no patient emergency (or other reason) for not completing assessments provided.
Joseph was scheduled to be at another facility for a med pass by 12:30PM which was located a short drive away.  He was given permission to leave at 11:30 if his work was completed, which would allow more than sufficient time for lunch and driving time.  The co-assigned nurse asked Joseph at 11:00AM to do a sterile dressing change on his patient and he stated that he “couldn\'t because he would be leaving soonâ€. I brought in supplies to do the dressing change and instructed Joseph to get a pair of sterile gloves. Joseph was still not in the patient\'s room after several minutes so the dressing change was completed by someone else. At this point, critical competencies are not being met such as \"recognizes deviations from normal anatomy and physiology of assigned patients\", \"performs basic head-to-toe assessments accurately\", and \"completes all assessments in a timely manner\".
