1-31-11, Monday It is now midway through the clinical rotation. Andrew\'s prep research was completed poorly. We discussed his patient\'s diagnosis and he was able to give me minimal information. When I entered his patient\'s room, I did not see an incentive spirometer which was ordered q1h while awake. I asked Andrew about it and he stated there was no incentive spirometer in the room. We left the room to obtain one. When Andrew found an incentive spirometer, I questioned him on how to use the incentive spirometer and he stated let me read the directions. I went through a detailed description of how to use the incentive spirometer. Andrew demonstrated no knowledge of its use, which he has had in theory. He also knew the day before that an incentive spirometer was ordered for his patient (it was in his research) and did not look in his book to understand how to use it. I went to the patient\'s room. Andrew had already instructed the patient on how to use the incentive, but stated that it was not working. I helped the patient with it and told him to suck in as if using a straw. The patient looked at Andrew and said, that\'s not what you told me to do, you said to blow into it. This same patient had on a Texas catheter. I questioned Andrew as to his care for the catheter. He was unsure. So I asked him about catheter care on an indwelling catheter. He stated that you wipe the catheter with alcohol from the bottom of the catheter upward. I told him this was incorrect and instructed him on the proper procedure. Andrew also has to work on his organizational skills. All information on his patient\'s care was included on his research paper and had no information close at hand.

2-3-11, I spoke with Andrew today about his research prep and clinical deficiencies.  I explained that he is in jeopardy of failing clinical, if these weak areas are not improved upon by the end of the level.  He stated understanding.