1. Confidential
Nurse: PATTI INTVELD Date Observed: 09/30/2013
Time: 5th Period
School: OTES
Township of Ocean School District School Nurse Observation
Observer: Marion Conrad
In addition to accurate knowledge of the typical developmental characteristics of the age group and exceptions to the
general patterns, Ms. Intveld displays knowledge of the extent to which individual students follow the general patterns.
Demonstrating medical knowledge and skill in nursing techniques
Demonstrating knowledge of child and adolescent development
Demonstrating knowledge of government, community, and district regulations and resources
Highly Effective (4)
Highly Effective (4)
Effective (3)
A. Planning and Preparation
Ms. Intveld's procedures for the nursing office are seamless and anticipate unexpected situations. During this 40 minute
visit, Ms. Intveld assessed and provided services to 10 students. No student waited more than 1 minute to be evaluated
by the nurse.
Creating an environment of respect and rapport
Establishing a culture for health and wellness
Following health protocols and procedures
Effective (3)
Effective (3)
Highly Effective (4)
B. The Environment
Organizing physical spaceHighly Effective (4)
The following issues, many a result of recess, were addressed during the observation:
stuffy nose and headache, need for inhaler, sore ankle, cough drop requests, skinned knee, scratched chest, ball injury,
and sore hand.
Assessing student needs
Administering medications to students
Demonstrating flexibility and responsiveness
Effective (3)
Highly Effective (4)
Effective (3)
C. Delivery of Service
Ms. Intveld participates actively in school and district events and projects and maintains positive and productive
relationships with colleagues.
Participating in a Professional Community
Demonstrating Professionalism
Maintaining health records in accordance with policy and submitting reports in a timely fashion
Effective (3)
Effective (3)
Effective (3)
D. Professional Responsibilties & Collegiality

2. Confidential
Total Points Earned: 44
The nurse clearly understands the concepts underlying the components and implements them well.Effective (3)
E. Summative Lesson Rating
Long Observation Rating Scale
Total Points:
46 - 52 = Highly Effective
33 - 45 = Effective
20 - 32 = Partially Effective
0 - 19 = Ineffective
The nurse does not appear to understand the concepts underlying the components.
The nurse appears to understand the concepts underlying the components but implementation is not entirely
successful.
The nurse clearly understands the concepts underlying the components and implements them well.
Ineffective (1)
Part. Effective (2)
Effective (3)
Key: Rating Scale & Levels of Performance
The nurse exhibits very high performance.Highly Effective (4)
Ms. Intveld is a valuable asset to the staff and students of OTES as well as the Health and Safety Committee. Her
positive attitude and demeanor contribute to an environment that is warm and respectful both in and out of her office.
Comments
Nurse's Comments
Marion Conrad
Assistant Superintendent
I have discussed the information contained in this document with my Principal/Supervisor and was given the opportunity
to ask questions about its content.
Nurse Date
Date