Far Eastern University Institute of Nursing Nicanor Reyes St.

, Manila

RLE ON LEADERSHIP AND MANAGEMENT (Headnursing) Name:_____________________________________ Section and Group:_______________ Hospital: _____________________________ Ward:_______Duration of exposure_____________ DAILY REQUIREMENT CHECKLIST CRITERIA Part I: Attendance On time Late Absent Part II: Paraphernalia Functional BP Apparatus w/ stethoscope Thermometer Bandage scissors Tourniquet Penlight w/ batteries Canister w/ dry cotton balls Canister w/ cotton balls soaked in alcohol Medicine tray Small alcohol Blue, black, red, green ballpens Micropore Pencil and eraser Tongue depressor Small notebook Clean gloves Sterile gloves Signature of student staff nurse TOTAL Prepared by: Mamoransing, Zuleika Joy Student Headnurse CLINICAL INSTRUCTOR Date:_____________ DAY 1 DAY 2