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RLE PARAPHERNALIA CHECKLIST

NAME: SEC:

12/08/2011 Uniform Female


White duty uniform with apron Cap with strips White shoes & stockings Nameplate & PLP pin Light make up Male White duty uniform with white plain tshirt/undershirt Nameplate & PLP pin Haircut Wrist Watch BP apparatus Stethoscope Thermometer (Digital) Bandage Scissor Pocket Notebook Penlight Small medicine tray Cotton balls with & without alcohol Micropore Tourniquet Nail Cutter Gloves(clean & sterile) Face mask Ballpen (black,blue,red) Tounge depressor Tape measure Syringes (1cc,3cc,5cc,10cc) Alcohol Calculator REMARKS Signature Student Head Nurse Signature Clinical Instructor Head Nurse: Clinical Instructor (OB WARD): Jennevy R. Buque Wilma Fernandez, RN, MAN

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