DAILY REQUIREMENT CHECKLIST Criteria I. Attendance II.

Paraphernalia BP apparatus / stethoscope Calculator Thermometer Bandage Scissor Tourniquet Tape measure Canister w/ dry cotton balls Canister w/ wet cotton balls Medicine tray Black / Red, Green ball pens, pencil Micropore Small Notebook Penlight w/ Batteries Clipboard Signature of Student Head Nursing Student Head Nursing Day 1 ORIENT ATION Day 2 5:30 Day 3 5:45 Day 4 5:45 Day 5 5:45 Day 6 5:45 Day 7 5:45 Day 8 5:45 Day 9 5:45

Prepared By: Student Head Nurse

Noted by: Clinical Instructor

Related Learning Experience Leadership And Management Head Nursing

EXAMINATION RESULT FORM Date: Clinical Area: NAME 1. 2. 3. 4. 5. 6. 7. RAW SCORE PERCENTAGE

Prepared By: Student Head Nurse

Noted By: Clinical Instructor

ACHIEVEMENT EVALUATION REPORT (Student Head Nurse to Student Staff Nurse)

Date: Clinical Area: Clinical Instructor:

Name of Students 1. 2. 3. 4. 5. 6. 7. 8.

Grade

Remark

Submitted By: Student Head Nurse

RLE LEADERSHIP AND MANAGEMENT (HEAD NURSING)

SCHEDULE OF ACTIVITY Date: TIME 6:OO 6:30 6:30 6:40 6:40 7:00 7:00 7:30 7:30 8:00 8:00 8:30 8:30 9:00 9:00 9:45 9:45 10:45 10:45 11:15 11:15 11:45 11:45 12:15 12:15 12:45 12:45 1:15 1:15 2:00 Clinical Area: Census: 18 ACTIVITY LOG IN PRAYER PRE CONFERENCE ENDORSEMENT / PATIENT ASSIGNMENT NURSING ROUNDS (BEDSIDE CARE, VITAL SIGN, MEDICATION, I AND O) SAMPLE CHARTING NCP / DRUG STUDY CHART READING BREAK CHECKING OF NCP AND DRUG STUDY NURSING ROUNDS PLOTTING (TPR SHEET) QUIZ CHECKING OF QUIZ POST CONFERENCE / ENDORSEMENT

RLE LEADERSHIP AND MANAGEMENT (Head Nursing)

ENDORSEMENT SHEET

Date: Student Head Nursing: Name of Patient Age Diagnosis Diet

Census: Clinical Area: Procedures Medications Vital Sign Output U S SPECIAL ENDORSEMENTS