Bulacan State University

City of Malolos Bulacan

COLLEGE OF NURSING
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STUDENT ASSIGNMENT SHEET

RLE AREA___________ YEAR LEVEL________ SHIFT__________ DATE_______

NAME OF STUDENT AREA

Staff name Medical ward

ACTIVITIES

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Endorsement Received by: Prepared and Endorsed by;

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Nurse on duty Clinical Instructor
 Bulacan State University
City of Malolos Bulacan
COLLEGE OF NURSING
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PLAN OF ACTIVITIES

Date:
Shift: 7am-3pm

TIME ACTIVITY

6:30-6:35 Logging In

6:35-6:45 Grooming/Paraphernalia

6:45-6:55 Assigning of Patient

11:00-12:00 IV meds

3:00-3:30 Post Conference

PREPARED BY: APPROVED BY:

Head Nurse Clinical Instructor

 Bulacan State University
City of Malolos Bulacan
COLLEGE OF NURSING
_________________________________________________________________________________________

Institution:___________________ Area_____________________________
Date :_______________________ Shift _____________________________
Year and Sec_________________ Group____________________________

ENDORSEMENT SHEET

Name of Bed no. Patient Diagnosis Vital Medication IV Diet Diganos Doctors
Student signs s Fluids tic/ order
laborato
ry

Pt. 1

Pt. 2

Pt. 3

Pt. 4

Pt. 5

Head nurse: Clinical Instructor

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