PLAN OF ACTIVITIES VS ACTUAL ACTIVITIES

Institution:
Ward: Medical Ward
Date:
Group No.:
Concept:
PLAN OF ACTIVITIES ACTUAL ACTIVITIES
06:00 A.M.

07:00 A.M.

08:00 A.M.

09:00 A.M.

10:00 A.M.

11:00 A.M.

12:00 P.M.

01:00 P.M.

02:00 P.M.

03:00 P.M.

04:00 P.M.

05:00 P.M.
Leader:
Members:
Clinical Instructor:

Copy To Faculty
NU0000
2016 Page 1 of 1
 STUDENT NURSE-PATIENT INFORMATION SHEET
Institution: Date:
Concept: Group No.:
Name of Student Name of Patient Room No. Diagnosis Special Function
01.
02.
03.
04.
05.
Objectives:
At the end of the shift, the students nurse will be able to:
01.
02.
03.
04.
05.

Prepared by:____________________________ Noted by:______________________________

Team Leader Clinical Instructor
Copy To: Faculty
NU0000
2016
Page 1 of 1