CAPITOL UNIVERSITY

College of Nursing
Cagayan de Oro City

HEAD NURSING

In Partial Fulfillment of the Requirements in

Intensive Nursing Practicum

Head Nursing

Submitted to:

Mr. Rey D. Pinalba RN MN

Head Nursing Clinical Instructor
and
__________________________________
Area Clinical Instructor

Submitted By:

_________________________
NAME OF STUDENT
GROUP ____ MTW

___ ROTATION ___ SEMESTER

School Year __________

NAME ___________________________

CHECKLIST HEAD NURSING COMPILATION

__ 1 Cover Page

___2. General and Specific Objectives

___3. Daily Plan of Activities

___4. Journal Reading with Handwritten Reaction

___5. Progress Notes

1 st week 2nd week 3rd week

a. Self ____ ____ ____

b. Partner/s in the area ____ ____ ____

c. Clinical Area (ward) assigned ____ ____ ____

d. Hospital staff ____ ____ ____

e. CI in head nursing ____ ____ ____

f. CI in assigned area ____ ____ ____

g. Student nurses assigned to you ____ ____ ____

____ 6. Shadowing and ARA of the Head nurse (Narrative)

____ 7. Staff Schedule for 15 days

8. Clinical Assignment Sheets and Monitoring Sheets (at least 2 patients per
week) 1st duty week ____2nd duty week _____ 3rd week____

10. Vital signs Monitoring sheet ___ ____ _____ _____

____11. Picture Documentation of Head Nursing exposure, defense and

interview with supervisor or head nurse) and head nursing performance Checklist
from dean’s office
___12. Organizational Chart
___13. Problem encountered and conflict management.
___14. Case study
____15. Pretest or posttest (hard and soft copy with answer key)