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INSTITUTE OF NURSING AND ALLIED HEALTH SCIENCES

Bachelor of Science in Nursing Program

Related Learning Experience Checklist

Name: ______________________________ RLE Area: ______________________


Year & Section: ______________________ Concept: ________________________

Date Remarks
I. Complete Uniform
1. Name Plate/School ID
2. Nursing Pin
3. Plain white undergarments/Skin tone (bra,
panty, brief, sando)
4. White Nursing shoes (2 extra pair in
special areas like OR and DR).
5. White Socks (Male)
White Stockings (Female)
6. Hairnet (Female)
Clean Haircut (Male)
7. PPE (Cap and Mask, Face Shield, Smock
Gown, Gown, Shoe Cover, working Gloves).
8. LIGHT make-up (Female)
9. Neat and Proper Placement of CAP
II. Paraphernalia
1. Watch with second hand
2. Sphygmomanometer (Aneroid)
3. Stethoscope
4. Bandage Scissors
5. Thermometer (Oral and Rectal)
6. Gauze 4x4
7. Sterile Gloves (2 pairs) (5pairs for special
area).
8. Working Gloves
9. Penlight
10. Nail Cutter
11. Tourniquet
12. 70% Alcohol
13. Povidone Iodine
14. Hydrogen Peroxide
15. Medicine Tray
16. Medicine Cup (Calibrated)
17. Medicine Tablet Cutter
18. Plaster (Micro pore)
19. Reflex Hammer
20. Cotton Balls with and without ROH (In
labelled Jars/Containers)
21. Tape Measure
22. Ruler
23. Pens (Black, Blue and Red)
24. Pencil with eraser
25. Ward Notebook (extra 1 Blue Record
Book for OR&DR Cases)
26. Drug Handbook
27. NANDA Book
Student’s Signature

_____________________________________ _____________________________
RLE Coordinator, INAHS Clinical Instructor

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