Professional Documents
Culture Documents
A head nurse is the one who assumes responsibility for managing the Human and material resources of a
nursing unit and takes lead in developing to provide quality patient care and an environment conductive to staff
growth and satisfaction.
Student nurse will be able to develop their potentials of being efficient and productive Leaders by
nurturing and enhancing their leadership skills by providing training in management in team handling. And be
able to familiarize with the different nurse responsibility.
Apply principles on head nursing and provide nursing standards and policies, and procedures regarding
patients care to guide the subordinates.
Ôromotes and utilize quality assurance of the program standards.
ëotivate the nursing staff to provide quality nursing care and improvement in nursing care.
ëanage the flow of activities by implementation of the nursing plan based on the nursing care.
Êevelop a skill in decision-making and other qualities of an efficient head nurse.
oordinate and communicate with the other members of the health team in providing patient care.
Êocument accurately the observation of the services rendered to the patient.
Supervises and evaluate the quality of patient care provided by the staff by observing them through
frequent rounds guided by the evaluation check list.
Student staff nurses
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Assumes the responsibility for the delivery of quality patient care to patients within the unit.
1. Ôrovide nursing standards and policies regarding patient care to guide the staff nurses.
2. They have the responsibility of orienting and updating the staff of the systems and standard of patient
care.
3. Responsible for the implementation of the health care programs, and standards of patient care.
4. Assumes the role of patient advocate.
5. Assumes the role of staff members advocate.
6. Acts as liaison with the medical staff to coordinate medical and nursing management of patient care.
7. Serves as resource person to nursing personnel under him in assessing, planning, implementation and
evaluating nursing care provided.
8. oordinates the patient care with the other members of the health care team.
9. Keeps superior informed regarding problems or issues in patient care.
10. Evaluates the quality of patient care through frequent rounds.
11. Evaluates the nursing standard cyclically to provide development of the new standards of patient care.
The staff nurse is to the one responsible for rendering holistic nursing care to patient in assigned areas,
the specific function and responsibilities of which depend upon the organizational structure of the Nursing
service.
Student nurses will be able to develop their knowledge, attitudes and skills through working on this
training, and be able to appreciate the importance of team work and working under a directory.
Dollow the nursing standards and policies imposed by the nursing administration.
Êevelop a sense of responsibilities and accountabilities on their action they make.
Ôrovide a quality nursing care and services.
Êevelop a good attitude towards the work.
[e able to work harmoniously with the fellow students and members of the health care team.
Êevelop good nursing skills, attitude and gain knowledge for the future use.
The staff nurse initiate and perform nursing care and services to meet the needs patient in assigned areas
utilizing the nursing process.
1. Assesses the individual needs for nursing care based on patient¶s history, results of physical, diagnostic,
and laboratory examinations.
2. Infers correct nursing diagnosis.
3. Ôlans and prioritizes nursing care activities considering overall health needs of the patient.
4. Institute nursing intervention consistent with the overall plan of care with special consideration of the
patient¶s safety and comfort.
5. Ôrovides health teaching to patient, his family and significant others so that they may understand this
illness and participate actively in his care.
6. oordinates patient care services with members of the health team.
7. Evaluates or modifies of nursing care by means of:
Effectiveness and efficiency of nursing measures rendered.
Deedback from patient/family and significant others.
8. Êocuments accurately the observation and services rendered to the patient.
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all time
Ôreconference
rientation
Êistribution of area of assignment
Endorsement
Rounds with the staff nurse
heck the patient¶s condition
heck for the IVD level from the
time received
hart reading
Ôatient¶s profile/data
Êiagnosis
Ôast/Ôresent history
Êoctor¶s rder
ëedication and time of medication
Reporting
Ôreparation of medications/Êrug
study/Vital signs
V/S Ôlotting
ase discussion
[reak of the first half of the group
[reak of the second half of the group
Êrug Ôreparation/ Êrug study
2:00-2:30 Endorsement
2:30-2:45 Rounds with the staff nurse
heck the patient¶s condition
heck for the IVD level from the
time received
2:45-3:00 hart reading
Ôatient¶s profile/data
Êiagnosis
Ôast/Ôresent history
Êoctor¶s rder
ëedication and time of medication
3:00-3:30
Reporting
3:30-4:00
Ôreparation of medications/Êrug study
V/S Ôlotting
4:00-4:15
Vital signs
4:15-5:00
ase discussion
5:00-5:30
[reak of the first half of the group
5:30-6:00
[reak of the second half of the group
6:00-7:15
Êrug Ôreparation
7:15-7:45
Êrug study
7:45-8:00
Vital Signs and Giving medication
8:00-8:30
Lecture
8:30-9:00
Ôrepare for SÔIE
9:00-9:30
Quiz
9:30-10:00
Endorsement
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9:30-10:00 all time
Ôreconference
rientation
Êistribution of area of assignment
10:00-10:30 Endorsement
10:30-10:45 Rounds with the staff nurse
heck the patient¶s condition
heck for the IVD level from the
time received
10:45-11:00 hart reading
Ôatient¶s profile/data
Êiagnosis
Ôast/Ôresent history
Êoctor¶s rder
ëedication and time of medication
11:00-11:30
Reporting
11:30-12:00
Ôreparation of medications/Êrug study
V/S Ôlotting
12:00-12:15
Vital signs / Giving medications
12:15-1:00
ase discussion
1:00-1:30
[reak of the first half of the group
1:30-2:00
[reak of the second half of the group
2:00-2:15
Êrug Ôreparation
2:15-2:45
Êrug study
2:45-3:00
Vital Signs and Giving medication
3:00-3:30
Lecture
3:30-4:00
Ôrepare for SÔIE
4:00-4:30
Quiz
4:30-5:00
Endorsement
Êirection: Ôut a check on the skills observed / performed, of not please include remarks on the space
provided.
Legend:
'- Is at a very satisfactory level. Has thorough knowledge and understanding of the said case/topic. ould
do and plan intervention on his/her own.
,- At satisfactory level. Has enough understanding to handle the case but needs areful guidance.
)- Needs to be reevaluated. ompetency is at an unsatisfactory level and needs to be reoriented on the
subject/case at hand.
________________________ _________________________
Êirection: Ôut a check on the skills observed / performed, of not please include remarks on the space
provided.
Legend:
'- Is at a very satisfactory level. Has thorough knowledge and understanding of the said case/topic. ould
do and plan intervention on his/her own.
,- At satisfactory level. Has enough understanding to handle the case but needs areful guidance.
)- Needs to be reevaluated. ompetency is at an unsatisfactory level and needs to be reoriented on the
subject/case at hand.
________________________ _________________________
Êirection: Ôut a check on the skills observed / performed, of not please include remarks on the space
provided.
Legend:
'- Is at a very satisfactory level. Has thorough knowledge and understanding of the said case/topic. ould
do and plan intervention on his/her own.
,- At satisfactory level. Has enough understanding to handle the case but needs areful guidance.
)- Needs to be reevaluated. ompetency is at an unsatisfactory level and needs to be reoriented on the
subject/case at hand.
_____________________ ________________________
Student¶s Signature linical Instructor¶ Signature
Y
Y
Name: ____________________________________Date:___________________
Yr/Sec:______________Group:___________ Rating:__________________
Area:____________________Clinical Instructor:__________________________
Y
Y
Y
Outstanding Carries out expected tasks in a very consistent manner with
5
minimal guidance and supervision
Very Carries out expected tasks in a consistent manner with
4
Satisfactory minimal guidance and supervision
Satisfactory Carries out expected tasks in a moderately consistent
3
manner with frequent guidance and supervision
Needs Carries out expected tasks in a rarely consistent manner
2
Improvement with close guidance and supervision
Unsatisfactory Does not carry out expected tasks even with close guidance
1
and supervision
1.1 Establishes rapport with subordinates
1.2 Able to involve patients in plan of care
1.3 Punctual and prompt in all activities
1.4 Able to maintain stability under pressure
1.5 Gathers data using interview, observation, records review
and reports
1.6 Formulates appropriate nursing care plan
1.7 Wears complete prescribed RLE uniform
a. Carries out assigned tasks based on the criteria of distribution
of assignments
b. Follows principles of time management
c. Equipped with required paraphernalia for RLE
d. Observes proper channels of communication
e. Carries out plan of care, including:
A. Bedside Care
B. Administration of medications
C. Administration of treatments (nebulization, IVF)
f. Shows initiative in performing tasks
g. Accomplishes delegated tasks within prescribed time frame
h. Provides psychological and spiritual support to patients
i. Accepts supervision and criticisms
j. Conducts appropriate health teachings
Y
1. Notifies immediate superior about untoward situations or
conditions related to patient care in the area
2. Make revisions in the plan of care as necessary
3. Evaluates Nursing Care rendered
1. Demonstrates honesty at all times
2. Conducts self in a tactful manner
3. Keeps confidential patient information
4. Observes the PNA Code of Ethics
5. Guided by RA 9173
6. Observes the 11 Core Competency Guidelines
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CONFORME BY :
STUDENT STAFF NURSE
NOTED BY:
CLINICAL INSTRUCTOR
c
1. Supervises and evaluates the quality of patient care through frequent rounds
2. versees the action of assigned staff nurse, medication nurse and chart nurse.
3. Damiliarized and take care of the emergency cart.
4. Takes note of the special procedures for the patients within the unit.
5. Keep superiors informed regarding the problems and issues in patient care with the nursing unit.
6. Ôarticipates in the selection of nursing staff for the unit.
7. Ôresents changes or innovations to staff in a positive manner.
8. Ôrovides conducive climate for work and maintains effective communication within the unit department.
9. ëakes the 24 hrs. Nursing report of the unit.
10. hecks daily time record of the staff.
c
1. Record all the vital signs taken on the TÔR sheet on the patients chart.
2. ëust know the normal values of [Ô, ÔR, RR and Temperature.
3. Reports intake and output
4. ëakes a narrative report of the vital signs recording system for the shift then submit to the assigned
student head nurse.
Y
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Name: ______________________________Date:______________
Yr/Sec: ______________Group:__________ Area: _____________
Clinical Instructor: _____________________
BED # :______________________________
PATIENT¶S NAME: ______________________________
AGE : ______________________________
DIAGNOSIS : ______________________________
VITAL SIGNS:
____
TEMP = ____
CR = ____
PR = ____
RR = ____
BP = ____
____
TEMP = ____
CR = ____
PR = ____
RR = ____
BP = ____
DIET : ______________________________
INTAKE : ______________________________
OUTPUT : ______________________________
IV INFUSED : ______________________________
ORAL ____
VOM ____
NGT ____
TOTAL____
!#-$%.% / 0 1 2 3
1. Applies as appropriate theory as a basis for decision
making in nursing practice.
2. Assesses staffs presenting symptoms to determine
a nursing diagnosis and plan of action based on a
medical expertise and knowledge.
3. Knowledge in communication, clarification and
interpretation of existing problems with staff and
nursing responsibilities.
4. Inform the staff of the likely causes of errors defects
and waste.
5. Suggest in which risk, errors, quality of problems
maybe reduce.
, .%
1. Neat and well groomed. Adheres to dress code.
2. Punctual in reporting for duty
3. Complies with the code of ethics of the nursing
profession and upholds and implements school
rules.
4. Assist in training staff in particular by setting a good
example.
5. Promotion of professional responsibility,
accountability and behavior.
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1. Provide leadership in the assessment, planning,
implementation, and evaluation of comprehensive
school health program.
2. Respond to the student/ staff medical emergencies.
3. Instruct subordinates in appropriate method and
procedure in providing care.
4. Initiate and facilitate any steps necessary to improve
methods, equipments, materials and condition in the
work area for which they are responsible.
Equivalent: ______________ Rating: _______________
Scaling Interpretation
This evaluation is to determine and appraise the performance of the staff according to their
assign task. By writing the appropriate score in the proper column denoting the extent to which the
nurses performed these functions.
_____________
Total 100%
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! 8
/ 0 1 2 3
1. Gathers data appropriately and completely,
then validating it focusing function needing
assistance support
2. Analyze and interpret collected data
3. Knows the correct way of doing physical
assessment.
4. Gives attention and synthesize the significant
laboratory findings
5. Knowledge in identifying nursing problems
and categorizing it according to the patients
need.
6. Knows the rationale behind every
intervention given for the care of the patient.
7. Have knowledge in giving proper instruction
for medicine
a. classification
b. nursing responsibility
c. drugs and solution
8. Explain or discuss the report clearly and able
to answer question correctly.
9. Knowledge in preparation of patient for any
diagnostic procedure
10. Knows how to formulate an accurate nursing
care plan for particular cases.
! / 0 1 2 3
1. Ability to give and respond to the care
needed by the patient
2. Perform procedure properly such as doing
physical assessment, taking VS, and giving
medication as ordered.
3. Able to provide or assist patient in
performance of activities of daily living
whenever needed.
4. Always guided in precautionary and
preventive measure in providing care to the
patient.
5. Able to give health teachings clearly to the
patient.
6. Communicate effectively in identifying the
needs of the patient.
7. Properly handling an instance of emergency
situation.
8. Implement Nursing care plan appropriately
9. Reassesses patient to determine whether a
remodification of care plan is necessary.
10. Able to conduct discharged planning with the
patient, his family and significant others.
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5 ± Outstanding (85)
4 ± Very Satisfactory (83-84)
3 - Moderately satisfactory (81-82)
2 ± Minimally satisfactory (75-80)
1 ± Unsatisfactory (74 and below)
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1:30- 2:00pm Pre- conference
2:00- 2:30 Endorsement
2:30-3:00 Rounds
3:00-3:30 Reading of patients chart
3:30-4:00 VS, preparation of medication
4:00-4:20 Giving of medication
4:20- 4:35 Plotting of vital signs
4:35-5:30 Bedside care, NPI
5:30-6:00 Break 1st Batch
6:00-6:30 Break 2nd Batch
6:30-7:15 Sample charting
7:15-7:45 Checking of sample charting
7:45- 8:00 VS, giving medication
8:00- 8:10 Plotting of vital signs
8:10- 9:00 Charting and final rounds
9:00-9:45 Post conference
9:45- 10:00 Endorsement
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6:45-7:00 Pre- conference
7:00-7:15 Endorsement
7:15- 7:30 Rounds
7:30- 8:00 Reading of patient chart
8:00-8:30 Bedside care/NPI
11:30-12:00 Vs, preparation of medication
12:00-12:20 Giving of medication
12:20-1:00 Plot of vital sign
1:00-1:30 Break 1st Batch
1:30-2:00 Break 2nd Batch
2:00-2:45 Sample charting
2:45-3:00 Checking of sample charting
3:00-3:30 Preparation of medication
3:30-4:00 VS, giving medication
4:00-4:30 Plotting of vital signs
4:30-5:00 Final rounds
5:00-5:30 Post conference
5:30-6:00 Endorsement
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As a student nurse, he/she will be able to acquire knowledge and at the same time
practice his/her own leadership and management skills, and understand thoroughly the importance of
being systemically in rendering nursing care the patients.
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1. Be able to know the proper collection of data and using of nursing process, in assessing
the problem of patient and the cause of his disease.
2. Possessing an attitude of being objective and work with their co-student in Camaraderie.
3. Be able to impact useful health teaching to client specific disease to they can apply it in
their respective lives.