RATING SHEET Student Head Nurse to Student Nurse

Numerical Rating Quantitative Description 5 Outstanding 4 Very Satisfactory 3 Satisfactory 2 Needs Improvement 1 Unsatisfactory

PERFORMANCE RATING

1. Assessment De Amari Coronado Dizon Guevarra Lupena Obmerga Ramos Villegas Planning Borja 1.1 Established 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 2. Implementation 2.1 Carries out assigned task based on the criteria of distribution of assignments 2.2 Follows principles of time

management 2.3 Equipped with required paraphernalia for RLE 2.4 Carries out plan of care including: a. Bedside care b. Administration of medications c. Administration of treatments d. Shows initiative in performing task e. Accomplishes delegated task within prescribed time frame f. Provide psychological and spiritual support to pt. g. Accept supervision and criticisms h. Conducts appropriate health teachings _________________________ Ronnie W. Del Rio Team Leader, Group III

RATING SHEET Student Nurse to Student Head Nurse

Numerical Rating Quantitative Description 5 Outstanding 4 Very Satisfactory 3 Satisfactory 2 Needs Improvement 1 Unsatisfactory

PERFORMANCE RATING
Del Rio

1. Assessment Planning 1.1 Established 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 2. Implementation 2.1 Carries out assigned task based on the criteria of distribution of assignments 2.2 Follows principles of time management 2.3 Equipped with required paraphernalia for RLE 2.4 Carries out plan of care including: a. Bedside care b. Administration of medications c. Administration of treatments d. Shows initiative in performing task e. Accomplishes delegated task within prescribed time frame f. Provide psychological and spiritual support to pt. g. Accept supervision and criticisms h. Conducts appropriate health teachings

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Name and Signature