AMA SCHOOL OF NURSING

BAGUIO CAMPUS
DATE: ___________________________
SHIFT: ___________________________
AREA: ___________________________

Activities:
( ) Vital Signs and I and O Monitoring
( ) Carry-out Doctor’s Order
( ) Preparing IV medications
( ) Giving Medications (_________________)
( ) Charting
( ) Bedside Care / Morning Care
( ) Others: ____________________________
_____________________________________

BSN _______ Year Level _______ Group _______

Name of Patient/s Bed # Name of Student Remarks
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Prepared by:

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Clinical Instructor