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Cagayan de Oro College – PHINMA

Carmen, Cagayan de Oro City


College of Nursing

Name of Student: _______________________ Date: ____________________


Level: _________________________________ Area / Shift: ______________
Block: _________________________________ C.I.: _____________________

General Objective:
At the end of 1 month duty at (Hospital – Area), (shift), I will be able
to……………………………………………………………………………………………………
……………………………………………………………………………………………………
……………………………………………………………………………………………………
………………………………………

(SKA Format)

Specific Objectives:
At the end of 1 month duty at (Hospital – Area), (shift), I will be able to:

1. S Format
2. K Format
3. A Format
Cagayan de Oro College – PHINMA
Carmen, Cagayan de Oro City
College of Nursing

Name of Student: _______________________ Date: ____________________


Level: _________________________________ Area / Shift: ______________
Block: _________________________________ C.I.: _____________________

Daily Plan of Activities

6:30 am - Assembly Time @ __________


6:31 – 7:00am - Preconference (Morning Prayer,
Checking of Attendance, Checking of
Paraphernalias, Patient Loading,
Setting of Roles & Responsibilities,
Reminders).

2:30 pm – 3:00pm - Post Conference (After Care,


Evaluation of the Day`s Duty &
Reminders).

3:00pm - Dismissal Time


Cagayan de Oro College – PHINMA
Carmen, Cagayan de Oro City
College of Nursing

Name of Student: _______________________ Date: ____________________


Level: _________________________________ Area / Shift: ______________
Block: _________________________________ C.I.: _____________________

Evaluation

After 1 month duty at (Hospital – Area), (shift), I was be able to / I was not able to
……………………………………………………………………………………………………
……………………………………………………………………………………………………
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