University of Bohol

COLLEGE OF NURSING
City of Tagbilaran

OPERATING ROOM NURSING EXPERIENCE

NAME: Torres Bernadette Ann Culpa ADDRESS:078-1 C.P.G. East Ave., Tagbilaran City, Bohol CLASS:
2009
(Family Name) (First Name) (Middle Name)

Case NO. Date Admitted Date Operated Name of Patient Diagnosis Agency Operation Supervised by:
Performed

Pregnancy Uterine 42 1/7 weeks Age Of

Gestation, Cephalic In Latent Labor, Governor Celestino
037196 March 14,2007 March 14, 2007 Cagalitan , Elisa H. fetal compromise(variable deceleration Gallares Memorial Emergency Cesarean
with slow recovery)secondary to Hospital Section Mrs. Rossini C. Birad
Surgeon: oligohydramnios, postdatism
intrauterine growth restriction
Dr. Lyn O. Sarigumba Mrs. Merlin C. Pieras

042965 May 28,2008 May 30, 2008 Calacat , Nemesio B. Chronic Calculus Cholecystitis Governor Celestino Cholecystectomy with
Surgeon: Gallares Memorial Intra-Operative Mrs. Azucena F. Salaum
Dr. Raymond Anthony Hospital Cholangiogram
Jude R. Maniwang
Mr. Godofredo L. Batingal Jr

August 12,2008 August 14, 2008 Macabudbud, Marigine Procedentia Uteri, Relaxed Vaginal Governor Celestino Vaginal Hysterectomy
047066 E. Outlet Gallares Memorial with Anterior- Mrs. Josefina S. Remoreras
Surgeon:
Hospital Posterior Colporraphy
Dr. Blanche Marie H.
Formilleza
Mrs. Maria Nadine A. Lagura

August 14,2008 August 16, 2008 Saloma , April John H. Supracondylar Fracture Right Humerus Governor Celestino Open Reduction
05-0019457 Secondary to Fall Gallares Memorial Internal Fixation
Surgeon: Hospital Cross-Pinning Elbow Mrs. Azucena F. Salaum
Dr. Erwin A. Mondragon Right
Mr. Godofredo L. Batingal Jr

2008- July 4,2008 July 4, 2008 Canteros, Diosdado M. Hydrops Gallbladder with Gallstones Ramiro Community Cholecystostomy
0130596 Surgeon: Pancreatitis Hospital Mrs. Clareta C. Acierto
Dr. Ronald L. Ramiro
Mrs. Jasmin T. Catamora
Summary:

Total Major:5

BERNADETTE ANN C. TORRES (MRS.) ANICETA D. BONGCAS (MRS) GLORIA M. INCON (MRS) LALAINE LAO-DOMAPIAS (MRS.) CASILDA C. LAPEZ
Student’s Signature over Printed Name GCGMH, OR Supervisor RCH, OR-DR Supervisor UBCN, OR Coordinator UBCN, RLE Coordinator

Certified correct: (MRS) ISABELITA G. MARGATE

 DEAN, College of Nursing

University of Bohol
COLLEGE OF NURSING
City of Tagbilaran

OPERATING ROOM NURSING EXPERIENCE

NAME: Torres Bernadette Ann Culpa ADDRESS:078-1 C.P.G. East Ave., Tagbilaran City, Bohol
CLASS: 2009
(Family Name) (First Name) (Middle Name)

Case No. Date Admitted Date Operated Name of Patient Diagnosis Agency Operation Performed Supervised by:

07- July 11, 2007 Governor Orchiectomy Mrs. Rossini C. Birad

0015582 July 13, 2007 Legaspi, Rufo Jr. Undescended Testes Celestino
Surgeon: Left Gallares Mrs. Maria Nadine A.
Dr. Zaldy O. Buac Memorial Lagura
Hospital

033857 February 1, 2008 1.5 Laceration Lower Governor Suturing Mr. Eleazar D. Lanzaderas
Surgeon: February 1, 2008 Tungol, Ephraim M. Lid Right Eye Celestino
Dr. Juvy U. Doroon Gallares Mr. Hector C. Rodriguez
Memorial
Hospital

34944 Governor Thoracentesis Mrs. Ana Melisa B.

Surgeon: February 15, 2008 Vallejo, Gualberto F. Sr. Ruled In PTB III, Celestino Jagonos
Dr. Giselle Penelope L. Pleural Effusion Right Gallares
Camacho Memorial
Hospital Ms. Elvira M. Cahanap

044600 August 13, 2008 Pleomorphic Adenoma Governor Excision of Mrs. Azucena F. Salaum
Surgeon: August 14, 2008 Escabusa,, Antonia S. Right Submandibular Celestino Submandibular Mass
Dr. Clint Peter G. Area Gallares Right Mrs. Maria Nadine A.
Tibon Memorial Lagura
Hospital
Summary
Total Minor: 4
BERNADETTE ANN C. TORRES (MRS.) JOSEPHINE C. SEROJE (MRS.) ANICETA D. BONGCAS (MRS.) LALAINE LAO-DOMAPIAS (MRS.) CASILDA C. LAPEZ
Student’s Signature over Printed Name GCGMH, OPD-ER Supervisor GCGMH, OR Supervisor UBCN, OR Coordinator UBCN, RLE Coordinator

Certified correct: (MRS.) ISABELITA G. MARGATE

DEAN, College of Nursing
 University of Bohol
COLLEGE OF NURSING
City of Tagbilaran

OPERATING ROOM NURSING EXPERIENCE

Name:_______________________________________________________________ Address:____________________________________ Class:_________________

(Family Name) (First Name) (Middle Name)

Case NO. Date Admitted Date Operated Name of Patient Diagnosis Agency Operation Performed Supervised by:

Surgeon:

Surgeon:

Surgeon:

Surgeon:

Surgeon:

Total Minor Cases: __________________

_________________________ JOSEPHINE C. SEROJE ANICETA D. BONGCAS LALAINE LAO-DOMAPIAS MRS. CASILDA C. LAPEZ
Student’s Signature over Printed Name GCGMH, OPD-ER Supervisor GCGMH, OR Supervisor UBCN, OR Coordinator UBCN, RLE Coordinator
 Certified correct: ISABELITA G. MARGATE
DEAN, College of Nursing

University of Bohol
COLLEGE OF NURSING
City of Tagbilaran

DELIVERY ROOM – NURSERY EXPERIENCE RECORD

Name: Torres Bernadette Ann Culpa Address: 078-1 C.P.G. East Ave., Tagbilaran City, Bohol CLASS:
2009
(Family Name) (First Name) (Middle Name)

Case No. Date of Delivery Name of Patient Diagnosis Supervised by Obstetrician/ Agency Type of
NOD CI Pediatrician Experience
Governor
2005- November 29, Escarten, Pregnancy Dr. Marie Celestino
0033530 2007 Jenalyn Uterine Ann N. Gallares Handle
Full – Term Mrs. Ma. Villa L. Uy Mrs. Bienvenida P. Catambaca Memorial
Borja n Hospital
Governor
028107 November 23, Carcallas, Pregnancy Dr. Marie Celestino Assist
2007 Janice Uterine Mrs. Cora G. Garay Mrs. Bienvenida P. Ann N. Gallares
Full - Term Borja Catambaca Memorial
n Hospital
Governor
2006- November 24, Tuyco, Maritess Cesarean Celestino Cord dress
0015567 2007 M. Section Gallares
Mrs. Rosa T. Mrs. Bienvenida P. Memorial
Secretaria Borja Hospital
Governor Cord dress
37351 March 27, 2008 Diez, Precy A. Normal Celestino
Spontaneous Mrs. Cora G. Garay Mrs. Bienvenida P. Gallares
Vaginal Borja Memorial
Delivery Hospital
Ramiro
120341- April 10, 2008 Iguiron, Rosalie Pregnancy Dr. Alice R. Community Handle
08 S. Uterine Ms. Judee Baguio Ms. Dulce Amor P. Ladaga Hospital
Full – Term Amora
Ramiro
72775- July 3, 2008 Pabe, Janice Normal Community Cord dress
06 Marie E. Spontaneous Ms. Judee Baguio Mrs. Clareta C. Hospital
Vaginal Acierto
Delivery
Summary:
 Handle :2
Assist :1
Cord dress:3

BERNADETTE ANN C. TORRES HELEN AUXTERO GLORIA M. INCON MA. CONSUELO C. FORMILLEZA MRS. CASILDA C. LAPEZ
Student’s Signature over Printed Name GCGMH,DR/NICU Supervisor RCH, OR Supervisor UBCN,DR/NICU Coordinator UBCN, RLE Coordinator

Certified correct: ISABELITA G. MARGATE

DEAN, College of Nursing

University of Bohol
COLLEGE OF NURSING
City of Tagbilaran

DELIVERY ROOM – NURSERY EXPERIENCE RECORD

Name:_______________________________________________________________ Address:____________________________________ Class:_________________

(Family Name) (First Name) (Middle Name)

Case No. Date of Delivery Name of Patient Diagnosis Supervised by Obstetrician/ Agency Type of Experience
NOD CI Pediatrician
Pregnancy Uterine Assist
Full – Term

Pregnancy Uterine Assist

Full - Term

Pregnancy Uterine Assist

Full - Term

Pregnancy Uterine Assist

Full - Term

Pregnancy Uterine Assist

Full – Term
Summary:
Handle :____
Assist :____
Cord dress:____

___________________________ MA. CONSUELO C. FORMILLEZA MRS. CASILDA C. LAPEZ

Student’s Signature over Printed Name UBCN,DR/NICU Coordinator UBCN, RLE Coordinator

Certified correct: ISABELITA G. MARGATE

DEAN, College of Nursing