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1. Obtain knowledge and ability to use and recognize channel of

communication.

2. Appreciate the value of professional duty in the care of the

patient.

3. Develop good relationship with the patients in the clinical area,

with the preceptor and with other staff involved.


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1. 8. 45am - Courtesy Call

2. 9.00am - Rounds with the Head Nurse

3. Orientation.


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1. Courtesy call

 c !"## is a formal meeting in which it pays a

visit out of courtesy to a head of the nursing service, the chief nurse.

The meeting is usually of symbolic value of respect. It signifies a polite

gesture of introducing oneself to the head of the organization, at the

same time, giving thanks to them f or greatly accepting a Graduate

student for the practicum.

 2. Rounds

Nursing Rounds is highly important before the start of

any nursing procedures to ensure proper assessment of patients from

time to time during his/her entire period in the unit or as essen tial by

the patient. It should be done to all patients without any exemptions.

Nursing rounds improve patient care by increasing patient satisfaction .

3. Orientation

A protocol for orientation help to better organize the practice and

made students better knowledgeable with the set up of the ward.

Properly introduction to the agency or organization is crucial to the

overall success of the internship and special project. Beginning with

an orientation, the preceptor provides the environment in which the

student can gain confidence in his or her ability to perform

successfully as a public health practitioner.

Orientation provide the student with a thorough orientation to the

organizations vision, mission, philosophies and objectives. One

facilitates the orientation of the student in the workplace including

introduction to the other staff, familiarization with procedures and

ethical practices. Preceptor define the learning activities with the

student, and in consultation with the practicum coordinator if

necessary. This will assist in a smooth transition into the site and

optimize the use of available resources. 



  c

cc According to David Mcclelland, American psychologist (1917 -

1998), there is a "need for authority motivated". That there is a need

to be influencial and effective to make an impact.

During this day, I came to realized that managing an

organization needs increasing motivation and need towards

increasing influence to others. Managing a "ward" is a difficult task,

what more if one will manage the whole hospital institution? Head

nurses served to be as "true motivators" driven towards constructive

management. The task seemed to be so complex, for to be an

effective leader, one must certainly has to manage the resources at

his/her disposal. One must possess conceptual, technical and human

skills. One must also involve himself/herself communicating, inspiring

and supervising successfully.

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At the end of my first day of clinical administrative practicum,

objectives were successfully met.

I came to realized the essence of being a professional nurse,

and that the value of serving other people is undisputed. My preceptor

encourages me to be self-directed. This enhances my development of

clinical decision-making skills. I also felt parented by the mentoring

preceptor I had who committed her time, energy, and resources to

me as a student.

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1. Enhance skills in managing the unit.

2. Possess personal qualities which makes it possible for the

nurse to maintain good interpersonal relationship.

3. Function as a professional manager.


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1. Endorsement - 7:00 am

2. . Collaborate with staff as appropriate.


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1. Endorsement

Endorsement is necessary, for the incoming nurses to know the

condition of the patient, as to who to prioritize first in giving care, or

other special procedures needed for the patients. Endo rsement made

possible communicating effectively.

2. Collaboration.

Collaboration promotes valued contributions to staff, shared

knowledge/skills when warranted. It also develops more direct

learning from the experience. In Collaboration, a student could act

appropriately as an adult learner . These opportunities not only provide

additional hands-on experiences and formal feedback to the agency,

but they also help students prepare for the future managerial

responsibility.
 $  c c

c I realized that becoming a head of a certain ward is such a

complex responsibility. Head nurses is a supervisory work, involving

responsibility for maintaining high standards of professional nursing

services, in the operation of a clinical unit or specia l unit

(http://www.co.genesee.ny.us/dpt/personnel/jobspecs/headnursespec

html ). Meaning, the work is performed with general supervision,

allowing an exercise of individual judgment in directing subordinates. c

c According to the Fundamentals of Nursing, co ordinating with

staff activities ensure quality patient care. The team leader attends

patient care conferences and provides input to the Nursing Care Plan.

He keeps abreast of any changes in patient status. He ensures

utilization of quality assurance and infection control policies. Which is

why,it is very important to ensure collaboration while at work. c

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1. Endorsement.

2. NUrsing Rounds.

3. Circulate through duty area.

4. Final Rounds


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1. Endorsement

Nursing endorsement is important since it is a process where

nurses provide shift-to-shift report at the patients involved under a

nurse' care. There are many benefits of

endorsing patients, including relationship building between staff

members and increased patient satisfaction, to both the patient and to

the healthcare team. Concerns about the traditional methods of

communication between the various shifts helped drive a nursing

unit¶s decision to move to a more patient-involved model of shift-to-

shift report.

2. Nursing Rounds

It is important to participate in the coordination and

implementation of nursing rounds to identify appropriate nursing

resources in developing appropriate nursing care plans for specific

patients.
 3. Circulate through duty area.

It is a must to roam around the area to familiarize the area of

duty, at the same time, be familiar with the facilities involved.

4. Final Rounds.

To make final rounds is very significant responsibility of a

nurse. It should be done about one hour before the shift ends, the

charge nurse, which is the charge nurse, should begin final rounds to

observe and assess patient care and patient needs, and to see that

everything is in order before the staff goes off duty for that shift. In

making final rounds, the charge nurse would include the following:

(a) Check for completion of assignments.

(b) Check input/output (I&O) sheets.

(c) Check intravenous (IV) infusions and nasogastric (NG)

intubations.

(d) Review nursing documentation.

(e) Talk to the patients. Gather information for the change of

shift report. Listen for compliments or complaints concerning

nursing care.

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At the end of a long day of caring for patients, there is a time to

give the end-of-shift report to the oncoming nurses. Although it may

be tempting to rush through the routine duty, patient safety hinges on

a complete and correct exchange of information. According to says

Elizabeth Henneman, RN, PhD, CCNS, writer, nursing endorsement

³is one of the most critical times we have to communicate accurate

information about the patient¶s status and the plan for future care.´

Which is why, I suggest if attainable, that aside from the usual

table endorsement, the outgoing nurse would also make rounds with

the next shift of staff. This is termed as "WALKING ENDORSEMENT".

This is kind of a difficult task especially in a medical-surgical ward, but

it could be positively done in private wards. Nurses may start walking

to each patient¶s room to give the report. In turn, oncoming nurses see

things in a patient¶s room that trigger important questions. An

additional benefit is that patients can confirm the details the outgo ing

nurses are communicating. With this, it could provide a more

comprehensive endorsement of patients.

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The practicum constitutes an integral part of many professional

courses in higher education. The objective of the practicum is to put

oneself in the position of a manager (in some cases a junior one) who

will accomplish some practical and observable purpose in which an

organization is positively interested .

This does not mean that during the entire exposure, there is a

need to achieve objectives in all respects, but rather including the

necessary adaptations that one could eventually make.

In the process, one will self-consciously take the viewpoint of a

manager, attempting to apply some selected principles of

management and carefully observe things in the area.

This paper provides an overview of the different ways in which

the practicum has been conceptualized, implemented and evaluated.

It focuses attention on the purpose and value of the practicum; the

relationship between the practicum and the learning outcomes of a

course as a whole; and the structure and placement of the practicum

within a course.

I, Domlhyn S. Jaictin, the Graduate student of the said

practicum was assigned at St. Luke's Ward of San Pedro Hospital,

Davao City for three ( 3 ) consecutive days under my preceptor,

Estrellita B. Magno, RN.

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12!34

The principal purpose of the practicum is to make practical

experiences, to test professional skills and to re -examine concepts

and theories against the conditions in a hospital setting. It provides

me, as a Graduate student with the opportunity to work in a particular

area in the hospital under the direction and guidance of a skilled

preceptor, a head nurse.

To achieve this purpose, the following objectives are set:

1. to experience the interaction with professionals in the

institution

2. to understand the institution, specifically the area

assigned

3. come to know major concepts of cooperation and

collaboration

4. to develop a sense of personal identification with the

profession and its attendant responsibilities,

competencies and workflows

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12!34 c

Specifically, this exposure aims to:

1. Be oriented in the clinical agency.

2. Maintain open communications with the preceptor and other

professionals in the area.

3. Maintain accountability for learning activities.

4. Prepare for each day of clinical experience as needed.

5. Be accountable for nursing actions while in the clinical setting.

6. Be under the preceptor's supervision when performing

procedures.

7. Respect the confidential nature of all information obtained

during clinical experience.

8. Give as much as possible, feedbacks to the preceptor as well

as to the nursing program regarding the clinical exposure for

program development.

9. Evaluate the clinical preceptorship by completing a student

evaluation of the clinical preceptorship form and directing the

completed form to the host site coordinator.

 "66307c

Staffing is the process of determining and providing the acceptable

number and mix of nursing personnel to produce a desired level of care to

meet the patients¶ demand

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The purpose of all staffing activities is to provide each nursing unit with

an appropriate and acceptable number of workers in each category to perform

the nursing tasks required. Too few or an improper mixture of nursing

personnel will adversely affect the quality and quantity of wo rk performed.

Such situation can lead to high rates of absenteeism and staffs turn -over

resulting in low morale and dissatisfaction.

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1. the type, philosophy, objectives of the hospital and the nursing service.

2. the population served or kind of patients served whether pay or charity.

3. the number of patients and severity of their illness -knowledge and ability of

nursing personnel are matched with the actual care needs of patients

4. availability and characteristics of the nursin g staff, including education, level

of preparation, mix of personnel, number and position.

5. administrative policies such as rotation, weekends, and holiday off -duties.

6. standards of care desired which should be available and clearly spelled out.

7. layout of various nursing units and resources available within the

department such as adequate equipment, supplies, and materials

8. budget including the amount allotted to salaries, fringe benefits, supplies,

materials and equipment

9. professional activities and priorities in nonpatient activities like involvement

professional organizations, formal educational development, participation in

research and staff development.

10. teaching program or the extent of staff involvement in teaching activities.

11. expected hours of work per annum of each employee. This is influenced

by 40 hour week law.

12. patterns of work schedule -traditional 5 days per week, 8 hours per day; 5

days a week, ten hours per day and three days off; or 3 ½ days of 12 hours

per day and 3 ½ days off per week.

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1. Vacation Leave 15 15
2. Sick Leave 15 15
3. Legal Holidays 10 10
4. Special Holidays 2 2
5. Special Privileges 3 3
6. Off-Duties as per R.A. 5901 104 52
7. Continuing Education Program 3 3
______ ______
Total Non-Working Days Per Year 152 100
Total Working Days Per Year 213 265
Total Working Hours Per Year 1,704 2,120

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To compute for relievers needed, the following should be considered:
1. Average number of leaves taken each year - - - - - - 15
a. Vacation Leave - - - - - - - - - - - - - - - - - - - - - - - 10
b. Sick Leave - - - - - - - - - - - - - - - - - - - - - - - - - - - 5
2. Holidays - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 12
3. Special Privileges as per CSC MC#6 s.1996 - - - - - - -3
4. Continuing Education Program for Professionals - - 3
Total Average Leaves 33
It will be noted that although an employee is entitled to 15 days s ick
leave and 15 days vacation leave, 12 holidays, 3 days for continuing
education, plus 3 days of special privileges or 48 days total, he or she gets
only an average of 33 days leave per year.
To determine the relievers needed, divide 33 (the average numb er of working
days an employee is absent per year) by the number of working days per year
that each employee serves (whether 213 or 265). This will be 0.15 per person
who works 40 hours per week and 0.12 per person for those working 48 hours
per week. Multiply the computed reliever per person by the computed number
of nursing personnel.
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Studies have shown that the morning or day shift needs the most number of
nursing personnel at 45 to 51 percent; for the afternoon shift 34 to 37 percent;
and for the night shift 15 to 18 percent. In the Philippines the distribution
usually followed is 45 percent for the mo rning shift, 37 percent for the
afternoon shift, and 18 shift for the night shifts.
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To compute for the staff needed in the In-Patient units of the hospital the
following steps are considered:
1. Categorize the number of patients according to the levels of care needed.
Multiply the total number of patients by the percentage of patients at each
level of care (whether minimal, intermediate, intensive or highly specialized).
2. Find the total number of nursing care hours needed by the patients at each
category level.
a. Find the number of patients at each level by the average number of nursing
care hours needed per day.
b. Get the sum of the nursing care hours needed at the various levels.
3. Find the actual number of nursing care hours needed by the given number
of patients. Multiply the total nursing care hours needed per day by the total
number of days in a year.
4. Find the actual number of working hours rendered by each nursing
personnel per year. Multiply the number of hours on duty per da y by the
actual working days per year.
5. Find the total number of nursing personnel needed.
a. Divide the total number of nursing care needed per year by the actual
number of working hours rendered by an employee per year.
b. Find the number of relievers. Multiply the number of nursing personnel
needed by 0.15 (for those working 40 hours per week) or by 0.12 (for those
working 48 hours per week).
c. Add the number of relievers to the number of nursing personnel needed.
6. Categorize the nursing personnel i nto professionals and non -professionals.
Multiply the number of nursing personnel according to the ratio of
professionals to nonprofessionals.
7. Distribute by shifts.
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Find the number of nursing personnel needed for 500 patients in a tertiar y
hospital.
1. Categorize the patients according to level of care needed.
500 (pts) x .30 = 150 patients needing minimal care
500 (pts) x .45 = 225 patients needing moderate care
500 (pts) x .15 = 75 patients need intensive care
500 (pts) x .10 = 50 patien ts need highly specialized nursing care
500
2. Find the number of nursing care hours (NCH) needed by patients at each
level of
care per day.
150 pts x 1.5 (NCH needed at Level I) = 225 NCH/day
225.5 pts x 3 (NCH needed at Level II) = 675 NCH/day
75 pts x 4.5 (NCH needed at Level III) = 337.5 NCH/day
50 pts x 6 (NCH needed at Level IV) = 300 NCH/day
Total 1537.5 NCH/day
3. Find the total NCH needed by 500 patients per year.
1537.5 x 365 (days/year) = 561,187.50 NCH/year
4. Find the actual working hours rendered by each nursing personnel per
year.
8 (hrs/day) x 213 (working days/year) = 1,704 (working hours/year)
5. Find the total number of nursing personnel needed.
a. Total NCH per year = 561,187.50 = 329
Working hrs/year 1,704
b. Relief x Total Nursing Personnel = 329 x 0.15 = 49
c. Total Nursing Personnel needed 329 + 49 = 378
6. Categorize to professional and non -professional personnel. Ratio of
professionals to
non-professionals in a tertiary hospital is 65:35.
378 x .65 = 246 professional nurses
378 x .35 = 132 nursing attendants
7. Distribute by shifts.
246 nurses x .45 = 111 nurses on AM shift
246 nurses x .37 = 91 nurses on PM shift
246 nurses x .18 = _ 44 _nurses on night shift
Total 246 nurses
132 Nursing attendants x .45 = 59 Nursing attendants on AM shift
132 Nursing attendants x .37 = 49 Nursing attendants on PM shift
132 Nursing attendants x .18 = _ 24 _Nursing attendants on night shift
Total 132 Nursing Attendants
It should be noted that the above personnel are only for the in -patients.
Therefore, additional personnel should be hired for those in supervisory and
administrative positions and for those in special units such as the Operating
Room, the Delivery Room, the Emergency Room, and Out -Patient
Department. A Head Nurse is provided for every nursing unit. Likewise, a
Nursing Superior is provided 1) to cover every shift in each clinical department
or area specialty unit; 2) for each geographical area in hospitals beyond one
hundred (100) beds and; 3) for each functional area such as Training,
Research, Infection Control, and Locality Management.