Studeni Name: P receptor: ,..

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Bon Secours Memorial College of Nursing
NUR 4143 Clinical lmmersion: Practicum Hours Log

Total hours required= 225

Orientation & MCAT = 3 hours
Acute Care= 215 hours
Professional Meeting= 4 hours
SBAR simulation= 3 hours

On my honor, I assert that this record is an accurate representation

of my participation in the required
practicum hours for this course.
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Student Signature:

Midterm Faculty

Date of Completion of Practicum

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Hours: /yn +{
Total
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Hours: \J*\
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Initials Signature Printed Name
SW .Svts Q v" WLLrzLv"s RN, MS N Susan \Yilkins Rli' NISN

Course Orientation Hours Preceptorr'

Date
3 hour* Facultr
Initials
1 SW
B/12119 Orientation
I SW
Bi12il9 T,ICAT #1
Preceptor/
Professional lleetings llours Facultl.
Date
.l hours Initials
4 SW

Preceptor/
SBAR Simulation Hours Faculq'
Date
3 hours Initials
J S\\'
TOTAL IIOURS 10

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BSMCON NUR 4143 Clinical lmmersion
-_

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Faciritv: Sr.rH 5s
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Acute Care Unit Preceptor/
Date 215 hours Time Time Total Running total Faculty
in out Hours Initials
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Bit 3i20 Example 07 30 2000 12 SW

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TOTAL HOURS

BSMCON NUR 4143 Clinical lmmersion