PCI Notebook

In Partial Fulfillment of the

Requirements in NCM 219 – RLE

Nursing Leadership & Management

Submitted to

Elvie Abesia, RN, MAN

Clinical Instructor

Submitted by

Karl Angelo Montano

BSN 4C

October 9, 2021
I. General Objectives
At the end of the 4 weeks of Practicing Clinical Instructor Rotation, the
student nurse will be able to grasp and develop the essential skills of a Clinical
Instructor to be competent in every field, and will be able to complete the
collection of requirements of his/her student.
II. Specific Objectives
To achieve the general objectives these things must be done by the
student nurse

a) Formulate a Daily Plan of Activities for the level II nursing students

b) Construct a lecturettes about Planning and prioritization of problems.
c) Presentation of lecturette.
d) Create 3 readings about nurse being a leader, manager and a teacher
e) Collects biosketch from each student assigned
f) Make shifting exam together with my Co-PCI’s
g) Make an excel for student’s complete class record
h) Evaluate students’ performance and requirements passed.
i) Grade the students output and record it
j) Make a daily anecdotal for assigned student
k) Prepare PCI notebook for collecting of requirements
l) Compile all requirements and students evaluations in portfolio
 BIOGRAPHICAL SKETCH

STEPHEN CARL D. NAVARRO

Bachelor of Science in Nursing Level II

San Pedro College, Davao City, Philippines
Mobile No. 09760016216
Facebook: stephen.navarro.018
Email: stephenc_navarro@spcdavao.edu.ph

Mr. Navarro completed his primary education at Shalom Crest Wizard

Academy, General Santos City, wherein he graduated with perfect attendance award.
He continued studying his secondary education at Shalom Crest Wizard Academy, but
was transferred and completed Grade 8-10 at Notre Dame of Dadiangas University
IBED-Lagao Campus also within General Santos City. He also graduated senior high
school in the same institution, Notre Dame of Dadiangas University. He is currently
taking Bachelor of Science in Nursing at San Pedro College, Davao City, and is now a
second year nursing student.
 BIOGRAPHICAL SKETCH

KYLA MARIE V. CAMINO Bachelor of Science in

Nursing Level II San Pedro College, Davao City,
Philippines Mobile No. 09959658316 FB messenger:
Kyla Camino Email: caminokylamarie@gmail.com

Ms. Camino completed her primary education at Notre Dame Village Central
Elementary School, Cotabato City wherein she graduated as the top 13 of her
class. She then studied her secondary education at Notre Dame of Cotabato
from Grade 7-10 of the same town and graduated with With Honors. She
finished her secondary education from Grade 11-12 of the same school wherein
she graduated with With Honors. She is currently taking up Bachelor of Science
in Nursing at San Pedro College and is now a second year nursing student.

Two of her research works together with her classmates in senior high school
include The Academic and Behavioral Performances of Notre Dame of Cotabato
(NDC) Students with OFW Parents and Antibacterial Potential of Momordica
charantia (Bitter gourd) as a Surface-active Micelle-forming Agent.
 BIOGRAPHICAL SKETCH

ELAIZA MAE P. GARCES Bachelor of Science in nursing Level II San Pedro

College, Davao City, Philippines Mobile No. 09085397903 FB messenger @
LaizaGrcs Email: elaizagarces0@gmail.com

Ms. Elaiza Mae P. Garces, when she was still in primary education kinder to
grade 2, she studied at Montserrat Camp School de Davao. When she was in
grades 3 to 6, she studied at St. Ignatius School of Davao. In her secondary
education, she studied at the International College of St. Ignatius de Loyola.

In her senior high secondary education, taking Accounting, Business, and

Management(ABM), she studied at Ateneo de Davao University-Senior High
School.

She is currently taking up a Bachelor of Science in Nursing at San Pedro

College and is now a second-year nursing student.
 Together with her classmates in senior high school, one of her research
works is Ateneo de Davao University Senior High School Learners’ Financial
Accountability and Spendthrift Behavior.

BIOGRAPHICAL SKETCH

ZANNALEI MARI T. PASAWILAN

Bachelor of Science in Nursing level II

San Pedro College, Davao City, Philippines

Mobile No. 09958709024

FB messenger @Zannalei.Zey

Email: zpasawilan@gmail.com

Ms. Pasawilan completed her Primary education at Montessori Learning Center,

Tacurong Sultan Kudarat. She then studied her secondary education at the Notre
Dame-Siena College of Tacurong and she also finished her senior high school as a
science, technology, engineering and mathematics student at the said school. She is
currently taking Bachelor of Science in Nursing at San Pedro College and is now a
second-year nursing student.

One of her research works together with her classmates in senior high school is
Seasonal Fruit Extract as Kitchen Vinegar.
BIOGRAPHICAL SKETCH

SWELLEN GRACE SELIM

Bachelor of Science in nursing Level II
San Pedro College, Davao City, Philippines
Mobile No.09487886338
FB messenger @swellengrace_selim@yahoo.com
Email: sswellen64@gmail.com
Ms. Selim completed her Primary Education at Lapu-Lapu Elementary
School, Katambak, Davao city. She then studied her secondary education at
Leon Garcia Sr. National High school from Grade 7-10 and graduated with
honors. She finished her secondary education at Assumption college of Davao,
Davao City from Grade 11-12 wherein she graduated with a perfect attendance
awardee and one of the members of cultural dance group. She is currently
taking up Bachelor of Science in Nursing at San Pedro College and is now a
second-year nursing student.

She likes to be in peaceful place and dislike to have an argument with

someone. Her hobbies include making poems, reading books and observing
people. Since she was young, she was aspired to become a nurse for the
reason that she really like to be a part of a health medical team and to teach
others how can they prevent to any disease She lives in a community where
 there were a lot of people who were suffering from this pandemic. She expects
this rotation to be fun and knowledgeable so that she can apply her learnings
in a real-life situation. Her life motto is “I only know that I know nothing”-
Socrates.

DAILY ANECDOTAL REPORT

DAY 1: September 20, 2021

(Monday)
NAME REPORT
Navarro The student was on time when attending the rle
virtual duty. He participated in morning circle and
he was wearing the prescribed clothing for rle.
When asked with questions he was able to
answer it comprehensively. On the entire session,
he opened his camera and participated on the
activities.
Camino The student was on time attending the rle virtual
duty. She participated in morning circle and was
properly groomed with hair bunned as prescribed
in the nursing handbook. She participated in the
morning exercise and introduced herself. She
opened her camera in the entire session. When
she was asked thoughts about community nursing
she has a little idea already.
Garces The student was on time attending the rle virtual
duty. She participated in morning circle amd was
properly groomed with hair bunned as prescribed.
She participated well on the exercise. Her room
was dark and was advised to put some lightings in
her room. Overall she was cooperative during the
whole sesion
Selim The student was on time attending the rle virtual
duty. She participated in morning circle amd was
properly groomed with hair bunned as prescribed.
She introduced herself and got a clear view of
what the rotation is about. She was cooperative in
the whole session
Pasawilan She was early in the zoom meeting was not
participative because she was not feeling well.
 She didn’t participate well in the morning exercise.
She opened her camera in the whole duration of
the session and has an idea of what the rotation
was all about.

DAY 2: September 21, 2021

(Tuesday)
Navarro The student was on time in joining the zoom. He
was properly groomed and was participative in the
morning exercise. I assigned him as the group
leader as I saw a potential to him. He was also
good at answering questions when I asked him to.
All throughout the session he opened his camera
and listening attentively to the lecture
Camino The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
was participative on the morning exercise as well
on the other activities we prepared. She was good
in interviewing when we let her simulate how to
interview. All throughout the session she opened
her camera and listening attentively to the lecture
Garces The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
was participative on the morning exercise as well
on the other activities we prepared. On answering
questions she answered it all and correctly. She
was also good in simulated interview with the
client.
Selim The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
was participative on the morning exercise as well
on the other activities we prepared. Together with
the other interviewers she perfomed well in
interviewing. She was also able to answer all
questions asked to her
Pasawilan The student was early in joining the zoom meeting
and was properly groomed with bunned hair.
Unlike yesterday she was now participating in the
morning exercise and was very cooperative in the
activities. She was the one who acted as the
mother who will be interviewed and was very good
on her performance.
DAY 3: September 22, 2021
(Wednesday)
Navarro The student was on time in joining the zoom. He
was properly groomed and was participative in the
morning exercise. He was very vocal as a leader
of the group and he was the one initiating ideas
for their output. he was cooperative in the game
that I prepared. All throughout the session he
opened his cam and was listening properly
Camino The student was early in joining the zoom meeting
and was properly groomed with bunned hair. In
the morning exercise, she participated well and I
can see that she was enjoying the exercise that I
prepared. In the group activity she helped her
group as the one who shared screen. She was
hesitant at first but gained confidence along the
session.
Garces The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
was the one sharing the screen for them to
brainstorm about the prioritized problem.
Selim The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
was very cooperative in the group activity and
contributed much for the interventions of the
prioritized problem.
Pasawilan The student was early in joining the zoom meeting
and was properly groomed with bunned hair.
Along with miss Selim, she was also the one
contributed for the interventions. She was very
cooperative in the game that I prepared.
DAY 4: September 27, 2021
(Monday)
Navarro The student was on time when attending the rle
virtual duty. He participated in morning circle and
he was wearing the prescribed clothing for rle. He
was good in executing the interventions rendered
to his client even though it was just a pre-recorded
video
Camino The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
was very creative in presenting her interventions
and has a good communication skills. Overall her
performance for doing the interventions was very
good.
Garces The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
was very energetic and was always smiling in
 doing the interventions. One thing I noticed is that
she needs to improve her communication skills.
Selim The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
was very passionate in the video where in they
have done their interventions. Her intervention
was a good, but it was very hard to achieve.
Pasawilan The student was early in joining the zoom meeting
and was properly groomed with bunned hair. In
Day 6: september 29, 2021
(wednesday)
Navarro The student was early in joining the zoom meeting
and was properly groomed. He was asked to
present his reading that day and was very good in
delivering it. He was advised to search for journal
articles in his future readings and took the advised
seriously. He has a talent in drawing
Camino The student was early in joining the zoom meeting
and was properly groomed with bunned hair.
When she presented her reading she didn’t turn
on her camera. She was asked a question about
her reading but failed to answer it. She has a
talent in cross-stitching.
Garces The student was early in joining the zoom meeting
and was properly groomed with bunned hair. She
presented her reading and it was a very good
reading. She has a good knowledge in her reading
because when asked a question she answered it
correctly.
Selim The student was early in joining the zoom meeting
and was properly groomed with bunned hair.
Before she presente her reading she first showed
her talent in drawing. She was good in delivering
her reading.
Pasawilan The student was early in joining the zoom meeting
and was properly groomed with bunned hair. The
talent that she showed was singing and she has a
really good voice. She needs to work on the way
she deliver her report but overall the content was
good.
DAY 7: October 5, 2021
(TUESDAY) – DUTY DAYS
Navarro The student was early in joining the zoom meeting
and was properly groomed. He presented their
case analysis with good delivery. The part that he
was assigned was the introduction and summary.
camino The student was early in joining the zoom meeting
and was properly groomed. The part that she was
assigned was the symptomatology. She needs to
read more about her topic because when asked
she has a hard time answering it.
Garces The student was early in joining the zoom meeting
and was properly groomed. The part that she was
assigned in the case analysis was the
management. She was good in answering
questions and shows that she really knows her
topic well
Selim The student was early in joining the zoom meeting
and was properly groomed. The part assigned to
her in the case analysis was the nursing theory
and management. She was advised to change the
nursing theorist because it was not really relatable
to the case.
Pasawilan The student was early in joining the zoom meeting
and was properly groomed. The part assigned to
her in the case analysis was pathophysiology. It
was just fascinating that she delivered
pathophysiology well knowing that she was just
level 2 nursing student.
Day 8: october 6, 2021
(wednesday) – duty days
Navarro The student was early in joining the zoom meeting
and was properly groomed. He opened his
camera during the whole duration of shifting
exam. He got a score of 70/80 in the shifting exam
Camino The student was early in joining the zoom meeting
and was properly groomed. She opened her
camera during the whole duration of shifting
exam. She got a score of 65/80 in the shifting
exam
Garces The student was early in joining the zoom meeting
and was properly groomed. She opened her
camera during the whole duration of shifting
exam. She got a score of 62/80 in the shifting
exam
Selim The student was early in joining the zoom meeting
and was properly groomed. She opened her
camera during the whole duration of shifting
exam. She got a score of 64/80 in the shifting
exam
Pasawilan The student was early in joining the zoom meeting
and was properly groomed. She opened her
 camera during the whole duration of shifting
exam. She got a score of 73/80 in the shifting
exam

PLANNED STRUCTURE OF ACTIVITIES

Week 1 Day 3

Objective Activities Evaluation

a. To prepare the student Morning Circle (15 mins) Assign a student to lead
nurses both physically - Nurses Prayer the Nurses Prayer, Pledge,
- Florence Nightingale and Panatang makabayan.
and mentally before
Pledge
their exposure to their - National Anthem - Encourage the students to
rotation. Panatang Makabayan turn on their cameras.
b. To practice punctuality -attendance
of student nurses Assess the students by
checking if they are
reciting the prayer, pledge,
c. To ask for guidance for
national anthem, and
the activities of the day Panatang Makabayan

d. To show patriotism to
the country

Morning exercise Assess the student by

a. To promote physical (15 mins) checking their cameras if
wellness -video presentation they are following the
steps
b. To keep clients
active and
energized
c. To enhance muscle
strength
d. To improve blood
circulation

a. To allow the Water break (15 mins)

students to do their
 personal
necessities.
b. To let the students
rest for the
upcoming activities

A. To guide us through Presentation of objectives To have a finished output

the day of the day (10 mins) at the end of the virtual rle
- able to prioritize problems
- present top problems to
the scenario given
- plan implementations to
the prioritized problems

B. To lighten the start of Parlor games

the day -charades
C. To orient students on Discuss about planning Ask a random student
what to do in phase (30 mins) about the lecture
planning
D. To know what Explain how to do Group students by sub
interventions should prioritization (30 mins) group and give them
scenarios and prioritize
be done
problems
Morning break (30 mins)
E. To let students Form a breakout room for
discuss with each sub groups to prioritize a
problem (30 mins)
other and plan
Closing prayer

lunch break
Exam week

Week 2 Day 3
Objective Activities Evaluation
To prepare the Morning Circle (15 mins) Assign a student to lead
student nurses both - Nurses Prayer the Nurses Prayer, Pledge,
physically and - Florence Nightingale and Panatang makabayan.
mentally before their Pledge
exposure to their - National Anthem - Encourage the students to
rotation. Panatang Makabayan turn on their cameras.
 -attendance
To practicepunctuality Assess the students by
of student nurses checking if they are
reciting the prayer, pledge,
To ask for guidance national anthem, and
for the activities of the Panatang Makabayan
day

To show patriotism to
the country

Morning exercise Assess the student by

To promote physical (15 mins) checking their cameras if
wellness -video presentation they are following the
steps
To keep clients
active and
energized
To enhance muscle
strength
To improve blood
circulation

To allow the Water break (15 mins)

students to do their
personal
necessities.
To let the students
rest for the
upcoming activities

To guide us Presentation of objectives To have a finished output

through the day of the day (10 mins) at the end of the virtual rle
To lighten the start Parlor games
of the day -charades
To teach student Discuss about DOH Ask a random student
the different kinds programs specifically NTP about the lecture
of DOH programs and FWBD Control
Program

Morning break (30 mins)

To know how the Presentation of Journal Ask students related
 student understand reading questions about their
their given topic topics
Lunch break
To practice Afternoon attendance Roll calling students
punctuality of student
nurses

Continuation of the
presentation of Journal
Reading
Closing Prayer

Week 3 day 3
Objective Activities Evaluation
To prepare the Morning Circle (15 mins) Assign a student to lead
student nurses both - Nurses Prayer the Nurses Prayer, Pledge,
physically and - Florence Nightingale and Panatang makabayan.
mentally before their Pledge
exposure to their - National Anthem - Encourage the students to
rotation. Panatang Makabayan turn on their cameras.
-attendance
To practicepunctuality Assess the students by
of student nurses checking if they are
reciting the prayer, pledge,
To ask for guidance national anthem, and
for the activities of the Panatang Makabayan
day

To show patriotism to
the country

Morning exercise Assess the student by

To promote physical (15 mins) checking their cameras if
wellness -video presentation they are following the
steps
To keep clients
active and
energized
To enhance muscle
strength
To improve blood
circulation
 To allow the Water break (15 mins)
students to do their
personal
necessities.
To let the students
rest for the
upcoming activities

To guide us Presentation of objectives To have a finished output

through the day of the day (10 mins) at the end of the virtual rle
To lighten the start Parlor games
of the day -charades
To allow students Summary of FCA Each group will have one
ask clarifications representative to
and question to summarize the FCA
their topic

To allow PCI and

CI to put input on
the topics
Morning break (30 mins)
To refresh students Review for shifting exams Ask students related
about the topics questions for their shifting
discussed in the exam
whole rotation
To evaluate Shifting exam Let the students answer
students for the questions in the google
whole rotation form
Lunch

To practice Afternoon attendance Roll calling students

punctuality of student
nurses

To let the students Review on the answers in Rationalize each answer in

know the answers the shifting exam the shifting exam
in the shifting exam
To let the students Evaluation of each student
know about their
strengths and what
to improve for the
next rotations
Closing prayer
 LECTURETTE
Week 1 Day 3
STEPS IN DETERMINING VENTILATION
1. Determine the Total Floor Area in meters (TFA)
2. Get the area of the window opening in meters (TWO). If no window, measure the
door.
3. Apply the following formula:
Ventilation= TWO ——————- x 100
TFA Consider the following scale for the state of ventilation:
20% Satisfactory
18-19%
Fair 17- below Poor

Formulating the plan of Care

 Planning involves priority setting, establishing goals and objectives, and determining
appropriate interventions to achieve goals and objectives.
 Priority setting – determining the sequence in dealing with identified family needs and
problems.

Establishing Goals and Objectives

 Goal – Desired observable family response to planned interventions in response to a
mutually identified family need.
 Objectives – the desired step by step family responses as they work toward a goal. -
Workable, well-stated objectives should be:
SMART: - S: Specific - M: Measurable - A: Attainable - R: Relevant - T: Time bound

A. Nature of the Problem - Wellness state, health deficit, health threat and stress point/
foreseeable crisis.
B. Modifiability of the Problem - Probability of success in enhancing wellness state,
improving conditions, minimizing, alleviating or totally eradicating the problem.
Factors in determining modifiability of the problem
• Current knowledge, technology and interventions.
• Resources of the family
• Resources of the nurse
• Resources of the community
C. Preventive Potential - Nature or magnitude of the problem that can be minimized or
totally eradicated.
• Scoring Preventive Potential
1. Gravity or severity of the problem
2. Duration of the problem
3. Current management
4. Exposure of high-risk groups
D. Salience- Refers to the family's perception and evaluation of the problem in. terms of
seriousness and urgency of attention needed
 Food and water Bourne Diseases
DESCRIPTION

FWBDs refer to the limited group of illnesses characterized by diarrhea, nausea,

vomiting with or without fever, abdominal pain, headache and/or body malaise. These
are spread or acquired through the ingestion of food or water contaminated by disease-
causing microorganisms (bacterial or its toxins, parasitic, viral).

VISION

Zero Mortality from FWBDs

MISSION

To reduce morbidity and mortality due to FWBDs

OBJECTIVES

 To guarantee universal access to quality FWBD-PCP intervention and

services at all stages of the life
 To guarantee financial risk protection of clients availing diagnosis,
management and treatment for FWBDs
 To guarantee a responsive service delivery network for the prevention and
control of FWBDs

PROGRAM COMPONENTS

A. Policy, Plans and Organizational Support. This component ensures that

supportive policies, directional and annual plans are developed and updated to
govern the design and implementation of the FWBD-PCP. It shall ensure that
organizational support to the FWBD-PCP is in place at various levels of
operations. This includes establishment of partnership between DOH and LGUs
and with other partners in the other sectors.
B. Diagnosis, Management and Treatment. This component ascertains the proper
diagnosis as well as prompt management and treatment of patients suffering
from FWBDs. Focus will be given to the development of clinical practice
guidelines (CPGs) on FWBD diagnosis, management and treatment. Diagnosis
will encompass strengthening the laboratory services and the use of rapid
diagnostic test (RDTs). In the management and treatment, support for the
establishment and sustained operations of ORT corners in the hospitals and
even in outpatient health facilities will be provided. Training of health providers
will be undertaken on the CPGs and overall FWBD-PCP management. 
C. Quality Assurance System. This component ensures the quality of diagnostic
services of FWBD cases. This requires regular test, validation and follow-up of
laboratory capacities and competencies of medical technologists as well as
provision of the necessary laboratory supplies and equipment.
D. Logistic Management. This component guarantees that essential
drugs/medicines, supplies and equipment are in place and available at the point
of service. While the LGUs are mainly responsible for placing-in these
commodities and other logistics at their level, the DOH shall design a system for
forecasting the needs nationwide and design a procurement, allocation and
distribution system to ensure these reach the facilities with proper tracking and
monitoring of their utilization.
E. Capability Building. This component secures the quality of services by training
the service providers on the standards and protocols on the diagnosis,
management and treatment of FWBDs. It shall also develop the managerial and
supervisory capability of FWBD-PCP managers/coordinators at various levels of
administration to ensure the efficient and effective implementation of the
Program.
F. Health Promotion and Advocacy. This component ensures the prevention of
FWBDs which hinges on the promotion of proper practices on water, sanitation
and personal hygiene. It takes off from the development of an overall Health
Promotion and Communication Plan aimed at effecting behavior change among
community members and garnering support from key stakeholders through
advocacy. It also encompasses collaboration with the Environmental Health and
Sanitation Unit on the installation of safe water and sanitation facilities.
G. Monitoring and Evaluation, Research, Surveillance and Response.  Under
this component, necessary system and tools will be developed to ensure that
quality and timely data are generated as basis for decision-making, prioritization
of resources and appropriate and immediate response to any outbreak. A FWBD
Surveillance System that will provide a comprehensive epidemiologic
information, on current situation on FWBD, in an area will be strengthened.
Regular monitoring of the status of FWBD-PCP implementation will be carried
out including special researches or studies as needed.
 H. Outbreak Response/Disaster Management. This component ensures that any
outbreak due to FWBD in any area is properly monitored and immediately
responded to especially during disaster or emergency situations where the
affected population became most prone to these infections as in evacuation
centers or flooded areas.

TARGET POPULATION/ CLIENT

FWBD by Sex

Based on EB’s data in 2016, there were slightly more males generally experiencing
FWBDs (cholera, typhoid, Hepa A, rotavirus and paralytic shellfish poisoning) than
females. However, for acute bloody diarrhea, there were more females than males
reported experiencing the disease in the same year.     

FWBDs by Age Group

Majority of the reported acute bloody diarrhea in 2016 were among the 1-4 year old
children. Rotavirus as characterized occurs mainly among the same age group and
those below 1 year old. As for Hepa A, mostly affected are the 15 to 39 year olds and
also notable among the younger age group (5-14 years old). As for typhoid, cholera and
paralytic shellfish poisoning, highest number of cases reported was among the 5-14
years old.

FWBDs by Geographical Areas

The Visayas Region particularly Regions 7 and 8 came out as hosts of the highest
incidence of FWBDs in the country. Incidence of acute bloody diarrhea is highest in
Region 7 and also the host of the highest number of reported Hepa A and Typhoid
cases in 2016.  Region 8 on the other hand had the highest incidence of cholera and
paralytic shellfish poisoning. Region 1 came out highest in the incidence of rotavirus in
the same year.

AREA OF COVERAGE

FWBDs are usually manifested as diarrhea. Based on the 2015 Global Health
Observatory (GHO) data, diarrhea accounts for 9% of the total deaths among children
below 5 years old. In the Philippines, a total of 11,876 cases of acute bloody diarrhea
(ABD) were reported from sentinel sites nationwide in the same year. In addition, 830
Hepatitis A cases and 74 cases of paralytic shellfish poisoning were also reported. The
Philippine Health Statistics data showed that diarrhea placed 5 th as a leading cause of
morbidity among general population in 2010 from being the top or second leading cause
in the 1990s. Morbidity rate due to diarrhea has gone down from 1,520/100,000
population in 1990 to 347.3/100,000 population in 2010. Despite this decline however,
several notable outbreaks continue to occur. It is believed that since the occurrence of
FWBDs is essentially related to economic and socio-cultural factors.

STRATEGIES, ACTION POINTS, AND TIMELINE

Strategy 1.  Regulate and monitor food and water sanitation practices at the local level
through enforcement of national and local legislations, application of appropriate
technical standards and participation of non-government agencies.
Strategy 2.  Sustain inter-agency collaboration to fast-track sanitation  infrastructure
development in poor urban areas and in rural areas with low access to safe water and
sanitation facilities.
Strategy 3.  Promote personal hygiene, food and water sanitation practices and the
principles of environmental health.
Strategy 4.  Promote the use of ORS in the management of diarrhea to prevent
dehydration, especially among infants and children.
Strategy 5.  Promote breastfeeding and other good feeding practices for infants and
children.
Strategy 6. Continue training of health personnel in the early diagnosis and treatment of
food-borne and waterborne diseases.
Strategy 7.  Continue nationwide information campaign for the prevention and control of
food-borne and waterborne diseases.
 National Tuberculosis control Program

I. Vision

TB -free Philippines

II. Mission

 To reduce TB burden (TB incidence and TB mortality)

 To achieve catastrophic cost of TB-affected households
 To responsively deliver TB service

III. Program Components

 Health Promotion
 Financing and Policy
 Human Resource
 Information System
 Regulation
 Service Delivery
 Governance

IV. Target Population / Client

Presumptive TB and TB affected households

V. Area of Coverage

Nationwide

VI. Partner Institutions

 Department of Health: Food and Drug Administration, Bureau of Quarantine

 Other Government: DepEd, DSWD, DILG (BJMP), DOJ (BuCor), PIA, DOLE
 Non Government Organizations: PhilCAT, PBSP
 International Organizations: WHO, USAID, GFATM, ICRC, HIVOS-KNCV
VII. Policies and Laws

RA 10767 : Comprehensive TB Elimination Plan Act of 2016

VIII. Strategies, Action Points and Timeline

2017-2022 Philippine Strategic TB Elimination Plan

 Activate communities and patient groups to promptly access quality TB

services
 Collaborate with other government agencies to reduce out-of-pocket
expenses and expand social protection programs
 Harmonize local and national efforts mobilize adequate and competent
human resources
 Innovate TB information generation and utilization for decision making
 Enforce standards on TB care and prevention and use of quality products
 Value clients and patients through integrated patient-centered TB services
 Engage national, regional and local government units/ agencies on multi-
sectoral implementation of TB elimination plan
 SHIFTING EXAM
SHIFTING EXAM
I. First part (DE RAMOS)

1. A step in nursing assessment wherein the nurse distinguishes relevant from irrelevant
data.
- Data Analysis
2. Identify if it is a first level assessment or second level assessment: Malnutrition as health
deficit
- 1st level assessment
3. Identify if it is a first level assessment or second level assessment: Inability to recognize
the presence of malnutrition in a dependent family member due to lack of knowledge
- 2nd level assessment
4. Identify if it is a first level assessment or second level assessment: Foreseeable crisis or
Stress point
- 1st level assessment
5. Identify if it is a first level assessment or second level assessment: The family’s failure of
inability to perform health tasks for a particular problem
- 2nd level assessment
6. Pregnant mother take this vitamin to help prevent major birth defects such as
anencephaly and spina bifida.
- Folic Acid
7. Identify at least 1 laboratory test indicated for pregnancy.
- Urinalysis, Fecalysis, Hgb, CBC
8. It is a situation in which there is a demonstrated health need with actual or potential
resources to apply remedial measures that interferes with the balance of health.
- Health Problem
9. During the in-home phase of a home visit, the nurse engages in brief social interaction
with family members. The rationale of this action is:
- A. Is not cost effective
B. Is disruptive to the purpose of the visit
C. Should be extended on future visits
D. Allows for establishment of nurse/client rapport
10. A step in community health nursing process where actual delivery of care transforms
plan into action.
 - Implementation
11. TRUE OR FALSE. The preparatory phase of home visit includes review records and
formulate plan of visit.
- TRUE
12. TRUE OR FALSE. During post visit the nurse carry out interventions and inform client
about referrals.
- FALSE
13. TRUE OR FALSE. In heat and acetic acid test the result appears cloudy which interprets
as positive.
- TRUE
14. TRUE OR FALSE. During assessment the nurse identified that the house has 2
windows and has a total window opening of 51.98 which gives us a ventilation rate of
17% indicated as satisfactory.
- FALSE
15. Enumerate the step of family nursing assessment. 3 points
- Data collection, Data Analysis, Health Conditions/ Problems and family nursing
diagnoses
16. The identified priority problem of the family is improper waste disposal, as a nurse what
are the appropriate interventions that the family must learn in order to eradicate the said
problem. List at last 3 interventions
II. SECOND PART (Karl Montano)
1. The typology of family nursing problems is used in the statement of nursing diagnosis
in the care of families. The youngest child of the delos Reyes family has been
diagnosed as mentally retarded. This is classified as:

A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point

Answer: (B) Health deficit

Failure of a family member to develop according to what is expected, as in mental
retardation, is a health deficit.

2. The delos Reyes couple have 6-year old child entering school for the first time. The
delos Reyes family has a:

A. Health threat
B. Health deficit
C. Foreseeable crisis
D. Stress point

Answer: (C) Foreseeable crisis

Entry of the 6-year old into school is an anticipated period of unusual demand on the
family.

3. Which of the following is an advantage of a home visit?

A. It allows the nurse to provide nursing care to a greater number of people
B. It provides an opportunity to do first hand appraisal of the home situation
C. It allows sharing of experience among people with similar health problems
D. It develops the family’s initiative in providing for health needs of its members
Answer: (B) It provides an opportunity to do first hand appraisal of the home situation.
Choice A is not correct since a home visit requires that the nurse spend so much time
with the family. Choice C is an advantage of a group conference, while choice D is true
of a clinic consultation.

4. Which is CONTRARY to the principles in planning a home visit?

A. A home visit should have a purpose of objective

B. The plan should revolve around the family health .needs
C. A home visit should be conducted in the manner prescribed by RHU
D. Planning of continuing care should involve a responsible-family member

Answer: (C) A home visit should be conducted in the manner prescribed by the RHU.
The home visit plan should be flexible and practical, depending on factors, such as the
family’s needs and the resources available to the nurse and the family.

5. The CHN bag is an important tool in providing nursing care during a home visit. The
most important principle in bag technique states that it;

A. Should save time and effort

B. Should minimize if not totally prevent the spread of infection
C. Should not overshadow concern for the patient and his family
D. May be done in variety of ways depending on the home situation, etc.

Answer: (B) Should minimize if not totally prevent the spread of infection.
Bag technique is performed before and after handling a client in the home to prevent
transmission of infection to and from the client.

6. To maintain the cleanliness of the bag and its contents, which of the following must
the nurse do?

A. Wash his/her hands before and after providing nursing care to the family members
B. In the care of family member’s, as much as possible, use only articles taken from the
bag
C. Put on an apron to protect her uniform and fold it with the right side out before putting
it back into the bag.
D. At the end of the visit, fold the lining on which the bag was placed, ensuring that the
contaminated side is on the outside.

Answer: (A) Wash his/her hands before and after providing nursing care to the family
members.
Choice B goes against the idea of utilizing the family’s resources, which is encouraged
in CHN. Choices C and D goes against the principle of asepsis of confining the
contaminated surface of objects.

7. Which of the following women should be considered as special targets for family
planning?
A. Those who have two children or more
B. Those with medical conditions such as anemia
C. Those younger than 20 years and older than 35 years
D. Those who just had a delivery within the past 15 months

Answer: (D) Those who just had a delivery within the past 15 months
The ideal birth spacing is at least two years. 15 months plus 9 months of pregnancy = 2
years.
8. Freedom of choice in one of the policies of the Family Planning Program of the
Philippines. Which of the following illustrates this principle?

A. Information dissemination about the need for family planning

B. Support of research and development in family planning methods
C. Adequate information for couples regarding the different methods
D. Encouragement of couples to take family planning as a joint responsibility

Answer: (C) Adequate information for couples regarding the different methods
To enable the couple to choose freely among different methods of family planning, they
must be given full information regarding the different methods that are available to them,
considering the availability of quality services that can support their choice.

9. You explain to a breastfeeding mother that breastmilk is sufficient for all of the baby’s
nutrient needs only up to:

A. 3 months
B. 6 months
C. 1 year
D. 2 years

Answer: (B) 6 months

10. Which immunization produces a permanent scar?

A. DPT
B. BCG
C. Measles vaccination
D. Hepatitis B vaccination
Answer: (B) BCG
BCG causes the formation of a superficial abscess, which begins 2 weeks after
immunization. The abscess heals without treatment, with the formation of a permanent
scar.
11. A 4 week old baby was brought to the health center for his first immunization. Which
can be given to him?

A. DPT1
B. OPV1
C. Infant BCG
D. Hepatitis B Vaccine

Answer: (C) Infant BCG

Infant BCG may be given at birth. All the other immunizations mentioned can be given
at 6 weeks of age.

12. Food fortification is one of the strategies to prevent micronutrient deficiency

conditions. RA 8976 mandates fortification of certain food items. Which of the following
is among these food items?

A. Sugar
B. Bread
C. Margarine
D. Filled milk

Answer: (A) Sugar

R.A. 8976 mandates fortification of rice, wheat flour, sugar and cooking oil with Vitamin
A, iron and/or iodine.

13. To improve compliance to treatment, what innovation is being implemented in

DOTS?
A. Having the health worker follow up the client at home
B. Having the health worker or a responsible family member monitor drug intake
C. Having the patient come to the health center every month to get his medications
D. Having a target list to check on whether the patient has collected his monthly supply
of drugs

Answer: (B) Having the health worker or a responsible family member monitor drug
intake
Directly Observed Treatment Short Course is so-called because a treatment partner,
preferably a health worker accessible to the client, monitors the client’s compliance to
the treatment.

14. In the Philippines, which condition is the most frequent cause of death associated by
schistosomiasis?

A. Liver cancer
B. Liver cirrhosis
C. Bladder cancer
D. Intestinal perforation

Answer: (B) Liver cirrhosis

The etiologic agent of schistosomiasis in the Philippines is Schistosoma japonicum,
which affects the small intestine and the liver. Liver damage is a consequence of fibrotic
reactions to schistosoma eggs in the liver.

15. Among the following diseases, which is airborne?

A. Viral conjunctivitis
B. Acute poliomyelitis
C. Diphtheria
D. Measles

Answer: (D) Measles

Viral conjunctivitis is transmitted by direct or indirect contact with discharges from
infected eyes. Acute poliomyelitis is spread through the fecal-oral route and contact with
throat secretions, whereas diphtheria is through direct and indirect contact with
respiratory secretions.

16. Which is the BEST control measure for AIDS?

A. Being faithful to a single sexual partner

B. Using a condom during each sexual contact
C. Avoiding sexual contact with commercial sex workers
D. Making sure that one’s sexual partner does not have signs of AIDS

Answer: (A) Being faithful to a single sexual partner

Sexual fidelity rules out the possibility of getting the disease by sexual contact with
another infected person. Transmission occurs mostly through sexual intercourse and
exposure to blood or tissues.

17. Enumerate 3 component in making ORS

1. water
2. sugar
3. salt

18. in prioritizing health problems, this is the probability of success in enhancing

wellness state, improving conditions, minimizing, alleviating or totally eradicating the
problem.
a. nature of the problem
b. modifiability
c. preventive potential
d. salience

answer: b. modifiability

19-20. Solve for the ventilation if the House has an area of 20 square meters and has a
2 windows with an opening of 3 square meters
Answer: 15%

III. (De Gracia)

BOLD - ANSWERS
1. Suppose you are a nurse of a prenatal clinic, and when reviewing antenatal electronic
records, you note that a high number of pregnant women seen in the clinic have
developed UTIs during their pregnancies. You should emphasize the need to do which
of the following?
a. Ensure that the housekeeping department is adequately cleaning the toilet
b. suggest all women be prescribed a prophylactic antibiotic during their first trimester
c. Educate women on the need for sound perineal care during pregnancy
d. Urge women to restrict fluid to keep their urine acidic and concentrated
ans C – good perineal care, a generous fluid intake, wearing cotton underwear, and
avoiding bath salts are common ways to avoid UTI
2. You routinely assess all pregnant women for signs of hypertension as you interview
them at Agdao Health Center and then document the findings in the health record.
Which statement would you document as possible evidence of developing gestational
hypertension?
a. “My feet are so swollen at night I can’t put on my bedroom slippers”
b.”I never guessed I would feel as tired as I do just from being pregnant”
c. My abdomen feels firm as if I had blown up a balloon inside me”
d. “I can live with my puffy feet, but not it’s also my hands and wrists”
Ans D –Edema is often first symptom a woman notes. The edema associated with
gestational hypertension can be separated from the typical ankle edema of pregnancy
because it begins to accumulate in the upper part of the body as well.
3. It is known as Mandatory Infants and Child Health Immunization Act of 2011. ANS
RA 10152
4. The following are the four pillars of Philippine Family Planning Program except one:
ANS C
a. Respect for life
b. Birth spacing
c. Responsible planning
d. Informed choice
5. Which of the following are the objectives of Family Planning Program according to
DOH? ANS A
a. To increase modern Contraceptive Prevalence Rate (mCPR) among all women
from 24.9% in 2017 to 30% by 2022
b. To reduce the met need for modern family planning from 10.8% in 2017 to 8% by
2022
c. To provide proper family counselling to mothers under 18 and above 34 years old
d. To promote freedom of responsible parents to decide on the timing and size of their
families in pursuit of a better life
6. It is a law that requires institutions to adopt rooming-in and breastfeeding practices.
a. RA 7600
b. RA 8976
c. EO 51
d. RA 7648
7. Exclusive breast feeding should be practiced up until which age of life? ANS C
a. 5 months
b. 8 months
c. 6 months
d. 7 months
8. These are conditions that are conductive to disease accidents or failure to realize
one’s health potential. ANS Health Threats
9. It is an anticipated periods of unusual demand on the individual or family in terms of
adjustment /family resources. ANS – Stress points/ Foreseeable Crisis
10. The following are vaccines that a 6 week child should receive. Which vaccine is
given per orem?
a. DPT
b. BCG
c. PCV
d. OPV
11. You are a nurse assigned to Miniforest Health Center and concluded that a
pregnant mother is at risk for PIH when blood pressure increases from:
a. 122/80 to 138/86
b. 90/56 to 110/70
c. 100/60 to 130/76
d. 134/80 to 140/88
R: An increase of 30mmhg systolic and 15 mmhg diastolic on two occasions is
diagnostic for PIH.
12. You are a community nurse performing a routine prenatal assessment of a client at
23 weeks' gestation. Which of the following would indicate to the nurse that the client
may be experiencing pregnancy-induced hypertension (PIH)?

a. A baseline blood pressure of 122/80.

b. Proteinuria.
c. Complaints of low back pain.
d. Glucose in the urine.
R: PIH begins to occur at 20 weeks' gestation, and proteinuria is one sign that the client
is experiencing PIH. A baseline pressure is not a determining factor for PIH. Glucose in
the urine indicates possible gestational diabetes, which puts the client at risk for PIH,
but is not diagnostic for PIH. Back pain is unrelated to PIH.
13. True or False: Insulin does not cross the placenta. ANS TRUE
14. True or False: Birth defects are more common in newborns of gestational diabetes.
ANS FALSE
R: More common in Pre-existing diabetics r/t lack of control at conception and during 1st
Trimester
15. Which organism commonly responsible for developing urinary tract infections
a. N. gonorrhea
b. E. coli
c. Streptococcus B
d. Trachomatis
16. Judy is prescribed an insulin pump to administer insulin for her gestational DM.
Which of the following would you teach her as to why nighttime is particularly hazardous
time for her fetus during pump therapy?
a. The fetus can develop hyperglycemia from excessive insulin administration
b. Continuous insulin administration with no food intake can lead to
hypoglycemia
c. Her lack of exercise at night tends to lead to hypercalcemia from muscle disuse
d. Her lack of fluid intake during the night causes a relative increase in serum insulin
levels
R: Women should typically eat a high protein /complex carbohydrate snack such as
peanut butter or celery before bedtime to prevent fetal hypoglycaemia from ingesting
little food during the night
17. Health Center prenatal check up is conducted on which day of the week?
a. Tuesday
b. Wednesday
c. Thursday
d. Saturday
18. It is a procedure that induces cutting or blocking of fallopian tubes. BILATERAL
TUBAL LIGATION
19. The following are advantages of breastfeeding to mothers. Except one:
a. Reduces risk of breast cancer
b. Promotes emotional health
c. Reduces osteoporosis
d. Promotes easy digestion
20. The following are under five care programs. Except one:
a. Vitamin A supplementation
b. Immunization
c. Deworming
d. Nutritional Program
 READINGS
Nurse as a Leader
Title: Good leadership in nursing: what is the most effective approach?
Bibliography: Maxwell, E. (2017). Good leadership in nursing: what is the most
effective approach?. Retrieved September 21, 2021 from
https://www.nursingtimes.net/clinical-archive/leadership/good-leadership-in-nursing-
what-is-the-most-effective-approach-17-07-2017/

SUMMARY:
There is no simple answer to the complex question of what makes good
leadership in nursing, despite the existence of evidence showing that it can have a
positive impact on both patient experience and outcomes, and nurse satisfaction and
retention. This article outlines different leadership theories, describing how they can be
applied to nursing and how effective they are. What emerges is that different
approaches are needed according to what leaders set out to achieve. One thing is
certain: success hinges on good relationships between leaders and teams.

Hersey and Blanchard (1969) observed that the leader’s actions should be
determined by the maturity of the team and that the behaviors of good leaders are
situational rather than fixed. Leaders in this model assess the needs of the followers
and adapt their actions accordingly. Resonant leadership is described by Goleman et al
(2002) as a type of leadership that invests time and effort into creating good
relationships rather than into setting an inspiring vision. Depending on the situation, the
vision and objectives can be coproduced or team members can operate autonomously,
reflecting Hershey and Blanchard’s situational leadership model. Similarly, Paquet et al
(2013) found that good relationships between leaders and staff were associated with
decreased medication errors and reduced length of stay. Vogus and Sutcliffe (2007)
found that one of the outcomes of resonant leadership – trust – was a factor in the
success of a project to reduce the incidence of medication errors. There is some
evidence that relationships alone are not sufficient, and attention must also be paid to
Herzberg’s other intrinsic factors (self-actualization and personal growth).
 Good leadership can have a positive impact on patient outcomes through
creating the conditions, which allow nurses to reach their full potential and build both
personal and organizational resilience in the face of unexpected or increased workload.
The evidence suggests that nurse leaders should adapt their leadership behavior’s
Given the uncertainties that nurse leaders face in their daily work, they can only achieve
this by being constantly aware of the changing environment and making sense of it.
REACTION:

The article recommends that the best method of authority style is Hersey and
Blanchard Situational Leadership hypothesis. Chips away at the suspicion that the best
style of initiative changes from one circumstance to another. To be best and effective, a
pioneer should have the option to adjust his style and way to deal with different
conditions.

What's the most ideal way of driving a gathering? Most answers would be logical
"it depends" and it does! Since Hersey and Blanchard specify that the best chiefs
dissect the circumstance and change their administration style likewise. For instance, a
few workers work better under a more despotic and mandate. pioneer. "gawin mo to,
kunin mo mga gamit doon at magsimula ka dito, dapat ganito ang paggawa mo" blabla
etc. For other people, achievement will be almost certain if the pioneer can venture back
and trust his group to simply decide and complete plans without the pioneer's immediate
inclusion. Recognizing the worker development level turns into a vital piece of the cycle,
and the pioneer should have the eagerness and capacity to utilize any of the four
authority styles depending on the situation.

I favor more the situational administration hypothesis on the grounds that not to
corrupt anybody, But an informed and uninformed individual ought to have various
pioneers, In this way you realize how might you approach a specific representative yet
that is simply me and you can have yours.
Nurse as a teacher

“Nursing students' experiences of nurse teacher mentoring and

beneficial digital technologies in a clinical practice setting”

BIBLIOGRAPHY
Heinonen AT, Kääriäinen M, Juntunen J, Mikkonen K. Nursing students' experiences of nurse
teacher mentoring and beneficial digital technologies in a clinical practice setting.
Nurse Educ Pract. 2019 Oct;40:102631. doi: 10.1016/j.nepr.2019.102631. Epub 2019
Sep 28. PMID: 31585310.

SUMMARY
Nurse teachers participate in the mentoring of students according to their own
professional expertise and the student's clinical learning outcomes; in this way, they can
act as a contact person, adopt the role of a coordinator, and/or support the student.
Nurse teacher is a responsible person to guide students in making a correct choice of
their clinical practice, to mentor students in their process of learning and to conduct a
final evaluation of the students' learning at the end of their practice. Once students enter
clinical practice, they receive a clinical mentor, who is a staff nurse responsible of
students' mentoring in their own learning context. The five focus groups included 3-5
students per group, 15 students in total. More precisely, the students were asked: what
kind of mentoring do students need during clinical practice; what kind of experiences do
they have relating to the role of a nurse teacher in clinical practice; has digital
technology been used in mentoring students' clinical practice; what digital technologies
have been implemented; and what kind of experiences did students have with digital
technology.

Students expressed a desire for flexible student-centered mentoring that could

be adjusted to the student's progress and needs during clinical practice. One students
expressed: "At least for me, it was important that I in some way knew the teacher from
before, that they had taught me previously, as this would help me be brave enough to
express my true experiences." Student-centered mentoring emerged from interaction, a
student orientation and the teacher's focus on student affairs. These types of teachers
also encouraged students to make contact and do not share their work issues and/or
stress with students. In challenging situations, students saw nurse teachers as a
support, or "Back wall", as well as a guardian of students' rights. Teachers were
supportive, conscious of the responsibilities of students and clinical mentors, and able
to guide students to focus on their professional growth.
One student shared: "If you think that you would not be the problem, then the role
of the teacher is very important, as they act as a mediator and will intervene if the
situation arises." Students felt that the teacher should have the ability and courage to
intervene and mediate the conversation in such situations. One student shared: "If there
is such a program that can be easily accessed, I only click and log in, so that is it. As
simple as possible and easy to use." Students identified the lack of digital technology
skills or nurse teachers having difficulties with the equipment and software as
challenges to the effective use of technology. Several students mentioned that the
ability to leverage technological solutions for face-to-face communications could
enhance interaction between mentor and student. The positive mentoring relationship
provides students with a higher motivation for their professional development and helps
students recommend clinical practice to their fellow students. Students did not wish to
resolve problem situations via text messages.

REACTION
Teaching is an art. Some people are born teachers while others acquire the skill.
To be a great teacher, one has to have a sense of humor and be very flexible. Teachers
will never teach to gain monetary reward. However, they will teach to achieve the best
reward and that is satisfaction that they have an impact on the education of the best
nurses of the world and the success of new breed of professionals.
In the article that I have read, it is important for nurse teachers need to learn the
new technologies as this will help them teach students easier and more efficiently. The
teachers also need to explore how students will learn easily so that they would be an
effective educator. Being a nurse teacher does not mean that you will stop learning
because you are teaching now, hence we should learn new technologies so that we can
keep up with other countries who are now relying not only in skills but in technologies
too.
Being a nurse teacher is hard, throughout my PCI rotation I can tell now how
hard it is to teach students. I am very thankful for all my clinical instructors as they were
so very patient in teaching us and very hard working to teach future nurses. I hope in
the future there will be more clinical instructors to breed new nurses.
Nurse as a manager

“How nurses and their work environment affect patient

experiences of the quality of care: a qualitative study”

BIBLIOGRAPHY
Kieft, R.A., de Brouwer, B.B., Francke, A.L. et al. How nurses and their work environment affect
patient experiences of the quality of care: a qualitative study. BMC Health Serv
Res 14, 249 (2014). https://doi.org/10.1186/1472-6963-14-249

SUMMARY
Increasing complexities in healthcare environments require nurse managers to
be well equipped to manage change in their workplace environments. Alongside these
influences, the external environment continues to pose challenges as globalisation of
healthcare knowledge, transferable nursing skills and global recruitment policies
increase the likelihood that nurse managers are managing culturally diverse groups of
both nursing staff and patients. Background A review of the literature on managerial
effectiveness, skills and attributes, leadership and patient outcomes highlighted the
challenges faced in defining and attaining the appropriate skills and attributes for nurses
to manage effectively. Responses from managers in the earlier studies undertaken in
the 1990s and nurse managers in the more recent studies undertaken in 2013 indicate
that the cultural context in their organisation in which the respondents work informs how
they perceive the different dimensions viewed as a necessary requirement for
managerial effectiveness. Kelly discusses how the functions of management are
differentiated into managing the work and managing the relationships whilst Harris and
Associates add that the context in which the manager does the work also needs to be
considered, as the functions will differ in different contexts.
Look at the health manager in the organisation and argue that the predominant
group of management is the middle managers and this group acts as a 'linking pin'
because of the need for co-ordination and communication. Inclusion criteria for
respondents included being a registered nurse and working in a nurse manager role
with the words nurse manager in their title. The final sample consisted of 155 nurse
managers of which 149 responded to the words nurse manager or manager in their job
title. The lack of value given to conflict resolution skills over interpersonal skills where a
greater emphasis was placed on having interpersonal skills as a nurse manager also
adds to the understanding of the New Zealand nursing context. The combination of
small rural and larger urban healthcare settings in the New Zealand landscape
reinforces the need for nurse manager adaptability in managing people through a mix of
human resource strategies which include having interpersonal and conflict resolution
skills.
Calculated risk-taking is considered a beneficial approach in a managerial culture
whereas impulsiveness is viewed by managers as a negative attribute that needs to be
managed due to the emotionally driven context in which impulsiveness arises.
Implications for nursing management In the constantly changing health environment it is
important that nurse managers are equipped with tools and knowledge that enable them
to adapt and manage change. Establishing such a pathway would encourage a formal
assessment of the skills and attributes that are required for nurse manager roles to
effectively manage in their workplace. The tindings on the perceptions of New Zealand
nurse managers indicate that whilst professional nursing skills around decision making
and directing are highly valued, informal and relational skills are critical in achieving
effectiveness in the work environment. Enabling Nurse Managers to not only
understand their organisational culture but also ensuring they have the skills and
attributes to adapt and manage change within that organisation is critical to not only
effective management but also improved patient outcomes.

REACTION
The essence of leadership involves the power to motivate and influence people.
This power can be wielded positively to engage others in worthy action, or negatively
through coercion or punishment. Although the latter approach may be justified in certain
extreme situations such as preserving patient safety, it won't foster strong team bonds if
it's the predominant approach. Power is toxic whenever it's employed to further a
personal agenda at the expense of good ethics or teamwork. The power of positive
influence requires emotional intelligence and the motivation to connect with people in a
way that engenders trust and confidence. Credentials and clinical skills are no substitute
for these leadership attributes. It's the wise nurse who establishes this foundation for
personal excellence.
Once a nurse finds a job that suits them well, the leadership in their organization
is often what makes it or breaks it for them when it comes to staying or leaving. As the
saying goes, “Employees don’t leave jobs. They leave managers.” This couldn’t be truer
in nursing.
III. EVALUATION

SELF:
Teaching has not been my bread and butter. For me being a speaker is very hard
since am not the kind of person who is good at public speaking. I realized that after I
have done this rotation, I have a hidden courage to speak in front and teach new
breeds of student nurses. I didn’t expect that I can pass my learnings to the students
it’s because I am not confident. Overall, this rotation really pushed me out of my
comfort zone and mold not only as a nurse but also a teacher.

ROTATION:

I did not expect that this rotation would become a memorable one. Before the
rotation start, I was very nervous because I am not confident on myself. I didn’t expect
that there would be a lot of requirements to be passed. But one thing I can assure in this
rotation is that it was very satisfying that the students have learned something from us
the seniors. I hope that this will not be the last one that I will be teaching and I am
looking forward for new opportunities to come

CLINICAL INSTRUCTOR:

It wouldn’t be a successful rotation without our Clinical instructor, Ma’am Elvie

Abesia, who is very helpful in guiding us to have a successful PCI rotation. At first we
didn’t have the voice to teach but after encouraging us to be more assertive we
immediately followed that advise. I have been always thankful to maam Abesia because
it is not only this time that she helped me, she has always been helping me become a
better student since senior high school and I wouldn’t be here teaching students without
her help. She always tells the exact words on correcting us that doesn’t make us feel
dumb and question our worth in being a practicing clinical instructor.