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Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE___________________________ Date When School/Program was recognized :September 28, 1998_ __ First Course (if any): NONE__________________________________ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE____________________________________________________ _ Number: 234_______________________________________________ Year: 1998___ _ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ _
I. MAJOR OPERATIONS No.
Date
Case No.
Name of Patient
1.
November 12, 2007
29
Jonard Ligmayo Lanbayo
2.
November 19, 2007
58
Wilfredo Castillo Osio
3.
November 27, 2007
85
4.
February 23, 2009
480423
5.
February 24, 2009
698523
Celestino Balabbo Jimenez
Desiree Perolin
Jerdilyn Mangaus
Diagnosis
Operation Performed
Acute Appendicitis
Emergency Appendectomy
Tumor Recurrence, descending colon S/P Right hemicolectomy
Exploratory Laparotomy, side to side anastomosis, ileum-sigmoid
Fracture, Open Complete, D/3rd Ulna Right Tendon Transection
Ectopic Pregnancy Right
Ruptured Appendicitis
Type of Anesthesia
Name of Surgeon
Name of Hospital
Supervised by: Name, Registration No. and Signature of C.I.
Supervised by: Name, Registration No. and Signature of O.R. SCRUB Nurse
Subarachnoid Block
Dr. Welbert A. Reyes
Veterans Regional Hospital
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865 Valid Until: December 31, 2009 Date Signed:__________
Rosemarie C. Bicad, R.N., MSN PRC#:0127446 Valid Until: January 9, 2012 PNA#:9938 Valid Until: Lifetime Date Signed:__________
Subarachnoid Block
Dr. Raul Emiliano G. Par
Veterans Regional Hospital
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________
Antonio A. Manubay, R.N. PRC#:0260262 Valid Until: June 19, 2011 PNA#:18491 Valid Until: Lifetime Date Signed:__________
General Anesthesia Mask
Dr. Antonio Mijares
Veterans Regional Hospital
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865 Valid Until: December 31, 2009 Date Signed:__________
Antonio A. Manubay, R.N. PRC#:0260262 Valid Until: June 19, 2011 PNA#:18491 Valid Until: Lifetime Date Signed:__________
Spinal Anesthesia
Dra. Emma Ruth P. Aquitania
Governor Faustino N. Dy Sr. Memorial Hospital
Edmar S. Licodini, R.N. PRC#:0482213Valid Until: November 16, 2011 PNA#:008127Valid Until: December 31, 2009 Date Signed:__________
Teresita M. Castañeda,R.N. PRC#:0035851 Valid Until: October 6,2010 PNA#:039059 Valid Until: December 31, 2009 Date Signed:__________
Spinal Anesthesia
Dr. Ferdinand O. Cacal
Governor Faustino N. Dy Sr. Memorial Hospital
Edmar S. Licodini, R.N. PRC#:0482213Valid Until: November 16, 2011 PNA#:008127Valid Until: December 31, 2009 Date Signed:__________
Teresita M. Castañeda,R.N. PRC#:0035851 Valid Until: October 6,2010 PNA#:039059 Valid Until: December 31, 2009 Date Signed:__________
Emergency Wound Debridement Myoraphy. Ligation of Bleeders, Tenorraphy
Exploratory Laparotomy Right Salphingectomy
Appendectomy
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a) b) c)
PRC No.: 0382671 Valid until: September 6, 2012 PNA No.: 008136 Valid until: December 31, 2009 ANSAP No.: 071193 Valid Until; February 23, 2010
a) b) c)
PRC No.: 0090287 Valid until: March 20, 2012 PNA No.:5465 Valid until: Lifetime ANSAP No.:0311 Valid until: Lifetime
a) b) c)
PRC No.: 0065793 Valid until: March 13,2010 PNA No.:002410 Valid until: December 31, 2009 ANSAP No.: 090093 Valid until: December 31, 2009
a) b) c)
PRC No.: 0239713 Valid until: May 7,2010 PNA No.:008135 Valid until: December 31,2009 ADPCN No.: 0830 Valid until: Lifetime
Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE____________________________ Date When School/Program was recognized :September 28, 1998 __ First Course (if any): NONE__________________________________ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE______________________________________________________ _ Number: 234_______________________________________________ Year: 1998___ _ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ __
Case No.
Name of Patient
Diagnosis
Operation Performed
Type of Anesthesia
II. MINOR OPERATIONS Name of Name of Surgeon Hospital
March 17, 2008
1172
Edgar I. Collado
Hacked Wound Posterior Forearm (4cm)
Suturing
Local Anesthesia
Dr. Sherwin T. Valdez
September 15, 2008
1052
Francisco B. Malana
Lacerated Wound 3cm Left Eyebrow
Suturing
Local Anesthesia
Dr. Frederick P. Fabian
S/P Subclavian Catheter Insertion for Hemodialysis
Removal of Subclavian Catheter
Local Anesthesia
Dr. Sherwin T. Valdez
Incomplete Abortion
Dilatation and Curettage
IV Sedation
Dra. Elsie V. Cruz
Abscess Frontal Head Right
Incision and Drainage
Local Anesthesia
Dr. Joseph A. Tibio
No.
Date
1.
2.
3.
October 16, 2008
1861
Roden D. Gatmaitan
4.
February 21, 2009
278920
Lailanie Dela Cruz
5.
February 22, 2009
408622
Maxene Alliah Iralabad
Supervised by: Name, Registration No. and Signature of C.I.
Supervised by: Name, Registration No. and Signature of O.R. SCRUB Nurse
Veterans Regional Hospital
Rosalie C. Carreon, R.N. PRC#: 0130443 Valid Until: December 19, 2010 PNA#: 007871 Valid Until: December 31, 2009 Date Signed:__________
Cheryl M. Bautista, R.N. PRC#:0256933 Valid Until: February 6, 2012 PNA#: 16561 Valid Until: Lifetime Date Signed:__________
Veterans Regional Hospital
Rosalie C. Carreon, R.N. PRC#: 0130443 Valid Until: December 19, 2010 PNA#: 007871 Valid Until: December 31, 2009 Date Signed:__________
Jennifer E. Valdez, R.N. PRC#: 0207028 Valid Until: November 24,2011 PNA#: 16556 Valid Until: Lifetime Date Signed:__________
Veterans Regional Hospital
Rosalie C. Carreon, R.N. PRC#: 0130443 Valid Until: December 19, 2010 PNA#: 007871 Valid Until: December 31, 2009 Date Signed:__________
Nicanor P. Dela Cruz Jr., R.N. PRC#:0242470 Valid Until: February 1, 2012 PNA#:16373 Valid Until: Lifetime Date Signed:__________
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Amelia A. Romero, R.N. PRC#:0107146 Valid Until: May 5, 2011 PNA#:002413 Valid Until: December 31, 2009 Date Signed:__________
Edmar S. Licodini, R.N. PRC#:0482213Valid Until: November 16, 2011 PNA#:008127Valid Until: December 31, 2009 Date Signed:__________
Amelia A. Romero, R.N. PRC#:0107146 Valid Until: May 5, 2011 PNA#:002413 Valid Until: December 31, 2009 Date Signed:__________
Governor Faustino N. Dy Sr. Memorial Hospital Governor Faustino N. Dy Sr. Memorial Hospital
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a) b)
PRC No.: 0382671 Valid until: September 6, 2012 PNA No.: 008136 Valid until: December 31, 2009
a) b)
PRC No.: 0090287 Valid until: March 20, 2012 PNA No.:5465 Valid until: Lifetime
a) b)
PRC No.: 0065793 Valid until: March 13,2010 PNA No.:002410 Valid until: December 31, 2009
a) b)
PRC No.: 0239713 Valid until: May 7,2010 PNA No.: 008135 Valid until: December 31,2009
c)
ANSAP No.:071193 Valid Until: February 23, 2010
c)
ANSAP No.:0311 Valid until: Lifetime
c)
c)
ANSAP No.: 090093 Valid until: December 31, 2009
ADPCN No.: 0830 Valid until: Lifetime
Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE____________________________ Date When School/Program was recognized :September 28, 1998___ First Course (if any): NONE_______________________________ _ _ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE_____________________________________________________ _ _ Number: 234_______________________________________________ Year: 1998__ _ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ _ III. ACTUAL DELIVERIES Time of Gender of Delivery Baby
No.
Case No.
Diagnosis
Name of Mother
Age
Date of Delivery
1.
120
Gravida 2 Para 1, Pregnancy Uterine Full Term Cephalic in Labor
Joanne Gambo Baria
28
November 14, 2007
12:53 am
2.
943623
Gravida 7 Para 5, Pregnancy Uterine, 40 weeks Age of Gestation
Rosemir Bautista
32
December 2, 2008
3.
293623
Gravida 2 Para 0, Pregnancy Uterine, 40 weeks Age of Gestation
Raquel Lucero
28
4.
824723
Gravida 2 Para 0, 40 weeks Age of Gestation
5.
108923
Gravida 2 Para 1, Pregnancy Uterine Full Term 38 1/7 wk Age of Gestation
Liezl Estorninis
Jinky Marquez
Supervised by: Name, Registration No. and Signature of C.I.
Name of Hospital
Type of Delivery
Male
Veterans Regional Hospital
Normal Spontaneous Delivery Right Medio-Lateral Episiotomy Repair
9:02 pm
Male
Governor Faustino N. Dy Sr. Memorial Hospital
December 3,2008
7:40 am
Male
Governor Faustino N. Dy Sr. Memorial Hospital
22
February 22, 2009
8:50 am
Male
Governor Faustino N. Dy Sr. Memorial Hospital
28
February 24, 2009
6:05 am
Male
Governor Faustino N. Dy Sr. Memorial Hospital
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Normal Spontaneous Delivery
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Normal Spontaneous Delivery
Normal Spontaneous Delivery
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Normal Spontaneous Delivery
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a)
PRC No.: 0382671 Valid until: September 6, 2012
a)
PRC No.: 0090287 Valid until: March 20, 2012
a)
PRC No.: 0065793 Valid until: March 13,2010
a)
PRC No.: 0239713 Valid until: May 7,2010
b) c)
b)
PNA No.: 008136 Valid until: December 31, 2009 ANSAP No.:071193 Valid Until: February 23, 2010
c)
b)
PNA No.:5465 Valid until: Lifetime
c)
ANSAP No.:0311 Valid until: Lifetime
b)
PNA No.:002410 Valid until: December 31, 2009
c)
ANSAP No.: 090093 Valid until: December 31, 2009
PNA No.: 008135 Valid until: December 31,2009 ADPCN No.: 0830 Valid until: Lifetime
Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE____________________________ Date When School/Program was recognized :September 28, 1998___ First Course (if any): NONE_______________________________ __ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE______________________________________________________ _ Number: 234_______________________________________________ Year: 1998___ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ _
IV. DELIVERIES ASSISTED No.
Case No.
Diagnosis
Name of Mother
Age
Date of Delivery
Time of Delivery
Gender of Baby
Name of Hospital
Type of Delivery
1.
165
Gravida 1 Para 0, Pregnancy Uterine Full Term, Cephalic in Beginning Labor
Jayren Florendo Marcos
18
November 19, 2007
6:00 pm
Male
Veterans Regional Hospital
Normal Spontaneous Delivery with Medial Episiotomy Repair
Gravida 1 Para 0, Pregnancy Uterine, 40 weeks Age of Gestation
Cris Delight Limon
20
November 24, 2008
11:47 am
Female
Governor Faustino N. Dy Sr. Memorial Hospital
Gravida 1 Para 0, Pregnancy Uterine, 39 weeks Age of Gestation
Crislyn Lumawig
18
December 1,2008
11:23 pm
Female
Governor Faustino N. Dy Sr. Memorial Hospital
Normal Spontaneous Delivery
Lailanie Dancel
24
February 21, 2009
1:56 am
Male
Governor Faustino N. Dy Sr. Memorial Hospital
Normal Spontaneous Delivery
26
February 22, 2009
7:56 pm
Male
Governor Faustino N. Dy Sr. Memorial Hospital
Normal Spontaneous Delivery
2.
3.
810523
741223
4.
445423
Gravida 2 Para 1, Pregnancy Uterine, 40 weeks Age of Gestation
5.
926423
Gravida 2 Para 1, 40 weeks Age of Gestation
Rowena Topinio
Supervised by: Name, Registration No. and Signature of C.I.
Normal Spontaneous Delivery
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a)
PRC No.: 0382671
a)
PRC No.: 0090287
a)
PRC No.: 0065793
a)
PRC No.: 0239713
Valid until: September 6, 2012
b) c)
PNA No.: 008136 Valid until: December 31, 2009 ANSAP No.:071193 Valid Until: February 23, 2010
Valid until: March 20, 2012
b) c)
Valid until: March 13,2010
b)
PNA No.:5465 Valid until: Lifetime
c)
ANSAP No.:0311 Valid until: Lifetime
Valid until: May 7,2010
b)
PNA No.:002410 Valid until: December 31, 2009
c)
ANSAP No.: 090093 Valid until: December 31, 2009
PNA No.: 008135 Valid until: December 31,2009 ADPCN No.: 0830 Valid until: Lifetime
Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE__________________________ Date When School/Program was recognized :September 28, 1998___ First Course (if any): NONE_______________________________ __ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE______________________________________________________ _ Number: 234_______________________________________________ Year: 1998___ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ _
V. CORD DRESSING Supervised by: Name, Registration No. and Signature of C.I.
No.
Case No.
Date Performed
Name of Baby
Gender of Baby
Name of Mother
Age
Name of Hospital
1.
106
November 13, 2007
Bb Boy Reyes
Male
Jean Babaran Reyes
23
Veterans Regional Hospital
November 21, 2007
Bb Boy Caramat
Male
Maricel Abella Caramat
27
Veterans Regional Hospital
Male
Melody Lumano Bayangan
25
Veterans Regional Hospital
Charity Dela Cruz
29
Governor Faustino N. Dy Sr. Memorial Hospital
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
20
Governor Faustino N. Dy Sr. Memorial Hospital
Gerald Roy R. Nipal PRC#:0425978 Valid Until:8-03-10 PNA#: 00786 Valid Until:12-31-09 Date Signed:__________
2.
181
Bb Boy Bayangan
3.
242
November 28, 2007
4.
965223
February 21, 2009
Bb Boy Dela Cruz
Male
5.
98923
February 23, 2009
Bb Boy Castillo
Male
Vanessa Castillo
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________ Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________ Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a)
PRC No.: 0382671
a)
PRC No.: 0090287
a)
PRC No.: 0065793
a)
PRC No.: 0239713
Valid until: September 6, 2012
b) c)
PNA No.: 008136 Valid until: December 31, 2009 ANSAP No.:071193 Valid Until: February 23, 2010
Valid until: March 20, 2012
b) c)
PNA No.:5465 Valid until: Lifetime ANSAP No.:0311 Valid until: Lifetime
Valid until: March 13,2010
b) c)
PNA No.:002410 Valid until: December 31, 2009 ANSAP No.: 090093 Valid until: December 31, 2009
Valid until: May 7,2010
b) c)
PNA No.: 008135 Valid until: December 31,2009 ADPCN No.: 0830 Valid until: Lifetime
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE___________________________ Date When School/Program was recognized :September 28, 1998_ __ First Course (if any): NONE__________________________________ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE____________________________________________________ _ Number: 234_______________________________________________ Year: 1998___ _ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ _
I. MAJOR OPERATIONS No.
Date
Case No.
Name of Patient
1.
November 12, 2007
29
Jonard Ligmayo Lanbayo
2.
November 19, 2007
58
Wilfredo Castillo Osio
3.
November 27, 2007
85
4.
February 23, 2009
480423
5.
February 24, 2009
698523
Celestino Balabbo Jimenez
Desiree Perolin
Jerdilyn Mangaus
Diagnosis
Operation Performed
Acute Appendicitis
Emergency Appendectomy
Tumor Recurrence, descending colon S/P Right hemicolectomy
Exploratory Laparotomy, side to side anastomosis, ileum-sigmoid
Fracture, Open Complete, D/3rd Ulna Right Tendon Transection
Ectopic Pregnancy Right
Ruptured Appendicitis
Type of Anesthesia
Name of Surgeon
Name of Hospital
Supervised by: Name, Registration No. and Signature of C.I.
Supervised by: Name, Registration No. and Signature of O.R. SCRUB Nurse
Subarachnoid Block
Dr. Welbert A. Reyes
Veterans Regional Hospital
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865 Valid Until: December 31, 2009 Date Signed:__________
Rosemarie C. Bicad, R.N., MSN PRC#:0127446 Valid Until: January 9, 2012 PNA#:9938 Valid Until: Lifetime Date Signed:__________
Subarachnoid Block
Dr. Raul Emiliano G. Par
Veterans Regional Hospital
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________
Antonio A. Manubay, R.N. PRC#:0260262 Valid Until: June 19, 2011 PNA#:18491 Valid Until: Lifetime Date Signed:__________
General Anesthesia Mask
Dr. Antonio Mijares
Veterans Regional Hospital
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865 Valid Until: December 31, 2009 Date Signed:__________
Antonio A. Manubay, R.N. PRC#:0260262 Valid Until: June 19, 2011 PNA#:18491 Valid Until: Lifetime Date Signed:__________
Spinal Anesthesia
Dra. Emma Ruth P. Aquitania
Governor Faustino N. Dy Sr. Memorial Hospital
Edmar S. Licodini, R.N. PRC#:0482213Valid Until: November 16, 2011 PNA#:008127Valid Until: December 31, 2009 Date Signed:__________
Teresita M. Castañeda,R.N. PRC#:0035851 Valid Until: October 6,2010 PNA#:039059 Valid Until: December 31, 2009 Date Signed:__________
Spinal Anesthesia
Dr. Ferdinand O. Cacal
Governor Faustino N. Dy Sr. Memorial Hospital
Edmar S. Licodini, R.N. PRC#:0482213Valid Until: November 16, 2011 PNA#:008127Valid Until: December 31, 2009 Date Signed:__________
Teresita M. Castañeda,R.N. PRC#:0035851 Valid Until: October 6,2010 PNA#:039059 Valid Until: December 31, 2009 Date Signed:__________
Emergency Wound Debridement Myoraphy. Ligation of Bleeders, Tenorraphy
Exploratory Laparotomy Right Salphingectomy
Appendectomy
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a) b) c)
PRC No.: 0382671 Valid until: September 6, 2012 PNA No.: 008136 Valid until: December 31, 2009 ANSAP No.: 071193 Valid Until; February 23, 2010
a) b) c)
PRC No.: 0090287 Valid until: March 20, 2012 PNA No.:5465 Valid until: Lifetime ANSAP No.:0311 Valid until: Lifetime
a) b) c)
PRC No.: 0065793 Valid until: March 13,2010 PNA No.:002410 Valid until: December 31, 2009 ANSAP No.: 090093 Valid until: December 31, 2009
a) b) c)
PRC No.: 0239713 Valid until: May 7,2010 PNA No.:008135 Valid until: December 31,2009 ADPCN No.: 0830 Valid until: Lifetime
Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE____________________________ Date When School/Program was recognized :September 28, 1998 __ First Course (if any): NONE__________________________________ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE______________________________________________________ _ Number: 234_______________________________________________ Year: 1998___ _ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ __
Case No.
Name of Patient
Diagnosis
Operation Performed
Type of Anesthesia
II. MINOR OPERATIONS Name of Name of Surgeon Hospital
March 17, 2008
1172
Edgar I. Collado
Hacked Wound Posterior Forearm (4cm)
Suturing
Local Anesthesia
Dr. Sherwin T. Valdez
September 15, 2008
1052
Francisco B. Malana
Lacerated Wound 3cm Left Eyebrow
Suturing
Local Anesthesia
Dr. Frederick P. Fabian
S/P Subclavian Catheter Insertion for Hemodialysis
Removal of Subclavian Catheter
Local Anesthesia
Dr. Sherwin T. Valdez
Incomplete Abortion
Dilatation and Curettage
IV Sedation
Dra. Elsie V. Cruz
Abscess Frontal Head Right
Incision and Drainage
Local Anesthesia
Dr. Joseph A. Tibio
No.
Date
1.
2.
3.
October 16, 2008
1861
Roden D. Gatmaitan
4.
February 21, 2009
278920
Lailanie Dela Cruz
5.
February 22, 2009
408622
Maxene Alliah Iralabad
Supervised by: Name, Registration No. and Signature of C.I.
Supervised by: Name, Registration No. and Signature of O.R. SCRUB Nurse
Veterans Regional Hospital
Rosalie C. Carreon, R.N. PRC#: 0130443 Valid Until: December 19, 2010 PNA#: 007871 Valid Until: December 31, 2009 Date Signed:__________
Cheryl M. Bautista, R.N. PRC#:0256933 Valid Until: February 6, 2012 PNA#: 16561 Valid Until: Lifetime Date Signed:__________
Veterans Regional Hospital
Rosalie C. Carreon, R.N. PRC#: 0130443 Valid Until: December 19, 2010 PNA#: 007871 Valid Until: December 31, 2009 Date Signed:__________
Jennifer E. Valdez, R.N. PRC#: 0207028 Valid Until: November 24,2011 PNA#: 16556 Valid Until: Lifetime Date Signed:__________
Veterans Regional Hospital
Rosalie C. Carreon, R.N. PRC#: 0130443 Valid Until: December 19, 2010 PNA#: 007871 Valid Until: December 31, 2009 Date Signed:__________
Nicanor P. Dela Cruz Jr., R.N. PRC#:0242470 Valid Until: February 1, 2012 PNA#:16373 Valid Until: Lifetime Date Signed:__________
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Amelia A. Romero, R.N. PRC#:0107146 Valid Until: May 5, 2011 PNA#:002413 Valid Until: December 31, 2009 Date Signed:__________
Edmar S. Licodini, R.N. PRC#:0482213Valid Until: November 16, 2011 PNA#:008127Valid Until: December 31, 2009 Date Signed:__________
Amelia A. Romero, R.N. PRC#:0107146 Valid Until: May 5, 2011 PNA#:002413 Valid Until: December 31, 2009 Date Signed:__________
Governor Faustino N. Dy Sr. Memorial Hospital Governor Faustino N. Dy Sr. Memorial Hospital
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a) b)
PRC No.: 0382671 Valid until: September 6, 2012 PNA No.: 008136 Valid until: December 31, 2009
a) b)
PRC No.: 0090287 Valid until: March 20, 2012 PNA No.:5465 Valid until: Lifetime
a) b)
PRC No.: 0065793 Valid until: March 13,2010 PNA No.:002410 Valid until: December 31, 2009
a) b)
PRC No.: 0239713 Valid until: May 7,2010 PNA No.: 008135 Valid until: December 31,2009
c)
ANSAP No.:071193 Valid Until: February 23, 2010
c)
ANSAP No.:0311 Valid until: Lifetime
c)
c)
ANSAP No.: 090093 Valid until: December 31, 2009
ADPCN No.: 0830 Valid until: Lifetime
Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE____________________________ Date When School/Program was recognized :September 28, 1998___ First Course (if any): NONE_______________________________ _ _ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE_____________________________________________________ _ _ Number: 234_______________________________________________ Year: 1998__ _ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ _ III. ACTUAL DELIVERIES Time of Gender of Delivery Baby
No.
Case No.
Diagnosis
Name of Mother
Age
Date of Delivery
1.
120
Gravida 2 Para 1, Pregnancy Uterine Full Term Cephalic in Labor
Joanne Gambo Baria
28
November 14, 2007
12:53 am
2.
943623
Gravida 7 Para 5, Pregnancy Uterine, 40 weeks Age of Gestation
Rosemir Bautista
32
December 2, 2008
3.
293623
Gravida 2 Para 0, Pregnancy Uterine, 40 weeks Age of Gestation
Raquel Lucero
28
4.
824723
Gravida 2 Para 0, 40 weeks Age of Gestation
5.
108923
Gravida 2 Para 1, Pregnancy Uterine Full Term 38 1/7 wk Age of Gestation
Liezl Estorninis
Jinky Marquez
Supervised by: Name, Registration No. and Signature of C.I.
Name of Hospital
Type of Delivery
Male
Veterans Regional Hospital
Normal Spontaneous Delivery Right Medio-Lateral Episiotomy Repair
9:02 pm
Male
Governor Faustino N. Dy Sr. Memorial Hospital
December 3,2008
7:40 am
Male
Governor Faustino N. Dy Sr. Memorial Hospital
22
February 22, 2009
8:50 am
Male
Governor Faustino N. Dy Sr. Memorial Hospital
28
February 24, 2009
6:05 am
Male
Governor Faustino N. Dy Sr. Memorial Hospital
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Normal Spontaneous Delivery
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Normal Spontaneous Delivery
Normal Spontaneous Delivery
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Normal Spontaneous Delivery
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a)
PRC No.: 0382671 Valid until: September 6, 2012
a)
PRC No.: 0090287 Valid until: March 20, 2012
a)
PRC No.: 0065793 Valid until: March 13,2010
a)
PRC No.: 0239713 Valid until: May 7,2010
b) c)
b)
PNA No.: 008136 Valid until: December 31, 2009 ANSAP No.:071193 Valid Until: February 23, 2010
c)
b)
PNA No.:5465 Valid until: Lifetime
c)
ANSAP No.:0311 Valid until: Lifetime
b)
PNA No.:002410 Valid until: December 31, 2009
c)
ANSAP No.: 090093 Valid until: December 31, 2009
PNA No.: 008135 Valid until: December 31,2009 ADPCN No.: 0830 Valid until: Lifetime
Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE____________________________ Date When School/Program was recognized :September 28, 1998___ First Course (if any): NONE_______________________________ __ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE______________________________________________________ _ Number: 234_______________________________________________ Year: 1998___ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ _
IV. DELIVERIES ASSISTED No.
Case No.
Diagnosis
Name of Mother
Age
Date of Delivery
Time of Delivery
Gender of Baby
Name of Hospital
Type of Delivery
1.
165
Gravida 1 Para 0, Pregnancy Uterine Full Term, Cephalic in Beginning Labor
Jayren Florendo Marcos
18
November 19, 2007
6:00 pm
Male
Veterans Regional Hospital
Normal Spontaneous Delivery with Medial Episiotomy Repair
Gravida 1 Para 0, Pregnancy Uterine, 40 weeks Age of Gestation
Cris Delight Limon
20
November 24, 2008
11:47 am
Female
Governor Faustino N. Dy Sr. Memorial Hospital
Gravida 1 Para 0, Pregnancy Uterine, 39 weeks Age of Gestation
Crislyn Lumawig
18
December 1,2008
11:23 pm
Female
Governor Faustino N. Dy Sr. Memorial Hospital
Normal Spontaneous Delivery
Lailanie Dancel
24
February 21, 2009
1:56 am
Male
Governor Faustino N. Dy Sr. Memorial Hospital
Normal Spontaneous Delivery
26
February 22, 2009
7:56 pm
Male
Governor Faustino N. Dy Sr. Memorial Hospital
Normal Spontaneous Delivery
2.
3.
810523
741223
4.
445423
Gravida 2 Para 1, Pregnancy Uterine, 40 weeks Age of Gestation
5.
926423
Gravida 2 Para 1, 40 weeks Age of Gestation
Rowena Topinio
Supervised by: Name, Registration No. and Signature of C.I.
Normal Spontaneous Delivery
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________ Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a)
PRC No.: 0382671
a)
PRC No.: 0090287
a)
PRC No.: 0065793
a)
PRC No.: 0239713
Valid until: September 6, 2012
b) c)
PNA No.: 008136 Valid until: December 31, 2009 ANSAP No.:071193 Valid Until: February 23, 2010
Valid until: March 20, 2012
b) c)
Valid until: March 13,2010
b)
PNA No.:5465 Valid until: Lifetime
c)
ANSAP No.:0311 Valid until: Lifetime
Valid until: May 7,2010
b)
PNA No.:002410 Valid until: December 31, 2009
c)
ANSAP No.: 090093 Valid until: December 31, 2009
PNA No.: 008135 Valid until: December 31,2009 ADPCN No.: 0830 Valid until: Lifetime
Saint Mary’s University SCHOOL OF HEALTH SCIENCES
Bayombong, Nueva Vizcaya Name of Student: SHEYENNE JOY APONGOL MARATA Accreditation Level: (if any) NONE__________________________ Date When School/Program was recognized :September 28, 1998___ First Course (if any): NONE_______________________________ __ Year of Admission in the Bachelor of Science in Nursing Program: 2005
Name and Address of School: SAINT MARY’ UNIVERSITY, BAYOMBONG, NUEVA VIZCAYA Year Granted: NONE______________________________________________________ _ Number: 234_______________________________________________ Year: 1998___ School Graduated From: NONE____________________________ Year: _NONE_____ _ _ Year Graduated (BSN Program): _2009_______________________________________ _
V. CORD DRESSING Supervised by: Name, Registration No. and Signature of C.I.
No.
Case No.
Date Performed
Name of Baby
Gender of Baby
Name of Mother
Age
Name of Hospital
1.
106
November 13, 2007
Bb Boy Reyes
Male
Jean Babaran Reyes
23
Veterans Regional Hospital
November 21, 2007
Bb Boy Caramat
Male
Maricel Abella Caramat
27
Veterans Regional Hospital
Male
Melody Lumano Bayangan
25
Veterans Regional Hospital
Charity Dela Cruz
29
Governor Faustino N. Dy Sr. Memorial Hospital
Gerald Roy R. Nipal, R.N. PRC#:0425978 Valid Until: August 3, 2010 PNA#: 00786 Valid Until: December 31,2009 Date Signed:__________
20
Governor Faustino N. Dy Sr. Memorial Hospital
Gerald Roy R. Nipal PRC#:0425978 Valid Until:8-03-10 PNA#: 00786 Valid Until:12-31-09 Date Signed:__________
2.
181
Bb Boy Bayangan
3.
242
November 28, 2007
4.
965223
February 21, 2009
Bb Boy Dela Cruz
Male
5.
98923
February 23, 2009
Bb Boy Castillo
Male
Vanessa Castillo
Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________ Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________ Mark Anthony B. Ramel, R.N. PRC#:0376177 Valid Until: October 28, 2011 PNA#: 007865Valid Until: December 31, 2009 Date Signed:__________
Prepared by: SHEYENNE JOY APONGOL MARATA (Name of Student) Supervised/Noted by:
Concurred by:
Concurred by:
Approved by:
RUBEN RAMUEL C. AMBATALI II Signature over Printed name of Clinical Coordinator Date signed: ______________________ Degree: RN, MSN
NELIA M. VICENTE Signature over Printed name of Chief Nurse of Veterans Regional Hospital Date signed: ______________________ Degree: RN, MAN
CRISTINA A. DUARTE Signature over Printed name of Chief Nurse of Gov. Faustino N. Dy Sr. Memorial Hospital Date signed: ______________________ Degree: RN, MSN
JHORDIN JAMES C. MONTEGRICO Signature over Printed name of Dean of School of Health Sciences Date signed: ______________________ Degree: RN, MSN
a)
PRC No.: 0382671
a)
PRC No.: 0090287
a)
PRC No.: 0065793
a)
PRC No.: 0239713
Valid until: September 6, 2012
b) c)
PNA No.: 008136 Valid until: December 31, 2009 ANSAP No.:071193 Valid Until: February 23, 2010
Valid until: March 20, 2012
b) c)
PNA No.:5465 Valid until: Lifetime ANSAP No.:0311 Valid until: Lifetime
Valid until: March 13,2010
b) c)
PNA No.:002410 Valid until: December 31, 2009 ANSAP No.: 090093 Valid until: December 31, 2009
Valid until: May 7,2010
b) c)
PNA No.: 008135 Valid until: December 31,2009 ADPCN No.: 0830 Valid until: Lifetime
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