PROTOTYPE PERSONAL FILE FOR STAFF NURSES
PROTOTYPE PERSONNEL FILE:
Prototype personnel file is the first or earlier form from which other forms are developed or
copied which belonging to a particular person who work for an organization, done by a
particular person rather than someone else. The state laws permit employees the right to
examine their personal employment records for verification. The main uses are:
To have accurate information handy and organized when you want to use it.
The need to produce documentation about employee performance and work history
by the manger task can be made easier
RECOMMENDED CONTENTS OF PERSONNEL FILES:
Employment
Request for application
Employee's original employment application
Prescreening application notes
College recruiting interview report form
Employment interview report form
Education verification
Employment verification
Other background verification
Rejection letter
Employment agency agreement if hired through an agency
Employee handbook acknowledgement form showing receipt of handbook
Employment offer letter
Checklist from new employee orientation showing subjects covered
Veterans/Disabled self-identification form
Transfer requests
Relocation offer records
Relocation report
Security clearance status
Payroll
Weekly time sheets
Individual attendance record
Pay advance request record
Garnishment orders and records
Authorization for release of private information
Authorization for all other payroll actions
Performance appraisal
New employee progress reports
Performance improvement program records
Performance appraisal form
Training and development
Training history records
Training program application/requests
Skills inventory questionnaire
In-house training notification letters
Training expense reimbursement records
Employee Separations
Exit interview form
Final employee performance appraisal
Exit interviewer's comment form
Record of documents given with final paycheck
Benefits
Emergency contact form
Medical/Dental Vision coverage waiver drop form
Vacation accrual/taken form
Request for non-medical leave of absence
Retirement application
Payroll deduction authorizations
COBRA notification election
Wage/ salary administration
Job description form
Payroll authorization form
Fair labors standard act exemption test
Compensation history record
Notification of wage or salary increase/decrease
ASPIRATION
Seeking an opportunity to work with your esteemed institution contributing to the
fulfilment of the institutional objectives by utilizing my skills and abilities that I earned
throughout my studies in the field of nursing and ensuring personal growth while being
resourceful, innovative and flexible.
PROFESSIONAL QUALIFICATIONS
Qualification Institution University Passing year
B.Sc. Nursing Tripura college of Tripura university 2012 September
nursing .Agartala
ACADEMIC QUALIFICATION
Qualification Institution Board Specialization Passing year
Higher Sishu Bihar CBSE HSSLC March 2008
secondary higher
examination secondary
school
Secondary Girls Bojung TBSE SSLC March 2006
school leaving high school
certificate
examination
MEMBERSHIP OF PROFESSIONAL BODIES
Organization Type Register number Registration date
Tripura state nursing Life membership 0151438 August 2012
council
EXPERIENCE DETAILS
Current employment details
Period: June 2016- oct 2018
Specification: Staff nurse
Hospital: ILS Hospital, Agartala
DUTIES AND RESPONSIBILITIES
1. Assess plans implements and evaluate nursing care from the admission to discharge
2. Has a specialized knowledge and confidence required to perform well in their
speciality.
3. Regularly takes charges of the unit in the absence of head nurse and assistant head
nurse.
4. Maintain the safety and well being of the patient and staff in accordance with health
and safety policy.
5. Participates in the orientation of unit routines for staff nurses.
6. Establishes and develops effective communication with all disciplines
7. Excellent in collection of blood and IV cannulation.
8. Competes in preparation and administration of medications, blood products and
parenteral nutrition.
9. Capable of assisting the physician for diagnostic and therapeutic procedure
aseptically.
10. Carries out doctor order in conformity with hospital and legal limitations
11. Ensure that all documentation is complete with both accuracy and legibility.
12. Up to date ongoing professional development education and attendance.
ADMINISTRATIVE DUTIES
Ordering of unit stocks
Orientation of new staff members
Presentation of in service training sections
Shift leader duties
SPECIAL PROCEDURES:
Exchange blood transfusion
Transfusion of blood and blood products
IV cannulation and blood extraction
Assisting in endotracheal intubation and extubation
Nasogastric tube introduction
Urinary catheterization
Bladder wash
Stomach wash
NG feeding
Tracheostomy assist
ET intubation
NG tube insertion
Suctioning
COMMON PROCEDURES
Intensive care
Administration of emergency medicines with doctors only
Admission and shifting procedure
General care and hygiene
Physical measurement
Cardiac monitoring
Oxygen administration
Collection of specimen
Wound dressing
IV cannulation
EQUIPMENTS USED IN HOSPITAL:
Cardiac monitor
Pulse oximetry
Glucometer
Laryngoscope
Suction apparatus
Nebulizer
Cardiac monitor
Syringe pump
Infusion pump
BP apparatus
Weighing machine
ECG machine
Doppler machine
Needle burner
Ventilator
Humidifier
Oxygen flow meter
PERSONAL DATA:
Permanent address: Ms. Reshmi Debbarma
Date of Birth: 15-05-1990
Sex : female
Language known: English, Hindi, Bengali , Kokborok
Nationality : Indian
Marital status:.. Unmarried
DECLARATION
I hereby declare that the curriculum is true and correct as on my knowledge.
Ms, Reshmi Debbarma
APPLICATION FOR THE POST OF STAFF NURSE
From,
Ms, Reshmi Debbarma
TBCU, A.D Nagar, 799003
To.
The chairman
TMC & Dr. BRAM TEACHING HOSPITAL
Subject: Application for the post of staff nurse
Respected Sir/Madam,
I am a dynamic young woman of pleasant manner and good personality. I
possess communication skills and I am true responsible. I wish to forward my candidature
for your kind consideration and I kindly request you to provide me an opportunity to work in
your esteemed organization. I assure that, I shall be an asset for your prestigious
organization.
Thanking you
Place: Yours’s faithfully
Date: Ms, Reshmi Debbarma
PROTOTYPE FILE FOR FACULTY
ASPIRATION:
Seeking an opportunity to work with your esteemed institution contributing to the
fulfilment of the institutional objectives by utilizing my skills and abilities that I earned
throughout my studies in the field of nursing and ensuring personal growth while being
resourceful, innovative and flexible.
PERSONAL PARTICULARS
Post applied: Tutor
Name : Ms. Rima Das
Fathers name: Mr. Uttam Das
Mother’s name: Mrs. Gita Das
Date of birth: 15-05-1990
Sex : Female
Religion : Hindu
Nationality : Indian
Marital status: Unmarried
Language known: English, Bengali, Hindi
Permanent address: Ms. Rima Das
c/o- Mr. Uttam Das
Amarpur,799101
EDUCATION QUALIFICATION
Qualification Institution Year of passing University/ Percentage of
board marks
Higher Sishu Bihar March 2008 CBSE 72%
secondary higher
examination secondary
school
Secondary Amarpur high March 2008 TBSE 78%
school leaving school
certificate
examination
PROFESSIONAL QUALIFICATION
Course and year Duration University Percentage & marks
I year B.Sc. Nursing 2008- 2009 Tripura university 70%
II year B.SC nursing 2008- 2010 Tripura university 62%
III year B.SC nursing 2010- 2011 Tripura university 70%
IV year B.SC nursing 2011-2012 Tripura university 65&
WORK EXPERIENCE
Worked as a tutor in Institute of nursing science, Agartala, Tripura from 2013 to 2015
ACCREDITATION:
Indian nursing council, Tripura nursing council.
DECLARATION:
I hereby declare that all the statement made in this application are true and correct to the
best of my knowledge. I undertake to produce all my original certificates at the time of
appearing in selection test/ interview.
Place : Ms. Rima Das
Date : Amarpur,799101
CUMULATIVE RECORD- B.Sc. NURSING
Name: Father’s Name: University Reg, No.
Date of birth: Date of admission: Date of completion: Marks obtained:
Address:
Remarks
Subject Theory instructions Hours of particle Examination marks
Examination
hours experience
Prescribed Attended Prescribed Attended Maximum Obtained
Theory Practical Theory Practical
Anatomy and physiology 60+60 100
Nutrition and Biochemistry 60+30 100
Nursing foundation 265+200 450 100 200
Psychology 60 100
B.Sc B.Sc. (N) 1st year
Microbiology 60 100
English 60 100
Computer 45 100
year
Sociology 60 100
.(N)
2nd
Medical Surgical Nursing I 210 720 100 200
Pharmacology, Pathology& 45+30+15 100
Genetics
Community Health Nursing 90 135 100
I
Communication& 60+30 100
Educational Technology
Medical Surgical Nursing II 120 270 100 100
Child Health Nursing 90 270 100 100
B.Sc. 3rd
Mental Health Nursing 90 270 100 100
Midwifery& Obstetrical 90 180 100 100
Nursing
Community Health Nursing 90 135 100 100
II
B.Sc. (N) 4th year
Nursing Research& 45 100
Statistics
Management of Nursing 60+30 100
services& education
Total 2055 2610 1900 900
LEAVE TAKEN
Year Annual Sick Conference
REGISTRATION
Registration Number with P.N.R.C. Registration Number with T.N.A.I.
R.N. (Registered Nurse)
R.M. (Registered Midwife)
CHARACTER & CONDUCT
Dated Principal’s signature
CUMULATIVE RECORD M.Sc. NURSING
Name: Father’s Name: University Reg, No.
Date of birth: Date of admission: Date of completion: Marks obtained:
Address:
Examination Subject Theory instructions Hours of practical Examination Marks
Hours Experience
Maximum Obtained
Practical Attended Practical Attended Theory Practical Theory & Remarks
Practical
Nursing 150 150 100 100
education
Advanced 150 200 100
Nursing
Practice
Nursing 150 100 100
Research and
statistics
M.Sc.(N) 1st year
Clinical 150 650 100 200
specialty-I
Total 600 1100 400 300
Nursing 150 150 100
Management
Nursing 300 200
research
(Dissertation)
M.Sc.(N) 2nd year
Clinical 150 950 100 200
specialty-II
Total 300 1400 200 400
LEAVE TAKEN
YEAR ANNUAL SICK
1st year
2nd year
REGISTRATION
Registration Number with B.Sc.(N) M.Sc.(N) Registration Number with
P.N.R.C
RN (Registration Nurse)
R.M, (Registration Midwife)
Character & Conduct:
Dated Principal
BIBLIOGRAPHY:
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