NAMA : …………………………………………………….
KELAS : ……………………………………………………..
NIS : …………………………………………………….
Kompetensi Keahlian :
Keperawatan
Salah satu tujuan Sekolah Menengah Kejuruan (SMK) adalah menyiapkan Peserta
Didik sebagai tenaga kerja tingkat menengah yang trampil, terdidik dan profesional serta
mampu mengembangkan diri sejalan dengan perkembangan ilmu dan teknologi Untuk
mencapai tujuan tersebut penyelenggaraan pendidikan dilakukan dengan sistem ganda, yaitu
penyelenggaraan pendidikan dan pelatihan memadukan antara pembekalan aspek normatif,
adaptif dan dasar produktif di sekolah dengan pembekalan aspek produktif serta spesialisasi di
Rumah sakit.
SMK Kesehatan Asy Syifa sebagai salah satu sekolah menengah kejuruan yang ada di
Kota Tangerang juga menyelenggarakan pendidikan dan pelatihan dengan sistem ganda.
Sebagai wujud pelaksanaan sistem ganda tersebut maka SMK Kesehatan Asy Syifa
menyelenggarakan Praktik Kerja Lapangan (PKL) bagi para Peserta Didik.
PKL sebagai suatu bentuk pembelajaran yang dilakukan di Rumah sakit perlu
senantiasa diawasi pelaksanaannya agar kegiatan tersebut benar-benar terarah dan sesuai
dengan ide dasarnya. Di sisi lain guru sebagai pembimbing tidak mungkin mengikuti
perkembangan Peserta Didik secara rutin di Rumah sakit dengan berbagai pertimbangan.
Untuk itulah selain adanya pengawasan langsung dari Pembimbing Rumah sakit maka
keberadaan Buku Kegiatan Peserta Didik merupakan perangkat yang diharapkan dapat
menjadi patokan kegiatan dan rekaman aktivitas Peserta Didik selama di Rumah sakit.
Atas dasar pola pikir tersebut diatas maka buku ini akan sangat membantu jika Peserta
Didik dengan bimbingan guru, pihak Rumah sakit memahami dan secara teratur mengisinya.
Semoga buku ini dapat memberikan manfaat bagi Peserta Didik dan pihak-pihak yang
berkepentingan, Amiin.
Halaman
IV. SANKSI
Semua Peserta Didik yang menyimpang dari aturan diatas akan diberi sanksi dan
pembinaan.
1. Nama : ..............................................................................................
2. NIS : ..............................................................................................
3. Tempat/Tanggal lahir : ..............................................................................................
4. Jenis Kelamin : ..............................................................................................
5. Golongan Darah : ..............................................................................................
6. Agama : ..............................................................................................
7. Alamat Rumah : ..............................................................................................
..............................................................................................
Telp/ HP...............................................................................
8. Alamat Kos : ..............................................................................................
..............................................................................................
Telp./ HP..............................................................................
9. Nama Orang Tua :
Ayah : ..............................................................................................
Ibu : ..............................................................................................
Alamat : ..............................................................................................
..............................................................................................
Telp./ HP..............................................................................
...................................
4. Nama Pembimbing :
..........................................................................................
Rumah sakit
Contact Person : ..........................................................................................
Telp./ HP. .........................................................................
.................................................
1. Nama : ..............................................................................................
2. Tempat/Tanggal lahir : ..............................................................................................
3. Jenis Kelamin : ..............................................................................................
4. Agama : ..............................................................................................
5. Alamat Rumah : ..............................................................................................
..............................................................................................
Telp/ HP...............................................................................
.................................................
HARI/TGL/ PARAF
NO URAIAN KEGIATAN PEMBIMBING
WAKTU
PARAF
NO HARI/TGL/ URAIAN KEGIATAN
HARI/TGL/ PARAF
NO URAIAN KEGIATAN PEMBIMBING
WAKTU
LEMBAR
ASUHAN KEPERAWATAN
1. PENGKAJIAN
2. PROSES KEPERAWATAN
A. Pengkajian
....................................................................................................................................
C. Rencana Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
D. Implementasi Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
E. Evaluasi Keperawatan
S : ...............................................................................................................
...............................................................................................................
O : ...............................................................................................................
...............................................................................................................
A : ...............................................................................................................
...............................................................................................................
P : ...............................................................................................................
...............................................................................................................
…………………………… ……………………………
LEMBAR
ASUHAN KEPERAWATAN
1. PENGKAJIAN
2. PROSES KEPERAWATAN
A. Pengkajian
....................................................................................................................................
C. Rencana Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
D. Implementasi Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
E. Evaluasi Keperawatan
S : ...............................................................................................................
...............................................................................................................
O : ...............................................................................................................
...............................................................................................................
A : ...............................................................................................................
...............................................................................................................
P : ...............................................................................................................
...............................................................................................................
…………………………… ……………………………
LEMBAR
ASUHAN KEPERAWATAN
1. PENGKAJIAN
2. PROSES KEPERAWATAN
A. Pengkajian
....................................................................................................................................
C. Rencana Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
D. Implementasi Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
E. Evaluasi Keperawatan
S : ...............................................................................................................
...............................................................................................................
O : ...............................................................................................................
...............................................................................................................
A : ...............................................................................................................
...............................................................................................................
P : ...............................................................................................................
...............................................................................................................
…………………………… ……………………………
LEMBAR
ASUHAN KEPERAWATAN
1. PENGKAJIAN
2. PROSES KEPERAWATAN
A. Pengkajian
....................................................................................................................................
C. Rencana Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
D. Implementasi Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
E. Evaluasi Keperawatan
S : ...............................................................................................................
...............................................................................................................
O : ...............................................................................................................
...............................................................................................................
A : ...............................................................................................................
...............................................................................................................
P : ...............................................................................................................
...............................................................................................................
…………………………… ……………………………
LEMBAR
ASUHAN KEPERAWATAN
1. PENGKAJIAN
2. PROSES KEPERAWATAN
F. Pengkajian
....................................................................................................................................
H. Rencana Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
I. Implementasi Keperawatan
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
J. Evaluasi Keperawatan
S : ...............................................................................................................
...............................................................................................................
O : ...............................................................................................................
...............................................................................................................
A : ...............................................................................................................
...............................................................................................................
P : ...............................................................................................................
...............................................................................................................
…………………………… ……………………………
CATATAN PEMBIMBING RUMAH SAKIT
PARAF PEMB
NO. HARI/TANGGAL KETERANGAN PARAF ORTU
Rumah sakit
................................. .......................................