REPUBLIC OF THE PHILIPPINES
BICOL UNIVERSITY POLANGUI
NURSING DEPARTMENT
Polangui, Albay
ISO 9001:2015 Email: [Link]@[Link]
SOCOTEC SCP000722Q
RELATED LEARNING EXPERIENCE RULES AND REGULATIONS
The conduct of Level II Related Learning Experience will be ruled by the following rules and regulations,
in accordance with the CMO 15 series of 2017 and the College of Nursing Training Manual.
I. Clinical Assignments
1. As determined by the Commission on Higher Education (CHED) one unit of RLE is equivalent to
fifty-one (51) hours of clinical experience unless changed. Students should complete the required
number of hours/RLE per level.
2. Students are required to attend the general orientation in the affiliating agency; only those who
attend the general orientation will be allowed to go on duty in the said agency.
3. The approved clinical assignments shall be followed strictly.
4. The students in the clinical area should be in complete prescribed uniforms and with proper
paraphernalia.
II. Attendance
1. Students should report for duty at least 15 minutes before the start of the shift.
2. A student may be late for duty only up to 15 minutes after the start of the shift; beyond 15 minutes,
he/she is considered absent but will be made to stay in the area for security reasons.
3. Students should indicate their time of arrival and departure in the logbook available in their work
stations.
4. A student absent from the clinical duty should present, on the first day he/she reports for duty
classes, an excuse letter signed by the Level Coordinator and/or the RLE Supervisor and noted by
the Dean. Students may be allowed to go on duty at the discretion of the Clinical Instructor,
otherwise, no students will be allowed to report for duty the following day without the duly signed
excuse letter.
5. Any student who fails to go on duty for two successive weeks or has been absent for 15% of the total
number of required RLE hours, shall be made to explain to the Level Coordinator who shall write a report
about it to the Dean and the College Guidance Coordinator. The parent/guardian shall likewise be notified
of the absences.
6. When the number of hours lost by absence of a student reaches fifty percent (50%) of the required
duty hours per shift, he/she shall be required to repeat the rotation.
7. Records of absences and tardiness shall be monitored by the RLE Supervisor/Level Coordinator
every shift of each day. The clinical instructors likewise make a monthly report of student absences
and tardiness to the respective Level Coordinators. The College Guidance Coordinator shall
likewise be informed.
8. Make up of excused absence shall be for the corresponding number of days of absence while one
day of unexcused absence shall be made up for three days; three times late shall be considered 1
absence and to be made-up for one (1) duty day.
9. Make up duty should be done outside the regular/required duty hours. Hence, the student shall pay the
corresponding additional affiliation fee and honorarium for the Clinical Instructors. Computation of the
amount to be paid by the students for the RLE honorarium shall be based on the prevailing approved rate
per hour and the number of students reporting for duty in a particular ward of clinical area. Computation of
the affiliation fee shall likewise be based on the rate approved by the DOH Regional Committee on
Affiliation Program. Collection of the fees shall be made prior to scheduling a duty. A letter will be sent
to the parents indicating the total amount the student has to pay for his/her make up duty. All fees to be
collected shall be paid directly to the BU Polangui cashier.
10. The respective Clinical Instructors shall report to the Level Coordinator all tardiness and absences
from duty during the month. The Level Coordinator will make a summary of absences and
tardiness for the month and in the semester and schedule the make-up duty during the Semestral,
Christmas, and Summer Vacation Months.
11. Absence without due cause during the make up duty shall be considered a double unexcused absence. For
example, one unexcused absence during the make up duty shall be made up for 6 days. Excused absence
during the make up duty shall be made up with the corresponding number of days of absence.
12. All absences from RLE should have been made up before the enrolment for the next semester of
the school year or before they are endorsed for graduation to the academic council. No student
REPUBLIC OF THE PHILIPPINES
BICOL UNIVERSITY POLANGUI
NURSING DEPARTMENT
Polangui, Albay
ISO 9001:2015 Email: [Link]@[Link]
SOCOTEC SCP000722Q
shall be allowed to enrol for the next higher learning unless he/she has completed the required
RLE hours of the prerequisite subject.
13. Students participating in other school activities should properly inform the Clinical Instructors and
the Level Coordinators to avoid being marked absent in the clinical area. A letter or document
pertinent to the participation for the activity duly approved by the Dean should be presented to the
concerned CI’s.
Conduct While on Duty
1. All students are required to observe proper decorum while on duty. Dealing with patients, hospital
staff and other affiliating students shall be done in a professional manner. Familiarity with these
persons is discouraged.
2. Students must be punctual and prompt and are expected to actively participate in all
ward/activities.
3. No visitor should be entertained except in very urgent cases with the permission of the CI’s.
4. Except for a very justifiable reason (illness or death in the family) no student is allowed to cut
short his/her duty hours; the student submits a written request for this to be approved by the CI or
the Dean.
5. Meals or snacks shall only be taken within the hospital premises; or no account shall a student be
allowed to take his meal or snacks outside the hospital premises. Snack time is limited to fifteen
(15) minutes while mealtime shall be thirty (30) minutes only.
6. No student is allowed to accept for safekeeping jewellery/personal belongings of clients who will
undergo surgery or diagnostic procedures. These should be endorsed to the staff nurse and properly
recorded in the patient’s chart.
7. Playing cards or other games, reading books, comics, and magazines except nursing books are
strictly prohibited while on duty. Text messaging and use of cell phones may be allowed for
emergency and a case-to-case basis only. Smoking is prohibited and students under the influence
of alcoholic drinks shall not be allowed to go on duty.
8. Noise should be minimized especially in the student’s area and student nurses should spend more
time with their patients rather than with their duty mates.
9. Littering, loitering and any act of vandalism is strictly prohibited.
10. The student shall at all times follow the rules and Regulations governing the affiliation imposed
by the affiliating agencies and the Rule and Conduct of students as provided by University/College
or School Student Handbook. Violation of these guidelines shall have corresponding sanctions.
III. Uniform
1. All students are required to be in prescribed uniform while on clinical or community duty. Any
student not in proper attire will not be accepted in the ward center. This will mean the student will
be marked absent for that day equivalent to an unexcused absence.
2. Smock gowns shall be worn in reporting and coming from the clinical areas.
In the Clinical Area, the approved uniforms for special areas are:
Female:
White close cap and gown (if in the OR, DR, and NICU) and CD Gown (isolation rooms),
Nameplate, Wrist watch with second hand
Male:
White close cap and gown (if in the OR, DR, and NICU) and CD Gown (isolation rooms),
Nameplate, Wrist watch with second hand
In the CHN the required uniform for both male and female as prescribed by the institution, college, or
university.
3. Every student should be equipped with the required paraphernalia as part of his/her uniform such
as bandage scissors, ballpens (red, blue, green, violet, or black), ruler, eraser, pencil, thermometer,
sphygmomanometer, and other paraphernalia required by the CI’s.
4. The no excessive make-up, no coloured nail polish, and no hair highlights policy shall be strictly
observed.
REPUBLIC OF THE PHILIPPINES
BICOL UNIVERSITY POLANGUI
NURSING DEPARTMENT
Polangui, Albay
ISO 9001:2015 Email: [Link]@[Link]
SOCOTEC SCP000722Q
5. Female students wearing nurse’s cap are not allowed to wear ribbon nor colored hairpins or clips.
6. The hair should not touch the collar or the neckline of the uniform.
7. Only the wrist watch with second hand and the wedding ring for married students may be worn in
the ward. Wearing of other pieces of jewellery except those earlier mentioned is prohibited.
8. Undergarments worn should only be white or skin tone. Females are required to wear chemise
and the males should wear undershirt without colored designs.
9. White rubber shoes are not allowed while on duty.
IV. Related Learning Experience
1. RLE requirements such as client care plans, case study, case analysis, drug notebook, etc., deemed
necessary by the CI’s must be submitted by the students on time as announced by the CI’s during
the first day of duty. The students must be aware that such requirements are part of the RLE grade.
2. Errors in medication committed by the student shall be properly reported to the Clinical Instructors
who shall deal with it according to approved agency policies. The student who committed the error
shall write a letter of explanation to this effect. This, together with the CI’s incident report, shall
be submitted by the Level Coordinator to the Dean who shall determine the veracity of the report.
The College Disciplinary Committee shall be convened when deemed necessary. Likewise, the
parents/guardians of the student shall be notified of the incident.
V. Incident Reporting
The primary purpose of the incident report is to document and prevent possible consequent injuries.
Classifying an event as an incident doesn’t imply that someone made a mistake; it only means that something
unusual happened.
An incident report should contain the following information:
1. The name of the client
2. The name of the client’s attending physician
3. The date and time of the incident
4. The name of all persons responsible for the care, and their responsibilities (not just the persons
involved in the incident)
5. The nature of the incident (equipment failure, drug allergy, medication error, etc.)
6. The nature of the client’s injuries, if there’s any
7. The physician who evaluated the client after the incident
8. The physical location of the client after the incident
9. The client’s condition before the incident
10. The client’s condition after the incident
11. The equipment or drugs involved in the incident
The incident report should be typewritten in short bond paper and submitted within 24 hours after the
incident. The report should be in five (5) copies, one (1) each for the college/university and Office of the affiliating
agency, the Level Coordinator, the Clinical Instructor, and personal file of the student.
All incident reports should be kept in conditional files. These guidelines may vary from school to school.
CECILIA MARIE G. SALLE
Signature over printed name of the STUDENT
ROBERTO S. SALLE JR.
Signature over printed name of the FATHER/GUARDIAN
AGNES G. SALLE
Signature over printed name of the MOTHER/GUARDIAN
REPUBLIC OF THE PHILIPPINES
BICOL UNIVERSITY POLANGUI
NURSING DEPARTMENT
Polangui, Albay
ISO 9001:2015 Email: [Link]@[Link]
SOCOTEC SCP000722Q
PERMIT FOR 1st SEMESTER RLE AFFILIATION
A.Y 2026-2027
TO WHOM IT MAY CONCERN
This is to certify that we are permitting our son/daughter CECILIA MARIE G. SALLE
to join the 1ST SEMESTER RLE AFFILIATION of the Level II student of BICOL UNIVERSITY
POLANGUI, NURSING DEPARTMENT to BICOL REGIONAL HOSPITAL AND MEDICAL
CENTER (BRHMC), DARAGA, ALBAY; JOSEFINA BELMONTE DURAN ALBAY
PROVINCIAL HOSPITAL (JBDAPH), LIGAO CITY; DR. LORENZO P. ZIGA MEMORIAL
DISTRICT HOSPITAL (DLPZMDH), RHU-BEMONC POLANGUI, POLANGUI, ALBAY;
RHU-LIBON LYING IN, LIBON ALBAY from AUGUST 8, 2026 to NOVEMBER 28, 2026. This is
in compliance with the requirements on the Related Learning Experience under the subject of NCM 104
and NCM 109.
We understand that the Bicol University and its concerned faculty and staff will take utmost care
and diligence in attending to the safety, welfare and needs of our son/daughter. However, in case of
untoward events beyond their control, we shall not hold them legally liable and responsible.
We further certify and understand the affiliation rules and regulation of the Bicol University
Polangui, Nursing Department (ND).
ROBERTO S. SALLE JR. AGNES G. SALLE
(Signature over Printed Name) (Signature over Printed Name)
Father/Guardian Mother/Guardian
JUNE 15, 2026
Date Signed: ________________________________
ACKNOWLEDGMENT
BEFORE ME THIS_____DAY OF__________ affiant exhibiting to me their Community Tax
No.____________________ issued on ____________________ at
________________________________________ and Community Tax No.____________________
know to me and to me know to be the same person who executed the foregoing instrument which we
acknowledge before me as his/her free voluntary act and deed.
WITNESSED MY HAND AND SEAL this _____ day of _________________, 20____ at
___________________________________________________________________________.
Doc. No.___________
Page No.___________
Book No.__________
Series of 2026. ______
REPUBLIC OF THE PHILIPPINES
BICOL UNIVERSITY POLANGUI
NURSING DEPARTMENT
Polangui, Albay
ISO 9001:2015 Email: [Link]@[Link]
SOCOTEC SCP000722Q
Name of Student: Date: ______________
Name of Parents/Guardian
Name of Father :
Name of Mother :
Guardian :
Provincial Address:
Home Address:
Name and Address of relative/guardian in Legazpi City and Ligao City, where the affiliate may stay
overnight during weekend:
Name: ___________________ Relationship: _______________ CP#: _____________
Complete Address:
Name of Person who fetch her at the dorm:
Indicate if she can leave the dorm alone:
Other relative in Legazpi City and Ligao City or in nearby where the affiliate may visit:
Name: ______________________ Relationship: _________ Address: ______________ CP#: _________
Name: ______________________ Relationship: _________ Address: ______________ CP#: _________
Name: ______________________ Relationship: _________ Address: ______________ CP#: _________
Name: ______________________ Relationship: _________ Address: ______________ CP#: _________
We certify, that the Information Stated above, is full of knowledge and they are True and Correct.
Parents Name and Signature
CP#: