RN-Occupational and Employee Health

I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Proficiency Scale

1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
Trauma Rating Stars (Click) 1 2 3 4
Care of Patient with Minor Trauma
Care of Patient with Major Trauma
MAST Suit
Burns Rating Stars (Click) 1 2 3 4
Care of Patient with First Degree Burns
Care of Patient with Second Degree Burns
Care of Patient with Third Degree Burns
Care of Patient with Electrocution
Care of Patient with Hazardous Materials Exposure
Lacerations Rating Stars (Click) 1 2 3 4
Assessment of Lacerations
Cleansing of Lacerations
Use of Steri-Strips for Lacerations
Dressing of Lacerations
Sprain/Strain Rating Stars (Click) 1 2 3 4
Assessment of Sprain/Strain
Care of Patient with Carpal Tunnel
Care of Patient with Tendonitis
Care of Patient with Epicondylitis
Physicals Rating Stars (Click) 1 2 3 4
Safety
Return to Work
Respirator
Vital Signs
Height/Weight
Blood Draw
Medical Referral Form
Medical Certification Form
Medical History Questionnaire
Potassium Iodine Assessment
Restrictions Rating Stars (Click) 1 2 3 4
Temporary Restrictions
Permanent Restrictions
Pulmonary Function
Audiometry
Vision Testing
X-ray
Urine Testing
Drug Testing
Breathalyzer
Immunizations Rating Stars (Click) 1 2 3 4
Havrix (Hepatitis A)
Influenza Vaccine
Meningitis Vaccine
Tetanus & Diphtheria
Oral Typhoid Vaccine
Polio Vaccine
Hepatitis B Vaccine
Japanese Encephalitis B
Rabies Vaccine
Typhim (Injectable Type)
Yellow Fever Vaccine
Age Specific Competencies Rating Stars (Click) 1 2 3 4
Newborn (birth to 30 days)
Infant (30 days - 1 year)
Toddler (ages 1-3 years)
Preschooler (3-5 years)
School Age Children (5-12 years)
Adolescents (12-18 years)
Young Adults (18-39 years)
Middle Adults (39-64 years)
Older Adults (64+)