Travel Nursing

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
Cardiac Rating Stars (Click) 1 2 3 4
Acute Coronary Syndrome
Congestive Heart Failure
Post Open Heart (12-24 hours)
Carotid Endarterectomy
Post Vascular Surgery
Heart Transplant
Pacemaker - Temporary/Permanent
Pacemaker - Epicardial
Sheath Removal
Heart Sounds
Pulmonary Rating Stars (Click) 1 2 3 4
Pneumonia
Respiratory Distress
COPD
Post Thoracic Surgery
Chest Tube Placement & Management
Trach Management
Modes of Ventilation (AC/PC/SIMV/CPAP)
Intubation/Extubation
External CPAP/BiPAP
Interpretation of Arterial Blood Gases
Neurologic & Psychiatric Rating Stars (Click) 1 2 3 4
Stroke Scale Assessment
CVA
Brain Injury
Post Craniotomy
Spinal Cord Injury
Seizure Disorders
ETOH/Drug Withdrawal
Gastrointestinal Rating Stars (Click) 1 2 3 4
GI Bleeding
GI Surgery
Liver Failure
Pancreatitis
Liver Transplant
Pancreas Transplant
Renal/Genitourinary Rating Stars (Click) 1 2 3 4
Renal Failure
Renal Surgery
Renal Transplant
Arteriovenous Fistula/Shunt
Nephrostomy Tubes
Peritoneal Dialysis
Endocrine Metabolic Rating Stars (Click) 1 2 3 4
Diabetes - Hypo/Hyperglycemic Crisis
Pituitary Disorders
IV Insulin Protocols
Indwelling Insulin Pumps
Medications Rating Stars (Click) 1 2 3 4
Anti-Arrhythmics
Anticoagulants (IV, oral, & injection)
Anti-Hypertensives
Anti-Psychotics
Anti-Seizure Medications
Benzodiazepines
Procedural Sedation
Diuretics
Emergency Medications
Inhaled Medications
Insulin
Titrate Vasoactive Drips
Manage Vasoactive Drips - No Titration
Nitrates (Oral & Topical)
Non-Opioid Analgesics (IV, Oral, & Injection)
Reversal Agents
Steroids (IV, Oral, Inhaled)
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
IV Therapy Rating Stars (Click) 1 2 3 4
Starting IVs
Central Line Blood Draws
Central Line/Implanted Line Care
Arterial Line Management
TPN & Lipids
Blood Product Administration
Administration of Chemotherapy
Cardiac Monitoring & Emergency Response Rating Stars (Click) 1 2 3 4
Dysrhythmia Interpretation
Dysrhythmia Management
Obtain 12 Lead EKG
Interpret 12 Lead EKG
Cardioversion
Defibrillation
Malignant Hyperthermia
Professional Knowledge and Skills Rating Stars (Click) 1 2 3 4
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
Pressure Ulcer Risk Assessment/Prevention
Restraints/Use of Least Restrictive Device
Patient/Family Teaching
Age Specific/Population-Based Care
Isolation Precautions
Infection Prevention
Pain Assessment & Management
Charge Experience
Interpretation and Communication of Lab Values
Specialty Beds
Age Specific Competencies Rating Stars (Click) 1 2 3 4
Infant (Birth - 1 year)
Preschooler (ages 2-5 years)
Childhood (ages 6-12 years)
Adolescents (ages 13-21 years)
Young Adults (ages 22-39 years)
Adults (ages 40-64 years)
Older Adults (ages 65-79 years)
Elderly (ages 80+ years)
EMR Rating Stars (Click) 1 2 3 4
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration