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Skills Checklist

Med/Surg

Let’s assess your clinical skills and experience. Fill out this checklist to get one step closer to your next opportunity.

1 = No theory and/or experience 2 = Limited Experience 3 = Experienced/minimal support needed to perform 4 = Proficient

General Skills
Standard Precautions*
- 1
- 2
- 3
- 4
Isolation Precautions*
- 1
- 2
- 3
- 4
Discontinue PIV*
- 1
- 2
- 3
- 4
Initiate Peripheral IV*
- 1
- 2
- 3
- 4
Crash Carts*
- 1
- 2
- 3
- 4
Defibrillators*
- 1
- 2
- 3
- 4
Care of Patients in Restraints*
- 1
- 2
- 3
- 4
Pain Management*
- 1
- 2
- 3
- 4
Automated Med Dispensing*
- 1
- 2
- 3
- 4
Care Planning and Discharge Planning*
- 1
- 2
- 3
- 4
Patient/Family Education*
- 1
- 2
- 3
- 4
Patient Head to Toe Assessment*
- 1
- 2
- 3
- 4
Dressing Changes*
- 1
- 2
- 3
- 4
Knowledge of Normal Serum Lab Values*
- 1
- 2
- 3
- 4
Obtaining Cultures*
- 1
- 2
- 3
- 4
Administration of Blood and Blood Products*
- 1
- 2
- 3
- 4
Infusion Pumps*
- 1
- 2
- 3
- 4
Calculate mcg/min and mcg/kg/min*
- 1
- 2
- 3
- 4
Titrating Medications*
- 1
- 2
- 3
- 4
Respiratory Cardiac Arrest*
- 1
- 2
- 3
- 4
Psychological
Overdose/Withdrawal*
- 1
- 2
- 3
- 4
Suicidal Precautions*
- 1
- 2
- 3
- 4
Manic Disorder/Behavior*
- 1
- 2
- 3
- 4
De-escalation Techniques*
- 1
- 2
- 3
- 4
Psych Medications*
- 1
- 2
- 3
- 4
Medications
Anticoagulants*
- 1
- 2
- 3
- 4
Narcotics*
- 1
- 2
- 3
- 4
PCA for Pain Control*
- 1
- 2
- 3
- 4
Epidural for Pain Control*
- 1
- 2
- 3
- 4
Non-narcotic Analgesics*
- 1
- 2
- 3
- 4
Topical Medications*
- 1
- 2
- 3
- 4
IM Medications*
- 1
- 2
- 3
- 4
SQ Medications*
- 1
- 2
- 3
- 4
Oral Medications*
- 1
- 2
- 3
- 4
IV Push and IV Drip Medications*
- 1
- 2
- 3
- 4
Antibiotics*
- 1
- 2
- 3
- 4
Chemotherapy*
- 1
- 2
- 3
- 4
Neuro General Skills and Care of Patients:
Assessing Levels of Consciousness*
- 1
- 2
- 3
- 4
Pupil Checks*
- 1
- 2
- 3
- 4
Seizure Precautions*
- 1
- 2
- 3
- 4
Aneurysm Precautions*
- 1
- 2
- 3
- 4
Assisting with Lumbar Puncture*
- 1
- 2
- 3
- 4
Use of Hyper/Hypothermia Blanket*
- 1
- 2
- 3
- 4
Stroke*
- 1
- 2
- 3
- 4
Spinal Cord – Acute or Long term*
- 1
- 2
- 3
- 4
Alzheimer’s Disease*
- 1
- 2
- 3
- 4
Neuromuscular Disease*
- 1
- 2
- 3
- 4
Cardiac General Skills and Care of Patient
Cardiac Monitors*
- 1
- 2
- 3
- 4
Auscultation of Cardiac Sounds*
- 1
- 2
- 3
- 4
EKG – 12 Lead*
- 1
- 2
- 3
- 4
Recognizing Basic and Life Threatening Dysrthymias*
- 1
- 2
- 3
- 4
Cardioversion/Defibrillation*
- 1
- 2
- 3
- 4
Pulse Checks*
- 1
- 2
- 3
- 4
Interpretation of Cardiac Enzymes*
- 1
- 2
- 3
- 4
Use of Doppler*
- 1
- 2
- 3
- 4
Use of Automatic BP Cuff*
- 1
- 2
- 3
- 4
Angina*
- 1
- 2
- 3
- 4
CHF*
- 1
- 2
- 3
- 4
Chest Pain*
- 1
- 2
- 3
- 4
Post MI*
- 1
- 2
- 3
- 4
Respiratory General Skills and Care of Patient
O2 Cannulas/Masks*
- 1
- 2
- 3
- 4
Nebulizer Set-Up/Use*
- 1
- 2
- 3
- 4
Incentive Spirometry*
- 1
- 2
- 3
- 4
Chest PT*
- 1
- 2
- 3
- 4
Pulse Oximetry*
- 1
- 2
- 3
- 4
Suctioning – Oral*
- 1
- 2
- 3
- 4
Suctioning – Chest Tube*
- 1
- 2
- 3
- 4
SOB*
- 1
- 2
- 3
- 4
Pulmonary Embolism*
- 1
- 2
- 3
- 4
Tracheostomy Tube*
- 1
- 2
- 3
- 4
Asthma Exacerbation*
- 1
- 2
- 3
- 4
Pneumonia*
- 1
- 2
- 3
- 4
Pre/Post Thoracic Surgery*
- 1
- 2
- 3
- 4
Chest Tubes*
- 1
- 2
- 3
- 4
COPD*
- 1
- 2
- 3
- 4
Knowledge and Use of:
Nitrates (Oral, Topical)*
- 1
- 2
- 3
- 4
Antiarrhythmics (Oral)*
- 1
- 2
- 3
- 4
Antihypertensives (Oral)*
- 1
- 2
- 3
- 4
Heparin Drip*
- 1
- 2
- 3
- 4
O2 Therapy*
- 1
- 2
- 3
- 4
Bronchodilators*
- 1
- 2
- 3
- 4
Oral Steroids*
- 1
- 2
- 3
- 4
IV Steroids*
- 1
- 2
- 3
- 4
Inhaler*
- 1
- 2
- 3
- 4
Gastrointestinal General Skills and Care of Patient with:
Insertion Care and Maintenance of Nasogastric Tube*
- 1
- 2
- 3
- 4
Nasointestinal Tubes*
- 1
- 2
- 3
- 4
Jejunostomy,Gastrostomy, Cecostomy Tubes*
- 1
- 2
- 3
- 4
Stoma*
- 1
- 2
- 3
- 4
Bowel Obstruction*
- 1
- 2
- 3
- 4
Pancreatitis*
- 1
- 2
- 3
- 4
Post Abdominal Surgery*
- 1
- 2
- 3
- 4
Colostomy*
- 1
- 2
- 3
- 4
Inflammatory Bowel Disease*
- 1
- 2
- 3
- 4
Obstruction*
- 1
- 2
- 3
- 4
Hepatitis*
- 1
- 2
- 3
- 4
Renal/GU General Skills and Care of Patient with:
Insertion of Catheter Straight*
- 1
- 2
- 3
- 4
Insertion of Catheter Foley*
- 1
- 2
- 3
- 4
Bladder Irrigation Continuous*
- 1
- 2
- 3
- 4
Peritoneal Dialysis*
- 1
- 2
- 3
- 4
Automatic Cycler Machine*
- 1
- 2
- 3
- 4
Collection of Urine Specimens*
- 1
- 2
- 3
- 4
Hemodialysis*
- 1
- 2
- 3
- 4
A-V Fistula/Shunt Care*
- 1
- 2
- 3
- 4
Pre/Post Dialysis Care*
- 1
- 2
- 3
- 4
Suprapubic Catheter*
- 1
- 2
- 3
- 4
Nephrostomy Tube*
- 1
- 2
- 3
- 4
Urinary Tract Infection*
- 1
- 2
- 3
- 4
Renal Calculi*
- 1
- 2
- 3
- 4
Pyelonephritis*
- 1
- 2
- 3
- 4
Urinary Retention/Incontinence*
- 1
- 2
- 3
- 4
Orthopedic General and Care of Patients with:
Cast Care*
- 1
- 2
- 3
- 4
C.M.S. Checks*
- 1
- 2
- 3
- 4
Traction – Skin*
- 1
- 2
- 3
- 4
Traction – Skeletal*
- 1
- 2
- 3
- 4
Range of Motion*
- 1
- 2
- 3
- 4
Use of Assistive Devices*
- 1
- 2
- 3
- 4
Applications of Splints Extremities*
- 1
- 2
- 3
- 4
Continuous Passive Motion Machine*
- 1
- 2
- 3
- 4
Total joint Replacements*
- 1
- 2
- 3
- 4
Amputation*
- 1
- 2
- 3
- 4
Wound Care
Dressing Change*
- 1
- 2
- 3
- 4
Air Fluidized*
- 1
- 2
- 3
- 4
Pressure Relief*
- 1
- 2
- 3
- 4
Pressure Sores*
- 1
- 2
- 3
- 4
Leg Ulcers*
- 1
- 2
- 3
- 4
Burns*
- 1
- 2
- 3
- 4
Hemovacs*
- 1
- 2
- 3
- 4
Jackson-Pratt Tubes*
- 1
- 2
- 3
- 4
Penrose Drains*
- 1
- 2
- 3
- 4
T-Tubes*
- 1
- 2
- 3
- 4
Vascular
Discontinue PICC*
- 1
- 2
- 3
- 4
Care of Patient with DVT*
- 1
- 2
- 3
- 4
Draw Blood from Arterial Line*
- 1
- 2
- 3
- 4
Draw Blood from Central Line*
- 1
- 2
- 3
- 4
Peripheral IV Insertion, Care and Maintenance*
- 1
- 2
- 3
- 4
Discontinue Peripheral IV*
- 1
- 2
- 3
- 4
IV Infusion Pumps*
- 1
- 2
- 3
- 4
CVP Lines – Measurement of CVP*
- 1
- 2
- 3
- 4
Central Line Care and Maintenance*
- 1
- 2
- 3
- 4
Blood/Blood Product Administration*
- 1
- 2
- 3
- 4
Multi-Lumen Central Catheters*
- 1
- 2
- 3
- 4
Port-A-Caths (Infusa-Ports)*
- 1
- 2
- 3
- 4
Continuous Subcutaneous Infusion Pumps*
- 1
- 2
- 3
- 4
Please list the EMR systems you have used*
*
I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form.*
*
I hereby consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*
Your Recruiter*
Name*
First Last
Email*
Phone*
TODAY'S DATE*
MM slash DD slash YYYY