Skills Checklist

Medical Surgical/Telemetry Skills Checklist

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
  • Age of Patients Cared For

  • General Skills

  • Psychological

  • Knowledge and Use of

  • Medications

  • Neuro General Skills

  • Neuro- Care of Patients With

  • Knowledge and Use Of

  • Cardiac General Skills

  • Cardiac- Care Of Patients With

  • Knowledge and Use Of

  • Respiratory General Skills

  • Respiratory- Care Of Patient With

  • Knowledge and Use of

  • Gastrointestinal General Skills

  • Tube Feedings via Flexible Tubes

  • Gastrointesinal - Care of Patients With

  • Knowledge and Use Of

  • Renal/GU General Skills

  • Renal/GU- Care Of Patient With

  • Endocrine General Skills

  • Endocrine Care of Patient With

  • Knowledge and Use of Insulin

  • Orthopedic General Skills

  • Orthopedic- Care Of Patients With

  • Wound/Skin Care

  • Wound Vacs

  • Vascular

  • Other

  • Application Agreement

  • MM slash DD slash YYYY

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