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1.877.891.4286
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Intensive Care RN – Skills Checklist
This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Precision Nationwide Staffing.
0 = Not Applicable
1 = No Experience
2 = Some Experience
3 = Intermittent Experience
4 = Experienced
5 = Very Experienced
Age of Patients Cared For
Newborn/Neonate (birth - 30 days)
*
0
1
2
3
4
5
Infant (30 days - 1 year)
*
0
1
2
3
4
5
Toddler (1 - 3 years)
*
0
1
2
3
4
5
Preschooler (3 - 5 years)
*
0
1
2
3
4
5
School Age Child (5 - 12 years)
*
0
1
2
3
4
5
Adolescents (12 - 18 years)
*
0
1
2
3
4
5
Young Adults (18 - 39 years)
*
0
1
2
3
4
5
Middle Adults (39 - 64 years)
*
0
1
2
3
4
5
Older Adults (64 - 79 years)
*
0
1
2
3
4
5
Elderly Adults (79+ years)
*
0
1
2
3
4
5
General Skills
Draw Blood Cultures
*
0
1
2
3
4
5
Perform Blood Draw
*
0
1
2
3
4
5
Discontinue ART Line
*
0
1
2
3
4
5
Discontinue PICC Line
*
0
1
2
3
4
5
Initiate IV Access
*
0
1
2
3
4
5
Adult Respiratory/Cardiac Arrest
*
0
1
2
3
4
5
Standard Precautions
*
0
1
2
3
4
5
Isolation Precautions
*
0
1
2
3
4
5
Pediatric Respiratory/Cardiac Arrest
*
0
1
2
3
4
5
Defibrillators
*
0
1
2
3
4
5
Care of Patients in Restraints
*
0
1
2
3
4
5
Pain Management
*
0
1
2
3
4
5
Automated Med Dispensing Systems
*
0
1
2
3
4
5
Automated Med Dispensing Systems - List Types
*
Care Planning
*
0
1
2
3
4
5
Discharge Planning
*
0
1
2
3
4
5
Patient/Family Education
*
0
1
2
3
4
5
Electronic Documentation
*
0
1
2
3
4
5
Electronic Documentation - List Types
*
Patient Head to Toe Assessment
*
0
1
2
3
4
5
Dressing Changes
*
0
1
2
3
4
5
Knowledge of Normal Serum Lab Values
*
0
1
2
3
4
5
Obtaining Cultures (Blood, Sputum, Swab)
*
0
1
2
3
4
5
Administration of Blood & Blood Products
*
0
1
2
3
4
5
PCA Pumps
*
0
1
2
3
4
5
Infusion Pump
Calculate mcg/min and mcg/kg/min
*
0
1
2
3
4
5
Titrating Medications
*
0
1
2
3
4
5
Neuro General Skills
Cranial Nerve Assessment
*
0
1
2
3
4
5
ICP Monitoring
*
0
1
2
3
4
5
Assessment of Neuro Signs
*
0
1
2
3
4
5
Glascow Coma Scale
*
0
1
2
3
4
5
Stroke Scale
*
0
1
2
3
4
5
Seizure Precautions
*
0
1
2
3
4
5
Assist with Lumbar Puncture
*
0
1
2
3
4
5
Crutchfield Tongs
*
0
1
2
3
4
5
Halo Traction
*
0
1
2
3
4
5
Stryker Frame
*
0
1
2
3
4
5
Hypo/Hyperthermia Blanket
*
0
1
2
3
4
5
Neuro-Care of Patient With
Meningitis
*
0
1
2
3
4
5
Coma
*
0
1
2
3
4
5
CVA/TIA
*
0
1
2
3
4
5
Seizure Activity
*
0
1
2
3
4
5
Overdose
*
0
1
2
3
4
5
Neuro Injury/Trauma
*
0
1
2
3
4
5
Pre/Post Neuro Surgery
*
0
1
2
3
4
5
Cranial Hemorrhage
*
0
1
2
3
4
5
Knowledge and Use Of
Anti-Seizure Meds
*
0
1
2
3
4
5
Sedatives
*
0
1
2
3
4
5
Analgesics
*
0
1
2
3
4
5
Cardiac General Skills
Interpretation of 12 lead EKG
*
0
1
2
3
4
5
Interpretation of Arrhythmias
*
0
1
2
3
4
5
Defibrillation/Cardioversion
*
0
1
2
3
4
5
Permanent Pacemaker
*
0
1
2
3
4
5
Temporary Pacemaker
*
0
1
2
3
4
5
AICD
*
0
1
2
3
4
5
Interpretation of Hemodynamic Monitoring
*
0
1
2
3
4
5
Art-Line (Transducer set-up, D/C)
*
0
1
2
3
4
5
Swan-Ganz (Transducer set-up, D/C)
*
0
1
2
3
4
5
Balloon Pump (IABP)
*
0
1
2
3
4
5
SVO2 Monitoring
*
0
1
2
3
4
5
Sheath Removal
*
0
1
2
3
4
5
Interpretation of Cardiac Enzymes
*
0
1
2
3
4
5
Cardiac-Care of Patient With
Aneurysm
*
0
1
2
3
4
5
Acute MI/Unstable Angina
*
0
1
2
3
4
5
CHF
*
0
1
2
3
4
5
Cardiogenic/Hypovolemic Shock
*
0
1
2
3
4
5
Pre/Post Cardiac Surgery
*
0
1
2
3
4
5
Pre/Post Cardiac Cath
*
0
1
2
3
4
5
Percutaneous Transluminal Coronary Angioplasty
*
0
1
2
3
4
5
Heart Transplant
*
0
1
2
3
4
5
Knowledge and Use Of
Atropine
*
0
1
2
3
4
5
Bretylol
*
0
1
2
3
4
5
Bumex
*
0
1
2
3
4
5
Digoxin
*
0
1
2
3
4
5
Dopamine
*
0
1
2
3
4
5
Dobutrex
*
0
1
2
3
4
5
Heparin Drip (Precautions & Maintenance)
*
0
1
2
3
4
5
Inderal
*
0
1
2
3
4
5
Inocor
*
0
1
2
3
4
5
Isuprel
*
0
1
2
3
4
5
Lidocaine
*
0
1
2
3
4
5
Nipride
*
0
1
2
3
4
5
Nitroglycerin
*
0
1
2
3
4
5
Pronestyl
*
0
1
2
3
4
5
Titrate Morphine
*
0
1
2
3
4
5
Thrombolytic Agents
*
0
1
2
3
4
5
Magnesium Sulfate
*
0
1
2
3
4
5
Versed
*
0
1
2
3
4
5
Prep/Titration of Emergency Drugs
*
0
1
2
3
4
5
Respiratory General Skills
Establishing an Airway
*
0
1
2
3
4
5
Oxygen Delivery Systems
*
0
1
2
3
4
5
Chest Tubes (Emerson/Pleuravac)
*
0
1
2
3
4
5
Pulse Oximetry
*
0
1
2
3
4
5
Interpretation of ABG
*
0
1
2
3
4
5
Drawing ABG Blood Sample from Art-Line
*
0
1
2
3
4
5
Use of Intermittent Positive Pressure Breathing
*
0
1
2
3
4
5
Use of Pressure Support
*
0
1
2
3
4
5
Suctioning
*
0
1
2
3
4
5
Ventilators
*
0
1
2
3
4
5
Ventilators - List Types
*
Respiratory-Care of Patient With
COPD
*
0
1
2
3
4
5
ARDS
*
0
1
2
3
4
5
Pre/Post Thoracic Surgery
*
0
1
2
3
4
5
Pulmonary Embolism
*
0
1
2
3
4
5
Pulmonary Edema
*
0
1
2
3
4
5
Pneumonia
*
0
1
2
3
4
5
Inhalation Injuries
*
0
1
2
3
4
5
Lung Transplant
*
0
1
2
3
4
5
Knowledge and Use Of
Bronchodilators
*
0
1
2
3
4
5
Corticosteroids
*
0
1
2
3
4
5
Gastrointestinal General Skills
NG Tube Insertion
*
0
1
2
3
4
5
Gastrostomy Tube
*
0
1
2
3
4
5
Jejunostomy Tube
*
0
1
2
3
4
5
Enterostomal Care
*
0
1
2
3
4
5
Gastrointestinal-Care of Patient With
PEG Tube
*
0
1
2
3
4
5
Pancreatitis
*
0
1
2
3
4
5
GI Bleed
*
0
1
2
3
4
5
Esophageal Bleeding
*
0
1
2
3
4
5
Bowel Obstruction
*
0
1
2
3
4
5
Whipple Procedure
*
0
1
2
3
4
5
Liver Transplant
*
0
1
2
3
4
5
Hepatitis
*
0
1
2
3
4
5
Paralytic Ileus
*
0
1
2
3
4
5
Endoscopic Retrograde Cholangio-Pancreatography
*
0
1
2
3
4
5
Knowledge and Use Of
Antiemetics
*
0
1
2
3
4
5
Proton Pump Inhibitors
*
0
1
2
3
4
5
TPN/Hyperalimentation
*
0
1
2
3
4
5
Genitourinary/Renal General Skills
Foley/Straight Catheter Insertion
*
0
1
2
3
4
5
GU Irrigations (Continuous and Intermittent)
*
0
1
2
3
4
5
Nephrostomy Tube
*
0
1
2
3
4
5
Suprapubic Tube
*
0
1
2
3
4
5
Electrolyte Imbalance/Replacement
*
0
1
2
3
4
5
Genitourinary/Renal-Care of Patient With
T.U.R.P.
*
0
1
2
3
4
5
Shunts & Fistulas
*
0
1
2
3
4
5
Nephrectomy
*
0
1
2
3
4
5
Renal Transplant
*
0
1
2
3
4
5
Renal Failure
*
0
1
2
3
4
5
Peritoneal Dialysis
*
0
1
2
3
4
5
Hemodialysis
*
0
1
2
3
4
5
Continuous Renal Replacement Therapy
*
0
1
2
3
4
5
Renal Trauma
*
0
1
2
3
4
5
Endocrine General Skills
Diabetic Teaching
*
0
1
2
3
4
5
Endocrine-Care General Skills
Hyper/Hypoglycemia
*
0
1
2
3
4
5
Diabetic Ketoacidosis
*
0
1
2
3
4
5
Knowledge and Use Of
Insulin (IV, SQ)
*
0
1
2
3
4
5
D50
*
0
1
2
3
4
5
Vascular General Skills
Peripheral Pulses
*
0
1
2
3
4
5
Dopplers
*
0
1
2
3
4
5
Peripheral IV Insertion, Care and Maintenance
*
0
1
2
3
4
5
Assisting with Insertion of Central Lines
*
0
1
2
3
4
5
Care and Maintenance of Central Lines
*
0
1
2
3
4
5
Assist with IV Cutdown
*
0
1
2
3
4
5
Other
Care of Patient with Trauma Wounds
*
0
1
2
3
4
5
Care of Oncology Patient
*
0
1
2
3
4
5
Chemotherapy Administration
*
0
1
2
3
4
5
Care of Patient with Burns
*
0
1
2
3
4
5
Care of Patient with HIV/AIDS
*
0
1
2
3
4
5
Hyperbaric Oxygenation
*
0
1
2
3
4
5
Suicide Precautions
*
0
1
2
3
4
5
Post Mortem Cares
*
0
1
2
3
4
5
Information & Agreement
Application ID
*
Please enter your application ID. This ID should be 15 characters long and have the format of PHNMS##########. You should have received an email containing your application ID when you submitted your initial application. If not, please contact our staff.
Applicant Name
*
First
Last
Applicant Email
*
Applicant Phone
*
I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified within the last 2 years.
*
I agree to the terms below.
The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Precision Nationwide Staffing. Submit this skills evaluation with your initial application. To be updated annually.
Signature
*