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Skills Checklists

Before you can begin applying for NurseChoice assignments, you need to complete a skills checklist. Required by hospitals, this mandatory form highlights your skills, proficiencies and experience in your specialty. The quickest and easiest way to complete your skills checklist is online. Just select your specialty from the list below, enter the necessary information on the form and click to submit. Once we receive your completed skills checklist you will be one step closer to finding a rewarding travel assignment that meets your needs.


Urgent Care/Clinic Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
 
Please mark your level of experience
1. No experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others
 
CARDIOVASCULAR
1 2 3 4
 
AED
 
Chest Pain
 
CHF
 
Dysrhythmia Management and Interpretation
 
Management of Emergent Resuscitation Situations
 
PULMONARY
1 2 3 4
 
Aspiration
 
Asthma/Reactive Airway Disease
 
Manual Resuscitation Bag (MRB, Ambu Bag)
 
Metered-Dose Inhaler (MDI)
 
Nebulizers
 
Pneumonia
 
Upper Respiratory Infection
 
NEUROLOGICAL
1 2 3 4
 
Assist with Lumbar Puncture
 
Cervical Collar
 
Migraine
 
Minor Head Injury
 
Seizures
 
Spinal Immobilization
 
TIA/Stroke
 
ORTHOPEDICS
1 2 3 4
 
Applying Splints
 
Assist with Casting
 
Assist with Reduction of Dislocation
 
Fracture/Dislocation
 
Joint Sprain
 
Spinal Immobilization
 
Transfer Boards
 
GASTROINTESTINAL
1 2 3 4
 
Constipation/Impaction
 
Diarrhea
 
Management of Gastric tubes (NG, GJ, G, PEG, DOBOFF)
 
Ostomy care
 
RENAL/GENITOURINARY
1 2 3 4
 
Pyelonephritis/UTI
 
Obstruction
 
Renal Calculi
 
Renal Trauma
 
Testicular Torsion
 
Priapism
 
STD/STI
 
ENDOCRINE/METABOLIC
1 2 3 4
 
Hypo/Hyperglycemia
 
Indwelling Insulin Pump
 
EENT
1 2 3 4
 
Ear Irrigation/Removal Foreign Body
 
Eye Injury/Foreign Body/Detached Retina
 
Assist with Removal of Nasal Foreign Body
 
Set Up/Assist Cautery
 
Set Up Slit Lamp
 
INFECTIOUS DISEASE
1 2 3 4
 
Infectious/Communicable Disease
 
Isolation/Reverse Isolation/Hepa Filter/Negative Pressure
 
WOUND MANAGEMENT
1 2 3 4
 
Burn Care
 
Wound Repair (Staples/Sutures, etc.)
 
PAIN MANAGEMENT
1 2 3 4
 
Moderate Sedation
 
PSYCHIATRIC
1 2 3 4
 
Managing Threatening/Violent Behavior
 
Psychiatric Hold
 
Restraints
 
Substance Overdose
 
Substance Withdraw
 
Suicide Risk
 
WOMEN'S HEALTH
1 2 3 4
 
Obtain Cultures
 
Pelvic Inflammatory Disease
 
Pelvic Tray
 
PEDIATRICS
1 2 3 4
 
Aspiration
 
Assist with Fracture Stabilization
 
Asthma/Reactive Airway Disease
 
Burns
 
Child Abuse Recognition/Reporting
 
Cooling/Warming Measures
 
Ear Care-Assist with Cleaning/Wash, Insert Ear Drops
 
Epiglottitis
 
Foreign Object
 
Fracture
 
Hypo/Hyperglycemia
 
Hypo/Hyperthermia
 
Lacerations
 
Lumbar Puncture
 
Minor Head Injury
 
Near Drowning
 
Nursemaid's Elbow
 
Obtain RSV Culture
 
Obtaining Consent to Treat
 
Papoose Board/Therapeutic Hold
 
Shaken Baby Syndrome
 
Start IV in Pediatric Patient
 
IV THERAPY
1 2 3 4
 
Starting IVs
 
Central Line Placement
 
Phlebotomy
 
Access Med Ports
 
Blood and Blood Product Administration
 
MEDICATIONS
1 2 3 4
 
Anti-Arrhythmics
 
Anticoagulants (IV, oral, & injection)
 
Anti-Hypertensives
 
Anti-Psychotics
 
Anti-Seizure Medications
 
Benzodiazepines
 
Procedural Sedation - Administration
 
Narcotics/Opioid Analgesics (IV, oral, & injection)
 
Nitrates (Oral & Topical)
 
Non-Opioid Analgesics (IV, Oral, & Injection)
 
Steroids (IV, Oral, Inhaled)
 
PROFESSIONAL KNOWLEDGE & SKILLS & MISCELLANEOUS
1 2 3 4
 
Bites
 
Disaster Management
 
EMTALA
 
Hazardous Materials Exposure
 
Intake and Triage
 
Victims of Acts of Violence
 
Triage (ESI Level)
 
Charge Experience
 
Fall Risk Assessment/Prevention
 
Restraints/Use of Least Restrictive Devices
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
My experience is primarily in the following settings
1 2 3 4
 
Adults
 
Physician's Office
 
Clinic
 
Urgent Care
 
Visits/Day: Emergency Dept - Yrs:
 
Pediatrics
 
Physician's Office
 
Clinic
 
Urgent Care
 
Visits/Day: Emergency Dept - Yrs:
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computer Physician Order Entry
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
Other: Specify
 
Other: Specify
 
EMR Conversion
 
CERTIFICATIONS (Current at time of completing this form)
 
BLS
 
ACLS
 
PALS
 
Other: Specify
Urgent Care/Clinic Skills Checklist, version 3

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. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

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