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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.


Medical/Surgical 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*
Last 4 of Social Security Number*
- -
E-Mail Address* Phone Number*
or
 
 
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
 
Cardiac
1 2 3 4
 
Angina
 
Congestive Heart Failure
 
Dysrhythmia Management/Interpretation
 
Medical Surgical patients with Cardiac History
 
PULMONARY
1 2 3 4
 
Pneumonia
 
COPD
 
Tuberculosis
 
Pulmonary Embolism
 
Neurological & Psychiatric
1 2 3 4
 
Stroke Scale Assessment
 
Traumatic Brain Injury
 
CVA
 
Seizure Disorders
 
Mood Disorders
 
Substance Withdrawal
 
ORTHOPEDICS
1 2 3 4
 
Continuous Passive Motion Devices
 
Ambulation Assistive Devices
 
Prosthetics
 
Cast Care
 
Pin Care
 
Traction
 
Total Joint Replacement
 
GASTROINTESTINAL
1 2 3 4
 
Bariatrics
 
Feeding Tubes
 
GI Bleeding
 
Bowel Obstruction
 
Liver Disease
 
Pancreatitis
 
RENAL/GENITOURINARY
1 2 3 4
 
Arteriovenous Fistula/Shunt
 
3 Way Catheter & Bladder Irrigation
 
Renal Failure
 
Peritoneal Dialysis
 
Nephrostomy Tubes
 
Management Pre/Post Hemodialysis
 
Gyn Surgery
 
ENDOCRINE METABOLIC
1 2 3 4
 
Diabetes Hypo/Hyperglycemia
 
IV insulin Protocols
 
Indwelling Insulin Pumps
 
ONCOLOGY
1 2 3 4
 
Bone Marrow Transplant
 
Chemotherapy Administration
 
Radiation Implants
 
MEDICATIONS
1 2 3 4
 
Antiarrhythmics
 
Anticoagulants (IV, oral, & injection)
 
Anti-Depressants
 
Anti-Hypertensives
 
Anti-Psychotics
 
Benzodiazepines
 
Epidural Analgesia
 
Narcotics/Opioid Analgesics (IV, oral, & injection)
 
Nitrates (Oral & Topical)
 
Non-Opioid Analgesics (IV, Oral, & Injection)
 
Oral Hypoglycemics
 
Patient Controlled Analgesia
 
Procedural Sedation Administration
 
Steroids (IV, Oral, Inhaled)
 
IV THERAPY
1 2 3 4
 
Starting IVs
 
Central Line/Implanted Line Care
 
TPN & Lipids
 
Blood and Blood Product Administration
 
Monitoring of Chemotherapy
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Universal Protocol Procedures (Time Out)
 
Charge Experience
 
Fall Risk Assessment/Prevention
 
Infection Prevention
 
Isolation Precautions
 
National Patient Safety Goals/Core Measures
 
Pain Assessment & Management
 
Patient/Family Teaching
 
Pressure Ulcer Risk Assessment/Prevention
 
Restraints/Use of Least Restrictive Device
 
Wound Care /Wound Vac
 
Age Specific/Population-Based Care
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computerized Physician Order Entry
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
EMR Conversion
 
Other: Specify
 
Other: Specify
 
CERTIFICATIONS (Current at time of completing this form)
 
CCRN
 
PALS
 
ACLS
 
BLS
 
Telemetry
 
Other: Specify
Medical/Surgical Skills Checklist, version 6

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.

© 2013 AMN Healthcare, Inc. All rights reserved. Reproduction and distribution of these materials is prohibited without the expressed written authorization of AMN Healthcare, Inc.