RN General Nursing Skills Checklist

First name:	Last name:
Phone:	Email:
SSN (last 4 only):	Date: (MM/DD/YYYY)

Key - for each box mark:

Limited or no experience
Somewhat experienced but may need review
Can function independently
Competent to supervise

	1	2	3	4
IV Therapy
Line Insertion/Maintenance
Angiocath/Intracath
Butterfly
Heparin Lock
Hang Piggyback
IV Push
PICC
Blood/Blood Products
Administration
Whole Blood/Packed Cells
Plasma/Extenders
Lipids/Albumin
Drawing Blood
Medication Administration
Administration Routes
Parenteral
IV
IM
ID
Subcutaneous
Oral
Topical
Rectal
Calculation
IV Rate Calculation
IV Pump
Dosage Calculation
Unit Dose System
Pain Management
Assessment
Pain Scales
Pain Tolerance

	1	2	3	4
Care of Patient with
Epidural Anesthesia/Analgesia
IV Conscious Sedation
PCA pump
Wound Care/Infectious Disease Management
Procedures
Collection of Cultures
Blood
Sputum
Stool
Wound
CSF
Universal Precautions
Isolation/Reverse Isolation Technique
Infectious Disease Reporting
Fever Management
Sterile Dressings
Decubitus Care
Other Basic Nursing Skills
Cardioversion/Defibrillation
Basic 12 Lead Placement and Interpretation
Insertion and Care of Urinary Catheters
Feeding tubes/G-tubes
Feeding Pumps
Glucose Monitoring
Oximetry
Documentation
Computer Charting System
Multipage Charting Form
Nursing Plan of Care Documentation

Age Specific Experiences and Certifications

Age Specific Experiences	Infants and Toddlers (birth-2 years)	Children (3-12 years)	Adolescent (13-18 years)	Young Adult (19-39 years)	Middle Adults (40-64 years)	Older Adult (65+ years)
1. Knows the normal growth and development for each age group and adapts care accordingly.
2. Knows the different communication needs for each age group and changes communication methods and terminology accordingly.
3. Knows the different safety risks for each age group and alters the environment accordingly.
4. Knows the different medications, dosages, and possible side effects for each age group and administers medications accordingly.

My Experience is Primarily in:

Medical	Year(s)
Neurology	Year(s)
Surgical	Year(s)
Pulmonary	Year(s)
Telemetry	Year(s)
Renal/GU	Year(s)
Orthopedics	Year(s)
Women's	Year(s)
Oncology	Year(s)
Other:	Year(s)

Certifications

BCLS	Expiration Date (mm/yyyy)
ACLS	Expiration Date (mm/yyyy)
Other:	Expiration Date (mm/yyyy)

The information I have provided in this skills checklist is true and accurate to the best of my knowledge. I hereby authorize Fortus Group to release this information to client facilities in relation to consideration of my employment.