LICENSED NURSING SKILLS/PROFICIENCY CHECKLIST
 

Please indicate level of knowledge and experience in all the listed criteria.
LEVELS OF PROFICIENCY:
0=never done 1=perform with supervision 2=perform independently
NEUROLOGIC
Neurological assessment 1 2
Assisting with Lumbar Puncture 1 2
I.C.P. Monitoring:      

Assembly of Equipment

1 2

Care of Patient

1 2
Hyper/Hypothermia 1 2
RESPIRATORY
Auscultation of Lung Sounds 1 2
Suctioning/Oral pharyngeal:      

Tracheotomy Tubes

1 2

Endotracheal Tubes

1 2
02 Equipment: Masks 1 2

Cannula

 1 2
Ventilators: Servo 1 2

MA-1

 1 2

MA-2

 1 2

Bear 1

1 2

Bear 2

1 2

Other

1 2
Obtain Arterial Blood Gas:

Via Arterial Line

1 2

Via Arterial Puncture

1 2
Intubation (assisting) with 1 2
Extubation 1 2
Weaning 1 2
Tracheotomies: Shiley 1 2

Portex

 1 2
Tracheotomies: Fenestrated 1 2
Other 1 2
Chest Tubes: H20 Seal 1 2

3-Bottle Suction

1 2

Pleurevac

 1 2
CARDIOVASCULAR
Auscultation of Heart Sounds 1 2
Arrhythmia Interpretation 1 2
Obtain Rhythm Strips 1 2
Obtain 12 Lead EKG 1 2
Telemetry 1 2
Rotating Tourniquets 1 2
Temp. Pacemaker Insertion (assisting) 1 2
Defibrillation 1 2
Cardioversion 1 2
Swan Ganz & Arterial Lines:      

Assembly of Equipment

1 2

Calibration of Transducer

1 2

Obtain P.A. Readings (S-G)

1 2

Obtain P.C.W. Readings (S-G)

1 2

Cardiac Output Computer

1 2
Intra-aortic Balloon Pump: 1 2
Type 1 2
RENAL/GU
Catheterization 1 2
Irrigation of Foley 1 2
Peritoneal Dialysis 1 2
Hemodialysis 1 2
GASTROINTESTINAL
Nasogastric Suction 1 2
Tube Feedings 1 2
Guaiac Testing 1 2
Stoma Care 1 2
Enema: Retention 1 2
Caring for: Blakemore 1 2

T-tube

 1 2

Miller-Abbott

 1 2

Gastrostomy

 1 2

Cantor

 1 2
INTRAVENOUS THERAPY

Venipuncture: Blood Speciman 1 2
IV using: Butterfly 1 2

Angio/Intracath

 1 2
CVP 1 2
Hyperalimentation 1 2
Admin. of blood & byproducts 1 2
Heparin Lock 1 2
Hickman & Broviac Catheters 1 2
Preparation & use of:      

Lidocaine drip

1 2

Dopamine drip

1 2

Nipride drip

1 2

Dobutrex drip

1 2

Bretylol drip

1 2

Pronestyl drip

1 2

Nitroglycerine drip

1 2
PUMPS
Travenol 1 2
Abbott 1 2
IVAC 1 2
Other 1 2
CARE OF PATIENTS WITH:

A.I.D.S. 1 2
C.O.P.D. 1 2
ARDS 1 2
Thoracic Surgery (immediate postoperative period) 1 2
Major Surgery 1 2
DT'S 1 2
Overdose 1 2
Burns 1 2
GI Bleeding 1 2
Shock 1 2
Acute: MI 1 2

CHF

 1 2

Angina

 1 2

Neuro. Disorders

1 2
Cardiac/Respiratory Arrest 1 2
Multisystem Failure 1 2
Multiple Failure 1 2
Other: please specify

 1 2
GENERAL
Writing & Updating Nursing Care Plans 1 2
Charting: Systems 1 2

P.O.M.R.

 1 2

 

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