1/13/25, 10:08 AM Medical Surgical RN Skills Checklist

Medical Surgical RN
Skills Checklist
NAME Sarina Oree

LAST 4 OF SSN

DATE 01/13/2025

I hereby certify that ALL information I have provided on this

skills checklist and all other documentation, is true and
accurate. I understand and acknowledge that any
misrepresentation or omission may result in disqualification
from employment and/or immediate termination.

Instructions: This checklist is meant to serve as a general guideline for our client facilities as
to the level of your skills within your nursing specialty. Please use the scale below to
describe your experience/expertise in each area listed below.

Proficiency Scale: 1 = No Experience

2 = Need Training
3 = Able to perform with
supervision
4 = Able to perform
independently

Rating Stars (Click) CARDIAC 1 2 3 4

Angina x

Post Acute MI x

Congestive Heart Failure x

Post Cardiac Cath x

Post Cardiac Surgery x

Aneurysm x

Carotid Endarterectomy x

Post Vascular Surgery x

Post Cardiac Transplant x

Rating Stars (Click) PULMONARY 1 2 3 4

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Pneumonia x

COPD x

Tuberculosis x

Pulmonary Embolism x

Tracheostomy Management x

CPAP/BiPAP x

Interpretation of Arterial Blood Gases x

Post Lung Transplant x

Rating Stars (Click) NEUROLOGICAL & PSYCHIATRIC 1 2 3 4

Stroke Scale Assessment x

Traumatic Brain Injury x

CVA x

Post Craniotomy x

Seizure Disorders x

Spinal Cord Injuries x

Mood Disorders x

Substance Withdrawal x

Rating Stars (Click) ORTHOPEDICS 1 2 3 4

Circulation/Skin Checks x

Continuous Passive Motion Devices x

Ambulation Assistive Devices x

Prosthetics x

Cast Care x

Pin Care x

Traction x

Total Joint Replacement x

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Amputation x

Rating Stars (Click) GASTROINTESTINAL 1 2 3 4

Bariatrics x

Feeding Tubes x

GI Bleeding x

Bowel Obstruction x

GI Surgery x

Liver Disease x

Pancreatitis x

Post Liver Transplant x

Post Pancreas Transplant x

Rating Stars (Click) RENAL/GENITOURINARY 1 2 3 4

Arteriovenous Fistula/Shunt x

3 Way Catheter & Bladder Irrigation x

Suprapubic Catheter x

Renal Failure x

Peritoneal Dialysis x

GU Surgery x

Nephrostomy Tubes x

Renal Transplant x

Management Pre/Post Hemodialysis x

Gyn Surgery x

Rating Stars (Click) ENDOCRINE METABOLIC 1 2 3 4

Diabetes Type I x

Diabetes Type II x

Blood Glucose Monitoring x

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IV Insulin Protocols x

Management of Hypoglycemia x

Indwelling Insulin Pumps x

Pituitary Disorders x

Rating Stars (Click) ONCOLOGY 1 2 3 4

Chemotherapy Administration x

Radiation Therapy x

Medical Oncology x

Surgical Oncology x

Radiation Implants x

Bone Marrow Transplant x

Rating Stars (Click) MEDICATIONS 1 2 3 4

Antiarrhythmics x

Anticoagulants (IV, oral, & injection) x

Anti-Depressants x

Anti-Hypertensives x

Anti-Psychotics x

Benzodiazepines x

Emergency Medications x

Epidural Analgesia x

Inhaled Medications x

Insulin x

Narcotics/Opioid Analgesics (IV, oral, &

x
injection)

Nitrates (Oral & Topical) x

Non-Opioid Analgesics (IV, Oral, & Injection) x

Oral Hypoglycemics x

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Patient Controlled Analgesia x

Procedural Sedation Administration x

Reversal Agents x

Steroids (IV, Oral, Inhaled) x

Automated Medication Dispensing (i.e. Pyxis,

x
Omnicell)
Rating Stars (Click) IV THERAPY 1 2 3 4

Starting IVs x

Central Line Blood Draws x

Central Line/Implanted Line Care x

TPN & Lipids x

Blood Product Administration x

Monitoring of Chemotherapy x

Rating Stars (Click) CARDIAC MONITORING & EMERG. RESPONSE 1 2 3 4

Placement of Telemetry Leads x

Rhythm Interpretation x

Dysrhythmia Management x

Obtain 12 Lead EKG x

Use of Rapid Response Teams x

Rating Stars (Click) PROFESSIONAL KNOWLEDGE AND SKILLS 1 2 3 4

National Patient Safety Goals/Core Measures x

Fall Risk Assessment/Prevention x

Pressure Ulcer Risk Assessment/Prevention x

Restraints/Use of Least Restrictive Device x

Patient/Family Teaching x

Age Specific/Population-Based Care x

Isolation Precautions x

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Infection Prevention x

Pain Assessment & Management x

Charge Experience x

Interpretation and Communication of Lab

x
Values

Wound Care /Wound Vac x

Specialty Beds x

Rating Stars (Click) EMR 1 2 3 4

Epic x

Cerner x

Eclipsys x

McKesson x

Meditech x

Other Computerized System x

Computerized Physician Order Entry x

Bar Coding for Medication Administration x

EMR Conversion YES

CERTIFICATIONS Expiry Date :

BLS

ACLS

Telemetry Certificate

ONS Chemo/Biotherapy Certification

Other Chemo Certification

Other: Specify

Other: Specify

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