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 | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| General Duties |
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| Admit/Orient Involuntary Clients |
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| Admit/Orient Voluntary Clients |
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| Advance Directives |
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| Ambulatory Cuffs |
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| Assist Activities of Daily Living |
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| Assist with Personal Hygiene |
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| Cultural Diversity |
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| Discharge Clients |
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| Discharge Planning |
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| Documentation-Computer |
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| Documentation-Written |
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| Full Restraints |
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| HIPAA Regulations |
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| Initial Interview |
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| Initial Screening Assessment |
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| Isolation Techniques |
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| Mutli-Disciplinary Planning |
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| Oxygen Administration |
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| Participate in Interdisciplinary Team |
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| Patient Teaching |
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| Reassess/Update Plan of Care |
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| Referral to Community Resources |
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| Supervise Unlicensed Personnel |
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| Vital Signs |
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| Wrist Restraints |
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| Eating Disorders | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Anorexia Nervosa |
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| Bulimia Nervosa |
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| Obesity |
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| Interventions/Therapies |
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| Assultive Behavior |
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| Care of Psychiatric Disorders | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Anxiety Disorders |
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| Bipolar Disorder |
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| Catatonic Psychotic Disorder |
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| Delusional Disorders |
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| Depression |
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| Dissociative Identity Disorder |
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| Hallucinations |
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| Obsessive/Compulsive Disorder |
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| Panic Attacks |
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| Paranoid Psychotic Disorder |
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| Phobias |
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| Schizophrenia |
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| Suicidal Ideation/Attempts |
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| Assist with Psychotherapy | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Behavioral |
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| Couple/Family |
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| Group |
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| Individual |
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| Personality Disorders | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Cluster A-Paranoid/Schizoid |
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| Cluster B-Antisocial/Borderline |
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| Cluster C-Anxious/Fearful |
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| Cognitive Disorders | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Alzheimer's (Dementia) |
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| Amnestic Disorders |
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| Delirium |
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| Dementia |
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| Certified "Management of Assultive Behavior" | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Crisis Intervention |
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| Drug & Alcohol Education |
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| Education or Vocational Training |
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| Teach Independent Living Skills |
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| Therapeutic Communication |
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| Therapeutic Milieu |
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| Assist with Alternative Therapies: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Biofeedback |
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| ElectroConvulsive Therapy |
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| Expressive Therapy (Art, Movement) |
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| Guided Imagery |
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| Massage Therapy |
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| Mediation |
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| Recreational Therapy |
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| Therapeutic Touch |
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| Meds/IV Therapy | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Administer IM & SQ Meds |
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| Administer PO Medications |
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| Administer Topical Medications |
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| Identify Appropriate Level of Care |
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| Discontinue Peripheral IV's |
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| Pain Assessment/Management |
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| Substance-Related Disorders: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| ADHD |
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| Alcohol-Related |
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| Developemntal/Autistic Disorders |
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| Drug-Related |
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| Mental Retardation |
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| Post Traumatic Stress Disorder |
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| Sexual Abuse/Assault |
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| Sexual Disorders |
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| Somatoform Disorders (Pain etc.) |
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| Survivor of Abuse/Violence |
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| Psychotropic Agents: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Antianxiety Agents |
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| Anticholinergics/Antiparkinsons |
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| Anticonvulsants |
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| Antidepressants/Mood Elevators |
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| Antimanic Agents |
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| Antipsychotic Agents |
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| Hypnotics |
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| Management of Med Side Effects |
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| Recognition of Med Side Effects |
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| PROFICIENCY SCALE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Newborn (birth-30 days) |
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| Infant (30 days-1 yrs) |
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| Toddler (1-3 yrs) |
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| Preschooler (3-5 yrs) |
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| School Age (5-12 yrs) |
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| Adolescents (12-18 yrs) |
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| Young Adults (18-39 yrs) |
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| Middle Adults (39-64 yrs) |
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| Older Adults (64 yrs +) |
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