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Hudson Staffing Travel Nurses| Psychiatric Online Checklist
Psychiatric Online Checklist
Thank you for your decision to apply for a travel nursing position with
Hudson Staffing
! Before we can offer you a nursing employment opportunity in the Psychiatric field, an electronic skills assessment must be completed. Please, complete the nursing skills checklist below, and be sure to review your information thoroughly before clicking the submit button.
GENERAL INFORMATION
Note:
*
Denotes a required field.
Please enter your full name as it appears on your Social Security Card:
First Name
Middle Name
Last Name
*
Please enter the Last Four digits of your Social Security Number:
-
-
*
Please check here if you do not hold a valid social security card.
Please provide your contact information:
Phone Number
*
E-mail Address
*
Confirm E-mail Address
*
Type your e-mail address again above.
This profile is for use by healthcare professionals in the Psychiatric discipline and specialty.
It will not be a determining factor for the program.
CHECKLIST INSTRUCTIONS
Please mark your level of experience
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
TREATMENT SETTINGS
1
2
3
4
Inpatient
Outpatient
Adolescent/Pediatrics
Substance Abuse/Rehab
Special Care Unit
Eating Disorders Unit
Locked Unit
ADULT DISORDERS
1
2
3
4
Violent Behavior
Suicidal Ideation
Suicidal Attempt
Depression
Bipolar Disorders
Anxiety/Panic Disorders
Psychotic Disorders
Schizophrenia
Post Traumatic Stress Disorder
History of Physical/Sexual Abuse
Alcohol/Drug Abuse
Alzheimer's Disease/Dementia
Anorexia/Bulimia
CHILD/ADOLESCENT DISORDERS
1
2
3
4
Violent Behavior
Suicidal Ideation/Self Destructive Behavior
Suicidal Attempt
Depression
Bipolar Disorders
Anxiety/Panic Disorders
Psychotic Disorders
Schizophrenia
History of Physical/Sexual Abuse
Alcohol/Drug Abuse
Anorexia/Bulimia
Autism
TREATMENT MODALITIES
1
2
3
4
Conduct Group Therapy
Therapeutic Limit Setting
Follow Behavior Modification Plans
Medication Management
Supervise Ancillary staff
EQUIPMENT AND PROCEDURES
1
2
3
4
Managing Assaultive Behavior
Crisis Prevention
Electroconvulsive Therapy
Restraints
Seclusion
Suicide Precautions
State Specific Regulations on Emergency Medications
Head to Toe Assessment
IV Start
IV Maintenance
MEDICATIONS
1
2
3
4
Antianxiety
Anticonvulsants
Antidepressants
Antipsychotics
Lithium
Cholinesterase Inhibitors/Memantine (Aracept/Namenda)
Sedative/Analgesics
Insulin
Anticoagulants
Digoxin
Antihypertensives
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
PROFESSIONAL KNOWLEDGE AND SKILLS
1
2
3
4
National Patient Safety Goals/Core Measures
Use of Rapid Response Teams
Fall Risk Assessment/Prevention
Pressure Ulcer Risk Assessment/Prevention
Patient/Family Teaching
Age Specific/Population-Based Care
Isolation Precautions
Infection Prevention
Pain Assessment & Management
Charge Experience
Interpretation and Communication of Lab Values
EMR
1
2
3
4
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
EMR Conversion
Yes
No
Certifications
1
2
3
4
BLS
Managing Assaultive Behavior
Crisis Prevention Institute (CPI)
Please read and agree to the statements below by marking the checkbox.
You will not be able to submit until you have marked the checkbox.
*
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. I hereby authorize Hudson Staffing to release this Psychiatric Skills Checklist to the client facilities in relation to consideration of employment as a healthcare professional with those facilities.
Privacy Note:
Hudson Staffing will record anonymous electronic information about your connection when you click on the submit button. This information is used for security purposes only. This information will include your IP Address (3.228.10.17) which will be used as a digital signature.
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Hudson Staffing
Phone:
1(866)256-8773
E-mail:
info@hudsonstaffing.net
Your resource for traveling nurse and allied health career opportunities.
Copyright (C) 2013 Hudson Staffing. All rights reserved.
