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Hudson Staffing Travel Nurses| Medical / Surgical Online Checklist
Medical / Surgical 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 Medical / Surgical 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 Medical / Surgical 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
Cardiac
1
2
3
4
Angina
Post Acute MI
Congestive Heart Failure
Post Cardiac Cath
Post Cardiac Surgery
Aneurysm
Carotid Endarterectomy
Post Vascular Surgery
Post Cardiac Transplant
PULMONARY
1
2
3
4
Pneumonia
COPD
Tuberculosis
Pulmonary Embolism
Tracheostomy Management
CPAP/BiPAP
Interpretation of Arterial Blood Gases
Post Lung Transplant
Neurological & Psychiatric
1
2
3
4
Stroke Scale Assessment
Traumatic Brain Injury
CVA
Post Craniotomy
Seizure Disorders
Spinal Cord Injuries
Mood Disorders
Substance Withdrawal
ORTHOPEDICS
1
2
3
4
Circulation/Skin Checks
Continuous Passive Motion Devices
Ambulation Assistive Devices
Prosthetics
Cast Care
Pin Care
Traction
Total Joint Replacement
Amputation
GASTROINTESTINAL
1
2
3
4
Bariatrics
Feeding Tubes
GI Bleeding
Bowel Obstruction
GI Surgery
Liver Disease
Pancreatitis
Post Liver Transplant
Post Pancreas Transplant
RENAL/GENITOURINARY
1
2
3
4
Arteriovenous Fistula/Shunt
3 Way Catheter & Bladder Irrigation
Suprapubic Catheter
Renal Failure
Peritoneal Dialysis
GU Surgery
Nephrostomy Tubes
Renal Transplant
Management Pre/Post Hemodialysis
Gyn Surgery
Endocrine Metabolic
1
2
3
4
Diabetes Type I
Diabetes Type II
Blood Glucose Monitoring
IV Insulin Protocols
Management of Hypoglycemia
Indwelling Insulin Pumps
Pituitary Disorders
ONCOLOGY
1
2
3
4
Chemotherapy Administration
Radiation Therapy
Medical Oncology
Surgical Oncology
Radiation Implants
Bone Marrow Transplant
MEDICATIONS
1
2
3
4
Antiarrhythmics
Anticoagulants (IV, oral, & injection)
Anti-Depressants
Anti-Hypertensives
Anti-Psychotics
Benzodiazepines
Emergency Medications
Epidural Analgesia
Inhaled Medications
Insulin
Narcotics/Opioid Analgesics (IV, oral, & injection)
Nitrates (Oral & Topical)
Non-Opioid Analgesics (IV, Oral, & Injection)
Oral Hypoglycemics
Patient Controlled Analgesia
Procedural Sedation Administration
Reversal Agents
Steroids (IV, Oral, Inhaled)
Automated Medication Dispensing (i.e. Pyxis, Omnicell)
IV THERAPY
1
2
3
4
Starting IVs
Central Line Blood Draws
Central Line/Implanted Line Care
TPN & Lipids
Blood Product Administration
Monitoring of Chemotherapy
CARDIAC MONITORING & EMERG. RESPONSE
1
2
3
4
Placement of Telemetry Leads
Rhythm Interpretation
Dysrhythmia Management
Obtain 12 Lead EKG
Use of Rapid Response Teams
PROFESSIONAL KNOWLEDGE AND SKILLS
1
2
3
4
National Patient Safety Goals/Core Measures
Fall Risk Assessment/Prevention
Pressure Ulcer Risk Assessment/Prevention
Restraints/Use of Least Restrictive Device
Patient/Family Teaching
Age Specific/Population-Based Care
Isolation Precautions
Infection Prevention
Pain Assessment & Management
Charge Experience
Interpretation and Communication of Lab Values
Wound Care /Wound Vac
Specialty Beds
EMR
1
2
3
4
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
EMR Conversion
Yes
No
CERTIFICATIONS
BLS
ACLS
Telemetry Certificate
ONS Chemo/Biotherapy Certification
Other Chemo Certification
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 Medical / Surgical 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 (44.192.65.228) which will be used as a digital signature.
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Hudson Staffing
Phone:
1(866)256-8773
E-mail:
info@hudsonstaffing.net
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