We heard you've got skills

Pediatric Intensive Care

  • This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Fusion Medical Staffing.

    • 0 = Not Applicable
    • 1 = No Experience
    • 2 = Some Experience
    • 3 = Intermittent Experience
    • 4 = Experienced
    • 5 = Very Experienced

    *Required fields

    AGE OF PATIENTS CARED FOR 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • CARDIOVASCULAR GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Invasive Hemodynamic Monitoring: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • Cardiovascular- Care of the Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Medications Knowledge and Use of 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • RESPIRATORY GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • Obtaining Blood Gases: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Airway Management: 0 1 2 3 4 5
  • 012345
  • 012345
  • Suctioning: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Chest Tube (Assist With): 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • O2 Therapy: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Ventilators: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Respiratory- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Medications Knowledge and Use of 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • NEURO GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Neuro- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Medications Knowledge and Use of 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • GASTROINTESTINAL GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Gastrostomy/Button: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • Gastrointestinal- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Medications Knowledge and Use of 0 1 2 3 4 5
  • 012345
  • RENAL/GENITOURINARY GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Collection of Urine Specimens: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Renal/Genitourinary- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • ENDOCRINE/METABOLIC GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • Endocrine/Metabolic- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Medications Knowledge and Use of 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • ORTHOPEDICS GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • Orthopedics- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • WOUND MANAGEMENT 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Burns: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • ONCOLOGY GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • 012345
  • Interpretation Of Lab Result: 0 1 2 3 4 5
  • 012345
  • 012345
  • Oncology- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Medications Knowledge and Use of 0 1 2 3 4 5
  • 012345
  • INFECTIOUS DISEASES GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • Obtain Culture Specimens: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • Infectious Diseases- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • PHLEBOTOMY/IV THERAPY 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Phlebotomy/IV- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • PAIN MANAGEMENT GENERAL SKILLS 0 1 2 3 4 5
  • 012345
  • Pain Management- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • Medication Knowledge and Use of 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • MISCELLANEOUS 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • Miscellaneous- Care of Child with: 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • Medication Administration for Children 0 1 2 3 4 5
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • 012345
  • YEARS OF EXPERIENCE IN EACH OF THE FOLLOWING PEDIATRIC AREAS

  • The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Fusion Medical Staffing. Submit this skills evaluation with your initial application. To be updated annually.

  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.
logo-header

Submitting.... Please don't leave this page.