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ER RN

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
n/a
1
2
3
4
5

* Required

Age of Patients Cared For

Newborn/Neonate (birth to 30 days)*

Infant (1 month to 1 year)*

Toddler (1 year to 3 years)*

Preschooler (3 years to 5 years)*

School Age Child (5 years to 12 years)*

Adolescents (12 years to 18 years)*

Young Adults (18 years to 39 years)*

Middle Adults (39 years to 64 years)*

Older Adults (64 years to 79 years)*

Elderly Adults (over 79+ years)*

General Skills

Isolation Precautions*

Pediatric Respiratory/Cardiac Arrest*

Adult Respiratory/Cardiac Arrest*

Crash Carts*

Defibrillators*

Care of Patient in Restraints*

Pain Management*

Automated Med Dispensing Systems*

Care Planning & Discharge Planning*

Patient/Family Education*

Electronic Documentation*

Patient Head to Toe Assessment*

Peripheral IV Insertion, Care and Maintenance*

Triage Procedures*

Lab Values*

Procedure for Patient Signing AMA*

Consent for Treatment of Minor*

Disaster Protocols*

Crisis Intervention*

Upholding Patient’s Rights*

Reporting Procedures for Acts of Violence*

Care of Patients with Infectious Diseases*

Care of Patient with Central Line*

Immunocompromised

Care of Patients with Cancer*

Care of Patients with HIV/ AIDS*

Care of Patients with Hepatitis*

Care of Patients with TB*

HEENT Disorders - Care of Patient With

Set-up for Lamp Exam*

Use of Morgan Lens Irrigation*

Ear Irrigations*

Eye Irrigations*

Eye Patch Application*

Epistaxis/Nasal Packing*

Visual Acuity*

Pulmonary - Care of Patients With

Pulmonary Edema*

Pulmonary Embolism*

ARDS*

Trach*

C.O.P.D*

Aspiration*

Tuberculosis*

Pneumothorax*

Intubation/Extubation*

T-Piece*

Obtaining Arterial Blood Gases*

Setting Up of Arterial Line*

Ventilator*

O2 Mask and Cannula*

O2 Cylinders*

Nebulizer Set-Up*

Oropharyngeal Suction*

Nasotracheal Suction*

Endotracheal Suction*

Assisting with Chest Tube Insertion*

Use of Pleuravac Drainage System*

Use of Emerson Drainage System*

End Tidal CO2 Monitoring*

Pulmonary - Knowledge and Use Of

Bronchodilators*

Racemic Epinephrine*

Steroids (IV/PO/INHALED)*

Cardiovascular - Care of Patients With

Acute MI, Angina*

CHF*

Abdominal Aortic Aneurysm*

Cardiac Monitoring*

Recognizing Arrhythmias*

Obtaining 12 Lead EKG’s*

Cardioversion*

Open Chest Heart Massage*

Assist with Insertion of Pacemakers (Temp/Perm)*

Set-up & Use of CVP*

Interpretation of CVP Readings*

Interpretation of Swan-Ganz Readings*

Thrombolytic Therapy*

Anaphylactic Shock*

Cardiogenic Shock*

Septic Shock*

Hypovolemic Shock*

Administration of Blood and Blood Products*

Cardiovascular - Knowledge and Use Of

Heparin*

Sodium Bicarbonate*

Lidocaine*

Bretylium*

Nipride*

Dopamine*

Isuprel*

Digitalis*

Sodium Bicarbonate*

Atropine*

Epinephrine*

Dobutrex*

Tridil/Nitroglycerine*

Neurological - Care of Patients With

Spinal Precautions*

Neuro Assessment*

Use of Glascow Coma Scale*

Acute Head Injury*

Acute T.I.A./C.V.A*

Acute Spinal Cord Injury*

Seizure Precautions*

Observing for Increased Intracranial Pressure*

Assist with Lumbar Puncture*

Neurological - Knowledge and Use Of

Narcan*

Dilantin*

Phenobarbital*

Decadron*

Mannitol*

Solu-Medrol*

Gastrointestinal - Care of Patients With

G.I. Bleed*

Abdominal Wounds*

Acute Abdominal Disorders*

Insertion of Nasogastric Tube*

Gastric Lavage*

Renal - Care of Patients With

Renal Failure*

Peritoneal Dialysis*

Renal Calculi*

Pyelonephritis/UTI*

Obstetrics/Gynecology - Care of Patients With

HELLP Syndrome*

Spontaneous Abortion*

Hemorrhage*

Placenta Previa*

Placental Abruption*

Pre-eclampsia/Eclampsia*

Emergency Delivery*

Fetal Heart Tones*

Sexually Transmitted Disease*

Obstetrics/Gynecology - Knowledge and Use Of

Pitocin*

Magnesium Sulfate*

Psychiatric - Care of Patients With

Suicidal Patient*

Overdose*

Emergency Police Hold*

ETOH Abuse/ DTs*

Seclusion*

Sexual Assault/Child Abuse - Care of Patients With

Sexual Assault*

Signs of Abuse*

Orthopedic - Care of Patients With

Traction*

Cast Application*

Checking C/M/S*

OCL Splinting*

Pins/Wires*

Closed Fracture/Dislocation Reduction*

Moderate Sedation*

Richmond Agitation and Sedation Scale (RASS)*

Application of Orthopedic Appliances*

Lacerations - Care of Patients With

Setting up Suture Tray*

Assist with Sutures/Staples*

Steri Strips*

Trauma - Care of Patients With

Air Transport of Trauma Patient*

Major Trauma*

Minor Trauma*

M.A.S.T. Suit*

Burns - Care of Patients With

First Degree*

Second Degree*

Third Degree*

Electrocution*

Hazardous Materials Exposure*

Radiation Exposure*

Pediatric General Skills

Abuse Reporting*

Vital Sign Parameters for Pediatric Patients*

Calculating Pediatric Medication Dosages*

Knowledge of Normal Serum Lab Values*

Pediatric - Care of Patients With

Febrile Seizure*

Epiglottitis*

Overdose/Poison Ingestion*

Asthma*

Near Drowning*

Environmental - Care of Patients With

Hypothermia*

Heat Stroke/Exhaustion*

Snake Bite*

Administration of Antivenom*

Animal Bite*

Poison Index*

Environmental - Knowledge and Use Of

Antibiotics*

Analgesics*

Antiemetics*

Sedatives*

Medication Titration and Calculations*

Reversal Agents*

Charcoal*

Miscellaneous Instruments/Trays

Pelvic Tray*

Cut Down Tray*

Procto Tray*

CVP Tray*

Trach Tray*

Culdocentesis Tray*

Thoracentesis Tray*

Application Agreement

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.

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