Progressive Care - Telemetry RN

Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1-2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only

1 = Limited Experience / Rarely Done (<6 times/year)

2 = May Need Some Review / Occasionally Done (1-2 times/month)

3 = Experienced / Frequently Done (daily or weekly)

"*" indicates required fields

Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1-2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

Type Of Facility Experience

TYPE OF FACILITY EXPERIENCE

Age Of Patients Cared For

Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler/Preschool (13 months to 5 years)
School Age Child/adolescent (6 years to 18 years)
Young Adults/Middle Adult (19 years to 64 years)
Older Adults/Elderly (65+ years)

General Skills

Care of Patient in Restraints
Automated Med Dispensing Systems
Electronic Documentation
IV Pumps
Peripheral IV Insertion, Care and Maintenance
Access/Management of Implanted Ports
Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, etc.)
Cardiac Monitoring/Interpretation
PCA/Epidural pumps
Titration of drips
Administration of Blood/Blood Products
Dressing Changes
Knowledge of Normal Serum Lab Values
Obtaining Cultures (Blood, Sputum, Swab, Urine)
Care of Patient with Burns
Care of Patient with HIV/AIDS
Hyperbaric Oxygenation
Suicide Precautions
Post Mortem Cares
Knowledge of current Joint Commission National Patient Safety Goals
Knowledge of "Do Not Use Abbreviations"
Do you have charge/supervisor experience?

Medication Knowledge And Use Of

Moderate/Conscious Sedation & Reversal Agents
Calculate mcg/min and mcg/kg/min
Antiemetics
Amiodarone
Cardizem
Decadron
Dilantin
Magnesium Sulfate
Phenobarbital
Steroids
Valium
Atropine
Diuretics
Digoxin
Dopamine
Dobutrex
Heparin Drip (Precautions & Maintenance)
Inderal
Inocor
Isuprel
Lidocaine
Neosynephrine/Nipride
Nitroglycerin
Pronestyl
Morphine
Thrombolytic Agents
Magnesium Sulfate
Prep/Titration of Emergency Drugs

Neuro General Skills

Assessment of Neuro Signs
Glascow Coma Scale
Seizure Precautions
Assist with Lumbar Puncture
Halo Traction

Neuro-care Of Patient With:

CVA
Seizure Activity
Overdose
Neuro/Head Injury/Trauma
Pre/Post Neuro Surgery
Cranial Hemorrhage
Multiple Sclerosis
Post-Op AV-Shunt

Cardiac General Skills

Auscultation of Cardiac Sounds
Dopplers
Tele/EKG Interpretation
Defibrillation/Cardioversion
Permanent Pacemaker
Temporary Pacemaker
AICD
Art-Line (Transducer set-up, D/C)
Sheath Removal

Cardiac-care Of Patient With:

Angina
CHF
Post MI
Pre/Post Cardiac Cath
Pre/Post Cardiac Surgery
Open Sternal Wound (Debridement)
Heart Transplant

Respiratory General Skills

Establishing an Airway
Ambuing Techniques
Chest Tubes
Pulse Oximetry
Interpretation of ABG
Use of IPPB
Incentive Spirometer

Respiratory-care Of Patient With:

COPD
ARDS
Pre/Post Thoracic Surgery
Pulmonary Embolism
Pulmonary Edema
Pneumothorax
Pneumonia
Inhalation Injuries
Emphysema
Asthma
Lung Transplant

Gastrointestinal General Skills

NG Tube Insertion, Care and Maintenance
Gastrostomy Tube
Jejunostomy Tube
Enterostomal Care
Tube feedings

Gastrointestinal-care Of Patient With:

Pancreatitis
G.I. Bleed
Esophageal Bleeding
Bowel Obstruction
Whipple Procedure
Liver Transplant
Paralytic Ileus
E.R.C.P.

Genitourinary/renal General Skills

Peritoneal Dialysis
Hemodialysis
Foley/Straight Catheter Insertion
GU Irrigations
Nephrostomy Tube
Suprapubic Tube
Electrolyte Imbalance/Replacement

Genitourinary/renal-care Of Patient With:

T.U.R.P.
Shunts & Fistulas
Nephrectomy
Renal Transplant
Renal Trauma
Chronic/Acute Renal Failure

Gynecology General Skills

GYN Exam/Pap

Gynecology-care Of Patient With:

Ectopic Pregnancy/Ruptured Ectopic Pregnancy
Hysterectomy
Repair of Cystocele/Rectocele

Orthopedic General Skills

Assessment of C/M/S
K-Wires/Steinman Pins
Removal of Hardware

Orthopedic-care Of Patient With:

Total Joint Replacement
Spica Cast/Body Cast
Amputation
Traction
Ortho Trauma
Laminectomy

Endocrine General Skills

Diabetic Teaching
Blood Glucose Monitoring

Endocrine -Care Of Patient With:

Hyper/Hypoglycemia

Medication Knowledge And Use Of:

Insulin (IV,SQ)
D50
CARDIAC MONITORS:
VENTILATORS: