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A = ADULT P = PEDIATRIC

Security Forces Hospital ProgramDEPARTMENT OF NURSING

RECRUITMENT CHECKLISTEMERGENCY ROOM

To:

Name of Candidate

Note: Please complete the skills checklist to ensure your individual experience may be clearly understood.

Tick (/) the appropriate column. The information will be used to ensure best possible placement

based on your clinical expertise and our hospitals needs.

I believe that this is an honest and accurate assessment of my skills, abilities and knowledge. I understand

that failure to perform and/or meet the checked duties will affect my evaluation and progress.

Please See Checklist Legend Below for Parameters A, B, C: Applicants Signature

Clinical SkillsA B C

A P A P A P

Basic Cardiac Life Support (BCLS)

Certified Advanced Cardiac Life Support (ACLS)

Certified Pediatric Advanced Life Support (PALS)

Certified Advanced Trauma Life Support (ATLS)

Advanced Trauma Course for Nurses (ATCN)

Certified Neonatal Resuscitation Program (NRP) Primary & Secondary Patient Assessment (Triage)

Knowledge of Glasgow Coma Scale

Peripheral and Central IV care and medication

administration

Arterial Puncture

Arterial Blood Gases (ABG) Interpretation

Biochemistry Interpretation

Perform & Interpret 12 lead Electrocadiogram (ECG)

Nurse Triage System

Application of Plaster of Paris

Care of ventilated patient

Management of a Code Team

Care of patient with acute multiple trauma

Endotracheal Tube Suctioning

A = Competent, 2+ years recent experience; Independent in skill and knowledgeable of disease process.

B = Novice; knowledgeable of skill/disease but need supervision

C = Unskilled; Lack knowledge/skill to attend to patient/need

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Prepare and Assist with ProceduresA B C

A P A P A P

Tracheostomy Tube Suctioning

External Cardiac Pacing

Defibrillation

Synchronized Cardioversion

Insertion of Central Venous Pressure (CVP) Line

(Assist)

Insertion of Nasogastric Tube

Insertion of Foleys Catheter

Insertion of Endotracheal Tube (Assist)

Insertion of Tracheostomy Tube (Assist)

Lumbar Puncture (Assist)

Insertion of Chest Tube (Assist)

Blood Transfusion

Equipment / Instruments Used

Cardio Respiratory Monitor (MP50, MP70)

Pulse Oximeter

Synchronizing Assisted Ventilator

Intra Venous (IV) Pumps

Syringe Pump

Blood Warmer

Rapid Infusion Pump

Glucometer

Tympanic Thermometers/Temp Plus II Thermometer

Electrocadiogram (ECG) Machine

Ambu Bag

BIPAP

MRX Defibrillator

Pyxis

Portable Doppler

Specific Condition Managed

Cardiac: Cardiac Arrest

Cardiogenic Shock

Acute Pulmonary Oedema

Hypertensive Crisis

Acute Coronary Syndrome

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Specific Condition ManagedA B C

A P A P A P

Acute Myocardial Infarction

Unstable Angina

Respiratory : Respiratory Arrest

Acute Asthma

Chronic Obstructive Pulmonary

Disease (COPD)

Hemothorax

Pneumothorax

Pneumonia

Pulmonary Embolism

Pleural Effusion

Endocrine : Hypoglycemia

Hyperglycemia

Diabetic Ketoacidosis (DKA) /

Hyperosmolar Hyperglycemic

State (HHS)

Neurology: Cerebrovascular Accident

(Stroke/ CVA)

Cerebral Palsy

Epilepsy

Head Injury

Hydrocephalus

Spinal Cord Injury

Guillain Barre Syndrome

Multiple Sclerosis

Transient Ischemic Attack

Urology: Renal Colic

Priapism

Gastrointestinal: Bleeding Esophageal Varices

Upper Gastro Intestinal

Bleeding (UGIB)

Lower Gastro Intestinal

Bleeding LGIB

Hepatitis

Diverticulitis

Acute Appendicitis

Pancreatitis

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Specific Condition ManagedA B C

A P A P A P

Ulcerative Colitis

Hematology:

Anemia

Sickle Cell Crisis

Nephrology: End Stage Renal Disease (ESRD)

on Hemodialysis

End Stage Renal Disease (ESRD)

on Automated Peritoneal Dialysis

(APD)

Peritoneal Dialysis

Acute Renal Failure

Rheumatology: Rheumatoid Arthritis

OB/Gyne Ectopic Pregnancy

Abortions

Pregnancy Induced Hypertension

(PIH)

Pre-Eclampsia

Eclampsia

Infectious:

Tuberculosis (TB)

Measles

Meningitis

Chicken Pox

H1N1

Others: Sepsis

Compartment Syndrome

Drug Overdose

Burns

Major Tauma

Seizures

Cancer Patients

Febrile Neutropenia

Incision and Drainage

Suturing

Dressing

Ref: ShareDoc - Recruitment Checklist - Revised 2011 - Ambulatory Care Division - ERRM/gcg (Revised Oct 2011)

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