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Security Forces Hospital Program

DEPARTMENT OF NURSING

RECRUITMENT CHECKLIST EMERGENCY 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:


A = ADULT Clinical Skills 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 A P A

Applicants Signature P = PEDIATRIC B P A C P

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

Page 1 of 3 A A P A B P A C P

Prepare and Assist with Procedures 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

Page 2 of 3 A A P A B P A C P

Specific Condition Managed Respiratory : Endocrine : Acute Myocardial Infarction Unstable Angina

Respiratory Arrest Acute Asthma Chronic Obstructive Pulmonary Disease (COPD) Hemothorax Pneumothorax Pneumonia Pulmonary Embolism Pleural Effusion Hypoglycemia Hyperglycemia Diabetic Ketoacidosis (DKA) / Hyperosmolar Hyperglycemic State (HHS) Cerebrovascular Accident (Stroke/ CVA) Cerebral Palsy Epilepsy Head Injury Hydrocephalus Spinal Cord Injury Guillain Barre Syndrome Multiple Sclerosis Transient Ischemic Attack Renal Colic Priapism Bleeding Esophageal Varices Upper Gastro Intestinal Bleeding (UGIB) Lower Gastro Intestinal Bleeding LGIB Hepatitis Diverticulitis Acute Appendicitis Pancreatitis

Neurology:

Urology:

Gastrointestinal:

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Specific Condition Managed Hematology: Nephrology: Ulcerative Colitis Anemia Sickle Cell Crisis End Stage Renal Disease (ESRD) on Hemodialysis End Stage Renal Disease (ESRD) on Automated Peritoneal Dialysis (APD) Peritoneal Dialysis Acute Renal Failure Rheumatoid Arthritis Ectopic Pregnancy Abortions Pregnancy Induced Hypertension (PIH) Infectious: Others: Pre-Eclampsia Eclampsia Tuberculosis (TB) Measles Meningitis Chicken Pox H1N1 Sepsis Compartment Syndrome Drug Overdose Burns Major Tauma Seizures Cancer Patients Febrile Neutropenia Incision and Drainage Suturing Dressing

A A P A

B P A

C P

Rheumatology: OB/Gyne

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

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