OR - TALENT Healthcare Staffing :: TALENT Healthcare Staffing

Operating Room Nursing Skills Checklist

Name

Date

Phone

E-mail

I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale: 1 = No Experience, 2 = Need Training, 3 = Able to perform with supervision, 4 = Able to perform independently

WORKSETTING:

GENERAL SURGERY:

CARDIOVASCULAR:

THORACIC:

ORTHOPEDIC:

NEUROLOGICAL:

GENITOURINARY:

GYNECOLOGICAL:

EAR/NOSE/THROAT:

CRANIOFACIAL/ORAL:

PLASTIC:

TRANSPLANTS:

OPHTHALMOLOGY:

GENERAL SURGERY:

GENITOURINARY:

NEURO:

CARDIAC/VASCULAR:

TRANSPLANT:

OPHTHALMOLOGY:

EAR/NOSE/THROAT:

CRANIOFACIAL/ORAL/PLASTICS:

ORTHOPEDICS:

OR EQUIPMENT:

PROFESSIONAL KNOWLEDGE AND SKILLS:

EMR:

EMR Conversion

Expiry Date of BLS

Expiry Date NRP

Expiry Date PALS

Expiry Date of Certified Nurse Operating Room

Expiry Date of Registered Nurse First Assist

Operating Room Nursing Skills Checklist

Operating Room Nursing Skills Checklist

CERTIFICATIONS