RRT/CRT Skills Checklist

    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

    AGE OF PATIENTS CARED FOR:

    GENERAL SKILLS:

    CARE OF PATIENTS WITH:

    MEDICATION ADMINISTRATION:

    KNOWLEDGE OF EFFECTS OF:

    EQUIPMENT:

    OXYGEN/ AIR DELIVERY SYSTEMS:

    MEDICATION DELIVERY:NEBULIZER:

    MEDICATION DELIVERY: MDI (METERED DOSE INHALER):

    PROCEDURES:

    AIRWAY MANAGEMENT & SUCTIONING:

    ADULT:

    MANUAL VENTILATION:

    DIAGNOSTIC:

    ASSIST WITH HIGH RISK DELIVERIES:

    TEACHING:

    WORK SETTINGS:

    POSITION CATEGORY:

    TOTAL YEARS OF EXPERIENCE:

    ATTESTATION:

    I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified, particularly within the last 2 years. I hereby authorize TALENT Healthcare Staffing to collect, store, and release any information that I have provided in this Skills Checklist and/or any other documentation and information they have collected or that I have submitted in any form to its parent company(s), its subsidiaries, or other subcontractors/its service providers as it deems necessary in its business operations as well as to individuals and companies in relation to consideration of employment as a Healthcare Professional with those companies and individuals. I acknowledge that The Company will take precaution and care to protect my personal information that is collected/stored/shared but cannot guarantee permanent data security and I release The Company from all related liability for damages or punitive liability.

    CERTIFICATIONS