Med/Surgical Skills Checklist Medical/Surgical Skills ChecklistName*Date PLEASE CHECK THE APPROPRIATE COLUMN THAT MOST ACCURATELY REFLECTS YOUR LEVEL OF EXPERIENCE OR SKILL: LEVELS OF PROFICIENCY 0 - No Experience or skills | 1 - Minimal experience, need review and supervision, have performed at least once | 2 - Comfortable performing with resource available | 3 -Competent to perform independently and safely | 4 -Expert, able to act as resource to othersPATIENT RIGHTSNEUROLOGYNEUROLOGY: Care of Patient with:CARDIOVASCULARMEDICATION AND ADMINISTRATION Knowledge of Indications, Actions, Contraindications, Side Effects, Methods of Administration, Calculation of Dose, Rate of Infusion, caring for and monitoring patient receiving the following:PULMONARYGASTROINTESTINALGENITOURINARY/RENALENDOCRINEONCOLOGYMUSCULOSKELETALMISCELLANEOUSEXPERIENCE AREAS: Please provide the number of years/months of experience you have in each of the following. Insert zero (0) for those areas in which you have no experience. Medical/Surgical ExperienceYearsMonthsTelemetry/Stepdown ExperienceYearsMonthsOrtho ExperienceYearsMonthsRehabilitation ExperienceYearsMonthsMother - Baby ExperienceYearsMonthsOncology ExperienceYearsMonthsNeurology ExperienceYearsMonthsPediatrics ExperienceYearsMonthsUrology ExperienceYearsMonthsSkilled ExperienceYearsMonthsHospice ExperienceYearsMonthsGeneral Medicine ExperienceYearsMonthsGeneral Surgery ExperienceYearsMonthsCharge Experience ExperienceYearsMonthsIV Certified ExperienceYearsMonthsOther Experience & Years/MonthsBy clicking 'Submit', you acknowledge that the information provided is true and accurate to the best of your knowledge and further authorize Galileo Search, LLC. to share the above skills checklist with their clients/potential employees.
