Self Assessment: RN
Name:
Directions:
Indicate your level of skill and experience by checking the boxes below according to the definitions listed.
Highly Skilled:
Able to instruct and supervisor
Skilled:
Able to function independently
Limited Skill:
Experienced, but may need review
No Experience:
No direct experience
Core Skills:
Highly
Skilled
Skilled
Limited
Skill
No
Experience
Admission of Patient
Discharge of Patient
Documentation
Incident Reports
Transcribing Orders
Patient Assessment Skills:
Auscultation of Heart and Lung Sounds
Auscultation of Bowel Sounds
Identification of Abnormal Heart Sounds
Identification of Abnormal Lung Sounds
Assessing Pupillary Response
Assessing Level of Consciousness
Using Appropriate Interview Techniques
Assessing According to Age Specific Changes
Assessing for Fall Risk
Assessing Skin Breakdown Potential
Care Plan Formulation:
Use a Goal Directed Care Plan
Use a Care Pathway
Work with a Multidisciplinary Team
Medication Adminsitration:
Administer Oral and Topical Route Medications
Administer Medications via Injection
Administer IV Push and Piggyback Medications
Administer Medications via Gastric Tubes
Administer Medications via Ports
Recognize Adverse Reactions to Medications
Intravenous Therapy and Specialty Medications:
Give Chemotherapy Medications
Calculate IV Drip Rates for Cardiac Medications
Modify IV Administration for Latex Allergy
Prepare Primary and Secondary IV Setup
Start IVs
Assess for and Manage Adverse Reactions
Add Medications to IV Solutions
Do Heparin Flushes
Convert IVs to Heparin Locks
Hang Blood Products and Monitor Infusion
Assist w/Central Line Insertion
Use IV Pumps and PCA Pumps
Specimen Collection:
Collect Urine for UA, Culture and Sensitivity
Collect Stool for Blood, Ova, and Parasites
Collect Specimens for Culture
Collect 24 Hour Urine Specimens
Conduct Capillary Blood Sugar Test
Cardiac Patient Care:
Can Apply Telemetry Leads for Monitoring
Can Recognize Death-Producing Rhythms
Familiar with ACLS Algorithms
Can use a Defibrillator and/or AED
Can Insert Oral and Nasal Airway
Can use a Bag/Valve/Mask Setup
Can Put a Laryngoscope Together
Can Assist with Intubation
Able to use Portable Oxygen Tank
Assist with Temporary Pacemaker Insertion
Care for a Pre and Post Cardiac Cath Patient
Care for a CABG Patient Pre and Post Op
Understand Principles of Cardiac Rehab
Age Specific Care:
Newborn/Neonatal
Infant (30 days - 1 yr)
Toddler (1-3 yrs)
Preschool (3-5 yrs)
School Age (5-18 yrs)
Young Adults (18-39 yrs)
Middle Adults (39-64 yrs)
Older Adults (64+ yrs)
Nursing Unit Experience:
Please indicate number of years
Medical Surgical
years From:
To:
Telemetry
years From:
To:
Orthopedics
years From:
To:
Oncology
years From:
To:
Labor and Delivery
years From:
To:
Pediatrics/NICU/PICU
years From:
To:
PACU
years From:
To:
Psychiatry
years From:
To:
Operating Room
years From:
To:
Hemodialysis
years From:
To:
ICU/CCU
years From:
To:
CVICU
years From:
To:
ER
years From:
To:
Case Management
years From:
To:
Certifications:
BCLS
ACLS
NRP
Other
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