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
(PROFICIENCY)
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
(FREQUENCY)
1 = Never performed observed only
2 = Less than 6 times per year
3 = 1-2 times per month
4 = Daily or Weekly
PROFICIENCY / FREQUENCY
PROFICIENCY
FREQUENCY
Admit/Orient Involuntary Clients
Admit/Orient Voluntary Clients
Assist Activities of Daily Living
Assist with Personal Hygiene
Initial Screening Assessment
Multi-Disciplinary Planning
Participate in Interdisciplinary Team
Reassess/Update Plan of Care
Referral to Community Resources
Supervise Unlicensed Personnel
Care of Psychiatric Disorders
Catatonic Psychotic Disorder
Dissociative Identity Disorder
Obsessive/Compulsive Disorder
Paranoid Psychotic Disorder
Suicidal Ideation/Attempts
Assist with Psychotherapy
Cluster A-Paranoid/Schizoid
Cluster B-Antisocial/Borderline
Cluster C-Anxious/Fearful
Certified %22Management of Assaultive Behavior%22
Education or Vocational Training
Teach Independent Living Skills
Therapeutic Communication
Assist with Alternative Therapies
ElectroConvulsive Therapy
Expressive Therapy (Art, Movement)
Administer PO Medications
Administer Topical Medications
Identify Appropriate Level of Care
Discontinue Peripheral IV's
Pain Assessment/Management
Substance-Related Disorders
Developmental/Autistic Disorders
Post Traumatic Stress Disorder
Somatoform Disorders (Pain etc.)
Survivor of Abuse/Violence
Anticholinergics/Antiparkinsons
Antidepressants/Mood Elevators
Management of Med Side Effects
Recognition of Med Side Effects
Middle Adults (39-64 yrs)