Standards Care Staffing

Psychiatric Nursing Checklist

Please indicate your overall practical experience level with each skill using the key below. All fields are required.

Key
0	No experience
1	Requires additional training
2	Have performed and able to do without supervision
3	Very experienced and able to perform independently
4	Able to teach and supervise

Psychiatric Care	0	1	2	3	4
Admission of the Psychiatric Patient
Adolescent Patients
Assaultive Patient
Behavioristic Charting
Crisis Intervention
Detoxification Therapy
Discharge Planning
Eating Disorders
Electroconvulsive Therapy
Group Psychotherapy
Hallucinatory Patient
Isolation
Locked Ward
Manic-Depressive Patient
Milieu Therapy
Multi-Disciplinary Staffing
Nursing Assessment and Care Plan
Open Ward
Overdose Patient
Rapid Tranquilization
Schizophrenic Patient
Seizure Disorders
Seizure Precautions
Substance Abuse
Suicidal Patient
General Nursing Care	0	1	2	3	4
Insertion of a Foley Catheter
NG Tube Feeding
Neuro Signs
Oxygen Administration
CPR
Starting IV Therapy
Heparin Locks
Hanging Blood and Blood Products
Hyperalimentation/TPN
Obtaining Venous Blood Sample
Infusion Pumps: TYPES
Diabetic Patient Care
Oncology Patient
Specialized Nursing Care	0	1	2	3	4
Pediatrics
OB-GYN-L&D
Medical/Surgical
Neurosurgery
ICU/CCU
Telemetry
OR
ER
Other (please specify)

How many years have you worked in Psychiatric Nursing:


	The information I have provideded is true and accurate to the best of my knowledge. I hereby authorize my prospective employer to release this Checklist to Client in relation to consideration of my employment with them.