Psychiatric Nurses Skills Checklist 

* Denotes required field
This profile is for use by Psychiatric nurses with more than one year experience in their discipline and specialty. It will not be a determining factor for employment but it may aid in promoting yourself at the Interview.

Please enter your full legal name as it appears on your Social Security Card.

First name*

___________________________________
Last name*

_____________________________

Social Security number:

______ - ______ - ______

 Date:

______ / ______ / ______

 

Email: _________________________________________________
Please indicate your level of experience
A. Theory, no practice C. One - two years experience
B. Intermittent experience D. Two plus years experience
 
A. PSYCHIATRIC
  1. Assessment
    a. Admission | A |     | B |     | C |     | D |
    b. Initial nursing assessment and care plan | A |     | B |     | C |     | D |
    c. Initial treatment plan | A |     | B |     | C |     | D |
    d. Neurological vital signs | A |     | B |     | C |     | D |
    e. Nursing diagnoses | A |     | B |     | C |     | D |
    f. Nursing reassessment and care planning update | A |     | B |     | C |     | D |
    g. Suicide risk assessment | A |     | B |     | C |     | D |
  2. Equipment & procedures  
    a. Active participation in multi-disciplinary staffing | A |     | B |     | C |     | D |
    b. Assist physician in administration of  
      electroconvulsive therapy | A |     | B |     | C |     | D |
    c. Assist with lumbar puncture | A |     | B |     | C |     | D |
    d. Cardiopulmonary resuscitation | A |     | B |     | C |     | D |
    e. Charge nurse experience | A |     | B |     | C |     | D |
    f. Charting  
      (1) Behavioristic | A |     | B |     | C |     | D |
      (2) Treatment/goal oriented | A |     | B |     | C |     | D |
    g. Discharge planning | A |     | B |     | C |     | D |
    h. Electroconvulsive therapy | A |     | B |     | C |     | D |
    i. Group therapy leader | A |     | B |     | C |     | D |
    j. Insertion & care of straight and Foley catheter  
      (1) Female | A |     | B |     | C |     | D |
      (2) Male | A |     | B |     | C |     | D |
    k. Management of drug/alcohol detox symptoms | A |     | B |     | C |     | D |
    l. Management of assaultive behavior | A |     | B |     | C |     | D |
    m. Multi-disciplinary treatment team participation | A |     | B |     | C |     | D |
    n. O2 therapy & medication delivery systems  
      (1) Bag and mask | A |     | B |     | C |     | D |
      (2) External CPAP | A |     | B |     | C |     | D |
      (3) Face masks | A |     | B |     | C |     | D |
      (4) Inhalers | A |     | B |     | C |     | D |
      (5) Nasal cannula | A |     | B |     | C |     | D |
      (6) Portable O2 tank | A |     | B |     | C |     | D |
      (7) Trach collar | A |     | B |     | C |     | D |
    o. Oro-naso-pharynx suctioning | A |     | B |     | C |     | D |
    p. Participation in milieu therapy | A |     | B |     | C |     | D |
    q. Patient teaching | A |     | B |     | C |     | D |
    r. Psychiatric emergency response team | A |     | B |     | C |     | D |
    s. Psychiatric home health | A |     | B |     | C |     | D |
    t. Rapid tranquilization | A |     | B |     | C |     | D |
    u. Restraints, application and assessment of  
      (1) Ambulatory cuffs | A |     | B |     | C |     | D |
      (2) Full restraints | A |     | B |     | C |     | D |
      (3) Wrist restraints | A |     | B |     | C |     | D |
    v. Telephonic crisis intervention | A |     | B |     | C |     | D |
    w. Therapeutic communication skills | A |     | B |     | C |     | D |
    x. Tube feeding | A |     | B |     | C |     | D |
  3. Care of the patient with:
    a. Alcohol dependency | A |     | B |     | C |     | D |
    b. Drug dependency | A |     | B |     | C |     | D |
    c. Electroconvulsive therapy | A |     | B |     | C |     | D |
    d. Hallucinations | A |     | B |     | C |     | D |
    e. Manic behavior | A |     | B |     | C |     | D |
    f. Med-psych patient | A |     | B |     | C |     | D |
    g. Organic disorder | A |     | B |     | C |     | D |
    h. Partial hospital/intensive outpatient  
      program patient | A |     | B |     | C |     | D |
    i. Seclusion and restraints | A |     | B |     | C |     | D |
    j. Seizure disorder | A |     | B |     | C |     | D |
    k. Suicidal behavior | A |     | B |     | C |     | D |
    l. Tracheostomy | A |     | B |     | C |     | D |
  4. Medications
    a. Administration of oral psychotropic medications | A |     | B |     | C |     | D |
    b. Heparin | A |     | B |     | C |     | D |
    c. Intramuscular | A |     | B |     | C |     | D |
    d. Management of extrapyramidal symptoms (EPS) | A |     | B |     | C |     | D |
    e. Oral | A |     | B |     | C |     | D |
    f. Rectal | A |     | B |     | C |     | D |
    g. Sub-q | A |     | B |     | C |     | D |
    h. Unit dose | A |     | B |     | C |     | D |
    i. Z-technique | A |     | B |     | C |     | D |

B. PHLEBOTOMY/IV THERAPY
  1. Equipment & procedures  
    a. Administration of blood/blood products  
      (1) Packed red blood cells | A |     | B |     | C |     | D |
      (2) Whole blood | A |     | B |     | C |     | D |
    b. Drawing blood from central line | A |     | B |     | C |     | D |
    c. Drawing venous blood | A |     | B |     | C |     | D |
    d. Management of patient with hyperalimentation | A |     | B |     | C |     | D |
    e. Management of patient with IV | A |     | B |     | C |     | D |
    f. Starting IVs  
      (1) Angiocath | A |     | B |     | C |     | D |
      (2) Butterfly | A |     | B |     | C |     | D |
      (3) Heparin lock | A |     | B |     | C |     | D |

AGE SPECIFIC PRACTICE CRITERIA
Please check the boxes below for each age group for which you have expertise in providing age-appropriate nursing care.

A. Newborn/Neonate (birth - 30 days)
F. Adolescents (12 - 18 years)
B. Infant (30 days - 1 year) G. Young adults (18 - 39 years)
C. Toddler (1 - 3 years) H. Middle adults (39 - 64 years)
D. Preschooler (3 - 5 years) I. Older adults (64+)
E. School age children (5 - 12 years)  
EXPERIENCE WITH AGE GROUPS: A B C D E F G H I
Able to adapt care to incorporate normal growth and development.
Able to adapt method and terminology of patient instructions to their age, comprehension and maturity level.
Can ensure a safe environment reflecting specific needs of various age groups.

My experience is primarily in: (Please indicate number of years.)
Adolescent ___ year(s)
Adult ___ year(s)
Chemical dependency/detox ___ year(s)
Certification:
Please check the boxes below and indicate the expiration date for each certificate that you have. If you do not know the exact date, please use the last date of the specific month (e.g., 08/31/2003).

BCLS
Exp. date:
 ___________ (mm/dd/yyyy)
MAB
Exp. date:
 ___________ (mm/dd/yyyy)
Other (type): ________________
Exp. date:
 ________ (mm/dd/yyyy)
Computerized charting system: ________________
date:
 ________  (mm/dd/yyyy)
Medication administration system: ________________
date:
 ________  (mm/dd/yyyy)

The information I have given is true and accurate to the best of my knowledge.

Signature: ______________________________  Date: _____________