Nurse Skills Checklist – Newborn and Pediatrics

Personal Information

Please fill the Recruiter Email correctly for successful application submission.

Candidate Name

Email of Recruiter / POC

Select Submission Date

SSN (Last 4 digits)

Proficiency Scale & Legend

1 No experience

2 Require training

3 Have performed this task and able to perform without supervision

4 Experienced and able to perform independently

5 Able to teach and supervise

General

Administration of Blood/Blood Products

Adolescent

Apnea Monitoring

Assist with Lumbar Puncture

Blood Exchange

Calculation of Pedi Dosage

Cardiac Arrest/CPR

Chemotherapy

Cord and Circumcision Care

ECMO

Glascow Coma Scale

Hemodynamic Monitoring

IMV

Infant

Infusion Pumps

Interpretation of Arrhythmias

Jet Vents

Knowledge of Normal Serum Lab Values

Maintenance of Heparin Locks

Neonatal Level (Circle Level)

Newborn Nursery

Pediatric Icu

Care Of Patient With

Please list any additional skills/training/equipment:

Skills

Training

Equipment

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct, and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from the agency.