Nurses
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Operating Room Nursing Skills Checklist

Candidate Self Assessment

Personal Information

Please fill the Recruiter Email correctly for successful application submission.

Proficiency Scale & Legend

1 No experience
2 Need Training
3 Able to perform with supervision
4 Able to perform independently

Worksetting

1
2
3
4

General Surgery

1
2
3
4

Cardiovascular

1
2
3
4

Thoracic

1
2
3
4

Orthopedic

1
2
3
4

Neurological

1
2
3
4

Genitourinary

1
2
3
4

Gynecological

1
2
3
4

Ear/nose/throat

1
2
3
4

Craniofacial/oral

1
2
3
4

Plastic

1
2
3
4

Transplants

1
2
3
4

Ophthalmology

1
2
3
4

General Surgery

1
2
3
4

Genitourinary

1
2
3
4

Neuro

1
2
3
4

Cardiac/vascular

1
2
3
4

Transplant

1
2
3
4

Ophthalmology

1
2
3
4

Ear/nose/throat

1
2
3
4

Craniofacial/oral/plastics

1
2
3
4

Orthopedics

1
2
3
4

Or Equipment

1
2
3
4

Professional Knowledge And Skills

1
2
3
4

Emr

1
2
3
4

EMR Conversion

  Expiration Date
BLS
NRP
PALS
Certified Nurse Operating Room
Registered Nurse First Assist
Other: Specify