REGISTERED NURSE ONCOLOGY

		REGISTERED NURSE ONCOLOGY
NAME

LAST 4 OF SSN

DATE

	I hereby certify that ALL information I have provided to IMCS Group on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.

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 below to describe your experience/expertise in each area listed below.
Proficiency Scale:	1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently

Rating Stars (Click)	RADIATION THERAPY:		1	2	3	4
	Skin Assessment
	Total Body Irradiation
	Side Effect Management
	External Radiotherapy
	Brachytherapy
	Radiation Safety Precautions
	Intraoperative Radiation
Rating Stars (Click)	ONCOLOGY PATIENT CARE:		1	2	3	4
	Renal Failure
	Fever
	Pneumonia
	Cqrdiac Arrhymias
	Hypercalcemia
	Hyperkalemia
	Pancreatitis
	Pulmonary Embolism
	Bowel Obstruction
	Diabetes
	Pneumothorax
	Stress Fractures
	RespiratoryDistress
	Spinal Cord Compression
	GI Bleed
	Pleural Effusion
	Infection
	Hypokalemia
	DIC
	Atlelectasis
	Lymphedema
Rating Stars (Click)	VASCULAR DEVICES:		1	2	3	4
	Flush Catheter
	Punctured Catheter
	Chemo Port
	Omega-Port
	S.E.A. Port
	Port-A-Cath
	Opti-Port
	PICC Lines
	Obtain Blood Specimens
	Line Insertion Assistance
	De-Clotting Ports
	Groshong Catheters
	Catheter Port
	Site Care
	Broviac Catheters
	Patient/Teaching
	Hickan Catheters
Rating Stars (Click)	CARE OF PATIENTS WITH:		1	2	3	4
	Foley Catheter Irrigations
	CVP Line Insertion
	Jejunostomy Tubes
	Wound Care
	Colostomy Care
	TURP
	Reverse Isolation
	Liver Biopsy
	Platelet Precautions
	Accucheck
	NG Tube Insertion
	Suprapubic Catheter
	Ileostomy
	Thoracentesis
	Isolation
	Foley Catheter Irrigations
	Bone Marrow Biopsy
	Enterostomal Care
	Chest Tube Care
	Paracentesis
	Gastrostomy Tube
	Narcotic Infusion
	Hemodialysis
	Nephrostomy Tube
	Pain Management
	Pulse Oximetry
	Fistulas/Shunts
	Seizure Precautions
	Peritoneal Dialysis
	Nasotracheal Suctioning
	PCA Pumps
Rating Stars (Click)	CARDIOVASCULAR:		1	2	3	4
	Hyperalimentation
	Peripheral Blood Stem Cells
	Packed RBC’s
	IV Fluid Hydration
	Venoclusive Disease
	Fresh Frozen Plasma
	Infections
	Pneumonitis
	Graft Rejection
	Platelets
	WBC/Lukocytes
	Blood /Byproducts
	Antivirals
	Donor Education
	Allogeneic BMT
	Antibiotics
	GVHD Graft
	Autologous BMT
	Antifungals
	Implantable Infusion Pumps
	Medtronic
	Infusaid
	Ambulatory Infusion Pumps
	Synchormed
	Cormed
	Pharmacia
	Auto Syringe
	Pancretec
	Patency Maintenance
	Patient Teaching
Rating Stars (Click)	PSYCHO & SOCIAL CARE:		1	2	3	4
	Palliative Care
	Hospice Care
	Family Support
	Counseling/Death/Dying
	Identifying Support Groups
	Advance Directives
	Identifying Resources
	Health Care Proxy
Rating Stars (Click)	PHARMACOLOGY:		1	2	3	4
	Floxuridine/FUDR
	Doxorubicin/Adrianycin
	Heparin/Coumadin
	Carmustine/BiCNU
	Dopamine
	Cistplatin
	Mitonycin/Mutanycin
	Dilantin
	Fluorouracil/-FU
	Usulfan/Myleran
	Neupogen/Epogen
	Hydroxyurea/Hydrea
	Corticosteroids
	Vincristine/Oncovin
	Methotrexate/Amethopterin
	Morphine
	Etoposide/VP-6-
	Cyclophosphamide/Cytoxan
	Decadron
	Belomycin/Blenoxane
	Vinblastine/Velban
	Melphalan/Alkeran
	IV Care/Skills
	Chemotherapy Adm
	IM/SQ
	IVPB
	IV Push/Intrathecal
Rating Stars (Click)	ONCOLOGY & GENERAL CARE:		1	2	3	4
	Thrombocytopenia
	Stomatitis
	Hemorrhabe
	Oncology PCU
	Neuropathy
	Bone Marrow Transplant
	Death /Dying
	Venous Access Devices
	Electrolyte Imbalance
	Palliative/Hospice Care
	Neutropenia
	Pain Management
	Telemetry
	Nutritional Needs
	Immunosuppression
	IV Maintenance
	Septic Shock
	Vomiting/Diarrhea/Nausea
	Skin Care
	Blood/Blood Byproducts
	Normal Serum Labs Values
	Radiation Therapy
	Surgical Patient Care
	Chemotherapy Protocols
	Implantable Vascular Ports
	Patient Teaching
	Implantable Infusion Pumps
Rating Stars (Click)	EMR		1	2	3	4
	Epic
	Cerner
	Eclipsys
	McKesson
	Meditech
	Other Computerized System
	Computerized Physician Order Entry
	Bar Coding for Medication Administration
MY EXPERIENCE IS PRIMARILY IN:
Unit	No. of Years	Unit	No. of Years
BURN		POST PARTUM
CRITICAL UNIT		LABOR & DELIVERY
PACU		NEWBORN NURSERY
NEUROLOGY		LEVEL II NICU
TELEMETRY		LEVEL III NICU
MEDICAL		PICU
SURGICAL		PEDIATRICS
ONCOLOGY		OB/GYN
ORTHOPEDICS		PSYCHIATRY
OPERATING ROOM		RRT
EMERGENCY ROOM		CRT
TRAUMA CENTER LEVEL 1
COMMUNITY ER
RURAL ER
Rating Stars (Click)	Age Specific Competencies		1	2	3	4
	Newborn/Neonatal (birth – 30 days)
	Infant (30 days-1 year)
	Toddler (1-3 years)
	Preschool (3-5 years)
	School Age Children (5-12 years)
	Adolescent (12-17 years)
	Young Adults (18-44 years)
	Middle Adults (45-64 years)
	Older Adults (>65 years)