This checklist was electronically signed on
July 26, 2026
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
PATIENT RIGHTS
COMMUNICATION
NEUROLOGICAL ASSESSMENT
NEUROLOGICAL EQUIPMENT AND PROCEDURE
CARE OF PATIENT WITH NEUROLOGICAL DISEASE
PULMONARY ASSESSMENT
INTERPRETATION OF PULMONARY LABORATORY RESULTS
PULMONARY EQUIPMENT AND PROCEDURES