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Ambulatory RN

Ambulatory RN

  • Date Format: MM slash DD slash YYYY
  • Self-Assessment Rating Scale:

    No Experience
    Theory or observation only during the past 12 months

    Limited Experience
    Performed less than 12 times within the past 12 months and may need a review

    Experienced
    Performed at least once per month within the past 12 months and may need minimal assistance

    Highly Skilled
    Performed on at least a weekly basis over the past 12 months; proficient
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Newborn (birth-30 days)
    Infant (30 days - 1 year)
    Toddler (1 - 3 years)
    Preschooler (3 - 5 years)
    School Age (5 - 12 years)
    Adolescents (12 - 18 years)
    Young Adults (18 - 39 years)
    Middle Adults (39 - 64 years)
    Older Adults (64+ years)
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Standard Precautions
    Isolation Precautions
    Adult Respiratory/ Cardiac Arrest
    Pediatric Respiratory/Cardiac Arrest
    Defibrillators
    Patient/ Family Education
    Crash Carts
    Admit and Assess Patients
    Automated Med Dispensing Systems
    Electronic Documentation
    Obtaining Cultures (Blood, Sputum, Swab, Urine)
    Advance Directives
    Collect Appropriate Data
    Discharge Teaching
    Preoperative Teaching
    Patient Prep
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Assess Heart Tones
    Bedside Tele Monitoring
    Interpretation of Coagulation Studies
    Perform Pulse/ Circulation Checks
    Pre-Post Op Pacemaker Care
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Assess Breath Sounds
    Apply Oxygen
    Interpret ABGs
    Thoracentesis
    Oximetry
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Assess Neurological Signs
    Epidurals
    Selective Nerve Root Blocks
    Assess Level of Consciousness
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Insertion/ Monitoring NG Tubes
    Assessment
    Flexible Sigmoidoscopy
    Hemorrhoid Banding
    Liver Biopsy
    Paracentesis
    Lap Band Surgery
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Bladder Biopsy
    Cystoscopy
    Urethral Dilation
    Nephrostomy
    Kidney Biopsy
    Suprapubic Catheter
    Prostate Biopsy
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Care of Diabetic Patient
    Diabetic Teaching
    Blood Glucose Testing
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Prosthodontics -Restorative Dentistry
    Mouth Biopsy
    Myringotomy
    Maxillofacial Prosthetics
    Nose Biopsy
    Thyroid Aspirate Biopsy
    Fiberoptic Laryngoscopy
    Tonsillectomy
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Application of Burn Dressing
    Dressing Changes
    Debridement of Wound
    Wound Care
    Wound Vac
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Electrodesiccation and Curettage (ED7C)
    Assist with In-Office Procedures
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Arthrocentesis
    External Hardware and Pin Care
    Arthroscopy
    Open Reduction and Internal Fixation
    Closed Reduction and Internal Fixation
    Trigger Point Injections
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Rhinoplasty
    Liposuction
    Nipple Reconstruction
    MOHS Repairs
    Blepharoplasty
    Mole/ Cyst Removal
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Administer IM and SQ Medications
    Administer Inhalation Medications
    Administer PO Medications
    Bladder Irrigation and Installation
    Needleless System
    Chemotherapy
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Infusion Pumps
    Peripheral IV Insertion
    Syringe Pumps
    Vascular Access Devices Care/ Maintenance
    Administer IV Medications