MEDICAL SURGICAL COMPETENCY SELF ASSESSMENT
CARDIOVASCULAR AND/OR TELEMETRY
Use and administrative of the following
Care of patients with
NEUROLOGY
Use & administration of the following
RESPIRATORY
Care of the patient with
GASTROINTESTIAL ASSESSMENT
GENITOURNINARY/RENAL
ORTHOPEDIC
ENDOCRINE/METABOLISM
Care of patient with
Administration of
PAIN MANAGEMENT
OTHER
Additional skills
YEARS EXPERIENCE
Please indicate number of years of experience in the following disciplines.
All the information on this page is true and accurate to the best of my knowledge. By completing this form, I am authorizing Professional Staffing to release this information to the appropriate client facilities in consideration of employment as a registry, local traveler of full traveler.
This form has been Electronically Signed and Authenticated by:
Date:
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