The following checklist is a profile used to assess your Labor, Delivery, Postpartum, and Newborn Nursery proficiency and assist in matching your skills with available assignments. Your employment is not dependent upon responses given on this checklist. Please rate your ability as accurately as possible by checking the appropriate option. Step 1 of 6 16% Name* First Middle Last PLEASE MARK YOUR LEVEL OF EXPERIENCE 0 - No Experience 1 - Theory/Observed Only 2 - Intermittent Experience 3 - Moderate Experience 4 - ExpertGeneral SkillsPatient/family teaching01234Coaching Needs: Physical/Emotional/Comfort01234Universal precautions01234Care of the patient in isolation01234Care of the patient in restraints01234Cardiac monitoring01234Ventilator management01234Preparation and administration of emergency drugs01234Infant/neonatal arrest/NRP01234Adult cardiac arrest/ACLS01234Pulse oximetry01234Interpretation of ABG's01234Basic fetal monitoring course01234Advanced fetal monitoring course01234Assist with sterile speculum exam (effacement, dilation, station, presentation)01234Perform sterile speculum exam independently01234Use of Doppler01234Venous access: Peripheral IV starts01234Scalp veins01234Maintenance of saline locks01234Administration of blood/blood products01234TPN/Lipids01234Knowledge and communication of normal lab values01234Use of infusion pumps/drips/IV Monitoring01234Assessment/Management of pain01234PCA (Patient Controlled Analgesia)01234Assist/monitor anesthesia01234General Anesthesia01234Regional/Spinal/Epidural01234End of life care01234Lift/transfer devices01234Computerized documentation01234Automated medication dispensing systems01234 Labor Assessments and ProceduresAssess and document progression of labor01234Assist with AROM procedure01234Assess and document fetal status01234Use of EFM (External Fetal Monitor)01234Use of IFM (Internal Fetal Monitor)01234Assist with IUPC placement and calibration01234Ammioinfusion01234Assist with vaginal delivery01234Forceps/Vacuum extraction01234Shoulder Dystocia01234Emergency delivery01234Hemorrhage/shock01234Assist with high risk delivery01234Circulate for C-Section01234Scrub for C-Section01234Abdominal shave/scrub prep01234Perineal prep01234Internal monitor/lead connection and calibration01234Assist with placement of intrauterine pressure cath01234Assist with fetal scalp blood sampling01234Fundal assessment/height01234 Immediate Care of Baby in Delivery RoomNewborn assessment/Apgar score01234Routine neonatal medications01234Meconium01234Suctioning01234Eye prophylaxis01234Collect cord samples01234Heelsticks01234Radiant warmer/Thermoregulation01234ID/Security branding01234Postpartum CareFundus/Lochia/Perineum care01234Episotomy/incision care01234Post-Op C-Section01234Bladder assessment01234Foley catheter insertion01234Couplet care01234Breastfeeding instruction01234Care of the Patient with Pre-existing ProblemsCardiac Disease01234Neurological Disease01234Seizure disorder01234Prior tubal ligation01234Diabetes Mellitus01234Infectious disease01234Sickle Cell Disease01234RH incompatibilities01234HIV01234Drug addiction/withdrawal01234 Antepartum Care and ProceduresTriage of obstetrical patients01234NST (non stress tests)01234OCT (Oxytocin Challenge tests)01234Reflex checks/Edema assessment/Clonus01234Assist with Amniocentesis01234Care of patient with:Pregnancy induced hypertension01234Pre-eclampsia/Eclampsia01234Preterm labor01234VBAC Management/trial of labor01234Placenta previa01234Abruptio Placenta01234Uterine Rupture01234Multiple gestation01234Malpresentations01234Breech01234Version01234Medication AdministrationPitocin01234Ritodrine01234Magnesium Sulfate therapy01234Insulin drips01234Oxytocin01234Turbutaline01234AZT01234 Newborn Care General SkillsNeonatal Level II/ Level III (Complete NNICU checklist)01234Newborn nursery01234Full body assessment01234Assist with UAC insertion and maintenance01234Assist with UVC insertion and maintenance01234Assist with Swanz Ganz insertion and maintenance01234Assist with Arterial Lines insertion and maintenance01234Obtain Specimens from UAC/UVC01234Jet Vents01234ECMO01234IMV01234PIP01234Oxyhood01234Radiant warmers01234Apnea monitoring01234Glascow Coma Scale01234Assist with Lumbar puncture01234Calculation of Pedi dosage01234Phototherapy01234Cord and circumcision care01234 Care of the Infant withBowel obstruction01234Broncho-Pulmonary Dysplasia01234Endotracheal tube care and sunctioning01234Tracheostomy care and sunctioning01234CHF01234Cystic Fibrosis01234Diabetes Mellitus01234HIV01234Intracranial hemorrhage01234Low birth weight infants01234Meconium aspiration01234NEC01234Neuromuscular Disease01234PDA ligation01234Pneumonia01234Pulmonary Edema01234RDS01234Seizure activity01234Sickle Cell Disease01234Spina Bifida01234Systemic infection01234Tetralogy of Fallot01234Tracheoesophogeal Fistula01234Transposition of Great Vessels01234Age Specific CriteriaPlease check the box corresponding to each age group for which you have expertise in providing age appropriate nursing care. Infants and Toddlers (ages 0-3 years) Young Children (4 - 6 years) Older Children (7 - 12 years) Adolescents (13 - 20 years) Young Adults (21 - 39 years) Middle Adults (40 - 60 years) Older Adults (65 - 79 years) Additional SkillsPlease list any additional experience or skills that have not been included above:The information I have given is true and accurate to the best of my knowledge. In addition, I hearby authorize Fidelis Partners to release this profile to client institutions of Fidelis Partners in consideration of my employment with that institution.SignatureSign using your mouse or finger (if on a mobile or tablet device) to draw your signature.
