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Skills Checklists

Congratulations on your decision to apply for an allied position with ClubStaffing! Before we can offer you an allied employment opportunity, an electronic skills assessment must be completed. From the skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!

ClubStaffing
5901 Broken Sound Pkwy.
Suite 450
Boca Raton, Florida 33487
Fax: (561) 367-0884


Respiratory Therapist/Pulmonary Function Technologist Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
Last 4 of Social Security Number*
- -
E-Mail Address* Phone Number*
or
 
 
Please mark your level of experience
1. No experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others
 
WORK SETTING
1 2 3 4
 
Acute Care
 
Adult
 
Critical Care
 
Emergency Department
 
Home Health
 
LII Nursery
 
LIII Nursery
 
NICU
 
Pediatrics
 
PICU
 
Pulmonary Rehab
 
Skilled/Subacute
 
Sleep Lab
 
Transports
 
THERAPEUTICS AND PROCEDURES
1 2 3 4
 
Airway Management Devices and Suctioning
 
Assist with Intubation
 
Bronchial Alveolar Lavage (BAL)/Mini BAL
 
Bronchopulmonary Hygiene (Acapella, Percussion, etc.)
 
Comfort Flow
 
Croup Tent Set Up/Troubleshoot
 
External CPAP
 
Extubation
 
High Flow Nasal Cannula
 
Hyperinflation Therapy (Incentive Spirometer, IPV, etc)
 
Infant Hood Set Up
 
Intubate Adult Patient
 
Monitor Cuff Pressure-Airway Management Devices
 
Tracheostomy Care
 
ARTERIAL BLOOD GASES
1 2 3 4
 
Allen Test
 
Draw from Brachial Artery
 
Draw from Radial Artery
 
Insert Arterial Line
 
PULMONARY FUNCTION TESTS
1 2 3 4
 
Lung Volume by Helium Dilution
 
Lung Volume by Nitrogen Washout
 
Lung Volume by Plethysmograph
 
VENTILATOR SET UP AND CARE
1 2 3 4
 
Assist Control
 
CPAP/Pressure Support
 
Weaning
 
Non-Invasive Ventilation
 
Bilevel Ventilatory Assistance
 
High Frequency Oscillator
 
IMV/SIMV
 
Bivent
 
MEDICATIONS
1 2 3 4
 
Acetylcysteine (Mucomyst)
 
Albuterol/Proventil/Ventolin
 
Brovana
 
Inhaled Flolan
 
Inhaled Nitric Oxide
 
Inhaled Steroids
 
Lidocaine
 
Pentamadine
 
Performist
 
Racemic Epinephrine
 
Respimat MDI
 
Medication Education
 
VENTILATOR TYPES
1 2 3 4
 
Drager Infant
 
Hamilton
 
Puritan Bennett
 
Respironics
 
Servo
 
Other-Specify
 
Other-Specify
 
Other-Specify
 
EQUIPMENT AND PROCEDURES (Neonate/Pediatrics)
1 2 3 4
 
Assist in High Risk Delivery
 
Capillary Blood Gases
 
ECMO
 
O2 to Tent
 
Umbilical Blood Gases
 
OXYGEN THERAPY DELIVERY (Neonate/Pediatrics)
1 2 3 4
 
Bag and Mask
 
Nasal Cannula/Oxyhood/Tent
 
Trach Collar
 
Vapotherm
 
VENTILATOR (Neonate/Pediatrics)
1 2 3 4
 
Apnea Monitor
 
Bivent
 
Bubble CPAP
 
CPAP/Nasal CPAP/BIPAP
 
End Tidal CO2 Monitoring
 
High Frequency/Jet Ventilator
 
IMV/SIMV
 
Oscillating Ventilator
 
Pressure/Volume Ventilator
 
PROFESSIONAL KNOWLEDGE AND SKILLS
 
Do you have experience as a Lead Respiratory Therapist?
 
EMR Conversion
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
CERTIFICATIONS/LICENSURES/REGISTRATIONS (Current at time of completing this form)
 
BLS
 
ACLS
 
PALS
 
NRP
 
CRTT
 
RRT
 
CPFT
 
Other: Specify
Respiratory Therapist/Pulmonary Function Technologist Skills Checklist, version 7

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

© 2018 AMN Healthcare, Inc. All rights reserved. Reproduction and distribution of these materials is prohibited without the expressed written authorization of AMN Healthcare, Inc.