Nurse Practitioner Skills Checklist
In order to provide suitable assignments for you, this checklist is intended as a method of assessing your professional proficiency. Please rate your skill level as accurately as possible by placing a check (√) in the appropriate box.
PROFICIENCY SCALE 1. No experience; Theory/observed only 2. Limited competency; < 5 times per year; Needs supervision 3. Acceptable competency; > 5 times per year 4. Competent; Performs on a daily or weekly basis; Proficient
Specialty1234
Anesthesiology*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Cardiology*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Corporate Health*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Critical Care*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Dermatology*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Emergency Medicine*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Ears, Nose, and Throat*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Correctional Care*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Family Practice*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Genetics*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Forensic Medicine*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Internal Medicine*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Interventional Radiology*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Substance Abuse*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Ob and Gynecology*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Occupational Med*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Ophthalmology*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pain Medicine*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pathology*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Peds*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Physical Med/Rehab*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Psychiatry*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Public Health*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Radiation Oncology*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Surgery*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Non Clinical*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Disorders Emergencies1234
Anaphylaxis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Cardiac arrest*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Seizures*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Minor head injuries*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Animal bites*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Ingestions and poisonings*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Overdose - sedative, hypnotics*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Disorders Emergencies cont.1234
Snake bites*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Minor burns*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Shock*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Open wounds*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Respiratory1234
Croup*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Influenza*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Tracheobronchitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Bronchitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
COPD*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Asthma*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pneumonia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Viral*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Bacterial*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Nonbacterial*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
URI (Upper respiratory infection)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Cardiovascular system1234
Congestive heart failure*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Chronic obstructive pulmonary disease*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Stasis ulcer of lower extremities*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Angina*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pericarditis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Coronary artery disease*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Functional murmurs*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Congenital heart disease*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hypertension*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
OB/GYN1234
Nausea/vomiting - pregnancy*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Dysmenorrhea*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Candida vaginitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pap smears*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Abnormal pap smear findings*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Trichomonal Vaginitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Atrophic vaginitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
OB/GYN cont.1234
Fibrocystic breast disease*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Menopause*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Bartholin’s cyst/ abscess*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Preparation for childbirth*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pregnancy-diagnosis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pain relief (in active phase of labor)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Intrapartum medications*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Medications in the third stage*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Dysfunctional uterine bleeding*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Rh blood factor*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Mastitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Medications in the Post-Partum*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Birth control methods*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pre-natal care*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Fetal well-being*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
GI System1234
Constipation*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Diarrhea (simple)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Irritable bowel syndrome*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Acute gastroenteritis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hiatal hernia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hemorrhoids*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hepatitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Duodenal ulcer*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Cholecystitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pyloric stenosis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Colic*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Appendicitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Skin1234
Warts*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Basal skin carcinoma*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Scabies*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Impetigo*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Diaper dermatitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Acne*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Folliculitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Furuncles*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Carbuncles*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Herpes simples*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Herpes zoster*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Malignant melanoma*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pityriasis Rosea*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Contact dermatitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Tinea corporis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Tinea pedis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Ears, Nose, and Throat1234
Epistaxis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Otitis externa*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Serous otitis media*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Acute purulent Otitis media*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Allergic rhinitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pharyngitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Oral candidiasis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Eye1234
Conjunctivitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Strabismus*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Chalazion*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Stye*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Musculoskeletal1234
Osteoporosis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Osteomyelitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Rheumatoid arthritis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Juvenile diabetes*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Gout*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Minor sprains and strains*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Osteoarthritis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Carpal Tunnel Syndrome*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Scoliosis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Tendonitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Bursitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Muscular dystrophy*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Parasitic Infections1234
Pinworms*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Ascariasis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pediculosis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Genitourinary System1234
Syphilis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Chlamydia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Herpes*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Cystitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pyelonephritis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Urinary tract infection*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Benign prostatic hypertrophy*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Vulvovaginitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hypospadias*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hydrocele*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Gonococcal infections*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Prostatitis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Nervous System1234
Vasovagal syncope*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Migraine headaches*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Nervous System cont.1234
Multiple sclerosis*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Headaches*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Head injury*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Tension*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Migraine*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Anxiety*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Parkinsons*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Bells Palsy*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
TIA (transient ischemic attacks)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Trigeminal neuralgia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Endocrine1234
Type I diabetes mellitus*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Type II diabetes mellitus*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Graves’ disease*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Addison’s disease*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hypoglycemia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hypothyroidism*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Hematological1234
Folic acid deficiency anemia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Aplastic anemia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Iron deficiency*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Sickle cell anemia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Pernicious anemia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Psychosocial1234
Depression*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Suicide*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Obesity*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Grief*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Anorexia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Bulimia*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Miscellaneous1234
Suturing*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Cell biopsy*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Starting IV*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Casting and splinting*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Age Appropriate Care1234
Newborn (Birth-30days)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Infant (30 Days – 1 year)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Toddler (1-3 years)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Preschooler (3-5 years)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
School Age (5-12 years)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Adolescents (12-18 years)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Young Adult (18-39 years)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Middle Adult (39-64 years)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Older Adult (64 + years)*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
EMR1234
AllScript*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Canopy*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Epic*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Cerner*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Eclipsys*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
McKesson*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Meditech*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Homecare Homebase*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Other Computerized System*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Computerized Physician Order Entry*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Bar Coding for Medication Administration*1 - No Experience2 - Limited Competency3 - Acceptable competency4 - Competent
Date*
Name*
Category* Nursing
Email*
Phone*
