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Travel Nursing Skills Checklists

Congratulations on your decision to apply for a travel nursing position with American Mobile! Before we can offer you a nursing employment opportunity, an electronic skills assessment must be completed. From the nursing 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!


Operating Room Nursing Skills Checklist

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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*
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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
 
ADULTS WORKSETTING
1 2 3 4
 
CVOR
 
First Assist
 
General OR
 
Outpatient
 
Peds-General OR
 
Peds-CVOR
 
Trauma
 
Scrub Experience
 
GENERAL SURGERY
1 2 3 4
 
Abdominal Perineal Resection
 
Appendectomy/Cholescystectomy
 
Breast Biopsy
 
Colon Resection/Surgery
 
Fundoplication
 
Gastrectomy
 
Gastric Bypass
 
Laparoscopic General Surgeries
 
Mastectomy
 
Splenectomy
 
Thyroidectomy
 
Scrub General Surgery
 
CARDIAC/VASCULAR
1 2 3 4
 
Aortic Bypass Surgery
 
Cardiac Bypass/Valve Replacement
 
Carotid Endarterectomy
 
Endoscopic Vascular Procedures
 
Endovascular Aneurysm Repair
 
Laparascopic Cardiac Surgery
 
Robotic Assisted Cardiac Surgery
 
Ventricular Assist Device
 
Scrub CV Surgery
 
THORACIC
1 2 3 4
 
Esophagoogastrectomy
 
Lobectomy
 
Mediastinotomy/Sternotomy
 
Robotic Assisted Thoracic Surgery
 
Thoracoscopy
 
Video Assisted Thoracoscopic Surgery
 
Scrub Thoracic Surgery
 
ORTHOPEDIC
1 2 3 4
 
Arthroscopy
 
External Fixators
 
Foot Procedures
 
Hand Procedures
 
Intramedullary Rodding Procedure
 
Knee Ligament Repair
 
ORIF Hip Fractures
 
ORIF Other Fractures
 
Total Hip/Knee Replacement
 
Total Shoulder Replacement
 
Scrub Orthopedics
 
NEUROLOGICAL/SPINAL
1 2 3 4
 
Anterior Laminectomy/Spinal Fusion
 
Cerebral Aneurysm Clipping
 
Craniotomy
 
Insertion of Vagal Nerve Stimulator
 
Insertion of VP Shunt
 
Laparoscopic Anterior Laminectomy
 
Posterior Laminectomy/Spinal Fusion
 
Steriotactic Guided Brain Biopsy
 
Scrub Neurological Surgery
 
GENITOURINARY
 
Cystoscopy/TURP
 
Laparoscopic GU Procedures
 
Nephrectomy
 
Orchidectomy/Orchidopexy
 
Prostatectomy
 
Robotic GU Procedures
 
Ureterostomy
 
Scrub GU Surgery
 
GYNECOLOGICAL
1 2 3 4
 
Abdominal Hysterectomy
 
Anterior Posterior Repair
 
Cervical Cryo Surgery
 
Laparoscopic Hysterectomy
 
Laparotomy with Microtuboplasty
 
Scrub Gyn Surgery
 
EAR/NOSE/THROAT
1 2 3 4
 
Endoscopic ENT Procedures
 
Laryngectomy
 
Mastoidectomy
 
Radical Neck
 
Septoplasty
 
Tonsillectomy & Adenoidectomy
 
Tracheostomy
 
Scrub ENT Surgery
 
CRANIOFACIAL/ORAL
1 2 3 4
 
Leforte Procedures
 
ORIF Facial Fractures
 
Other Craniofacial Reconstructions
 
Scrub Craniofacial/Oral
 
PLASTIC
1 2 3 4
 
Blepharoplasty
 
Breast Augmentation
 
Breast Reconstruction
 
Breast Reduction Mammoplasty
 
Rhinoplasty
 
Rhytidectomy (Face Lift)
 
Skin Graft
 
Scrub Plastics
 
TRANSPLANTS
1 2 3 4
 
Corneal
 
Heart
 
Liver
 
Lung
 
Organ Donation
 
Pancreas
 
Scrub Transplants
 
OPHTHALMOLOGY
1 2 3 4
 
Cataract Surgery
 
Scrub Ophthalmology
 
PEDIATRICS GENERAL SURGERY
1 2 3 4
 
Anal Fistulectomy/Anoplasty
 
Gastroschisis Repair
 
Kasai Procedure (Hepato-Portoenterostomy)
 
Shuster Procedure (Omphalocele Repair)
 
Tracheoesophageal Fistula Repair
 
Scrub Peds General Surgery
 
GENITOURINARY
1 2 3 4
 
Hydrocelectomy
 
Orchidopexy
 
Pyloplasty
 
Repair of Hypospadias
 
Ureteral Procedures
 
Scrub Peds GU
 
NEURO
1 2 3 4
 
Craniotomy
 
Insertion of VP Shunt
 
Rhizotomy
 
Spinal Fusion
 
Scrub Peds Neuro
 
CARDIAC/VASCULAR
1 2 3 4
 
Arterial Switch
 
ASD/VSD Repair
 
Atrial Septectomy
 
Bidirectional Glenn
 
Blalock-Taussig Shunt
 
Fontan Procedure
 
Norwood Procedure
 
PDA Ligation
 
Repair of Coarctation of Aorta
 
Ross Procedure
 
Tetralogy of Fallot Repair
 
Scrub Peds Cardiac/Vascular
 
TRANSPLANT
1 2 3 4
 
Heart
 
Kidney
 
Liver
 
Lung
 
Organ Donation
 
Pancreas
 
Scrub Peds Transplant
 
OPHTHALMOLOGY
1 2 3 4
 
Corneal Transplant
 
Eye Muscle Surgery
 
Orbitotomy of Eye
 
Repair of Ptosis
 
Scrub Peds Opthalmology
 
EAR/NOSE/THROAT
1 2 3 4
 
Cochlear Implant
 
Laryngotracheoplasty
 
Myringotomy with Tubes
 
Septoplasty
 
Suspension Microlaryngoscopy
 
Tonsillectomy & Adenoidectomy
 
Tracheostomy
 
Tympanoplasty/Typanomastoidectomy
 
Scrub Peds ENT
 
CRANIOFACIAL/ORAL/PLASTICS
1 2 3 4
 
Craniofacial Reconstruction
 
Dental Surgery
 
Leforte Maxillary Procedure
 
Mandibular Osteotomy
 
Open Cranial Vault Remodeling
 
Repair of Cleft Lip, Nose, Palate
 
Rhinoplasty
 
Scrub Peds C-Fl/Oral/Plastics
 
ORTHOPEDICS
1 2 3 4
 
Acetabuloplasty/Triple Innominate
 
External Fixators
 
Femoral Varus Derotational Osteotomy
 
ORIF Fractures
 
Tendoachilles Lengthening
 
Scrub Peds Ortho
 
OR EQUIPMENT
1 2 3 4
 
Lasers (List Types)
 
OR Fracture Tables (List Types)
 
Robotics Systems (List types)
 
Spinal Fusion Instrumentation (List Types)
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Isolation Precautions
 
Patient/Family Teaching
 
Administer and Monitor Moderate Sedation
 
Fall Risk Assessment/Prevention
 
Malignant Hyperthermia Protocol
 
National Patient Safety Goals/Core Measures
 
Pressure Ulcer Risk Assessment/Prevention
 
Restraints/Use of Least Restrictive Device
 
Universal Protocol for Wrong Site Surgery
 
National Patient Safety Goals/Core Measures
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
EMR
 
Allscripts
 
GE
 
PISCES
 
Cerner
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
Computerized Physician Order Entry
 
Other Computerized System (List Types)
 
CERTIFICATIONS (Current at time of completing this form)
 
ACLS
 
CNOR
 
RNFA
 
BLS
 
PALS
 
Other: Specify
 
Other: Specify
Operating Room Nursing 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.

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