|
NUCLEAR MEDICINE TECHNOLOGIST SKILLS CHECKLIST | ||||||
| NAME | |||||||
| LAST 4 OF SSN | |||||||
| DATE | |||||||
| I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination. | |||||||
| Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below. | |||||||
| Proficiency Scale: |
1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently |
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| Rating Stars (Click) | Procedures | 1 | 2 | 3 | 4 | ||
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Bone scan | ||||||
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Whole body | ||||||
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Dual head | ||||||
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Triple head | ||||||
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Renal scan | ||||||
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Renograms | ||||||
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Three phase renal scan | ||||||
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Spleen scan | ||||||
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Testicular studies | ||||||
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Thyroid scan | ||||||
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Parathyroid scan | ||||||
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Liver scans | ||||||
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Lung scan | ||||||
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VQ scan | ||||||
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Aerosol lung scan | ||||||
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Cerebral blood flow | ||||||
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Shunt patency | ||||||
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Gallium scan/ imaging | ||||||
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Tumor localization | ||||||
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I-123 uptake | ||||||
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I-131 therapy | ||||||
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MUGA scan | ||||||
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GI bleeding study | ||||||
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Radionuclide arteriogram | ||||||
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Radionuclide Venogram | ||||||
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SPECT scanning | ||||||
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Brachytherapy | ||||||
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CCK-HIDA scan | ||||||
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RIA (Radio Immuno Assay) | ||||||
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Myocardial Perfusion | ||||||
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Persantine infusion | ||||||
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Thallium stress test | ||||||
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Dual isotopes | ||||||
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Adenosine infusion | ||||||
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Vena Cava imaging | ||||||
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CCK/ejection fraction | ||||||
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Gastric emptying | ||||||
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SPECT (single-photon emission CT) scan | ||||||
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Brain SPECT | ||||||
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Brain with Glucoheptonate | ||||||
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Gated SPECT (post infarct | ||||||
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Stress Holter monitoring | ||||||
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NVG stress | ||||||
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NVG rest | ||||||
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Hot lab | ||||||
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Shillings | ||||||
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Biopsy’s | ||||||
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Angiography | ||||||
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Carotid | ||||||
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Stent placement | ||||||
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Arteriogram | ||||||
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CO2 studies | ||||||
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ERCP (endoscopic retrograde cholangio pancreatography) | ||||||
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PET (position emission tomography) scanning | ||||||
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Wipe test | ||||||
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ALARA (as low as reasonably achievable) standards | ||||||
| Rating Stars (Click) | Equipment | 1 | 2 | 3 | 4 | ||
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GE Star cam SPECT | ||||||
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GE Maxi 400 Camera | ||||||
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GE Star 1 Computer | ||||||
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ADAC Computer/ Camera | ||||||
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Centiview | ||||||
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Hitach | ||||||
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Siemens Computer | ||||||
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Siemens Orbiter Camera | ||||||
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Siemens SPECT | ||||||
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Elsinct Camera | ||||||
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Ohio Nuclear | ||||||
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Ohio Nuclear 410 Camera | ||||||
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Omega 500 | ||||||
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Omega 500 computer | ||||||
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Hepatic Hernangloma | ||||||
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Micro Dot computer | ||||||
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Phillips | ||||||
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PhoGamma IV | ||||||
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Picker | ||||||
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Technicare Computer | ||||||
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Technicare Camera | ||||||
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Picker Prism | ||||||
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Toshiba 6000 | ||||||
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Sophy Computer | ||||||
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Summit | ||||||
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Other (list): | ||||||
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Doctor’s office | ||||||
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Hospital | ||||||
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Mobile Route | ||||||
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Nuclear Cardiology | ||||||
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Teaching/ Educational | ||||||
| Rating Stars (Click) | Patient populations | 1 | 2 | 3 | 4 | ||
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Neonatal | ||||||
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Pediatrics | ||||||
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Adolescent | ||||||
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Adults | ||||||
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Geriatrics | ||||||
| Rating Stars (Click) | General | 1 | 2 | 3 | 4 | ||
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Venipuncture techniques | ||||||
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Vital signs | ||||||
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Oxygen administration | ||||||
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Contrast media | ||||||
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Administration | ||||||
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Anaphylactic reactions | ||||||
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Side effects | ||||||
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Patient positioning | ||||||
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Shielding | ||||||
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Obtaining consent | ||||||
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Code Blue | ||||||
| Rating Stars (Click) | EMR | 1 | 2 | 3 | 4 | ||
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Epic | ||||||
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Cerner | ||||||
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Eclipsys | ||||||
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McKesson | ||||||
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Meditech | ||||||
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Other Computerized System | ||||||
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Computerized Physician Order Entry | ||||||
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Bar Coding for Medication Administration | ||||||
| MY EXPERIENCE IS PRIMARILY IN: | |||||||
| Unit | No. of Years | Unit | No. of Years | ||||
| BURN | POST PARTUM | ||||||
| CRITICAL UNIT | LABOR & DELIVERY | ||||||
| PACU | NEWBORN NURSERY | ||||||
| NEUROLOGY | LEVEL II NICU | ||||||
| TELEMETRY | LEVEL III NICU | ||||||
| MEDICAL | PICU | ||||||
| SURGICAL | PEDIATRICS | ||||||
| ONCOLOGY | OB/GYN | ||||||
| ORTHOPEDICS | PSYCHIATRY | ||||||
| OPERATING ROOM | RRT | ||||||
| EMERGENCY ROOM | CRT | ||||||
| TRAUMA CENTER LEV | |||||||
| COMMUNITY ER | |||||||
| RURAL ER | |||||||
| Rating Stars (Click) | AGE APPROPRIATE CARE | 1 | 2 | 3 | 4 | ||
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Newborn/Neonatal (birth – 30 days) | ||||||
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Infant (30 days-1 year) | ||||||
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Toddler (1-3 years) | ||||||
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Preschool (3-5 years) | ||||||
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School Age Children (5-12 years) | ||||||
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Adolescent (12-17 years) | ||||||
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Young Adults (18-44 years) | ||||||
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Middle Adults (45-64 years) | ||||||
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Older Adults (>65 years) | ||||||