PEDIATRIC SKILLS CHECKLIST                                                                                                                            

This profile is for use by Pediatric nurses with more than one year experience in their discipline and specialty. It will not be a determining factor for the Advantage RN program.

Please enter your full legal name as it appears on your Social Security Card.

First Name:  Last Name: email:

Please check the boxes below for each age group for which you have provided age appropriate nursing care:

My experience is primarily in:  (please indicate number of years)

Please indicate your level of experience:   A.  Theory, no practice     B.  Intermittent     C.  One- Two Years Current Experience                          D.  Two plus years experience, can function independently