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Travel Nursing
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Hiring Interview Appointment

Primary area(s):

Rehab
LTC
Home health
Hospice
Case management

Personal Information (copy)

Name *

First

Last

Email *

Phone

No experience: requires education, training and supervision
Intermittent experience: may need support or supervise
Proficient: consistent experience, independent
Expert level: can teach/supervise others.

General skills

Staff/physician relations

1
2
3
4
5

Patient-family relations/teaching

1
2
3
4
5

Conflict resolution/prevention

1
2
3
4
5

Charge/management

1
2
3
4
5

Admits/intake

1
2
3
4
5

Plan of care/discharge plan

1
2
3
4
5

Advance directives

1
2
3
4
5

General computer skills

1
2
3
4
5

Selected clinical skills (copy)

Code response

1
2
3
4
5

Physical assessment

1
2
3
4
5

- Breath sounds/work assessment

1
2
3
4
5

Psychiatric assessment

1
2
3
4
5

Isolation protocols

1
2
3
4
5

NG insertion

1
2
3
4
5

Wound care/VACs, surgical drains

1
2
3
4
5

Culture collection

1
2
3
4
5

Trach/stoma care

1
2
3
4
5

Care/prevention pressure ulcers

1
2
3
4
5

IV start

1
2
3
4
5

Venous blood draw

1
2
3
4
5

Feeding tubes

1
2
3
4
5

Central line protocols

1
2
3
4
6

Implanted port access

1
2
3
4
5

TPN

1
2
3
4
5

CPAP/BiPAP

1
2
3
4
5

Ventilator

1
2
3
4
5

Rehab

Acute setting

1
2
3
4
5

Skilled nursing facility (LTC)

1
2
3
4
5

Pediatric

1
2
3
4
5

☐Home ☐Outpatient ☐Industrial

1
2
3
4
5

Functional independence score (FIM)

1
2
3
4
5

CVA/head injury

1
2
3
4
5

Orthopedic

1
2
3
4
5

Pulmonary

1
2
3
4
5

TENS/ultrasound treatment

1
2
3
4
5

Assist devices

1
2
3
4
5

Home health

Medicare 485/486 forms

1
2
3
4
5

Pediatrics

1
2
3
4
5

Mother/baby

1
2
3
4
5

LTC

MDS, RUG scores

1
2
3
4
5

Resident centered care

1
2
3
4
5

Resident rights

1
2
3
4
5

Hospice/LTC end of life care

Quality of life

1
2
3
4
5

Pain management

1
2
3
4
5

Stages of grieving

1
2
3
4
5

Psychosocial support

1
2
3
4
5

Spiritual support

1
2
3
4
5

Survivor needs

1
2
3
4
5

Administration/case management

Concurrent review

1
2
3
4
5

Utilization review

1
2
3
4
5

Comorbidity identification

1
2
3
4
5

Payor identification

1
2
3
4
5

Prior authorization review

1
2
3
4
5

CMS

1
2
3
4
5

MediCal (California only)

1
2
3
4
5

Required clinical documentation

1
2
3
4
5

Billing procedures

1
2
3
4
5

DRG

1
2
3
4
5

ICD

1
2
3
4
5

CPT

1
2
3
4
5

InterQual (McKesson)

1
2
3
4
5

Milliman

1
2
3
4
5

Oasis

1
2
3
4
5

Case management practice settings

Acute care

1
2
3
4
5

Long term care

1
2
3
4
5

Rehab

1
2
3
4
5

Home health

1
2
3
4
5

Hospice

1
2
3
4
5

Occupational health

1
2
3
4
5

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