RADIATION THERAPIST
Name
Email
LAST 4 OF SSN
This checklist was electronically signed on (Today’s date)
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
Newborn/Neonate (birth to 30 days)
Infant (1 month to 1 year)
Toddler (1 year to 3 years)
Preschooler (3 years to 5 years)
School Age Child (5 years to 12 years)
Adolescents (12 years to 18 years)
Young Adults (18 years to 39 years)
Middle Adults (39 years to 64 years)
Older Adults (64 years to 79 years)
Elderly Adults (over 79+ years)
Standard Precautions
Isolation Precautions
Pediatric Respiratory/ Cardiac Arrest
Adult Respiratory/ Cardiac Arrest
Crash Carts
Defibrillators
Hospital
Doctor's Office
Orthopedics
Surgery
Trauma
Ortho Voltage Radiation Treatment
Simulation of Treatment Sites
Cobalt 60 Therapy
Strontium 90 Therapy
Accelerator with Electrons
Calculations
Radiation Precautions
Hyperthermia Treatment
Linear Accelerator
Superficial Radiation Treatment
Block Cutting
Geometric Parameters
Patient Measurements
Venipuncture
Proton Beam
Neutron Beam
Brachytherapy Wires
Brachytherapy Seeds or Molds
Brachytherapy Rods
Interstitial Brachytherapy
Intraluminal Radiation Therapy
Intravenous Radioactively Tagged Molecules
I-131
Anal Cancer
Bone Cancer
Brain Cancer
Breast Cancer
Bladder Cancer
Cervical Cancer
Childhood Cancer
Colon Cancer
Esophageal Cancer
Endometrial Cancer
Gallbladder Cancer
Hodgkin’s and Other Lymphomas
Hypopharyngeal Cancer
Kidney Cancer
Laryngeal Cancer
Lip and Oral Cavity Cancer
Lung Cancer
Liver Cancer
Metastatic Squamous Cancer
Ovarian Cancer
Oropharyngeal Cancer
Penile Cancer
Pancreatic Cancer
Testicular Cancer
Uterine Cancer
Vaginal Cancer
Vulvular Cancer
Aria
Mosiaq
Telerad
Nighthawk
Please list the EMR systems you have used
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.
