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.
| Knowledge of Assessment Process | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Psychosocial assessment (social history, living situation, career, hobbies, support systems, decision making, communication difficulties, flexibility, prolonged mental illness / emotional Problems, lack of community / caregiver support, family discord, ab |
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| Communication Abilities | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Develop and maintain communication with people on complex matters, issues and ideas, and/or in complex situations |
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| Personal and People Development | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Develop oneself and contribute to the development of others |
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| Quality Improvement & Service | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Contribute to the improvement of services & maintain quality in own work and encourage others to do so |
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| Health Protection & Well Being | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Implement aspects of a protection plan and review its effectiveness |
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| High risk intervention / patient vulnerability or safety risk |
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| Monitor and maintain health, safety and security of self and others |
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| Provide crisis intervention |
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| Care Planning | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Assess complex health and well being needs and develop, monitor and review care plans to meet those needs |
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| Knowledge and InformationResources | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Organize knowledge and information resources and provide information to meet needs |
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| Demonstrates respect for patient/family confidentiality |
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| Documentation Skills (accurate, timely, complete and legible) |
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| Counseling for long range planning and decision making |
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| Equality and Diversity | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Promote equality and value diversity |
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| Experience in all or any of the following: | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Medical Social Work |
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| School Social Work |
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| Clinical Social Work |
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| Social Work-Admin/management |
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| Social work-case manager |
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| International Social Work |
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| Social Work-Children & Families |
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| Social Work in Acute Psychiatric Hospital |
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| Forensic Social Work |
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| Employment/Occupational Social Work |
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| Social Work- Community Organizer |
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| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Infant (Birth - 1 year) |
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| Preschooler (ages 2-5 years) |
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| Childhood (ages 6-12 years) |
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| Adolescents (ages 13-21 years) |
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| Young Adults (ages 22-39 years) |
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| Adults (ages 40-64 years) |
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| Older Adults (ages 65-79 years) |
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| Elderly (ages 80+ years) |
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