Nuclear Medicine Technologist Skills Checklist
   NAME  
   Email-Id
   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

 
Rating Stars (Click)
PROCEDURES 1
2
3
4
Arteriogram/Radionuclide
Abscess Localization Whole Body
Abscess Localization Individual Sites
CCK/Ejection Fraction
Cisternogram
CSF Leak Localization
Gallium Scan
Gastric Emptying
GI Bleed
HIDA Scan
Indium 111 WBC Scan Whole Body
Indium 111 WBC Scan Limited
Injection-Lymphatic
Lymphatic Scan-Melanoma
Meckels Scan
Morphine Augmentation
MUGA Scan
Radiopharmaceutical Prep
Radionuclide Arteriogram
Renagram
Parathyroid
Salivary Glands
Ventricular Shunt
Zevalin Treatment
Hyperthyroid Treatment
I 131 Therapy Thyroid Ablation
Therapy Pain
Rating Stars (Click)
BONE SCAN 1
2
3
4
Whole Body
3 Phase
Limited
Rating Stars (Click)
BRAIN SCAN 1
2
3
4
Cerebral Blood Flow
Rating Stars (Click)
LIVER/SPLEEN SCAN 1
2
3
4
Liver/Spleen Scan
Liver Scan-Hemangioma
Liver Imaging
Liver Flow
Rating Stars (Click)
LUNG SCAN 1
2
3
4
DTPA Aerosol
Perfusion
Ventilation/Perfusion
Rating Stars (Click)
RENAL FLOW 1
2
3
4
With Lasix
Flow/Function
Three Phase
Captopril
Rating Stars (Click)
SHUNT 1
2
3
4
Abdominal
Ventricular
Rating Stars (Click)
THYROID STUDIES 1
2
3
4
Cancer Survey
Uptake Scan
I 123 Scan
Rating Stars (Click)
TUMOR LOCALIZATION 1
2
3
4
Whole Body
Limited
Rating Stars (Click)
NM SPECT 1
2
3
4
Bone
Brain
Liver
Liver Spect w/Flow
Renal
Rating Stars (Click)
MYOCARDIAL 1
2
3
4
Infarction
Exercise/Rest-Single
Exercise/Rest-Multiple
Pharmacological Stress
Thallium/Persantine
Rating Stars (Click)
PROFESSIONAL KNOWLEDGE AND SKILLS 1
2
3
4
Quality Control Equipment
Daily Surveys/Wipe Testing
Hot Lab Management Dose Calibrators
Hot Lab Management Generators
Computerized Charting
National Patient Safety Goals
Universal Protocol Procedures/Core Measures
Isolation Precautions
Infection Prevention
Age Specific/Population-Based Care
Fall Risk Assessment/Prevention
Rating Stars (Click)
AGE SPECIFIC 1
2
3
4
Under 12 Years Old
Adolescents (12 to 18 years)
Young Adults (18 to 39 years)
Middle Adults (40 to 64 years)
Older Adults (65 years & up)