Psychiatric Tech Skills Checklist
   LAST 4 OF SSN      
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) Proficiency Scale 1 2 3 4  
General Duties  
Admit/Orient Involuntary Clients  
Admit/Orient Voluntary Clients  
Advance Directives  
Ambulatory Cuffs  
Assist Activities of Daily Living  
Assist with Personal Hygiene  
Cultural Diversity  
Discharge Clients  
Discharge Planning  
Full Restraints  
HIPAA Regulations  
Initial Interview  
Initial Screening Assessment  
Isolation Techniques  
Mutli-Disciplinary Planning  
Oxygen Administration  
Participate in Interdisciplinary Team  
Patient Teaching  
Reassess/Update Plan of Care  
Referral to Community Resources  
Supervise Unlicensed Personnel  
Vital Signs  
Wrist Restraints  
Rating Stars (Click) Eating Disorders 1 2 3 4  
Anorexia Nervosa  
Bulimia Nervosa  
Assultive Behavior  
Rating Stars (Click) Care of Psychiatric Disorders 1 2 3 4  
Anxiety Disorders  
Bipolar Disorder  
Catatonic Psychotic Disorder  
Delusional Disorders  
Dissociative Identity Disorder  
Obsessive/Compulsive Disorder  
Panic Attacks  
Paranoid Psychotic Disorder  
Suicidal Ideation/Attempts  
Rating Stars (Click) Assist with Psychotherapy 1 2 3 4  
Rating Stars (Click) Personality Disorders 1 2 3 4  
Cluster A-Paranoid/Schizoid  
Cluster B-Antisocial/Borderline  
Cluster C-Anxious/Fearful  
Rating Stars (Click) Cognitive Disorders 1 2 3 4  
Alzheimer's (Dementia)  
Amnestic Disorders  
Rating Stars (Click) Certified "Management of Assultive Behavior" 1 2 3 4  
Crisis Intervention  
Drug & Alcohol Education  
Education or Vocational Training  
Teach Independent Living Skills  
Therapeutic Communication  
Therapeutic Milieu  
Rating Stars (Click) Assist with Alternative Therapies: 1 2 3 4  
ElectroConvulsive Therapy  
Expressive Therapy (Art, Movement)  
Guided Imagery  
Massage Therapy  
Recreational Therapy  
Therapeutic Touch  
Rating Stars (Click) Meds/IV Therapy 1 2 3 4  
Administer IM & SQ Meds  
Administer PO Medications  
Administer Topical Medications  
Identify Appropriate Level of Care  
Discontinue Peripheral IV's  
Pain Assessment/Management  
Rating Stars (Click) Substance-Related Disorders: 1 2 3 4  
Developemntal/Autistic Disorders  
Mental Retardation  
Post Traumatic Stress Disorder  
Sexual Abuse/Assault  
Sexual Disorders  
Somatoform Disorders (Pain etc.)  
Survivor of Abuse/Violence  
Rating Stars (Click) Psychotropic Agents: 1 2 3 4  
Antianxiety Agents  
Antidepressants/Mood Elevators  
Antimanic Agents  
Antipsychotic Agents  
Management of Med Side Effects  
Recognition of Med Side Effects  
  Years of Experience Continuum of Care Settings Hospital Settings Years  
  Med-Psych Unit  
  Transitional Care Hospital  
  Freestanding Psych Hospital  
  Community-Based Hospital  
  Subacute Care Units  
  Long-Term Care Facilities  
  Community Mental Health Services Years  
  Emergency Clinic  
  Day Treatment Programs  
  Residential Programs  
  Home Care  
  Aftercare/Rehab Clinic  
  Corrections/ Prison  
Rating Stars (Click) PROFICIENCY SCALE 1 2 3 4  
Newborn (birth-30 days)  
Infant (30 days-1 yrs)  
Toddler (1-3 yrs)  
Preschooler (3-5 yrs)  
School Age (5-12 yrs)  
Adolescents (12-18 yrs)  
Young Adults (18-39 yrs)  
Middle Adults (39-64 yrs)  
Older Adults (64 yrs +)