Skill Checklists

LMSW

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

Knowledge of Assessment Process

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, ability to deal with loss)

Communication Abilities

Develop and maintain communication with people on complex matters, issues and ideas, and/or in complex situations

Personal and People Development

Develop oneself and contribute to the development of others

Quality Improvement & Service

Contribute to the improvement of services & maintain quality in own work and encourage others to do so

Health Protection & Well Being

Implement aspects of a protection plan and review its effectiveness

High risk intervention / patient vulnerability or safety risk

Monitor and maintain health, safety and security of self and others

Provide crisis intervention

Care Planning

Assess complex health and well being needs and develop, monitor and review care plans to meet those needs

Knowledge and Information Resources

Organize knowledge and information resources and provide information to meet needs

Demonstrates respect for patient/family confidentiality

Documentation Skills (accurate, timely, complete and legible)

Counseling for long range planning and decision making

Equality and Diversity

Promote equality and value diversity

Experience in all or any of the following:

Medical Social Work

School Social Work

Clinical Social Work

Social Work-Admin/management

Social work-case manager

International Social Work

Social Work-Children & Families

Social Work in Acute Psychiatric Hospital

Forensic Social Work

Employment/Occupational Social Work

Social Work- Community Organizer

Age Specific Competencies

Infant (Birth - 1 year)

Preschooler (ages 2-5 years)

Childhood (ages 6-12 years)

Adolescents (ages 13-21 years)

Young Adults (ages 22-39 years)

Adults (ages 40-64 years)

Older Adults (ages 65-79 years)

Elderly (ages 80+ years)

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.