Please note that hand written applications will not be accepted

CV Template

Title:      Surname:      Forename:     

Gender: Male Female Date of Birth:       Nationality:      

Full Employment History Summary (any gaps in employment must be explained)

DATES (from most recent position) HOSPITAL (Name and Address) POSITION HELD
Position 1:                 

Position 2:                 

Position 3:                 

Position 4:                 

Position 5:                 

Position 6:                 

Please list additional roles on a separate page

Position 1

Hospital:      

Position:      

Dates:      

Rotations/Departments/Experience:

Surgery (General, Orthopaedics, Cardiothoracic) Duration (months):      

Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):      

Paediatrics (Includes exposure to paediatrics) Duration (months):      

Anaesthetics Duration (months):      

Intensive Care and HDU Duration (months):      

Emergency/A&E Duration (months):      

Please give details about the hospital including: Number of beds, number of theatres, the main specialities the hospital deals with, whether it is a
primary/secondary or tertiary set up, the size of the population it services:      

Please give details about the department /departments you work in, and the number of patients are you responsible for? If you have ‘on call’ duties
please specify the number of hours per week and what a typical on call duty looks like:      

Please describe in detail your daily routine and the procedures and clinical skills you use (these should include basic skills such as blood taking,
cannulation, catheterisation, as well as more complex ones). Are these procedures performed supervised or unsupervised? Give details of the team
you work with, and how work is divided between you :     

Please detail your exposure to paediatric patients in this role including the age range of patients, are these inpatients or outpatients, medical or
surgical cases? Do you care for these patients pre-post operatively? Do you regularly cannulate and take blood? :      

If you have exposure to oncology patients please describe your involvement with these patients. Do you administer chemo or radiotherapy? Do you
take blood, cannulate, treat side effects, or administer or prescribe medication to these patients?:      
Position 2

Hospital:      

Position:      

Dates:      

Rotations/Departments/Experience:

Surgery (General, Orthopaedics, Cardiothoracic) Duration (months):      

Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):      

Paediatrics (Includes exposure to paediatrics) Duration (months):      

Anaesthetics Duration (months):      

Intensive Care and HDU Duration (months):      

Emergency/A&E Duration (months):      

Please give details about the hospital including: Number of beds, number of theatres, the main specialities the hospital deals with, whether it is a
primary/secondary or tertiary set up, the size of the population it services:      

Please give details about the department /departments you work in, and the number of patients are you responsible for? If you have ‘on call’ duties
please specify the number of hours per week and what a typical on call duty looks like:      

Please describe in detail your daily routine and the procedures and clinical skills you use (these should include basic skills such as blood taking,
cannulation, catheterisation, as well as more complex ones). Are these procedures performed supervised or unsupervised? Give details of the team
you work with, and how work is divided between you :     

Please detail your exposure to paediatric patients in this role including the age range of patients, are these inpatients or outpatients, medical or
surgical cases? Do you care for these patients pre-post operatively? Do you regularly cannulate and take blood? :      

If you have exposure to oncology patients please describe your involvement with these patients. Do you administer chemo or radiotherapy? Do you
take blood, cannulate, treat side effects, or administer or prescribe medication to these patients?:      
Position 3

Hospital:      

Position:      

Dates:      

Rotations/Departments/Experience:

Surgery (General, Orthopaedics, Cardiothoracic) Duration (months):      

Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):      

Paediatrics (Includes exposure to paediatrics) Duration (months):      

Anaesthetics Duration (months):      

Intensive Care and HDU Duration (months):      

Emergency/A&E Duration (months):      

Please give details about the hospital including: Number of beds, number of theatres, the main specialities the hospital deals with, whether it is a
primary/secondary or tertiary set up, the size of the population it services:      

Please give details about the department /departments you work in, and the number of patients are you responsible for? If you have ‘on call’ duties
please specify the number of hours per week and what a typical on call duty looks like:      

Please describe in detail your daily routine and the procedures and clinical skills you use (these should include basic skills such as blood taking,
cannulation, catheterisation, as well as more complex ones). Are these procedures performed supervised or unsupervised? Give details of the team
you work with, and how work is divided between you :     

Please detail your exposure to paediatric patients in this role including the age range of patients, are these inpatients or outpatients, medical or
surgical cases? Do you care for these patients pre-post operatively? Do you regularly cannulate and take blood? :      

If you have exposure to oncology patients please describe your involvement with these patients. Do you administer chemo or radiotherapy? Do you
take blood, cannulate, treat side effects, or administer or prescribe medication to these patients?:      
Position 4

Hospital:      

Position:      

Dates:      

Rotations/Departments/Experience:

Surgery (General, Orthopaedics, Cardiothoracic) Duration (months):      

Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):      

Paediatrics (Includes exposure to paediatrics) Duration (months):      

Anaesthetics Duration (months):      

Intensive Care and HDU Duration (months):      

Emergency/A&E Duration (months):      

Please give details about the hospital including: Number of beds, number of theatres, the main specialities the hospital deals with, whether it is a
primary/secondary or tertiary set up, the size of the population it services:      

Please give details about the department /departments you work in, and the number of patients are you responsible for? If you have ‘on call’ duties
please specify the number of hours per week and what a typical on call duty looks like:      

Please describe in detail your daily routine and the procedures and clinical skills you use (these should include basic skills such as blood taking,
cannulation, catheterisation, as well as more complex ones). Are these procedures performed supervised or unsupervised? Give details of the team
you work with, and how work is divided between you :     

Please detail your exposure to paediatric patients in this role including the age range of patients, are these inpatients or outpatients, medical or
surgical cases? Do you care for these patients pre-post operatively? Do you regularly cannulate and take blood? :      

If you have exposure to oncology patients please describe your involvement with these patients. Do you administer chemo or radiotherapy? Do you
take blood, cannulate, treat side effects, or administer or prescribe medication to these patients?:      
Position 5

Hospital:      

Position:      

Dates:      

Rotations/Departments/Experience:

Surgery (General, Orthopaedics, Cardiothoracic) Duration (months):      

Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):      

Paediatrics (Includes exposure to paediatrics) Duration (months):      

Anaesthetics Duration (months):      

Intensive Care and HDU Duration (months):      

Emergency/A&E Duration (months):      

Please give details about the hospital including: Number of beds, number of theatres, the main specialities the hospital deals with, whether it is a
primary/secondary or tertiary set up, the size of the population it services:      

Please give details about the department /departments you work in, and the number of patients are you responsible for? If you have ‘on call’ duties
please specify the number of hours per week and what a typical on call duty looks like:      

Please describe in detail your daily routine and the procedures and clinical skills you use (these should include basic skills such as blood taking,
cannulation, catheterisation, as well as more complex ones). Are these procedures performed supervised or unsupervised? Give details of the team
you work with, and how work is divided between you :     

Please detail your exposure to paediatric patients in this role including the age range of patients, are these inpatients or outpatients, medical or
surgical cases? Do you care for these patients pre-post operatively? Do you regularly cannulate and take blood? :      

If you have exposure to oncology patients please describe your involvement with these patients. Do you administer chemo or radiotherapy? Do you
take blood, cannulate, treat side effects, or administer or prescribe medication to these patients?:      
Position 6

Hospital:      

Position:      

Dates:      

Rotations/Departments/Experience:

Surgery (General, Orthopaedics, Cardiothoracic) Duration (months):      

Medicine (General, Cardiology, Neurology, Respiratory) Duration (months):      

Paediatrics (Includes exposure to paediatrics) Duration (months):      

Anaesthetics Duration (months):      

Intensive Care and HDU Duration (months):      

Emergency/A&E Duration (months):      

Please give details about the hospital including: Number of beds, number of theatres, the main specialities the hospital deals with, whether it is a
primary/secondary or tertiary set up, the size of the population it services:      

Please give details about the department /departments you work in, and the number of patients are you responsible for? If you have ‘on call’ duties
please specify the number of hours per week and what a typical on call duty looks like:      

Please describe in detail your daily routine and the procedures and clinical skills you use (these should include basic skills such as blood taking,
cannulation, catheterisation, as well as more complex ones). Are these procedures performed supervised or unsupervised? Give details of the team
you work with, and how work is divided between you :     

Please detail your exposure to paediatric patients in this role including the age range of patients, are these inpatients or outpatients, medical or
surgical cases? Do you care for these patients pre-post operatively? Do you regularly cannulate and take blood? :      

If you have exposure to oncology patients please describe your involvement with these patients. Do you administer chemo or radiotherapy? Do you
take blood, cannulate, treat side effects, or administer or prescribe medication to these patients?:      
Practical experience Paediatrics: Number
Resuscitation of Newborn      

Please write the total number of times you have carried out Acute Respiratory Distress      

Eg. IV Cannulations 750 Pneumonia      

Post Tonsillectomy Bleeds      

General Experience: Number
Resuscitation of shock/ dehydration      
Cardio-Pulmonary/Resuscitations (Team Leader)      
Lumbar Punctures      
Endotracheal/Laryngeal Mask Intubations      
Age range of Paediatrics worked with (eg 2 yrs +)      
Conducting/Interpreting/Responding to ECGs      

Cardioversion and Sedation      

Accident and Emergency: Number
IV Cannulations      
Blood taking       Allergic Reactions      

Arterial Blood Gas Sampling (ABG)       Myocardial Infarctions      

Urethral Catheterisation       Arrhythmia      

Suturing wounds       Acute Psychosis      

Insertion of naso-gastric tubes       Major Bone Fractures      

Thrombolytic Therapy administered       Acute Bowel Obstruction      

Drug Overdose      

Oncology: Number
Intercostal Drain Insertion      
Chemotherapy Administered      

General Surgery: Number Internal Medicine: Number

Laparotomies      
Adult Respiratory Distress Syndrome      
Incision and Drainage of Abscesses      
Multiple Organ Failure      
Bladder washouts      
Cardiac Failure      
Debridement of wound      
Pneumonia, Respiratoty Failure and COAD      
Haemorrhoidectomies      
Diabetic Keto-Acidosis      
Skin Graft      
Anemia      

Blood Transfusions      

Anaesthetics and ICU: Number
Infusion Pumps      
General anaesthetics performed       Stress ECG’s      

Local anaesthesia and blocks performed      

Orthopaedics: Number
Epidural and Spinal anaesthesia performed      
N Arthroscopy      

Lumbar Puncture performed       Hip Replacement      

Ventilated Patients in ICU       Knee Replacement      

CVP Lines       Spinal Surgery      

Inotropes used in ICU      

Patients cared for in HDU      

 Self Declaration Procedures Checklist

Regular Procedures
Competent

Blood taking

Peripheral IV Cannulation

Prescribing analgesics, antibiotics and common drugs

as described in the BNF

Introduction to Programming/Management of drug

Infusion pumps (PCAs)

Bladder catheterisation (male and female)

Conducting, interpreting and responding to ECGs

Adult resuscitation including defibrillation

Paediatric resuscitation including defibrillation

Desirable Procedures

Competent Exposed

Performing lumbar puncture and epidural

Chemotherapy administration

Intubation with endotracheal tube

Laryngeal mask insertion

Obtaining arterial blood for blood gas analysis

Placing of central venous lines

Venous pacemaker placement

Intercostal drain insertion/ Chest drains

TIVA Anaesthesia

Topping up Epidurals
 CONSOLIDATED SUMMARY OF PRACTICAL EXPERIENCE BY DISCIPLINE

Skills/Experience Months Comments

worked

General            

Orthopaedic            

Surgery
Cardiothoracic            

Other (please state)            

General            

Medicine Cardiology            

Neurology            

Respiratory            

Dedicated
Paediatric Rotation            
Paediatrics
Acquired as part of
another speciality            

Anaesthetics            

ITU / ICU (Intensive Therapy/ Care Units)            

HDU (High Dependency Units)            

Emergency/A+E            

Oncology Medical Oncology            

Chemotherapy
Administration Yes No      

Other (please state)                  

Please note that some of the above experience may have been gained concurrently.

As well as being dedicated to your needs, we are also committed to security. Any personal information you give us is kept secure and can only be accessed by
NES. If you are looking for employment we will only divulge your personal information to a prospective employer or other third party with your permission and if we deem it necessary.