Potential Strike - California

Submit Request

High Risk Antepartum - RN

Requirements:

California RN license
BLS
ACLS
NRP
AWHONN FHM

-- please complete this submission form honestly and accurately --

First Name*

Last Name*

Email Address*

Phone*

Do you have an active California state RN license?*

Yes

If Yes, what is your active California state RN license number?

What is your RN license expiration date?*

Do you have BLS certification? *

Yes

Do you have ACLS certification?*

Yes

Do you have NRP certification?*

Yes

Do you have AFM certification?*

Yes

List any other certification you have:*

At what facility have you worked Antepartum most recently, and what dates?*

What other specialties do you float to?*

Do you have the COVID Vaccination?*

No - Requesting Exemption

Yes - Vaccinated

Yes - Vaccinated with Booster

Typically for strike assignments: 5x12/hr shifts (60/hrs week) Are you ok with this?*

Yes

Can you work a Day shift?*

Yes

Can you work a Mid shift?*

Yes

Can you work a Night shift?*

Yes

What is your Primary Shift preference?*

Day

Mid

Night

100% Flexible

Can you perform an NST (non-stress test)?*

Yes

Can you perform a BPP (biophysical profile)?*

First

Second

Third

Have you cared for high risk moms post delivery?*

Yes

Are you a lactation nurse?*

Yes

If yes, are you certified?"

Yes

How much Labor and Delivery experience do you have, if any?*

How much Post Partum experience do you have, if any?*

How much NICU experience do you have if any? *

If you do have experience, which level?

Can you catch the baby and perform initial assessments?*

Yes

Can you work independently in well baby nursery?*

Yes

Do you have Charge RN experience within the last two years?*

Yes

Can you start an IV?*

Yes

Can you manage or titrate a Magnesium drip?*

Yes

Can you circulate C-sections?*

Yes

Do you scrub C-sections?*

Yes

Can you care for a patient on moderate sedation?*

Yes

Can you work OB Triage?*

Yes

Do you have experience caring for fetal demise during and after delivery?*

Yes

Please supply an Emergency Contact name and phone number:*