California - Potential Strike
Submit Request
ICU-CVICU RN
Requirements
:
California RN License
BLS
ACLS
NIHSS
Meditech experience
-- please complete this submission form honestly and accurately --
First Name
*
Last Name
*
Email Address
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Phone
*
Do you have an active California RN license?
*
No
Yes
List your RN license number:
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RN license expiration date:
*
Do you have BLS certification?
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No
Yes
Do you have ACLS certification?
*
No
Yes
Do you have NIHSS (stroke scale) certification?
*
No
Yes
List any other certification you have:
*
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?
*
No
Yes
Do you have Charge RN experience within the last two years?
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No
Yes
Can you work a Day shift?
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No
Yes
Can you work a Mid shift?
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No
Yes
Can you work a Night shift?
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No
Yes
What is your Primary Shift preference?
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Day
Mid
Night
100% Flexible
How much ICU experience do you have?
None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
Have you worked ICU during the past year?
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No
Yes
What facility do you or did you last work ICU?
*
How much recent CVICU experience do you have, if any?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
Can you take care of patients on CRRT or CVVH?
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No
Yes
If yes, what CRRT machines do you have experience with?
If yes, can you set up and take down and change the circuit for CRRT?
No
Yes
How much experience do you have with Balloon Pumps?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
Are you skilled with Tablo SLED (Nxstage) IABP and able to function independently?
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No
Yes
How much experience do you have with Impella?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
How much experience do you have with LVADs?
*
None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
If you have LVAD experience, what type?
When was the last time you recovered a fresh heart immediately from the OR?
How much ECMO experience do you have?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
If you have ECMO experience, do you do VV and VA?
No
Yes
Can you take care of patients after transplants?
*
No
Yes
If yes, what type of Transplants?
Do you have recent experience with Internal and External pacer wires?
Yes
No
Can you care for a Swan-Ganz catheter?
Yes
No
Can you infuse CHEMO?
*
No
Yes
If yes, are you CHEMO Certified?
No
Yes
How much Burn ICU experience do you have?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
If burn experience, can you calculate total body surface area?
No
Yes
If burn experience, can you utilize the rule of 9?
No
Yes
If burn experience, can you calculate fluid replacement?
No
Yes
If burn experience, are you comfortable doing burn wound dressing changes?
No
Yes
Do you have wound vac experience?
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No
Yes
How much Impella experience do you have?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
Do you have experience assisting with conscious sedation?
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No
Yes
How much Neuro ICU experience do you have?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
If Neuro experience, have you cared for patients after brain surgery?
No
Yes
Do you have experience administering TPA?
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No
Yes
Do you have experience with ICP (intra-cranial pressure monitoring)?
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No
Yes
Do you have experience with bolts?
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No
Yes
Do you have current experience in Trauma ICU??
*
No
Yes
Can you pull an arterial sheath?
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No
Yes
Do you have procedural experience?
*
Yes
No
Do you have experience with Meditech?
*
No
Yes
What procedures are you comfortable assisting with?
*
Are you familiar with Arctic Sun or Zoll brand therapeutic temperature control?
*
Please supply an Emergency Contact name and phone number:
*