California - Potential Strike
Submit Request
ICU Neuro / SLED - RN
Requirements
:
California RN License
BLS
ACLS
NIHSS
Meditech experience
-- please complete this submission form honestly and accurately --
First Name
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Last Name
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Email Address
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Phone
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Do you have an active California RN license?
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No
Yes
List your RN license number:
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RN license expiration date:
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Do you have BLS certification?
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No
Yes
Do you have ACLS certification?
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No
Yes
Do you have NIHSS (stroke scale) certification?
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No
Yes
List any other certification you have:
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What other specialties do you float to?
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Do you have the COVID Vaccination?
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No - Requesting Exemption
Yes - Vaccinated
Yes - Vaccinated with Booster
Typically for strike assignments: 5x12/hr shifts (60/hrs week) Are you ok with this?
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No
Yes
Do you have charge nurse experience within the last 2 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 CVICU 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
Have you worked CVICU during the past year?
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No
Yes
What facility do you or did you last work CVICU?
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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?
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If yes, can you set up and take down and change the circuit for CRRT?
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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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Yes
No
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?
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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 LVAD experience, what type?
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When was the last time you recovered a fresh heart immediately from the OR?
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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?
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No
Yes
Can you take care of patients after transplants?
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No
Yes
If yes, what type of Transplants?
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Do you have recent experience with Internal and External pacer wires?
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Yes
No
Do you have experience with ICP monitoring?
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No
Yes
Do you have experience with CABG patients day 2?
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No
Yes
Do you have experience with Bolts?
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No
Yes
Can you care for a Swan-Ganz catheter?
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Yes
No
Can you infuse CHEMO?
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No
Yes
If yes, are you CHEMO Certified?
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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?
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No
Yes
If burn experience, can you utilize the rule of 9?
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No
Yes
If burn experience, can you calculate fluid replacement?
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No
Yes
If burn experience, are you comfortable doing burn wound dressing changes?
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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
What types of ICU do you usually work in?
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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?
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No
Yes
Do you have experience administering TPA?
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No
Yes
Do you have experience caring for post op surgical icu patients?
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Yes
No
Do you have current experience in Trauma ICU??
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No
Yes
Do you have experience acting as the rapid repsonse RN/ resource RN for the hospital?
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Yes
No
Can you pull an arterial sheath?
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No
Yes
Do you have experience with Meditech?
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No
Yes
Are you familiar with Arctic Sun or Zoll brand therapeutic temperature control?
*
Please supply an Emergency Contact name and phone number:
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