Potential Strike - California

Submit Request

Chemo Infusion - RN

Requirements:

California RN License
BLS
Chemo / ONS

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

First Name*

Last Name*

Email*

Phone*

Do you have an active California RN license?*

No

Yes

List your State and RN license number:*

RN license expiration date:*

Do you have BLS certification? *

No

Yes

Do you have PALS certification?*

No

Yes

Do you have ONS Chemo certification?*

No

Yes

List any other certification you have:*

What 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 recent charge nurse experience, within the last 2 years?*

No

Yes

Can you work a Day shift?*

No

Yes

Can you work a Mid shift?*

No

Yes

Can you work a Night shift?*

No

Yes

What is your Primary Shift preference?*

Day

Mid

Night

100% Flexible

Which type of infusions can you do: Chemo? Immunotherapy? Blood? Antibiotics?

How many years Chemo Infusion experience do you have?*

Have you worked Chemo Infusion in the past year?*

No

Yes

What Facility have you worked Chemo Infusion at most recently?*

Can you infuse chemo?*

No

Yes

What chemo training have you had: ie, ONS, ONC, Hospital Trainings, etc?*

Can you infuse Immunotherapy? *

No

Yes

Can you infuse Blood? *

No

Yes

Can you infuse antibiotics?*

No

Yes

Can you access a port?*

No

Yes

Can you start an IV?*

No

Yes

Do you have BMT experience?*

No

Yes

If you have BMT experience, do you administer stem cells?

No

Yes

Can you insert PICC lines?*

No

Yes

Can you troubleshoot PICC lines?*

No

Yes

Can you draw labs?

No

Yes

Do you have outpatient experience?*

No

Yes

Do you have inpatient experience?*

No

Yes

What age patients are you able to perform infusion?*

Please supply an emergency contact name and phone number:*