Potential Strike - Illinois

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Clinic - Apheresis - RN

Requirements:

Illinois RN license
BLS
Competency with Spectra Optia apheresis machine

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

First Name*

Last Name*

Email*

Phone*

Do you have an active Illinois RN license?*

Yes

List your RN license number:*

RN license expiration date:*

Do you have BLS certification? *

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?*

Yes

Do you have Charge Nurse Experience?*

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

What age patients are you comfortable caring for?*

At which Clinic or facility have you worked Apheresis most recently, and when?*

How much recent Plasma Apheresis experience do you have?*

How much recent Red Blood Cell apheresis (erythrocytaphereis) experience do you have?*

How much recent White Blood Cell apheresis (leukapheresis) experience do you have?*

How much recent Platelet apheresis (plateletpheresis, thrombyocytapheresis) experience do you have?*

How much recent experience do you have with the Spectra Optia apheresis machine, specifically?*

How much recent stem cell harvesting experience do you have? (circulating bone marrow cells)*

Can you perform Hemodialysis?*

Yes

Do you have experience managing Hemodialysis Techs?*

Yes

Can you perform Peritoneal dialysis?*

Yes

If yes, which peritoneal dialysis machines are you familiar with?

How much experience do you have with manual peritoneal dialysis?*

Please list any additional clinical skills or duties you are comfortable to perform:

Please supply an emergency contact name and phone number:*