Potential Strike - Illinois
Submit Request
Clinic - Apheresis - RN
Requirements
:
Illinois RN license
BLS
Competency with Spectra Optia apheresis machine
-- please complete this submission form honestly and accurately --
First Name
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Last Name
*
Email
*
Phone
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Do you have an active Illinois 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
List any other certification you have:
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What 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?
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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
What age patients are you comfortable caring for?
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At which Clinic or facility have you worked Apheresis most recently, and when?
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How much recent Plasma Apheresis 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
How much recent Red Blood Cell apheresis (erythrocytaphereis) 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
How much recent White Blood Cell apheresis (leukapheresis) 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
How much recent Platelet apheresis (plateletpheresis, thrombyocytapheresis) 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
How much recent experience do you have with the Spectra Optia apheresis machine, specifically?
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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 recent stem cell harvesting experience do you have? (circulating bone marrow cells)
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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 perform Hemodialysis?
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No
Yes
Do you have experience managing Hemodialysis Techs?
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No
Yes
Can you perform Peritoneal dialysis?
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No
Yes
If yes, which peritoneal dialysis machines are you familiar with?
How much experience do you have with manual peritoneal dialysis?
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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
Please list any additional clinical skills or duties you are comfortable to perform:
Please supply an emergency contact name and phone number:
*