Potential Strike - Illinois
Submit Request
Clinic - Chemo Infusion - RN
Requirements
:
Illinois RN license
BLS
ONC/ONS Chemotherapy certification
Biotherapy certification (preferred)
-- please complete this submission form honestly and accurately --
First Name
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Last Name
*
Email
*
Phone
*
Do you have an active Illinois state RN license?
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No
Yes
If Yes, list your Illinois state RN license number:
RN license expiration date:
*
Do you have BLS certification?
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No
Yes
Do you have ONS Chemo certification?
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No
Yes
Do you have a biotherapy certification?
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No
Yes
List any other certification you have:
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What specialties do you float to?
*
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?
*
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
How many years Infusion 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 Infusion in the past year?
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No
Yes
What Facility have you worked Infusion at most recently?
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Can you infuse chemo?
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No
Yes
What chemo training have you had: ie, ONS, ONC, Hospital Trainings, if any?
Can you comfortably and competently deliver high-dose chemotherapy to high-risk patients?
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No
Yes
Can you infuse Immunotherapy?
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No
Yes
Can you infuse Blood?
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No
Yes
Can you infuse antibiotics?
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No
Yes
Can you access a port?
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No
Yes
Can you start an IV?
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No
Yes
Do you have BMT experience?
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No
Yes
If you have BMT experience, do you administer stem cells?
No
Yes
Can you insert PICC lines?
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No
Yes
Can you troubleshoot PICC lines?
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No
Yes
Can you draw labs?
No
Yes
Do you have outpatient experience?
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No
Yes
Do you have inpatient experience?
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No
Yes
Can you manage work flow, answer phones, do med refills?
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No
Yes
What age patients are you able to perform infusion?
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Can you work Epic in basket?
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No
Yes
Please supply an emergency contact name and phone number:
*
