Potential Strike - Illinois

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Clinic - Primary Care / Peds Care - RN

Requirements:

Illinois RN license
BLS
ACLS (preferred)
PEDS (preferred)

-- 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

Do you have ACLS certification?*

Yes

Do you have PEDS 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

How many years Primary Care Clinic experience do you have?*

Have you worked Primary Care Clinic in the past year?*

Yes

At which Clinic have you worked Primary Care most recently?*

What clinic settings do you have experience working in?*

What age patients are you comfortable caring for?*

Can you perform allergy scratch testing?*

Yes

How much recent experience do you have with D.O.T. physicals?*

How much recent experience do you have drawing blood?*

How much recent experience do you have administering shots?*

How much recent experience do you have completing 12-lead EKG?*

How much recent experience do you have with Moderate Sedation?*

What other outpatient testing can you perform?*

Can you start an IV?*

Yes

In which settings do you have experience and are comfortable to specialize? (select all that apply)

Allergy

Apheresis

Chemo Infusion

Cardiac/Heart Failure

Cardiac/Thoracic/Vascular

Cardiology

Cystic Fibrosis

Dermatology

Diabetes

Digestive Disease

Ear/Nose/Throat

Endocrinology

Gastroenterology

Geriatric

Infectious Disease

Infertility

Infusion

Medical

Neurology

Neurosurgery

OBGYN

Oncology

Orthopedic

Pain Clinic

Pediatric

Primary Care

Psychiatric Care

Pulmonary Op

Radiation Oncology

Rheumatology

Urology

Urogynecology

Womens Specialties

Please highlight any additional clinical skills or unique experience you may have:

Please supply an emergency contact name and phone number:*