Potential Strike - Illinois

Submit Request

Dialysis - RN

Requirements:

Illinois RN license
BLS
BONENT Hemodialysis certification (preferred)

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

First Name*

Last Name*

Email*

Phone*

Do you have an active Illinois RN license?*

Yes

RN license number:*

RN license expiration date:*

Do you have BLS certification? *

Yes

Do you have a BONENT Hemodialysis 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 range of patients are you comfortable caring for?*

How much recent experience do you have working Dialysis?*

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

How much recent experience do you have with plasma pheresis?*

Can you set up, take down, and troubleshoot the circuit on a CRRT machine?*

Yes

How much recent experience do you have with NXT Stage CRRT machines?

Which other machine brands do you have experience with, if any?*

Can you set up CRRT for ICU patients?*

Yes

Is your experience in an inpatient setting or outpatient?*

Inpatient

Outpatient

Both

Please supply an Emergency Contact name and phone number:*