Potential Strike - Illinois

Submit Request

Emergency Room - RN

Requirements:

Illinois RN license
BLS
ACLS
TNCC (ATCN, TCRN, TNS)
SANE (preferred)
PALS (preferred)
ENPC (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 ACLS certification?*

Yes

Do you have a PALS certification?*

Yes

Do you have TNCC (TCRN, TNS, ATCN) certification?*

Yes

Do you have ENPC certification?*

Yes

Do you have SANE 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 much recent experience do you have working Emergency Room?*

What level ER are you most comfortable in?*

What age range of patients are you comfortable caring for?*

Do you have experience in a PEDS ER?*

Yes

Can you work triage or Fast Track?*

Yes

Do you have burn experience?*

Yes

How much recent experience do you have transporting patients via ambulance?*

If recent ambulance experience, which types of patients are you comfortable to transport?*

Balloon Pump

ECMO patients

NICU/PICU patients

VAD patients

Ventilated patients

What equipment are you comfortable to transport via ambulance?*

Do you have experience transporting patients via helicopter?*

Yes

Please supply an Emergency Contact name and phone number:*

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