Potential Strike - Illinois
Submit Request
Operating Room / Same Day Surgery - RN
Requirements
:
Illinois RN license
BLS
CNOR
-- please complete this submission form honestly and accurately --
First Name
*
Last Name
*
Email
*
Phone
*
Do you have an active Illinois RN license?
*
No
Yes
RN license number:
*
RN license expiration date:
*
Do you have BLS certification?
*
No
Yes
Do you have CNOR certification?
*
No
Yes
Are you certified to First-Assist (RNFA)?
*
No
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?
*
No
Yes
Do you have Charge Nurse Experience?
*
No
Yes
Can you work a Day shift?
*
No
Yes
Can you work a Mid shift?
*
No
Yes
Can you work a Night shift?
*
No
Yes
What is your Primary Shift preference?
*
Day
Mid
Night
100% Flexible
How many years SDS experience do you have?
*
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 SDS in the past year?
*
No
Yes
What Facility and City, state have you worked SDS most recently?
*
Which phase of recovery are you comfortable caring for?
*
Which ages can you recover?
*
Do you have a critical care background, and can you recover ICU patients?
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No
Yes
Can you work in Preop?
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No
Yes
Can you work in Postop?
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No
Yes
Can you perform and interpret a 12 lead EKG?
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No
Yes
Can you assist with central or A-line placement?
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No
Yes
Can you assist with nerve blocks?
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No
Yes
Can you perform moderate sedation?
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No
Yes
Are you able to implement malignant hyperthermia protocols?
*
No
Yes
Do you have experience with mass transfusions?
*
No
Yes
Can you start an IV?
*
No
Yes
Please supply an Emergency Contact name and phone number:
*
