Potential Strike - Illinois
Submit Request
ICU RN in L&D Unit - RN
Requirements
:
Illinois RN license
BLS
ACLS
-- please complete this submission form honestly and accurately --
First Name
*
Last Name
*
Email Address
*
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 ACLS certification?
*
No
Yes
List any other certification you have:
*
What other 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?
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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 much ICU 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
How much CVICU 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 in the ICU during the past year?
*
No
Yes
What facility do you or did you last work ICU?
*
What type of ICU unit do you typically work in?
*
Do you have L&D experience?
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No
Yes
Can you take care of patients on CRRT?
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No
Yes
If yes, what CRRT machines do you have experience with?
Can you take care of patients after transplants?
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No
Yes
If yes, what type of Transplants?
Can you infuse CHEMO?
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No
Yes
If yes, are you CHEMO Certified?
No
Yes
Do you have wound vac experience?
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No
Yes
How much Impella 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
Do you have experience assisting with conscious sedation?
*
No
Yes
How much Neuro ICU 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
If Neuro experience, have you cared for patients after brain surgery?
No
Yes
Do you have experience with ICP (intra-cranial pressure monitoring)?
*
No
Yes
Do you have experience with bolts?
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No
Yes
Are you proficient in A-Lines?
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No
Yes
Can you perform EKGs?
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No
Yes
Can you read EKGs?
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No
Yes
Are you able to work in a high demand unit?
*
No
Yes
Can you work with high risk pts?
*
No
Yes
Can you pull an arterial sheath?
*
No
Yes
Please supply an Emergency Contact name and phone number:
*
