Pennsylvania - Potential Strike
Submit Request
ICU
Requirements
:
Active Pennsylvania RN License
BLS
ACLS
First Name
*
Last Name
*
Email Address
*
Phone
*
Do you have an active Pennsylvania RN license?
*
No
Yes
What is your PA license #?
*
PA 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
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 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 typically take care of the sickest patients?
No
Yes
Can you take care of patients on CRRT?
*
No
Yes
If yes, what CRRT machines do you have experience with?
If yes, can you set up and take down and change the circuit for CRRT?
No
Yes
How much experience do you have with Balloon Pumps?
*
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 experience do you have with LVADs?
*
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 you have LVAD experience, what type?
How much ICP 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 ECMO 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
If you have ECMO experience, do you do VV and VA?
No
Yes
Can you recover a fresh open heart patient immediately from OR?
No
Yes
Can you take care of patients after transplants?
*
No
Yes
If yes, what type of Transplants?
Can you infuse CHEMO?
*
No
Yes
If yes, are you CHEMO Certified?
No
Yes
How much Burn 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
If burn experience, can you calculate total body surface area?
No
Yes
If burn experience, can you utilize the rule of 9
No
Yes
If burn experience, calculate fluid replacement?
No
Yes
If burn experience, are you comfortable doing burn wound dressing changes?
No
Yes
How much Impella 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
Do you have Wound Care experience?
*
No
Yes
If yes, are you Wound Care Certified?
No
Yes
How much Trauma 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 Neuro 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 PEDS 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
Can you insert PICC lines?
*
No
Yes
If yes, are you PICC certified?
No
Yes
Do you have Infusion experience (None-Chemo)?
*
No
Yes
