California - Potential Strike
Submit Request
ER and PEDS ER - Emergency Room - RN
Requirements
:
Active California RN License
BLS
ACLS
PALS
NIHSS
First Name
*
Last Name
*
Email
*
Phone
*
License
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Do you have an active California RN license?
*
No
Yes
What is your California license #?
*
License Expiration Date?
*
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Certifications
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Do you have BLS certification?
*
No
Yes
Do you have ACLS certification?
*
No
Yes
Do you have PALS certification?
*
No
Yes
Do you have NIHSS certification?
*
No
Yes
Do you have CPI certification?
*
No
Yes
Do you have MAB certification?
*
No
Yes
List any other certification you have:
*
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What 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
Shift
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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
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Work History
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How many years ER 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, if any, PEDS ER 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 ER in the past year?
*
No
Yes
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Work History - Current Employment
Are you currently employed?
*
No
Yes
If yes, what facility do you currently work at?
If yes, what month and year did you start working at this facility?
If yes, what city and state is this facility located in?
If yes, what specialty do you work at this facility?
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Work History - Previous Employment
Before your current Job, what facility did you previously work at?
*
What city and state was this facility located in?
*
What month and year did you start working at that facility?
*
What month and year did you end working at that facility?
*
What specialty did you work at that facility?
*
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ER Submit Questions
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What level ER are you the most comfortable in? (Level 1 is the highest)
*
Level 1
Level 2
Level 3
Have you worked in an ER trauma room?
*
No
Yes
If yes, how much experience do you have in an ER Trauma room?
*
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 transport via ambulance?
No
Yes
Can you transport via helicopter?
No
Yes
Can you transport NICU/PICU?
No
Yes
Can you transport patients on ECMO?
No
Yes
Can you transport patients on VAD?
No
Yes
Can you transport patients on Vents?
No
Yes
Can you transport patients on Balloon Pumps?
No
Yes
Do you have burn experience?
No
Yes
Do you have experience with VAD patients?
No
Yes
Can you start an IV?
No
Yes
Can you work in Triage or Fast track?
No
Yes
