Massachusetts - Potential Strike
Submit Request
Pre-Admission Testing - RN
Requirements
:
BLS
Massachusetts RN License
-- please complete this submission form honestly and accurately --
First Name
*
Last Name
*
Email
*
Phone
*
Do you have an active Massachusetts RN license?
*
List your Massachusetts RN license number:
*
RN license expiration date:
*
Do you have BLS certification?
*
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 experience Pre Admission Testing 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 Pre Admission Testing in the past year?
*
No
Yes
What Facility have you worked Pre Admission Testing at most recently?
*
Can you draw blood?
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No
Yes
Can you perform and interpret a 12 lead EKG?
*
No
Yes
Do you have experience inserting PICC lines?
*
No
Yes
If yes, what ages can you insert PICC lines?
*
How much phone triage 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 experience with surgical scheduling systems?
*
No
Yes
Can you start an IV?
*
No
Yes
What other specialty can you work?
*
Please supply an Emergency Contact name and phone number:
*
