MICHIGAN - Potential Strike
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Nurse Practitioner (NP) - Neonatal
Requirements
:
Active Michigan Nurse Practitioner (NP) License
BLS
NRP
STABLE (preferred)
First Name
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Last Name
*
Email
*
Phone
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Do you have an active Michigan Nurse Practitioner (NP) license?
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No
Yes
If NO, which state issued your NP license?
Nurse Practitioner (NP) License number:
*
NP License Expiration Date:
*
Do you have BLS certification?
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No
Yes
Do you have NRP certification?
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No
Yes
Do you have STABLE certification?
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No
Yes
List any other certification you have:
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What specialties do you float to?
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Do you have the COVID Vaccination?
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No
Yes - Vaccinated
Yes - Vaccinated with Booster
Typically for strike assignments: 5x12/hr shifts (60/hrs week) Are you ok with this?
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No
Yes
Do you have Charge Nurse Experience?
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No
Yes
Can you work a Day shift?
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No
Yes
Can you work a Mid shift?
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No
Yes
Can you work a Night shift?
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No
Yes
What is your Primary Shift preference?
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Day
Mid
Night
100% Flexible
How many years Neonatal NP 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
Have you worked Neonatal NP in the past year?
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No
Yes
What Facility and City, State have you worked as an NP most recently?
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Are you able to order, perform, and interpret diagnostic tests independently as an NP?
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What level NICU do you typically work in?
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None
Level 1
Level 2
Level 3
Level 4
What is the earliest gestation you can care for?
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Can you place peripheral, central, arterial, or umbilical lines?
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No
Yes
Are you able to transport patients from facility to facility?
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No
Yes
Have you transported neonates outside the hospital?
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No
Yes
If YES, describe your experience transporting neonates, and whether by ambulance or helicopter:
