Oregon - Potential Strike
Submit Request
House Supervisor - RN
Requirements
:
BLS
-- please complete this submission form honestly and accurately --
First Name
*
Last Name
*
Email
*
Phone
*
Do you have an active Oregon RN license?
*
What is your Oregon RN license number?
*
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?
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No
Yes
What is your Primary Shift preference?
*
Day
Mid
Night
100% Flexible
What age range of patients are you comfortable caring for?
*
Do you circulate?
*
No
Yes
Do you Scrub?
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No
Yes
How much recent experience do you have as a House Supervisor?
*
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
At which facility have you most recently worked as a House Supervisor?
*
Describe your experience as a House Supervisor and why you are best fit for this role?
*
Please provide an Emergency Contact name and phone number:
*