Oregon - Potential Strike

Submit Request

I.V. Team RN

Requirements:

BLS
I.V. certification (preferred)

-- please complete this submission form honestly and accurately --

First Name*

Last Name*

Email*

Phone*

Do you have an active Oregon state RN license?*

No

Yes

What is your RN license number?*

RN license expiration date?*

Do you have BLS certification? *

No

Yes

Do you have an IV certification?*

No

Yes

List any other certification you have:*

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

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

Can you insert, maintain and remove an IV?*

No

Yes

Can you perform an ultrasound IV?*

No

Yes

Can you address issues with IV insertions?*

No

Yes

Can you recognize S/S of infiltration?*

No

Yes

Are you comfortable with "hard sticks"?*

No

Yes

What ages can you insert and maintain an IV?*

Please supply an emergency contact name and phone number:*