Potential Strike
California
submit request
California Cath Lab / Recovery - RN
Requirements
:
BLS
ACLS
-- please complete this form honestly and accurately --
First Name
*
Last Name
*
Email
*
Phone
*
Do you have an active California license?
*
What is your California RN license number?
*
License Expiration Date?
*
Do you have BLS certification?
*
No
Yes
Do you have an ACLS certification?
*
No
Yes
List any other certification you have:
*
Do you have Charge RN experience within the last two years?
Yes
No
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 in the last 2 years?
*
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
What ages can you administer moderate sedation to?
*
What ages are you comfortable caring for?
Do you circulate?
*
No
Yes
Do you Scrub?
*
No
Yes
Can you Monitor/document?
Yes
No
How much recent experience do you have with IVUs?
*
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 recent experience do you have with extremity cases?
*
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 recent experience do you have with Impella Heart Pumps?
*
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 recent experience do you have with balloon pumps?
*
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 set up and maintain a patient on a balloon pump?
*
No
Yes
How much recent experience do you have with Watchman implant cases?
*
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 monitor/document?
*
No
Yes
Can you pull arterial sheaths?
Yes
No
Can you perform a medicated stress test?
Yes
No
How much recent experience do you have performing NIPS? (Non-Invasive Program Stimulation testing)
*
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 recent experience do you have with TAVRs?
*
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 recover adults or peds or both?
Can you recover cath lab patients?
Yes
No
How much recent experience do you have assisting with T.E.E.?
Which phase of recovery are you comfortable caring for?
Can you work phase I, phase II and discharge patients?
Yes
No
Can you assist with A-lines procedures?
Yes
No
Can you assist with central line procedures?
Yes
No
Can you assist with nerve block procedures?
Yes
No
Are you able to implement malignant hyperthermia protocols?
Yes
No
Can you perform and interpret a 12 lead EKG?
Yes
No
Can you start an IV?
Yes
No
Can you pull sheaths?
Yes
No
Can you assist with LINQ insertions?
Yes
No
Can you assist with cardioversions?
Yes
No
Can you administer moderate sedation?
Yes
No
Can you preop adults or peds or both?
Yes
No
Can you preop open heart surgery patients?
Yes
No
Can you preop cath lab patients?
Yes
No
Please supply an Emergency Contact name and phone number:
*
