Potential Strike - Washington
Submit Request
Labor & Delivery - RN
Requirements
:
Washington State or Multistate compact RN license
BLS
ACLS
NRP
AFM
-- please complete this submission form honestly and accurately --
First Name
*
Last Name
*
Email Address
*
Phone
*
Do you have an active Washington State RN license?
*
No
Yes
If Yes, list your Washington state RN license number:
If No, list your compact state and RN license number:
List your RN license expiration date:
*
Do you have BLS certification?
*
No
Yes
Do you have ACLS certification?
*
No
Yes
Do you have NRP certification?
No
Yes
Do you have AFM certification?
No
Yes
Are you a lactation nurse and are you lactation-certified?
*
No
Yes
List any other certification you have:
*
What other 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
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
At which facility have you most recently worked in a Labor and Delivery unit?
*
Do you care for high risk patients?
*
No
Yes
Do you titrate magnesium drips?
*
No
Yes
Do you circulate C-Sections?
*
No
Yes
Do you scrub C-sections?
*
No
Yes
How much NICU experience do you have if any?
*
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
If you do have experience, which level?"
None
Level 1
Level 2
Level 3
Level 4
Can you work in Post partum or a LDRP?
*
No
Yes
Can you catch the baby and do the initial assessments?
*
No
Yes
Can you work independently in well baby nursery?
*
No
Yes
Can you care for a patient on moderate sedation?
*
No
Yes
Can you work in OB Triage?
No
Yes
Do you have experience caring for fetal demise during and after the delivery?
*
No
Yes
Do you have charge nurse experience?
*
No
Yes
Can you start an IV?
*
No
Yes
How much recent EPIC 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
Please supply an Emergency Contact name and phone number:
*
