Application form

RN-MEDICINE UNIT

Full-Time/Night

Previous Experience Required

Must be current with CPR, ACLS, PALS and NIH Stroke Certification

Specialized or Technical Education Required

Must be a graduate of an accredited school of nursing, and be currently licensed by the State Board of Nursing. Membership in a professional organization is encouraged.

Manual or Physical Skill Required

Physical Effort Required: Must possess good physical health. Required to stand for long periods of time. Lifting and transporting of patients is required. Motor coordination and manual dexterity are necessary. Strength: Medium Push: Occasionally Pull: Occasionally Carry: Occasionally Lift: Occasionally Sit: Occasionally Stand: Frequently Walk: Frequently

 

Personal Information

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Referral Information

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Placement Information

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Education

High School

*All below fields are required.

College

Graduate School

Vocational School/ Other

Certifications / Licenses

License 1

License 2

License 3

License 4

Skills & Qualifications

Employment History

Current Employer

Previous Employer 1

Previous Employer 2

References

*All below fields are required.

Reference 1

Reference 2

Reference 3

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