Last Name | |
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First Name |
1. PATTERN I Experience - Do you possess two years of progressively responsible experience as a registered nurse, one year of which includes Clinical Information Systems experience, in an acute care or ambulatory care setting at a level equivalent to a San Joaquin County Staff Nurse III? |
Yes No |
If you answered yes, provide the following:
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2. OR PATTERN II Education: Do you possess a Bachelor's Degree in Nursing, Health Science, or closely related field? |
Yes No |
If you answered yes, provide the following:
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2b. Experience: Do you possess one year of progressively responsible Clinical Information Systems experience as a registered nurse in an acute care hospital or ambulatory care setting at a level equivalent to a San Joaquin County Staff Nurse III? |
Yes No |
If you answered yes, provide the following:
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Please indicate if you possess any of the following certificates (check all that apply). Note: Copies of certificates may be attached in your online application, emailed to jripp@sjgov.org, or faxed to (209) 468-0508, ATTN: Joanne Ripp. |
Preceptor course or Nursing Trainer certificate |
ACLS Certification |
BLS Certification |
National certifications (CEN, CCRN, CNN, CDN, CPAN, CNOR, PCCN) |
Other |
3. License and Certificates: Do you possess current and valid registration as a registered nurse in the State of California? if yes, provide the license number and the expiration date. |
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If you selected "other", please describe: |
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