Have you completed an approved Nurse Practitioner training program at an accredited college or university or certified program? (If Yes, please be sure the information is noted clearly on your employment application and/or resume as it will be source verified)
Yes
No
2
The following licenses are all required to qualify for this position: RN license, Nurse Practitioner license, and current Nurse Practitioner Furnishing license all issued by the CA Board of Registered Nursing (BRN). Please provide the license number for each one so that it can be sourced verified by Human Resources. If you do not possess the license, please note "N/A":
California RN License Number
Nurse Practitioner Certification Number
Nurse Practitioner Furnishing Number
3
This position requires that you possess licensed Nurse Practitioner experience in the area in which you would be assigned. This position will be assigned to the hospital's Perioperative Department and will require experience in an acute care Perioperative Department. If you possess this experience, please provide the name of your employer, dates of employment and a description of duties performed as a licensed Nurse Practitioner in the department noted.
4
Do you acknowledge and accept the following:
In order to practice at San Joaquin General Hospital, you must be credentialed and granted privileges through the San Joaquin General Hospital Committee on Interdisciplinary Practice (CIDP) within ninety (90) days of appointment and in accordance with medical staff bylaws and state regulations. New employees may be granted temporary privileges by the Medical Director or designee, pending Committee Interdisciplinary Practice approval. Eligibles may be certified only to job vacancies in the area of specialization in which they posses specialized education and certification. Additionally, the successful completion of approved nursing training programs, possession of specific nursing experience or the possession of specified professional certificates may be required depending on the nature of the area of assignment.
Yes
No
5
San Joaquin General Hospital is a 24/7 operating facility. Incumbents employed with San Joaquin General Hospital must have the ability to work rotating shifts which include nights, weekends and holidays. Please indicate if you acknowledge and accept this requirement.
Yes, I acknowledge and accept that the position may require working rotating shifts, including nights, weekends, and holidays.
No, I'm unable to work rotating shifts which includes nights, weekends, and holidays.
San Joaquin County Human Resources Division