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Exceptional Care That Transforms.

Summer Nurse Extern Packet

Name(Required)
MM slash DD slash YYYY

Nursing School Instructors (References)

Reference 1 – Name(Required)
Reference 2 – Name(Required)
Did you have a clinical rotation at Memorial?(Required)
Have you ever been employed at Memorial?(Required)
Number the Following Clinical Areas in Order of Preference(Required)
Cardiac Telemetry
Emergency Department
ICU
L&D
Medical Surgical
Medical Telemetry
Mother/Baby
Oncology/Medical/Telemetry
Ortho/Neuro/Medical
Progressive Care Unit
Surgery
 
Desired Shift(Required)

Experience

Select the option that indicates your level of performance for each of the following skills.

IVs(Required)
NG Tubes(Required)
Urinary Catheters(Required)
Chest Tubes(Required)
Trach Care(Required)
Suctioning(Required)
Dressings(Required)
Isolation Rooms(Required)
Medication Administration(Required)
Blood Administration(Required)