Service Provider Questionnaire
Hello there! Thank you for your interest in the nurse contractor position with The Cure IV and its affiliates.

Please READ all information below before completing the questionnaire below. If you are unable to meet one or more of the requirements listed below, please reconsider applying for this position. Thank you!

Please note the following:

- For providers in Los Angeles Area: the majority of our current clients live in the Hollywood/ West Hollywood/Beverly Hills and surrounding areas within 12.5 miles one way. This contract requires nurses who are willing and able to drive to these areas to provide in-home services to our clients. The service area includes appointments that are sometimes in the hills where roads are narrow and windy at times. - A requirement for this position you are confirming your willingness to travel to such appointments in the hills and the serving area. 

- For providers in Miami Area: This contract requires nurses who are willing and able to drive to house calls in Miami-Dade County and surrounding areas within 12.5 miles one way.

REQUIREMENTS 

-  A requirement of all our nurses is that each nurse has successfully placed AT LEAST 2,000 peripheral intravascular (IV) lines.

- A requirement of all our nurses is that you are willing and able to (when provided with PEE) see patients that have possible or confirmed influenza, covid, and/or RSV.

- A requirement for this position is all nurses must have direct access to their own vehicle for commuting to and from house calls. This is a fully MOBILE position. 

- A requirement for this position - all nurses must have active NSO Policy. It generally costs between $92-119 for the year. More info on NSO Policies can be found at nso.org.

- An expectation of all our nurses is that each nurse must maintain a minimum of a 97%+ success (first stick) for all our clients. 

- An expectation of our nurses is that you are able to commit to at least 6 months or longer of providing services. Preference is 12 months of commitment.  

- An expectation of our nurses is that you are experienced with administering common IV push and/or IM medications such as toradol, famotidine, diphenhydramine and ondansatron. 



Email *
First and Last name *
What is your phone number *
How did you hear about us?
Clear selection
What city and state are you currently living in?  *
Are you currently working as a travel nurse or do you plan on becoming a travel nurse within the next year?
Clear selection
One of the requirements for this contractor position is the contractor's ability to travel to and from appointments. Are you able to travel at least 25 miles to an appointment? *
One of the requirements of this contract position is to have successfully placed more than 2,000 peripheral IVs. Have you successfully placed at least 2,000 IVs successfully? *
What shift are you currently working? *
What is your current work schedule? *
What department are you currently working in? *
What departments do you have experience working in? *
Required
Currently, how many shifts do you work per week? *
What year did you do your first IV in a clinical setting? *
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On average, how many IVs are you placing during one shift? *
On average, how many IVs are you currently starting per week? *
Using the total number of IVs you start per week, what percentage of the total number are you successfully placing the IV on the first stick?
Clear selection
If you had to insert an IV on 100 patients ages 18-65, all who are generally healthy and without medical history. How many of them would you successfully place their IV on the first stick? Please give a number. *
How many nurses work with you in your current department? TOTAL. Not just on your shift. An estimate is ok. *
Out of the number of people in your entire department, how many of them are better at IV insertion than you? *
Critical Thinking/Knowledge Q: What do you do for a patient who has lymphedema and you need to place an IV for life/death situation.  *
Critical Thinking/Knowledge Q: What are conditions or disease processes that make IV insertion difficult for you? *
How many hours per week are you interested in working for this position?
Clear selection
For this position, which days are you available to work? *
Required
Which months can you not work over the next 12 months? *
Required
Travel/gas reimbursement is available. And for this position, RNs are required to drive to and from appointments. What vehicle do you currently drive? (Make and model) *
The software we use requires an iPhone for use. For this position - *
If you were given the PPE required, are you willing and able to see covid positive patients?
 *
Are you able to commit to this position for a minimum of 6 - 9 months? *
Are you experienced with administering common IV push and/or IM medications such as toradol, famotidine, diphenhydramine and ondansatron?
 *
Are you experienced and comfortable with administering provider ordered IV fluid boluses? Such as 1,000-2,000 mL of LR or NS over 30-60 minutes. *
Please explain how to prevent AND treat vasovagal syncope in a patient afraid of needles.  *
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