What position are you looking for? *
— Select —
Registered nurse
Licenced practical nurse
Registered care aide
Office administrative assistant
Coordinator
Companion
Housekeeper
Other
If other, please specify
Name *
Address and postal code
Email address *
Contact number (preferably cell) *
Alternate phone number
Are you eligible to work in Canada? *
— Select —
Yes
No
Select the credential that applies for you
— Select —
RN
LPN
Nursing student (must be at least the second year of your program)
International nurse
International physician
Allied health professional
Other
If selected other or you would like to work in more than one city/ area, please specify
What city/area you would like to work in? *
— Select —
West Vancouver
North Vancouver
Vancouver
Burnaby
Richmond
Coquitlam
Port Coquitlam
Surrey
Langley
New Westminster
White Rock
Delta
Peace Arch
Other
I would like to work in more than one city/ area.
If other, please specify *
If you selected last two options (other city/ area or multiple cities/ areas) please specify in this box.
What shifts do you prefer to work?
— Select —
Days (8, 10, 12 hours)
Nights (8,10,12 hours)
Both day and night shifts (8,10,12 hours)
Short shifts (2–7 hours)
Other
If other, please specify *
What is your availability?
Your availability will help us plan for our staff and clients. Indicate your availability to work for ICB. If you have a planned day off or vacation, we will accommodate it. Please use one of the following options to let us know your availability. You can select from the dropdown menu or you can use an open text box for this purpose.
Mondays *
— Select —
Day Shift (0700–1500)
Evening Shift ( 1500–2300)
Night Shift (2300–0700)
Day Shift (0800-2000_
Night Shift (2000-0800)
Other
If other, please specify
Tuesdays *
— Select —
Day Shift (0700–1500)
Evening Shift ( 1500–2300)
Night Shift (2300–0700)
Day Shift (0800-2000_
Night Shift (2000-0800)
Other
If other, please specify *
Wednesdays *
— Select —
Day Shift (0700–1500)
Evening Shift ( 1500–2300)
Night Shift (2300–0700)
Day Shift (0800-2000_
Night Shift (2000-0800)
Other
If other, please specify *
Thursdays *
— Select —
Day Shift (0700–1500)
Evening Shift ( 1500–2300)
Night Shift (2300–0700)
Day Shift (0800-2000_
Night Shift (2000-0800)
Other
If other, please specify
Fridays *
— Select —
Day Shift (0700–1500)
Evening Shift ( 1500–2300)
Night Shift (2300–0700)
Day Shift (0800-2000_
Night Shift (2000-0800)
Other
If other, please specify *
Saturdays *
— Select —
Day Shift (0700–1500)
Evening Shift ( 1500–2300)
Night Shift (2300–0700)
Day Shift (0800-2000_
Night Shift (2000-0800)
Other
If other, please specify *
Sundays *
— Select —
Day Shift (0700–1500)
Evening Shift ( 1500–2300)
Night Shift (2300–0700)
Day Shift (0800-2000_
Night Shift (2000-0800)
Other
If other, please specify *
If you did not use the previous Dropdown method, please use the following text box to let us know your availability.
Use the text box only if you did not use the Dropdown method for describing your availability.
Please enter your preferred start date if hired (dd/mm/yy).
How many hours per week are you planning to work with ICB? *
— Select —
10 hours or less
10–20 hours
20–30 hours
40 hours
Other
If other, please specify
POSITION-SPECIFIC INFORMATION ABOUT THE APPLICANT
Registered care aides and companions:
Answer only if you are applying for care aid and/ or companionship positions.
Select all the areas that you are skilled or experienced in (credentials and work experience): *
— Select —
Dementia/behavioural clients
Stroke
Elderly care
Degenerative issues (such as ALS or Parkinson’s)
Home Care
Live-in care
Facility/agency
Companionship
Medication support reminders/management
Palliative care
Medical escort
Lift machines
Personal care
Meal preparation
Other
None
If other, please specify *
Which of the following certifications do you currently have?
— Select —
Valid CPR
Valid TB test (completed within the past 2 years)
Valid criminal record check
BC Care Aide Registry number
Medication Management Certificate (care aides only)
Other
If other, please specify
How many years of experience do you have in Canada as a care aide?
— Select —
More than 10 years
5–10 years
3–5 years
1–2 years
Less than 1 year
None
Registered nurses (RNs) and licenced practical nurses (LPNs)
Answer only if you are applying for RN or LPN positions.
I have up-to-date certification of:
— Select —
Full registration with BC College of Nursing Professionals (BCCNP)/ BC College of Nurses and Midwives (BCCNM)
Valid CPR for health care
Wound care certificate
Other specialty certificates
If other, please specify
Select all the departments/programs that you have worked in.
— Select —
Home care
Long-term care (LTC)
Hospice
Community nursing
Acute care
Which of the following areas do you have work experience in?
— Select —
Palliative care
Medical surgical
Intensive care
Wound care (simple and/or complex)
Ostomy management
Post-surgical nursing (e.g., dressing, sutures. and drains)
Inserting/changing Subcutaneous Butterfly
Catheter management (e.g., insertion, change and/or irrigation of Foley catheter, changing Suprapubic catheter)
End-of-life support for client families
Neurological/degenerative issues
Diabetes (management and education)
Vaccination
Select all the medications that you have experience working with in palliative care:
Glycopyrrolate (oral) *
— Select —
Yes, recent experience
Yes, but past experience
No
Glycopyrrolate (sc/sq) *
— Select —
Yes, recent experience
Yes, but past experience
No
Hydromorphone (oral) *
— Select —
Yes, recent experience
Yes, but past experience
No
Hydromorphone (oral) *
— Select —
Yes, recent experience
Yes, but past experience
No
Lorazepam *
— Select —
Yes, recent experience
Yes, but past experience
No
Methotrimeprazine (Nozinan) (oral) *
— Select —
Yes, recent experience
Yes, but past experience
No
Methotrimeprazine (Nozinan) (sc/sq) *
— Select —
Yes, recent experience
Yes, but past experience
No
Morphine *
— Select —
Yes, recent experience
Yes, but past experience
No
Sufentanyl (sublingual) *
— Select —
Yes, recent experience
Yes, but past experience
No
Other medication (please specify)
— Select —
Yes, recent experience
Yes, but past experience
If you selected "Other Medications", please specify:
Please submit your resume. *
Acceptable file formats: PDF and Word document (max file size: 500 KB)