Ortho-Neuro Surgical Stepdown RN
Rapid City, SD
Olaro
3x12 hrs, Nights

Job Opportunity: Ortho Neuro Surgical (ONS) Nurse

Location: Rapid City, South Dakota
Facility: Rapid City Hospital, Monument Health

Unit Overview

• 64 beds across 2 floors
• Mixed acuity unit: Intermediate Care (Stepdown), Telemetry, MedSurg
• Patient types include:

  • Surgical: urology, prostatectomy, bowel obstruction, mass removal, cholecystectomy, appendectomy, general abdominal surgeries
  • Ortho: total joints (knees/hips/shoulders), ortho trauma, external fixation, soft tissue injury, minor fractures
  • Neuro/Spine: CVA/TIA with neurovascular interventions (coiling, clipping, thrombectomy), seizures/epilepsy, brain tumors, hematomas, aneurysms, AV malformations, craniotomies, shunts, halos, flaps
  • Spinal surgeries: laminectomies, fusions, discectomies
  • General medical: cellulitis, influenza, COVID, pneumonia, COPD, CHF, renal failure (with/without hemodialysis), hepatic failure, rib fractures, GI disorders, DVTs, UTIs
  • Wound care and telemetry monitored patients

Experience & Skills Required

• Minimum 1 year nursing experience (Intermediate/Stepdown RN level)
• EPIC experience required (mandatory for first-time travelers)
• Comfort with MedSurg assignments is essential
• Experience with IMC/stepdown acuity and neuro patients preferred
• Ability to manage:

  • Cardiac strips interpretation
  • Chest tubes, trach care (no fresh trachs)
  • NGT tube placement and management
  • JP drains
  • Line management (PICC, Midline, CVL, PIV)
  • Wound care/dressing changes and wound vac assessment (RN changes wet/dry dressings if needed)
  • Medication administration including TPN, tube feeding, blood transfusions
• Drip titration experience with: Heparin, Insulin, Cardizem, Amiodarone, Levophed (up to 5 mcg), esmolol (training provided if needed), beta blockers, and other antihypertensives

Certifications & Education

• RN license approved by South Dakota Board of Nursing
• Required certifications: BLS, ACLS, NIH Stroke Scale (NIHSS)

Patient Ratios & Unit Support

• RN to patient ratio: 1:4 (including MedSurg assignments)
• CNA to patient ratio: 1:8
• Pod structure: 8 patients per pod, staffed with 2 RNs and 1 CNA
• Two dedicated charge nurses (no patient load)
• Flex nurse coverage daily from 10am-10pm
• Phlebotomy available on unit
• Respiratory Therapist (RT) and Hospitalist support available
• No IV/VAT team

Charting Systems

• Epic (required)
• Alaris
• Omnicell

Floating & Orientation

• Floating within scope to any adult inpatient unit including Med Surg, Ortho/Neuro/Surgical, Heart and Vascular, Oncology, Observation
• Orientation includes:

  • 2 days classroom and online learning with Nursing Professional Development Team
  • 2 shifts on unit with preceptor

Scheduling & Time Off

• 6-week schedules
• Weekend rotation: up to 4 out of 6 weekends (Friday-Sunday)
• No mandatory on-call; optional on-call for extra shifts if staffing allows
• Holiday time off requires prior approval; currently no holiday RTO accepted
• Up to 1.5 weeks off approved if contract extended to full 13 weeks
• Blackout dates: August 1-18 (Sturgis Motorcycle Rally) – no time off approved

Additional Notes

• Scrub color: Navy Blue
• Free parking available
• Monthly audits for pre/post pain scoring with 90% compliance required

This position is ideal for nurses with intermediate/stepdown experience who are comfortable managing a diverse patient population including ortho, neuro, surgical, and general medical cases in a supportive team environment.