Step-Down Registered Nurse
Saint Louis, MO
Access Healthcare
4x12 hrs, Nights

Job Opportunity: Step Down Registered Nurse

Location: Saint Louis, Missouri
Employment Type: Travel/Contract
Contract Length: 13 weeks

Job Overview

• Work setting: Surgical Progressive Care Unit (Step Down)
• Shift: Night shift, 4 shifts per week, 12 hours each (19:00 - 7:30)
• Patient ratio: 1 nurse to 3 patients on all shifts
• Weekend requirement: Every other weekend
• Floating: May float within service line, including Medical-Surgical units
• Local candidates: Not accepted (home must be at least 75 miles from facility)
• Pending license accepted
• Maximum return-to-office restriction: No more than 7 days
• Guaranteed hours: Minimum 3 shifts per 13 weeks

Specialty & Experience Requirements

• Valid RN license in Missouri
• Minimum 1 year of experience in Progressive Care Unit (PCU) within the last year
• Experience in PCU (Progressive Care Unit) required
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN)
• BLS (Basic Life Support) certification
• ACLS (Advanced Cardiac Life Support) certification issued by the American Heart Association

Required Certifications & Licenses

• Active RN license in Missouri (Primary source verification required)
• BLS (Basic Life Support) - AHA only
• ACLS (Advanced Cardiac Life Support) - AHA only, required for this unit
• Must pass Relias EKG exam (Interpretation and management of dysrhythmias required)
• BSN preferred but not required

Skills & Competencies

• Experience with:

  • Epic electronic health record system
  • Telemetry and Medical-Surgical/Telemetry work settings
  • Blood product administration
  • Isolation precautions
• Unit-specific skills:

  • Cardiac ECG monitoring
  • Central lines and ports care
  • Tracheostomy and laryngectomy care
  • Management of free flaps and leech therapy
  • Arterial lines and drip titration (vasopressors, antiarrhythmics, antihypertensives, insulin, heparin)
• Equipment familiarity:

  • EKG and Phillips central station monitors
  • Bladder scanner, dopplers
  • Sequential Compression Devices (SCDs)
  • Hoyer lifts (ceiling and portable)
  • CPAP/BiPAP machines

Unit Patient Population & Procedures

• Abdominal transplant surgeries (kidney, liver, pancreas)
• Hepatobiliary surgeries (liver resection, Whipple procedure, pancreatectomy)
• ENT surgeries (fresh tracheostomy, laryngectomy, free flap, mandibulectomy, glossectomy)
• Plastic and orthopedic microsurgery (digital/limb replant, flaps, leech therapy, nerve transfers)
• General surgery, trauma, geriatric trauma (gunshot wounds, MVC, polytrauma, TBI)
• Orthopedic surgeries (spinal fusion, hip replacement)

Compliance & Background Requirements

• Government-issued ID required
• Criminal background check within 6 months, including:

  • Statewide searches
  • Highway patrol check (MO)
  • Nationwide and sex offender searches
  • International searches if applicable
• EPLS/GSA/SAM and HHS/OIG quarterly checks
• Education verification of highest nursing degree required before start
• Fingerprinting required for assignments in Illinois long-term care or rehab units
• Drug testing within 1 year of start, including panels for amphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, oxycodone, PCP
• Physical exam within 1 year of start
• Fit mask testing (N95) required and must be renewed annually
• Immunizations and titers required:

  • Tdap vaccine or declination (no exemption in Bone Marrow Transplant Unit)
  • Negative TB test or chest x-ray (2 PPDs or T-Spot/Q-Gold within 1 year)
  • Measles, mumps, rubella, varicella immunity or vaccination (no exemptions in NICU, special care nursery, newborn nursery, or bone marrow transplant unit)
• Seasonal flu vaccination or approved exemption required during flu season (Sept 30 - Apr 1)

Orientation & Facility Policies

• Orientation modules required via online platform (approx. 16 hours) unless completed in current calendar year
• Must review and sign facility policies prior to start:

  • HIPAA Acknowledgement
  • Latex Allergy Questionnaire
  • Confidentiality Form
  • Hand Hygiene Policy
  • Fingernail Policy
  • Dress Code Policy
• Badge photo required (head and shoulders, white background, no obstructions, taken within 6 months)
• Vehicle registration form required for day shift workers
• No on-call requirement

References & Documentation

• Two professional references required (supervisors preferred)
• Unit-specific skills checklist required within 1 year of start
• Employment application must be submitted and uploaded
• Performance evaluations may be requested but are not mandatory for extensions or per diem

Additional Notes

• No block scheduling accommodations
• No local candidates accepted
• Floating within service line expected to meet facility needs
• Must pass unit-specific competency exams annually, including medication/pharmacology and dysrhythmia/EKG competency

This position offers an opportunity to work in a high-acuity step down unit with diverse surgical and trauma patient populations, requiring strong critical care nursing skills and certifications.