Progressive Care Unit (Step Down) Registered Nurse
Saint Louis, MO
Access Healthcare
3x12 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, 3 shifts per week, 12 hours each (19:00 - 7:30)
• Patient ratio: 1 nurse to 3 patients for all shifts
• Weekend requirement: Every other weekend
• Floating: Floating within service line including Medical-Surgical units
• Local candidates: Not accepted (home address must be at least 75 miles from facility)
• Pending license accepted
• Return to Office (RTO) restrictions: No more than 7 days
• Guaranteed hours: Minimum 3 shifts per 13 weeks

Specialty & Experience Requirements

• Specialty: Registered Nurse (Step Down/Critical Care)
• Minimum experience: 1 year required, 2 years preferred
• Critical care experience highly preferred
• First-time travel nurses accepted
• Prior travel experience: Not required

Required Certifications & Licenses

• Active RN license in Missouri (pending license accepted)
• 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
  • Medical-Surgical/Telemetry/Step Down/Progressive Care Unit settings
  • Blood product administration
  • Isolation precautions
  • Cardiac ECG monitoring and interpretation
  • Central lines and ports care
  • Tracheostomy and laryngectomy care
  • Free flaps and leech therapy
  • Arterial lines
  • Drip titration (vasopressors, antiarrhythmics, antihypertensives, insulin, heparin)
• Equipment familiarity:

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

Unit Patient Population & Procedures

• Surgical Progressive Care Unit includes:

  • Abdominal transplants (kidney, liver, pancreas)
  • Hepatobiliary surgery (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 (GSW, MVC, polytrauma, TBI)
  • Orthopedics (spinal fusion, hip replacement)

Schedule & Work Conditions

• 36 or 48 hours per week available (typically 3 night shifts per week)
• No on-call required
• No block scheduling accommodation
• Floating within service line expected

Compliance & Background Requirements

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

  • Statewide searches
  • Highway patrol check (Missouri)
  • Nationwide and international searches if applicable
• EPLS/GSA/SAM and HHS/OIG quarterly checks required
• Education verification of highest nursing degree required
• Drug testing within 1 year of start, must include standard panels (amphetamines, benzodiazepines, cocaine, opiates, etc.)
• Physical exam within 1 year of start
• Fit mask testing (N95) required and must be renewed annually
• Immunizations and health screenings required:

  • Tdap vaccine or declination
  • Negative TB test or chest x-ray (2 negative PPDs or T-Spot/Q-Gold within 1 year)
  • Measles, mumps, rubella, varicella immunity or vaccination/declination
  • Seasonal flu vaccination or approved exemption during flu season
• Various facility-specific compliance documents required prior to start, including:

  • HIPAA acknowledgement
  • Latex allergy questionnaire
  • Confidentiality form
  • Regulatory compliance education (annual quiz)
  • Hand hygiene, fingernail, and dress code policies
  • Orientation modules (approx. 16 hours, completed via online platform)

Documentation & Other Requirements

• Two professional references required (supervisors preferred)
• Employment application must be submitted
• Unit-specific skills checklist required within 1 year of start
• Competency exams required annually, including:

  • Dysrhythmia/EKG competency exam (Relias or equivalent)
  • Medication/pharmacology competency exam
  • Unit-specific competency exams (e.g., oncology if applicable)

Additional Notes

• Candidates must be prepared to work in a fast-paced, acute care, teaching hospital environment with a Level 1 trauma designation
• Parking is available but not reimbursed; night shift parking is free in employee lots
• Candidates must adhere to all facility policies and complete all required training and documentation before starting assignment

Requirements/Qualifications

• Valid RN license in Missouri
• Minimum 1 year of Progressive Care Unit (PCU) experience within the last year
• BLS certification issued by the American Heart Association
• ACLS certification issued by the American Heart Association
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN)
• Proficient in interpretation and management of dysrhythmias
• Experience with Epic electronic health record system