Step-Down RN
Saint Louis, MO
Access Healthcare
3x12 hrs, Days

Registered Nurse - Step Down Unit (Travel/Contract)

Location: Saint Louis, Missouri
Contract Length: 13 weeks

Unit & Shift Details

• Unit: Step Down (Acute Care Hospital)
• Shift: Day, 3 shifts per week, 12 hours each (7:00 AM - 7:30 PM)
• Guaranteed Hours: 36 hours per week (3 x 12-hour shifts)
• Patient Ratio: 1 nurse to 4 patients
• Weekend Requirement: 2 shifts every other weekend

  • Day shift weekends: Saturday and Sunday every other weekend
  • Night shift weekends (if applicable): Friday/Saturday or Saturday/Sunday depending on rotation
• Floating: Yes, float to lower acuity floors within scope as needed
• Local Radius Rule: 75 miles (locals not accepted)
• Pending License Accepted: Yes
• On-call: No
• Block Scheduling: Not accommodated

Required Experience & Skills

• Minimum 2 years of Registered Nurse experience (highest requirement)
• Must have recent bedside experience within the last 6 months
• Clinical skills required:

  • Ventilator management
  • Titration of vasopressors and sedation medications
  • Insulin drips
  • Management of tracheostomy vents, arterial lines, external pacemakers, chest tubes

Required Certifications

• ACLS (Advanced Cardiac Life Support) - AHA only
• BLS (Basic Life Support) - AHA only
• NIH Stroke Certification (required for all nurses)
• Additional certifications may be required based on unit specifics (verify during onboarding)

Licensure

• Valid Registered Nurse license for Missouri (Primary Source Verification required via NURSYS)
• Missouri licenses verifiable only on NURSYS; upload verification accordingly
• Illinois temporary licenses require approval and permanent license for extension (if applicable)

Compliance & Background Requirements

• Government-issued ID required (e.g., Driver’s License or State ID)
• Criminal background check within 6 months, including:

  • 7-year search with statewide and nationwide components
  • State-specific checks for Missouri (EDL, Highway Patrol, Family Care Safety Registry)
  • Quarterly EPLS/GSA/SAM and HHS/OIG checks
• Education verification of highest nursing degree required before start
• Fingerprinting required for assignments or float to long-term care or rehab units in Illinois
• Drug testing within 1 year of start, including a comprehensive panel (amphetamines, benzodiazepines, opiates, etc.)
• Physical exam within 1 year of start
• Fit mask testing (N95) required and must be renewed annually; onsite testing available if needed
• Immunizations and health documentation required:

  • Tdap vaccine or declination (cannot decline in Bone Marrow Transplant Unit)
  • Negative TB test or chest x-ray within 1 year (two-step PPD or equivalent)
  • Measles, Mumps, Rubella, Varicella immunity or vaccination (no exemptions in certain units)
  • Seasonal flu vaccination or approved exemption required during flu season (Sept-April)
• HIPAA Acknowledgement, Latex Allergy Questionnaire, Confidentiality Form, Hand Hygiene, Fingernail, and Dress Code policies must be reviewed and signed prior to start
• Regulatory Compliance Education completed annually via online training platform
• Employment application and unit-specific skills checklist required within 1 year of start
• Two professional references required (supervisors preferred)

Requirements / Qualifications

• Valid Registered Nurse (RN) license in Missouri
• Minimum 2 years of Progressive Care Unit (PCU) experience, with at least 1 year of recent PCU experience within the last year
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN)
• Current ACLS certification issued by the American Heart Association
• Current BLS certification issued by the American Heart Association
• NIH Stroke Scale (NIHSS) certification
• Clinical experience with ventilator management
• Experience with titration of vasopressors (pressors)
• Experience managing insulin drips
• Experience with sedation medication administration and management
• Experience caring for patients with tracheostomy ventilators (trach vent care)
• Experience managing arterial lines (art lines)
• Experience managing external pacemakers

Additional Notes

• Must be able to work 3 consecutive 12-hour day shifts per week with weekend rotation
• No first-time travelers accepted for this position
• Badge photo required (head and shoulders, white background, no obstructions, taken within 6 months)
• Orientation modules required for all RNs, approximately 16 hours of online training
• Candidate may be required to float to lower acuity floors as needed
• No guaranteed block scheduling or local hires accepted

This position is ideal for experienced Registered Nurses with strong critical care skills in ventilator and drip management, seeking a travel contract in an acute care step down unit with a structured day shift schedule.