Stepdown RN
Martinsburg, WV
Access Healthcare
3x12 hrs, Rotating

Stepdown RN, 2 South

Location: Martinsburg, West Virginia Contract Length: 13 weeks Schedule: 12-hour day or night shifts (7:00 to 7:30), 48 hours per week Unit: 2 South, 2nd floor, 20 private rooms Unit Status: Currently telemetry only. Stepdown is not active, and no return date has been given.

Required Qualifications

• BLS
• ACLS
• NIHSS
• Prior travel experience required: at least 1 year of travel experience

Assignment Details

• Ratio: 1:5 for both day and night shifts
• Weekends: Every other weekend required. Day shift works Saturday/Sunday, night shift works Friday/Saturday.
• Holidays: Every other holiday, including Memorial Day, 4th of July, Labor Day, Thanksgiving, Christmas, and New Year's
• Scheduling: Schedule requests are entered at least 2 weeks in advance, for 4 weeks at a time. Block scheduling is allowed if written into the contract. Pay period runs Sunday to Saturday.
• Floating: Nurses are first to float. They may float to a comparable or lower-level unit (telemetry or med/surg). Occasionally staff help with admitted boarded patients in the emergency department or telemetry patients housed in the ICU.
• Precepting/Charge: Travelers may be asked to precept or take charge, depending on comfort level. This is discussed first, and the request is respected if there is no comfort level.

Patient Care and Unit Overview

• Cardiac monitoring: 10 rooms have hardwired monitors. The rest are portable telemetry-capable. Monitor techs are on the 6th floor and call the assigned nurse about issues. Nurses must understand basic dysrhythmias and verify telemetry strip interpretation.
• Strip review: Strips are reviewed every 4 hours and exported to the chart. Nurses must document the strip, rhythm, and review in the chart.
• Drips: Cardizem, amiodarone, labetalol, dopamine, dobutamine, heparin, Integrilin per protocol, nitroglycerin, Ativan, and insulin. Drips are set-rate only for now; titration is not currently done.
• Respiratory: BiPAP, CPAP, and high-flow managed per RT
• Common patients: Elevated troponin without titration, no DKA, no ventilators, active chest pain, pre/post cath with or without intervention, post-STEMI after ICU recovery, NSTEMI, peritoneal dialysis (training provided), pacemakers, and occasional post-surgical patients (hip if orthopedics is full or a cardiac issue exists), and oncology (if full)

Support Staff and Coverage

• Hospitalist: In-house 24/7
• RT: In-house 24/7
• Pharmacy: In-house 24/7 and on the unit during the day
• IV team: None. Nurses place IVs and draw labs from central lines only with an order.
• Patient care techs (PCTs): 2 PCTs for 20 beds, with a goal of 3 per floor when fully staffed. PCTs ambulate patients, do fingerstick glucose checks, take vitals, bathe, document intake and output, feed, and turn patients. They share Q2-hour rounding with nurses.
• Charge nurse: Varies daily. Sometimes a floating charge nurse covers the 2nd and 6th floors. Otherwise, each floor has a charge nurse who also takes a full assignment.

Orientation

• Day 1: Required education modules and shadowing. Report to the corporate center for a badge and parking pass, then to the 2nd floor.
• Day 2: Orientation shift
• Day 3: Independent shift

Dress Code

• Navy blue scrubs
• Navy or white jacket
• White or navy undershirt
• Natural hair color only
• No pink, purple, or blue
• Cover distasteful tattoos