Step-Down Registered Nurse
Waco, TX
ADN Healthcare
4x12 hrs, Days
Referral Bonus

Registered Nurse - Step Down

Location: Waco, Texas
Employment Type: Long-Term Assignment (LTA)
Contract Length: 13 weeks
Shift: 06:45 AM – 07:15 PM

Job Description / Clinical Experience

• Care for patients requiring HFNC (High Flow Nasal Cannula) and BIPAP (Bilevel Positive Airway Pressure)
• Manage stable GTT (Glucose Tolerance Test) patients
• Post-operative care for CABG (Coronary Artery Bypass Graft), AVR (Aortic Valve Replacement), MVR (Mitral Valve Replacement) on POD#1
• Cardiovascular and vascular experience including AAA (Abdominal Aortic Aneurysm) repair, lobectomy, and CEA (Carotid Endarterectomy)
• Manage patients with NSTEMI, STEMI, ACS (Acute Coronary Syndrome), pacers, sepsis, gastrointestinal bleeding (GIB), post-DKA (Diabetic Ketoacidosis), respiratory failure, and tracheostomies

Required Qualifications

• Valid RN license in Texas
• Minimum 2 years of stepdown nursing experience, including experience within the last year
• BLS certification issued by the American Heart Association
• ACLS certification
• NIHSS certification
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN)
• Valid driver’s license
• Cardiovascular (CV) experience
• Vascular experience

Onboarding and Compliance Requirements

• Submission of current resume/profile and at least two professional references prior to assignment
• Signed assignment agreement required before onboarding
• Completion of specialty competency exams with minimum 80% passing score (Ascension Specialty Exam, EKG Exam, Core Competencies)
• Completion of Epic electronic health record test-out and training checklist with signed attestation
• Completion of onboarding education attestation and nursing contract worker onboarding (onsite)
• Completion of pre-hire modules including Nova StatStrip training
• Criminal background check including Social Security Trace, OIG Search, National Sex Offender Registry, and EPLS within 90 days of start
• Employment and education verifications within 90 days of start; must be updated annually or after break in service > 90 days
• Skills checklist for specialty to be completed within one year of start and updated annually

Health and Immunization Requirements

• Proof of two MMR vaccines or positive IgG titer (no declinations accepted)
• Proof of two Varicella vaccines, serological immunity, or documented history (no declinations accepted)
• Valid Tdap vaccination within last 10 years (no declinations accepted)
• Hepatitis B vaccination series completion or signed declination
• Influenza vaccine recommended during flu season (exemptions accepted with mask requirement)
• 2-step PPD or negative IGRA test within required timeframes; if positive, chest X-ray and TB questionnaire required annually
• Fit test for respiratory protection (preferred prior to start, can be completed onsite)
• Annual health statement or physical exam confirming good health
• 12-panel drug screen within 30 days prior to start and annually thereafter; retesting required after break in service > 90 days

Identification and Documentation

• Valid driver’s license or state ID matching address on file; must show front and back
• Badge photo (optional): forward-facing headshot with white or blue background, no alterations

Additional Notes

• Optional unit-specific checklist may be required by unit leader within one week of assignment start
• Completion of exit survey at assignment completion is optional

This position requires a highly skilled RN with experience in step-down care and cardiovascular/vascular patient management, capable of working long shifts in a fast-paced environment with complex patient needs.