Step-Down RN
Saint Louis, MO
Care Career
3x12 hrs, Nights
Referral Bonus

Travel Registered Nurse (RN) – Cardiothoracic Step-Down / PCU

Specialty: Step-Down / Progressive Care Unit (PCU)
Shift: Nights, 4x12-hour shifts
Shift Timing: 7:00 PM – 7:30 AM
Guaranteed Hours: 36 or 48 hours per week (candidate may choose)
Contract Duration: 13 weeks 
Experience Required: Minimum 2 years
Patient Ratio: 1:5; may range from 1:3 to 1:5 depending on acuity
Certifications Required: BLS, ACLS
Charting System: Epic
Floating: Required within the service line
Local Candidates: Not accepted within a 75-mile radius
COVID-19 Vaccine: Not required
Flu Vaccine: Required; medical or religious exemptions only

Job Description

Seeking an experienced Travel RN for a Cardiothoracic Surgery Step-Down/PCU unit. The ideal candidate must have strong PCU experience caring for post-operative cardiac surgery patients, including CABG, valve replacement, TAVR, and other complex cardiothoracic procedures.

Required Qualifications

• Minimum 2 years of nursing experience.
• Strong PCU/Step-Down experience.
• Experience caring for post-operative cardiac surgery patients.
• Experience with CABG, MVR, AVR, and TAVR patients.
• Experience managing temporary pacemakers and epicardial wires.
• Experience with chest tubes.
• Experience titrating IV cardiac drips.
• Cardiac telemetry and dysrhythmia interpretation skills.
• BLS and ACLS certifications.
• Epic experience preferred.
• Must be flexible to float between PCU and Cardiac Telemetry units.

Unit & Facility Details

• Facility Type: Short-Term Acute Care Hospital.
• Hospital Type: Magnet and Teaching Hospital.
• Trauma Level: Level I.
• Total Staffed Beds: 1,273.
• EMR: Epic.
• Scrub Color: Navy Blue.
• Parking: $15/day or $70/month.
• Patient Population: Adult cardiothoracic surgery and cardiac patients.
• Daily Census: Approximately 30 patients.

Unit Overview

The Cardiothoracic Surgery Step-Down unit provides care to adult patients before and after cardiothoracic surgery, including patients transferring from the ICU through discharge.

Common procedures and patient conditions include:

• Coronary artery bypass grafting (CABG).
• Mitral valve repair or replacement (MVR).
• Aortic valve repair or replacement (AVR).
• Aortic aneurysm repair.
• Maze procedures.
• Transcatheter aortic valve replacement (TAVR).
• Heart transplant.
• Left ventricular assist device (LVAD) implantation.
• Cardiac overflow, chest pain, and pre-operative cardiac care.
• Post-cardiac catheterization care.

Clinical Responsibilities

• Provide nursing care to post-operative cardiothoracic surgery patients.
• Monitor cardiac telemetry and interpret dysrhythmias.
• Manage chest tubes and temporary pacemakers.
• Monitor and manage epicardial pacing wires.
• Administer and titrate IV cardiac medications and drips.
• Monitor patients receiving cardiac and vasoactive medications.
• Provide central-line, PICC-line, and peripheral-line care.
• Administer blood products and follow heparin protocols.
• Provide pre- and post-cardiac catheterization care.
• Recognize changes in patient condition and activate rapid response or code teams when necessary.
• Collaborate with the interdisciplinary team to support patient recovery and discharge planning.

Schedule & Requirements

• Night shifts: 7:00 PM – 7:30 AM.
• Four 12-hour shifts per week.
• Every other weekend required.
• No on-call requirement.
• Block scheduling is not available.
• Floating required between the PCU and Cardiac Telemetry units.
• Start date: Approximately 3–4 weeks after compliance clearance.
• Candidates may select 36 or 48 hours per week.

Time-Off & Submission Requirements

• All requested time off (RTO) must be submitted upfront.
• Maximum 7 days of RTO per 13-week period; requests exceeding 7 days require manager approval.
• No RTO is allowed during the first week of the assignment.
• No additional RTO or scheduling requests may be submitted after submission, offer, or start.
• Candidates must confirm their preferred weekly commitment of 36 or 48 hours at submission.
• License requirements depend on the applicable state:
  • Missouri: Missouri or qualifying Compact license required; submission without a license may be permitted.
  • Illinois: License must be in hand at submission.
  • Compact license: Must match the candidate's permanent residence; an update and ETA confirmation may be required if it does not.
• Compliance deadline: 3:00 PM CST on the Monday before the week of the initial start date.
• Labs must be completed within 48–72 hours of signing.
• Required modules must be completed by the specified compliance deadline.
• Travelers must meet facial hair requirements for fit testing; shaving may be required.

 Screening Checklist

1. Experience: At least 2 years of nursing experience.
2. PCU experience: Strong Step-Down/PCU experience required.
3. Cardiac surgery: Post-CABG, MVR, AVR, and TAVR experience.
4. Critical skills: Temporary pacemakers, epicardial wires, chest tubes, and titrating IV drips.
5. Certifications: BLS and ACLS.
6. Charting: Epic experience.
7. License: Appropriate state or Compact license status.
8. Availability: Every other weekend and night shifts.
9. Floating: Willing to float between PCU and Cardiac Telemetry.
10. RTO: All time-off requests disclosed upfront.
11. Location: Candidate must live outside the 75-mile exclusion radius.