ICU RN
Fremont, Nebraska
Fremont Health Medical Center

Medical/Surgical RN (Nights), Fremont, Nebraska

Overview

• Location: Fremont, Nebraska
• Contract length: 13 weeks, starting ASAP
• Shift: Nights per the job data (the description mentions day shift)
• Hours: 12-hour shifts, 36 hours per week
• Unit: Mixed unit, 50/50 ICU and Med-Surg
• Beds: 3rd floor, 24 Med-Surg beds; 4th floor, 10 Med-Surg beds; ICU, 8 beds

Required Qualifications

• Minimum 3 years of experience
• BLS certification (Med-Surg and ICU)
• ACLS certification (ICU)
• Telemetry nursing experience
• Ability to read strips and manage set-rate drips
• ICU: ability to interpret telemetry, manage multimodal sedation and vasopressor drips, manage ventilators with RT support, manage sepsis, and care for arterial lines

Patient Population and Acuity

• Med-Surg diagnoses: Ortho, post-cath/pacer, CHF, COPD, diabetes, pneumonia, NSTEMI, oncology (chemo-certified nurses administer chemo), COVID
• ICU diagnoses: DKA, sepsis/shock, ETOH withdrawal, acute respiratory failure, acute Afib/RVR
• Med-Surg ratios: Days 1:4-5 (aim for 4); nights 1:5-6 (aim for 5)
• ICU ratios: 1:2; PINS 1:3

Titratable and Set-Rate Drips

• Med-Surg: Titrating heparin and Lasix; set rates for dobutamine, amiodarone, Cardizem, and Lopressor
• ICU: Vasopressors, sedation drips, dobutamine, amiodarone, heparin, Cardizem, and Lopressor

Support Staff and Oversight

• Charge nurse: One each shift; does not take an assignment. ICU charge nurses are ICU-trained.
• House supervisor: Nights 365 days; days on weekends and holidays
• Nurse aids/patient care techs: Med-Surg ratios of 1:8 (days) and 1:10 (nights). ICU techs provide support but are not always assigned to ICU patients.
• Hospitalist and eICU: Hospitalist in house 24/7, plus eICU support
• RT: RT is in house 24/7 but not on the unit; responsible for oxygen titrations. RT manages respiratory equipment applications. Med-Surg uses stable BiPAP and CPAP. RNs in ICU are not required to do anything with respiratory equipment beyond troubleshooting.

Monitoring

• Telemetry monitoring is done by a tele tech at a central station. Strips are read and entered for RN review.
• RNs must visualize and document details in the electronic record.
• Monitor stations on the unit allow direct review.

Scheduling and Attendance

• Shifts are 12 hours, 6:45 to 7:15
• Scheduler considers traveler requests; block scheduling is allowed at times
• Permanent staff trade days when needed; extra shifts are typically available
• Weekends: every other weekend
• Holidays: rotate with core staff
• On call/standby: none required; traveler may volunteer for on-call

Floating

• Med-Surg: may float to 4th-floor Med-Surg
• ICU: may float to Med-Surg

Orientation

• Med-Surg: one 12-hour shift
• ICU: one to two 12-hour shifts (one Med-Surg day and one ICU day), plus three 12-hour night shifts

Dress Code

• Scrubs in Pewter Gray