ICU Stepdown Telemetry Registered Nurse
Winston Salem, North Carolina
Novant Health Forsyth Medical Center

Travel/Contract Registered Nurse (ICU)

Location: Winston Salem, North Carolina
Contract Length: 13 weeks

Job Overview

• Unit functions like an ICU with a focus on stepdown/PCU/IMC/Telemetry patients.
• Patient acuity includes post-rapid response, respiratory distress, unstable hemodynamics, GI bleeds, post-op surgeries (GYN, GU, GI, thoracotomies, neuro, ortho), and complicated OB patients.
• Patient age range: adolescent to geriatric.
• Average daily census: 18 patients on a 20-bed ICU stepdown unit.
• Target nurse-to-patient ratios: 3:1 or 4:1.
• Shift: 12-hour nights.
• Weekend requirement: every other weekend.
• Floating required as needed to a sister ICCU unit.
• No block scheduling allowed.
• Hospital orientation required during week one with daily classes.
• Must pass EKG competency testing prior to start.

Required Skills & Experience

• Minimum 2 years of ICU or related experience (higher value from data).
• Accepts first-time travelers (no prior travel experience required).
• Strong experience with arterial lines and titrating vasoactive drips.
• Experience with PCU/DOU/IMC/Stepdown and Telemetry monitoring.
• Ability to interpret and manage dysrhythmias.
• Use of Rapid Response Teams.
• IV insulin protocols and blood product administration.
• Central line, peripheral line, and PICC line care/management.
• Heparin protocols.
• Care for patients with CVA, chest tubes (Emerson/Pleur-evac), external CPAP/BIPAP, high flow nasal cannula (HFNC), nasal cannula, non-invasive airway management, and tracheostomy management.
• Knowledge of isolation precautions.
• Experience with IV starts, telemetry, and conscious sedation.
• Only one pressor drip per patient allowed on unit; multiple pressors require transfer to ICU.
• Familiarity with drips including Cardizem, Nitro, Precedex, Cardene, Levophed, Dopamine, Dobutamine, Neo.

Certifications & Licenses Required

• Current Registered Nurse (RN) license for North Carolina.
• ACLS (Advanced Cardiac Life Support).
• BCLS (Basic Cardiac Life Support).
• NIH Stroke Certification.
• Must complete and pass Dysrhythmia/EKG competency exam (minimum 82% score required).
• Other certifications as applicable: PALS, NRP, CHEMO, TNCC, EFM depending on unit needs.
• Must have current immunizations and health screenings including:

  • Negative TB test or chest X-ray within 1 year (or documentation of past positive).
  • Rubeola (Measles), Mumps, Rubella, Varicella immunity or vaccination.
  • Hepatitis B status or declination form.
  • Seasonal flu vaccination or approved exemption during flu season.
• Drug screening within 6 months of start.

Equipment & Systems

• Bedside telemetry monitors with remote backup.
• Use of Pyxis medication dispensing system and Epic electronic health record.
• No ventilators on unit.

Scheduling & Work Conditions

• 12-hour night shifts, 36 or 48 hours offered.
• Floating to sister ICCU unit as needed.
• Weekend work every other weekend.
• No block scheduling allowed.
• RTO (request time off) after booking is not allowed or worked out onsite; max 7 days RTO for auto-offer.

Orientation & Onboarding

• Hospital orientation week one with mandatory daily classes.
• Must pass EKG testing prior to start.
• Photo ID and badge photo required before start.
• Completion of facility-specific education modules and compliance training required.

Patient Population & Diagnoses

• ICU stepdown patients including:

  • Post rapid response team patients
  • Respiratory distress
  • Unstable hemodynamics
  • Withdrawal symptoms
  • GI bleeds
  • Post-operative patients (GYN, GU, GI, thoracotomies, neuro, ortho surgeries)
  • Pre/post OB with complications (e.g., Pitocin use)

Additional Notes

• Scrubs: Navy, white, or combination.
• Must be able to recognize and treat dysrhythmias.
• Floating to sister ICCU unit required.
• No vents on unit; familiarity with non-invasive airway management essential.

This position is ideal for ICU-experienced RNs comfortable with high-acuity stepdown patients, telemetry monitoring, and vasoactive drip management, seeking a 13-week travel contract in North Carolina.