ER RN
Bismarck, North Dakota
CHI Saint Alexius Health

ER RN

• Location: Bismarck, North Dakota
• Department: Emergency Room (RN)
• Contract Length: 13 weeks
• Shift: Nights, 12-hour shifts, 36 hours per week
• Trauma Level: Level II

Required Qualifications

• BLS, ACLS, PALS, and TNCC certifications

Preferred Qualifications

• Previous travel experience (first-time travelers are considered)

Department Details

• 21 beds/trauma bays, including fast track
• Fast track uses a vertical flow area with chairs; stable patients return to the waiting room while the MD enters orders. Travelers are used in vertical flow.
• Separate triage area. Core staff usually triage. Travelers may take triage competencies after time on the unit, if they have previous experience.
• ER RNs take boarding patients. Stable patients go to vertical flow; more unstable patients stay close to the nurses station.
• 1 psych room with cameras
• Security office is in the ER and staffed 24/7
• ED physicians are all MDs (no mid-levels), on site 24/7: 1 MD overnight until 6 AM and 3 MDs during the busiest times

Patient Population and Acuity

• Approximately 50-60 patients per day, mostly ESI Level 3, some Level 4, and rarely Level 1
• Nurse-to-patient ratio: 1:3-4 based on acuity, possibly 1:5 if boarding and grouped together
• Common patients: peds to geriatrics, traumas (travelers may take these), CAH transfers, stroke, STEMI, SOB, abdominal pain, and others
• Common drips: vasopressors, heparin, antiarrhythmics; critical care drips for ICU holds are 1:1

Staffing and Support

• 1-2 ED techs per shift, who perform EKGs, patient care, vitals, and blood glucose checks
• Charge nurse manages department throughput and acts as a helping hand; charge nurse does not take a patient assignment
• RT is in house but not physically in the department 24/7; RT arrives as needed and handles ventilators, CPAP/BiPap, high-flow equipment, and breathing treatments
• Telemetry monitored from the main nurses station with no monitor techs; RNs read and interpret strips, and MD verifies
• X-ray and CT are next to the ER; CT transports stable patients, and the RN accompanies unstable patients
• RNs draw labs off IV starts; phlebotomy is available as a resource

Scheduling and Float

• 12-hour shifts with varied start times: 7a-7p, 9a-9p, 11a-11p, 2p-2a, 7p-7a
• Manager schedules based on need and staff availability and will try to accommodate block scheduling
• Weekends: every other weekend
• Holidays: every other holiday
• Floating: rare, based on census and staffing, to tasks or as helping hands; first to float
• Orientation: 1-2 shifts in the ER
• Scrubs: any color

Other Requirements

• Radius: 50 miles
• Candidates may not hold full-time, part-time, or PRN positions with any affiliated facility in the health system.
• Requested time off (RTO) must be submitted upfront: 7 or fewer days per 13-week contract. Additional RTO will not be approved, including after submission.