Emergency Room Registered Nurse
Bismarck, North Dakota
CHI Saint Alexius Health

Registered Nurse (RN) – Emergency Room

Location: Bismarck, North Dakota
Contract Length: 13 weeks
Shift: Nights
Hours: 12-hour shifts (typical start times: 7p-7a)
Weekend/Holiday Requirements: Every other weekend and holiday
Orientation: 1-2 shifts of unit-specific orientation

Unit Overview

• Trauma Level II Emergency Room with 21 beds including fast track
• Average patient volume: 50-60 patients per day, mostly ESI Level 3, some Level 4, rarely Level 1
• Patient population ranges from pediatrics to geriatrics, including trauma cases, stroke, STEMI, shortness of breath, abdominal pain, and CAH transfers
• Nurse-to-patient ratio typically 1:3-4 based on acuity; may be 1:5 if boarding patients are grouped together
• Separate triage area staffed primarily by core staff; experienced travelers may take triage after competency validation
• Separate psych/seclusion room with camera monitoring
• Security is in-house 24/7 and located within the ER
• Fast track area with vertical flow for stable patients

Staffing & Support

• Emergency Department staffed 24/7 by MDs only (no mid-level providers)
• Charge nurse manages department throughput and assists but does not take patient assignments
• 1-2 ED techs per shift assist with EKGs, vitals, blood glucose, and patient care
• Respiratory therapists available as needed (not 24/7 in ER); handle ventilators, CPAP, BiPAP, high flow oxygen, and breathing treatments
• No dedicated Telemetry/Monitor techs; RNs interpret cardiac strips and MDs verify
• X-Ray and CT located adjacent to ER; stable patients transported by CT tech, unstable patients accompanied by RN
• Phlebotomy available as a resource; RNs draw labs from IV starts

Required Certifications & Skills

• BLS (Basic Life Support)
• ACLS (Advanced Cardiovascular Life Support)
• PALS (Pediatric Advanced Life Support)
• TNCC (Trauma Nursing Core Course)
• Experience with common critical care drips such as vasopressors, heparin, and antiarrhythmics
• Ability to manage ICU holds requiring 1:1 care for critical drips
• Prefer previous travel experience but open to first-time travelers

Scheduling & Other Details

• Scheduling managed by manager with attempts to accommodate block scheduling
• Floating is rare and only as needed to assist or for specific tasks
• Dress code: any color scrubs allowed
• Return to Office (RTO) required within 7 days of contract start; no additional RTO approvals after submission
• Radius rule: candidates must live within 50 miles and may not be currently employed full-time, part-time, or PRN with any related facilities

Required Qualifications

• Valid RN license for North Dakota
• Minimum 3 years of Emergency Room nursing experience (based on specialty code and job requirements)
• Current certifications: BLS, ACLS, PALS, TNCC

Additional Notes

• Trauma Level II designation indicates moderate to high acuity patient care environment
• Nurses may be required to take boarding patients and manage patient flow between vertical flow and main ER areas
• Critical thinking and ability to work independently in a fast-paced environment are essential