Step-Down RN
Redlands, California
Redlands Community Hospital

Job Opportunity: Step Down Nurse (Registered Nurse)

Location: Redlands, California
Employment Type: Travel/Contract
Contract Length: 13 weeks

Job Summary

• Provide nursing care on a step-down unit with a 1:3 patient ratio involving tracheostomy and ventilator management.
• Manage non-titrated cardiac drips including Amiodarone, Milrinone, Lasix, Cardizem (titrated), Dopamine, and Dobutamine.
• Float within areas of competency such as med/surg, telemetry, and observation units.
• Weekend requirement: minimum 2 weekends per month.
• Use of Omnicell medication system and SBAR communication expected.
• 24-hour orientation provided.
• Navy scrubs required (not provided).
• No local candidates within 50 miles considered.

Required Skills and Experience

• Experience in Medical-Surgical/Telemetry, PCU/DOU/IMC/Stepdown units.
• Ability to manage and interpret dysrhythmias and telemetry monitoring on the unit.
• Use of Rapid Response Teams.
• Care for post-MI patients, feeding tube management, pre/post hemodialysis care, renal failure management.
• Accessing and managing ports, central lines, peripheral lines, and PICC lines.
• Starting IVs and following heparin protocols.
• Management of cardiac and vasoactive drips (non-titrated).
• Care of ventilated patients including tracheostomy management.
• Chest tube care (Emerson/Pleur-evac), external CPAP/BIPAP, and high flow nasal cannula (HFNC).
• Interpretation of arterial blood gases (ABGs).
• Oxygen delivery via nasal cannula and face masks; non-invasive airway management.
• Isolation precautions and wound care including wound vac management.

Preferred Skills

• Post cardiac angiogram care.
• IV insulin protocols and titration of insulin drips.
• Titration of cardiac drips.
• Pre/post neurosurgery patient care.
• Meditech electronic health record experience preferred.

Certifications Required

• Registered Nurse license valid in California.
• NIH Stroke Certification (annual renewal required).
• ACLS (American Heart Association only; RQI not accepted).
• BLS (American Heart Association only; RQI not accepted).

Shift Details

• Day shift, 3 shifts per week, 12 hours each (7:00 AM – 7:30 PM).
• Total 36 hours per week.

Additional Requirements and Information

• First-time travelers with PCU experience and 1:3-4 ratios will be considered.
• Provider support available including interpretation services, lift teams, pharmacy, phlebotomy, physical therapy, radiology, rapid response teams, respiratory services, social services, and unit secretary. Intensivist and hospitalist coverage provided.
• Prior travel experience is not required.

Compliance and Documentation Requirements

• Unexpired government-issued photo ID or passport.
• Background checks including SS trace, county searches (7 years), nationwide, sex offender, and international if applicable.
• EPLS/GSA/SAM and HHS/OIG checks within 30 days of start.
• Drug screening (10-panel including THC) within 30 days of start.
• Immunizations and health screenings including:

  • COVID vaccination plus booster or approved exemption.
  • Flu vaccine or declination by October 31 annually.
  • Tdap within 10 years or declination.
  • Negative TB test or chest X-ray as applicable.
  • Titers or vaccinations for Rubeola (Measles), Mumps, Rubella, Hepatitis B, and Varicella.
• Physical exam within last 12 months, updated annually.
• Fit mask testing with approved respirators prior to start.
• Signed acknowledgments for job description, physical demands, abuse reporting, confidentiality, code of conduct, sexual harassment, drug-free workplace, and other facility-specific policies.
• References: 2 professional references within 3 years required for Vaya.
• Employment application and skills checklist required annually.
• Work history verification of most recent employer.

Notes

• Navy scrubs are required but not provided.
• No local candidates within 50 miles will be considered.
• Orientation lasts 24 hours.
• Single set of respiratory therapy orders up to 7 consecutive days will be considered.

This position offers a challenging and rewarding opportunity for experienced step-down nurses comfortable with complex cardiac and respiratory care in a telemetry/PCU environment.

Requirements/Qualifications

• Valid Registered Nurse (RN) license in California
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN)
• Minimum 1 year of stepdown nursing experience, with recent stepdown experience within the last year
• Current ACLS certification issued by the American Heart Association
• Current BLS certification issued by the American Heart Association
• NIH Stroke Scale (NIHSS) certification
• Experience managing vasoactive drips without titration
• Care of ventilated patients including tracheostomy management
• Experience with external CPAP/BIPAP and high flow nasal cannula (HFNC)
• Pre- and post-hemodialysis patient management
• Blood product administration (BPA) experience
• Central line care and management
• Knowledge and adherence to heparin protocols
• Care of post-myocardial infarction (post-MI) patients
• Care of cerebrovascular accident (CVA) patients