Step-Down Registered Nurse
Manchester, New Hampshire
Elliot Hospital

Job Opportunity: Step Down Nurse (Registered Nurse)

Location: Manchester, New Hampshire
Employment Type: Travel/Contract
Contract Length: 13 weeks

Job Overview

• Work on a brand new step-down unit expected to open by 3/8/2026.
• Flexibility required due to new unit setup.
• Accepting ICU RNs interested in step-down care.
• Patient ratio: 1:3
• Average daily census: 11 patients
• Unit has 12 beds/rooms.
• Floating expectations include assisting ICU and ED as part of a team nursing approach.
• Weekend requirement: every other weekend.
• Patient diagnoses include respiratory failure, diabetic ketoacidosis, sepsis, post-surgical care (neuro, cardio-thoracic, general), stable single organ trauma, and stroke.

Required Qualifications

• Valid RN license in New Hampshire
• Minimum 2 years of step-down nursing experience, with step-down experience within the last year
• Completion of at least one travel nursing assignment
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN)
• ACLS certification issued by the American Heart Association
• BLS certification issued by the American Heart Association
• NIH Stroke Scale (NIHSS) certification
• Experience with Epic electronic medical record system

Unit & Clinical Details

• Special procedures: arterial/central line management, telemetry, Bipap/high flow, epicardial wires, chest tubes
• Equipment: lifts in every room, noninvasive fluid management system, air taps for certain patient criteria, telemetry monitoring
• Documentation and communication systems: Omnicell, EPIC, SBAR
• Orientation: 36 hours
• Scrubs: Any color

Work Environment & Expectations

• Team nursing approach with "Helping Hands"
• Floating to ICU and ED as needed
• Patient sitting duties
• Will not take patients outside clinical assignment or team
• Must be flexible with unit opening and workflow changes

Compliance & Background Requirements

• Background check within 30 days of start including social security verification, national sex offender registry, criminal searches (excluding NH counties), and others as specified
• Drug screen: 10-panel within 14 days of start (with limited grace period)
• Physical exam within 1 year prior to start
• Annual fit mask test required (N95 or equivalent)
• Immunizations and titers required:

  • Flu vaccine (or approved medical/religious exemption)
  • Tdap within last 10 years
  • Negative TB test or chest x-ray with TB questionnaire
  • Measles, Mumps, Rubella (MMR) immunity or vaccination
  • Hepatitis B immunity or vaccination (declinations require waiver)
  • Varicella immunity or vaccination
• Respiratory safety clearance required
• Two professional references within last 3 years, including one from a supervisor or charge nurse
• Employment application and skills checklist required

Additional Notes

• Travelers who have ever been employees of the associated health system are not eligible.
• Floating expectations include assisting in ICU and ED units.
• Pass/fail dysrhythmia testing may be required depending on unit assignment.
• Facility requires various state and facility-specific releases and attestations.

This position is ideal for experienced step-down or ICU RNs with prior travel contract experience who are comfortable working in a new unit environment with a team nursing model and flexible floating assignments.