Emergency Department RN
Bismarck, North Dakota
CHI Saint Alexius Health

ER RN: Bismarck, North Dakota

Role: ER RN (Registered Nurse) Location: Bismarck, North Dakota Department: Emergency Room Contract Length: 26 weeks (the RTO policy below references a 13-week contract) Shift: Nights, 12 hours, 48 hours per week

Required Qualifications

• Certifications: BLS, ACLS, PALS, TNCC

Preferred Qualifications

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

Department Overview

• Trauma Level II
• 21 beds/trauma bays, including fast track
• Separate triage area, usually staffed by core staff. Travelers may take triage after time on the unit, if they have previous triage experience.
• Fast track (vertical flow) with chairs; stable patients return to the waiting room. Travelers are used in this area.
• 1 psych room with cameras
• Security office is in the ER and staffed 24/7
• Volume: 50-60 patients per day, mostly ESI Level 3, some Level 4, rarely Level 1
• Nurse-to-patient ratio: 1:3-4 based on acuity, possibly 5 if boarding and grouped
• Common patients: pediatrics to geriatrics, trauma (travelers may take these), CAH transfers, stroke, STEMI, SOB, abdominal pain
• Common drips: vasopressors, heparin, antiarrhythmics; critical care drips for ICU holds are 1:1
• Boarding: ER RN takes boarding patients. Stable patients go to vertical flow; unstable patients stay near the nurses' station.
• Physicians: all MDs, no mid-levels, on site 24/7 (1 overnight until 6 AM, 3 during busiest times)
• Charge nurse on each shift, who manages throughput and helps as needed
• ED techs: usually 1, up to 2 when busy. Duties include EKGs, patient care, vitals, and blood glucose.
• Respiratory therapy: in house, responds as needed, not physically in the department 24/7. RT manages equipment and breathing treatments.
• Telemetry: monitored from the main nurses' station with no techs. RN reads and interprets strips; MD verifies.
• X-ray and CT are next to the ER. Stable patients are transported by CT staff; unstable patients are accompanied by the RN.
• RNs draw labs off IV starts; phlebotomy is available as a resource.

Schedule and Logistics

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

Policies

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