Step-Down Registered Nurse (RN) Job Description
Job Title: Step-Down Registered Nurse (RN)
Department: Progressive Care Unit (PCU) / Step-Down Unit
Reports To: Nurse Manager / Director of Nursing
Position Summary
The Step-Down Registered Nurse (RN) provides specialized nursing care to patients requiring a higher level of monitoring and treatment than a medical-surgical unit but who do not require intensive care unit (ICU) services. The RN is responsible for assessing, planning, implementing, and evaluating patient care while collaborating with the interdisciplinary healthcare team to ensure optimal patient outcomes and safe transitions throughout the continuum of care.
Essential Duties and Responsibilities
- Perform comprehensive nursing assessments and develop individualized patient care plans.
- Monitor and care for patients with complex medical, surgical, cardiac, respiratory, and neurological conditions requiring continuous observation and frequent assessments.
- Interpret cardiac telemetry rhythms and promptly identify and respond to changes in patient condition.
- Administer medications, intravenous therapies, blood products, and treatments according to physician orders and established protocols.
- Manage patients with cardiac drips, post-procedural monitoring needs, respiratory support devices, and other specialized therapies as permitted by facility policy.
- Recognize signs of clinical deterioration and initiate appropriate interventions, including emergency response procedures.
- Monitor laboratory values, diagnostic test results, and treatment effectiveness.
- Collaborate with physicians, advanced practice providers, respiratory therapists, pharmacists, case managers, and ancillary staff to coordinate patient care.
- Educate patients and families regarding diagnoses, medications, procedures, lifestyle modifications, and discharge instructions.
- Maintain accurate and timely documentation in the electronic medical record (EMR).
- Participate in interdisciplinary rounds, quality improvement activities, and patient safety initiatives.
- Ensure compliance with infection prevention, regulatory, and organizational standards.
Required Qualifications
- Graduate of an accredited School of Nursing.
- Current Registered Nurse (RN) license in the state of practice.
- Current Basic Life Support (BLS) certification.
- Current Advanced Cardiovascular Life Support (ACLS) certification.
- One year of acute care nursing experience preferred.
- Previous experience in telemetry, medical-surgical, critical care, emergency, or step-down nursing preferred.
Knowledge, Skills, and Abilities
- Strong clinical assessment and critical thinking skills.
- Ability to interpret cardiac rhythms and telemetry monitoring.
- Knowledge of progressive care and acute care nursing principles.
- Ability to recognize and respond effectively to patient deterioration.
- Strong communication and interpersonal skills.
- Ability to prioritize multiple patient care needs in a fast-paced environment.
- Competency in IV therapy, medication administration, and electronic documentation.
Physical Requirements
- Frequent standing, walking, bending, reaching, and lifting.
- Ability to assist with patient transfers and repositioning using appropriate equipment.
- Manual dexterity required for patient care procedures and operation of monitoring equipment.
- Ability to work rotating shifts, weekends, holidays, and on-call assignments as needed.
Preferred Certifications
- Progressive Care Certified Nurse (PCCN)
- Critical Care Registered Nurse (CCRN)
- National Institutes of Health Stroke Scale (NIHSS)
- Advanced Cardiovascular Life Support (ACLS)