Registered Nurse (RN) Step-Down Unit (SDU)

Position Summary

The Registered Nurse (RN) in the Step-Down Unit (SDU) delivers high-acuity nursing care to patients requiring continuous monitoring and advanced clinical support, but not intensive care unit (ICU) level treatment. This role focuses on patients transitioning from critical care or those at elevated risk for rapid clinical deterioration.

Key Responsibilities

• Provide direct, patient-centered care in a high-acuity Step-Down Unit


• Perform continuous cardiac monitoring (telemetry) and interpret rhythms


• Conduct frequent and detailed patient assessments; escalate care as needed


• Administer medications, including titratable IV drips within SDU scope (e.g., cardiac, electrolyte, anticoagulation)


• Manage patients requiring non-invasive respiratory support (BiPAP/CPAP, high-flow oxygen where applicable)


• Collaborate with physicians, respiratory therapists, and interdisciplinary teams on care plans


• Recognize early signs of deterioration and initiate rapid response protocols


• Educate patients and families on conditions, treatments, and discharge planning


• Document care accurately in the EMR in compliance with regulatory standards

Patient Population

• Cardiac: arrhythmias, post-cardiac events, CHF exacerbations


• Respiratory: COPD exacerbation, pneumonia, non-invasive ventilation support


• Post-ICU step-down patients


• Sepsis (hemodynamically stable or improving)


• Neurological: stroke monitoring, post-TIA care


• Post-surgical patients requiring elevated monitoring

Qualifications

Required:

• Active Registered Nurse (RN) license (state-specific or compact)


• Basic Life Support (BLS) certification


• Minimum 1 year of acute care experience (telemetry, SDU, PCU, or ICU)

Preferred:

• Bachelor of Science in Nursing (BSN)


• Advanced Cardiac Life Support (ACLS)


• NIH Stroke Scale (NIHSS) certification


• Prior Step-Down / Progressive Care experience


• Strong telemetry and rhythm interpretation skills

Work Environment & Schedule

• 12-hour shifts (days, nights, or rotating)


• Typical nurse-to-patient ratio: 1:3 to 1:4 (acuity dependent)


• Fast-paced, high-acuity inpatient environment


• Weekend and holiday requirements