Registered Nurse Tier 1 OR
Company : Appalachian Regional Healthcare
Location : Prestonsburg, KY, 41653
Job Type : Full Time / Part Time
Date Posted : 30 December 2025
Overview
The Registered Nurse requires substantial specialized knowledge, judgement and nursing skills based upon the principles of psychological, biological, physical, and social sciences in the application of the nursing process in the respective departments in which assigned. The RN must collaborate with physicians and multidisciplinary team members; provide physical and psychological support to patients, friends, and families; supervising assigned team members and students.
Responsibilities
- Completes patient assessments, formulates plan of care, oversees implementation of plan of care, evaluate and adjust plan of care utilizing critical thinking skills
- The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nursing’s Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses.
- Care, counsel health teaching and promotion, utilizes Teach Back methodology as affirmation of comprehension
- The administration of medication, intravenous therapy and treatment as prescribed by a LIP
- Supervision, delegation and follow-through to other personnel in the performance of activities relating to nursing care.
- Mentors and precepts students and orients new staff as assigned
- Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information
- Participates on various teams, committees or performance improvement initiatives
- Ensures a safe and secure environment for patients, coworkers and self
- Participates in Discharge Planning and Transition of Care (able to define pt needs)
- Serves as a patient advocate and escalates patient related concerns timely
- Timely documents pertinent findings in medical record
- Assist patients in performing activities of daily living and functions as an active team member
- Assumes responsibility for personnel professional development
- Utilizes effective communication skills and active listening, exhibits compassionate and empathetic attitude
- Practices Hands Off communication utilizing SBAR; Performs Bedside Shift reporting utilizing SBAR (unless contradicted)
- Functions as a positive influence, role model and adheres to professional code of conduct
- Respects dignity and confidentiality of all matters relating to patients
- Performs other job duties as assigned.
Qualifications
- Associate's Degree Nursing Required
- Bachelor's Degree Preferred
- Up to 1 year Preferred
- Assures all members of the surgical team have been instructed in the surgical procedures performed and periodically updates personnel on new techniques, instrumentation and procedures.
- Prepares for each assigned case by ensuring the room is properly prepared and equipped, the required documentation is present on the medical record, and the patient is properly identified.
- Prepares the patient for operative procedure by positioning and grounding the patient as required, securing the patient on the table, assisting with intubation, and preparing operative site. Accompanies the patient to recovery room and may be required to provide nursing care in the recovery room.
- Monitors operative procedures by documenting proper patient positioning, breaks in sterile procedure, instrument, needle and sponge counts, preservation and labeling of all specimens, drugs and blood administration, and critical incidents during the operative procedure.
- Functions as a team member within the surgical department by assisting with gowning and gloving; procuring required medication, blood and supplies; coordinating involvement of other departments with the procedure; properly processing operative specimens.
- Maintains a safe and productive work environment by assisting with cleaning, maintenance, and re-supply.
- Successful completion of a training program and demonstrated competence in circulating nurse duties as determined by the Director of Surgical Services.
- The nurse shall be adequately oriented to unit policies, procedures and equipment. Orientation shall include safety procedures, infection control practices, and performance improvement activities.
- Training for OR shall consist of completion of competencies in various areas or roles the nurse will function.
- RN Required
- Basic Life Support Certification Required
- ACLS Required
- PALS Required
- De-Escalation Training within 6 months of hire Required
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Frequently asked questions
Registered Nurse Tier 1 Or professionals in Prestonsburg play a vital role by preparing operating rooms, ensuring patient safety during procedures, and coordinating with multidisciplinary teams. Their expertise in surgical protocols and patient monitoring is critical for smooth surgical operations in this Kentucky region.
Appalachian Regional Healthcare values certifications like Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), Pediatric Advanced Life Support (PALS), and recent de-escalation training. These credentials ensure nurses meet the high safety and clinical standards expected in surgical and critical care settings.
This role uniquely combines surgical support duties with direct patient care responsibilities, requiring specialized knowledge in operative procedures, sterile techniques, and intraoperative patient safety. Unlike general entry-level nursing jobs, it demands focused skills on surgical assistance and team coordination.
Career progression here often involves gaining specialized surgical nursing certifications, taking leadership roles in perioperative teams, or transitioning into clinical nurse manager positions. Engagement in performance improvement projects at Appalachian Regional Healthcare also fosters professional development.
Nurses in Prestonsburg face challenges like managing diverse patient needs in rural settings and adapting to evolving surgical technologies. Limited local resources sometimes require creative problem-solving and strong teamwork within Appalachian Regional Healthcare's perioperative units.
Prestonsburg’s demand for registered nurses, particularly in surgical settings, remains steady but competitive due to limited healthcare facilities. Candidates with solid certifications and surgical experience tend to stand out when applying to regional employers like Appalachian Regional Healthcare.
Appalachian Regional Healthcare is known for fostering a supportive work culture with mentorship programs, opportunities for continuing education, and involvement in clinical committees. These benefits enhance job satisfaction and skill advancement for surgical nursing staff.
The organization emphasizes collaboration by involving RN Tier 1 Or nurses in daily briefings, care planning, and quality improvement initiatives. This integration ensures that nurses contribute insights from the operating room to enhance overall patient outcomes.
In Prestonsburg, a Registered Nurse Tier 1 Or typically earns between $58,000 and $68,000 annually, reflecting local cost of living and demand. Appalachian Regional Healthcare offers competitive compensation packages aligned with regional nursing market benchmarks.
Effective communication, critical thinking, and empathy are essential. Nurses must confidently perform hands-off communication techniques like SBAR and demonstrate leadership in supervising team members while maintaining patient dignity during high-pressure surgical procedures.