Registered Nurse Tier 1 ICU
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 Graduation from an accredited school of nursing. Required
- Bachelor's Degree Preferred
- Up to 1 year Preferred Minimum of one (1) year acute care nursing experience (1) year of experience should be relevant to specific department in which they will be working. Refer to addendums for additional requirements. Experience with Electronic Health Record Preferred. Preferred
- Operates critical care equipment such as respirators, temporary pacemakers, defibrillators, and other emergency equipment.
- Set-up, maintains, interprets results of cardiac and hemodynamic monitor required and takes action as indicated by nursing practice and hospital procedures.
- Perform special procedures such as endotracheal and tracheostomy suctioning; tracheostomy care; extubation; cardio-pulmonary resuscitation; arterial punctures; care of chest tubes and pleurevac; set up and assistance with peritoneal dialysis, paracentesis, thoracentesis.
- Able to manage specialty drips using approved protocols
- Prior to assignment to unit as sole RN provider, the nurse must successfully complete critical care course acceptable to the Community Chief Nursing Officer and demonstrate mastery of equipment, diagnostic responsibilities, and procedures required of the critical care nurse. Such course work shall include: • Cardiopulmonary resuscitation and management of an obstructed airway. • EKG interpretation. • Drug therapy, including emergency drug therapy via the I.V. route, or routes normally left to the physician. • Hemodynamic monitoring. • Critical care procedures. The nurse shall be adequately oriented to unit policies, procedures and equipment. Orientation shall include safety procedures, infection control practices, and performance improvement activities.
- Completion of the following Competencies: Moderate Sedation Completion of Stroke Modules Restraints
- Registered Nurse Required
- Advanced Dysrhythmia/EKG Required
- NIH Stroke Certification Required
- BLS Required
- Advanced Life Support Certification Required
- De-Escalation Training within 6 months of hire Required
- Pediatric Advanced Life Support Certification (recommended) Preferred
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Frequently asked questions
In Prestonsburg, KY, ICU nurses often experience a tighter-knit team environment with a broad scope of responsibilities, unlike larger cities where roles might be more specialized. Nurses here may also engage more deeply in patient advocacy and cross-disciplinary collaboration due to the community-focused healthcare model.
Working at Appalachian Regional Healthcare, a Tier 1 ICU nurse may encounter challenges like managing critical care with limited resources, addressing rural health disparities, and adapting to diverse patient needs. This setting demands strong critical thinking and adaptability in high-pressure scenarios.
Certifications such as NIH Stroke Certification, Advanced Dysrhythmia/EKG, and Advanced Life Support are highly valued in Prestonsburg's healthcare environment. Additionally, de-escalation training within six months of hire supports effective patient management in regional critical care units.
Prestonsburg's ICU nursing roles have moderate competition due to regional healthcare demand and the specialized skills required. Nurses with acute care experience and critical care certifications tend to have an advantage, especially within Appalachian Regional Healthcare's reputable system.
Registered Nurse Tier 1 ICU salaries in Prestonsburg generally range between $58,000 and $72,000 annually, reflecting regional cost of living and healthcare funding. Experience and certifications can significantly influence compensation within Appalachian Regional Healthcare and similar institutions.
Appalachian Regional Healthcare fosters growth through mentorship programs, critical care courses, and participation in performance improvement initiatives. Nurses are encouraged to complete specialty competencies and engage in continuous education, enhancing both clinical skills and career progression.
Yes, this role uniquely emphasizes the integration of physical and psychological patient support, supervision of assigned team members, and active involvement in discharge planning. Nurses also perform critical procedures like hemodynamic monitoring and emergency response tailored to ICU demands.
New grads should prioritize mastering cardiopulmonary resuscitation, hemodynamic monitoring, and EKG interpretation. Developing strong communication skills for effective handoff reporting and team collaboration is equally critical to thrive in the ICU environment.
Technology integration includes the use of electronic health records to document patient data accurately, along with specialty equipment like cardiac monitors and ventilators. Nurses are trained to interpret diagnostic results and manage advanced life support devices essential for critical care.
The Appalachian culture fosters strong community ties and resilience, influencing ICU nursing with a patient-centered approach emphasizing empathy and personalized care. Nurses often build long-term relationships with patients and families, enhancing trust and treatment outcomes.