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Appalachian Regional Healthcare

Registered Nurse Tier 1 (Union) ER

Company : Appalachian Regional Healthcare

Location : Hazard, KY, 41701

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 orient 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
  • Refer to Special Addendum and Staff Nurse Position Description
  • Performs other job duties as assigned.
  • Training for all personnel assigned to the Emergency Room shall consist of the following:
  • 1.State and federal regulations related to emergency services.
  • 2.Nursing management of trauma.
  • 3.Nursing management of cardiac related disorders.
  • 4.Performance of EKG procedures, EKG interpretation, and appropriate nursing intervention.
  • 5.Pharmacological intervention (IV therapy).
  • 6.Patient assessment (triage).
  • 7.Nursing management of pediatric emergencies.
  • 8.Medicolegal aspects, particularly related to proper documentation.
  • 9.Nursing management of obstetrical emergencies.
  • 10.Patient/family emotional response.
  • 11.Cardiopulmonary resuscitation and airway management.

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
  • Excellent interpersonal skills and ability to work with providers at all levels essential.
  • Able to communicate clearly in writing and verbally and effectively influence others to achieve necessary outcomes.
  • Demonstrated ability to follow direction and facilitate a working environment conducive to change, enabling positive outcomes in a highly complex system.
  • Exhibit Critical Thinking Skills
  • Must possess basic computer skills.
  • Ability to pass Medication Exam.
  • Completion of hospital approved training program and documented competence in emergency care procedures as determined by the Director of Nursing Services.
  • Moderate Sedation
  • Completion of Stroke Modules
  • Restraints
  • The nurse shall be adequately oriented to the unit policies, procedures, and equipment. Orientation shall include safety procedures, infection control practices and performance improvement monitoring.
  • Registered Nurse in State Required
  • BLS Required
  • De-Escalation Training within 6 months of hire Required
  • ACLS Required
  • Trauma Nurse Core Curriculum Certification Required
  • Pediatric Advanced Life Support Certification Required
  • NIH Stroke Certification   Required
  • Advanced Dysrhythmia/EKG Required
  • Rural Trauma Team Development Course Preferred
  • Emergency Nurse Pediatric Course Preferred

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Frequently asked questions

This Registered Nurse Tier 1 ER role demands specialized emergency care skills, including trauma and cardiac nursing, distinct from general nursing jobs in Hazard, KY. It requires rapid assessment, critical thinking, and advanced certifications, aligning with the urgent and unpredictable nature of ER nursing in this region.

Certifications such as Trauma Nurse Core Curriculum, Pediatric Advanced Life Support, ACLS, and NIH Stroke Certification are crucial. These credentials enhance a Registered Nurse Tier 1's ability to deliver expert care in high-pressure ER environments, ensuring adherence to advanced protocols and patient safety.

Key daily responsibilities include patient triage, administering IV therapies, monitoring vital signs, collaborating with physicians, and mentoring new nurses. The role also emphasizes critical documentation and active participation in emergency care protocols unique to Appalachian Regional Healthcare's ER.

Orientation involves thorough training on ER-specific protocols such as trauma management, cardiac emergencies, and EKG interpretation. Candidates will also learn hospital safety standards, infection control, and hands-on emergency procedures tailored to Appalachian Regional Healthcare’s operational standards.

Appalachian Regional Healthcare offers structured mentorship, exposure to diverse emergency cases, and opportunities to engage in performance improvement teams. This environment fosters advanced clinical skills and leadership development, potentially accelerating career progression more than typical regional hospitals.

Hazard, KY, has a steady demand for ER registered nurses due to its rural setting and healthcare needs. Competition remains moderate, with preference given to candidates holding multiple emergency certifications and acute care experience, reflecting local employers’ emphasis on versatile emergency care practitioners.

Nurses in Hazard encounter rural healthcare challenges such as limited specialist availability, but benefit from strong community ties and lower patient-to-nurse ratios. These factors enable more personalized care but require nurses to be adaptable and skilled across a wide range of emergency scenarios.

Registered Nurse Tier 1 positions in Hazard, KY’s ER typically offer annual salaries between $55,000 and $70,000. Factors like union affiliation, emergency certifications, and experience level influence compensation, aligning with regional healthcare pay standards and cost of living.

This position emphasizes union-supported workplace rights, ER-specific emergency training, and multidisciplinary collaboration unique to Appalachian Regional Healthcare. Compared to other hospitals, it integrates comprehensive training modules and a focus on rural trauma care, enhancing both clinical skill and job security.

The healthcare system offers ongoing education, mentorship programs, and involvement in clinical committees to foster skill growth. It also prioritizes team communication and provides resources for stress management, helping Registered Nurse Tier 1 staff maintain high performance in a demanding ER setting.

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