Registered Nurse Tier 2 (Union)
Company : Appalachian Regional Healthcare
Location : West Liberty, KY, 41472
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.
Qualifications
- Bachelor's Degree Preferred
- Associate's Degree Required
- Mastery of problem solving and decision making skills.
- Mastery of collaboration and teamwork.
- Mastery of growth mindset (agility and developing yourself and others) skills.
- Mastery of execution and delivery (planning, delivering, and supporting) skills.
- Ability to consider the relative costs and benefits of potential actions to choose the most appropriate one.
- Ability to function in clinical setting with diverse cultural dynamics of clinical staff and patients.
- Mastery knowledge of phases of care transitions and resources available for patients.
- Mastery of digital literacy skills.
- Registered Nurse. Required
- BLS upon hire Required
- De-Escalation Training within 6 months of hire Required
- Advanced Dysrhythmia/EKG (Med/Surg telemetry unit ONLY) Required
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Frequently asked questions
Appalachian Regional Healthcare’s Registered Nurse Tier 2 position emphasizes advanced clinical judgment and mentorship duties, setting it apart from entry-level nurse roles in West Liberty. This role involves supervising team members, critical care planning, and participating in performance improvement initiatives, reflecting a middle-tier nursing responsibility with growth opportunities.
Holding an active RN license, BLS certification, and de-escalation training within six months of hire are crucial. Mastery of digital literacy and clinical decision-making skills also enhances performance, especially in multidisciplinary collaboration and patient care transitions typical at Appalachian Regional Healthcare.
The Tier 2 status often serves as a stepping stone toward nurse management or specialized clinical roles. Nurses gain leadership experience through supervising staff and mentoring students, which Appalachian Regional Healthcare supports by fostering continuous professional development in a growing healthcare community.
Daily responsibilities blend patient assessments, implementing and adjusting care plans, medication administration, and team supervision. Communication through SBAR handoffs and participation in discharge planning are integral, ensuring seamless patient care continuity in a fast-paced West Liberty hospital environment.
West Liberty experiences steady demand for registered nurses, with Appalachian Regional Healthcare among top local employers. While competition exists, candidates with strong clinical skills, certifications, and teamwork abilities stand out due to ongoing healthcare expansion and rural community needs.
Union settings often involve collaborative contract negotiations affecting work schedules, benefits, and job security. Nurses must adapt to collective decision-making processes, which can influence clinical duties and teamwork dynamics but also provide structured support and grievance procedures.
Registered Nurses at Tier 2 level in West Liberty typically earn between $58,000 and $68,000 annually. Appalachian Regional Healthcare offers competitive wages reflecting local cost of living and union-negotiated pay scales, often supplemented by benefits and shift differentials.
Yes, new hires receive structured orientation including clinical protocols, de-escalation techniques, and digital tools training. Continuous education is encouraged, with opportunities to precept students and participate in quality improvement projects, supporting skill advancement within the union framework.
Registered Nurse Tier 2s lead collaborative care by coordinating with physicians, multidisciplinary staff, and nursing students. Emphasis on communication skills, including SBAR reporting and compassionate patient advocacy, fosters a supportive environment crucial for effective patient outcomes.
This tier involves enhanced supervisory duties, mentoring responsibilities, and active participation in committees and performance improvement initiatives. Unlike standard registered nursing roles, it requires mastering decision-making, executing care transitions, and maintaining union compliance, elevating the professional scope.