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Appalachian Regional Healthcare

Registered Nurse Tier 2 (Union)

Company : Appalachian Regional Healthcare

Location : McDowell, KY, 41647

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

In McDowell, KY, possessing a current BLS certification and advanced dysrhythmia/EKG skills are vital for a Registered Nurse Tier 2 (Union). Additionally, completing de-escalation training within six months of hire enhances your qualifications, aligning with regional healthcare standards and increasing your hiring potential.

McDowell's demand for Registered Nurse Tier 2 professionals remains steady due to regional healthcare needs. Appalachian Regional Healthcare’s union position offers stability, but candidates should highlight specialized nursing skills and certifications to stand out amid a moderate pool of qualified applicants.

Registered Nurse Tier 2 (Union) roles involve supervising nursing teams, mentoring students, and managing complex patient care plans. Unlike entry-level nurses, this position demands critical thinking for care adjustments and active participation in committees, reflecting advanced practice within multidisciplinary settings.

Holding a Tier 2 union designation often signals a mid-level nursing position with leadership responsibilities, fostering pathways into clinical coordination or management. This role balances bedside care with supervisory tasks, making it a strategic step for nurses targeting upward mobility in healthcare organizations.

This role requires mastery in clinical problem-solving, effective delegation, and care transition knowledge. A Tier 2 nurse excels in teamwork, digital literacy, and emotional intelligence, setting them apart by their ability to lead nursing activities while maintaining high standards of patient advocacy and safety.

Appalachian Regional Healthcare fosters development through mentorship programs and structured orientation for new staff. Their commitment to continuous learning ensures Tier 2 nurses receive opportunities for skills enhancement, leadership training, and participation in performance improvement initiatives.

Registered Nurse Tier 2 professionals at Appalachian Regional Healthcare are expected to follow nationally recognized nursing standards, employ SBAR communication during handoffs, and engage actively in safety protocols to maintain a secure environment for patients and staff alike.

Registered Nurse Tier 2 (Union) salaries in McDowell, KY typically range between $58,000 and $72,000 annually, depending on experience and certifications. This range reflects the regional market and union-negotiated pay scales common within Appalachian Regional Healthcare and similar institutions.

Nurses in McDowell may encounter diverse cultural dynamics and resource constraints typical of rural healthcare settings. Successfully navigating these requires adaptability, strong communication skills, and a mastery of care transition processes to ensure comprehensive patient support.

These roles fill essential gaps by providing advanced nursing care and leadership in team coordination. Appalachian Regional Healthcare relies on Tier 2 nurses to uphold quality standards while addressing local healthcare demands, contributing significantly to patient outcomes in McDowell's medical community.

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