Registered Nurse Tier 1 ER
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.
- 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
In Prestonsburg, a Registered Nurse Tier 1 ER must swiftly assess patients using specialized triage protocols tailored to rural emergency room demands. This role emphasizes critical thinking to prioritize care efficiently, ensuring timely intervention in trauma and cardiac emergencies common in Appalachian Regional Healthcare settings.
Progression often involves gaining certifications like ACLS or Trauma Nursing Core Curriculum and acquiring experience in complex emergency cases. Moving into roles such as ER Nurse Manager or specialized pediatric ER nurse becomes accessible with demonstrated leadership and further education, especially valued within healthcare systems like Appalachian Regional Healthcare.
Essential certifications for this role include BLS, ACLS, Pediatric Advanced Life Support, Trauma Nurse Core Curriculum, and NIH Stroke certification. These validate expertise in emergency interventions, pharmacological treatments, and trauma management, setting Tier 1 ER nurses apart in Kentucky’s acute care settings.
Yes, Appalachian Regional Healthcare provides comprehensive emergency care training covering trauma nursing, cardiac disorder management, EKG interpretation, and pediatric emergency procedures. This ensures nurses are equipped to handle diverse ER challenges effectively, fostering a competent and confident nursing team.
Registered Nurse Tier 1 ER positions in Prestonsburg generally offer salaries ranging from $55,000 to $70,000 annually, depending on experience and certifications. Appalachian Regional Healthcare aligns compensation competitively within the region to attract skilled nurses proficient in emergency care.
Prestonsburg's demand for ER registered nurses is moderately high due to rural healthcare needs. Appalachian Regional Healthcare actively recruits professionals with emergency certifications and acute care experience, making the hiring environment competitive but favorable for qualified candidates.
Nurses in this role often handle a diverse patient mix with limited immediate resources, requiring adaptability and comprehensive emergency training. The rural context demands proficiency in trauma, cardiac, and pediatric emergencies while fostering strong communication with multidisciplinary teams under Appalachian Regional Healthcare’s protocols.
While a bachelor's degree is preferred, an associate's degree combined with relevant acute care experience and core certifications like BLS and ACLS can make new grads competitive. Orientation programs and mentorship at Appalachian Regional Healthcare support entry-level nurses transitioning into emergency roles.
This role requires acute patient assessments, managing emergency protocols, mentoring students, and performing advanced interventions like IV therapy and EKGs. The Tier 1 ER nurse also plays a key role in discharge planning and acts as a patient advocate in high-pressure emergency scenarios.
Beyond standard certifications, Prestonsburg nurses benefit from rural trauma team development courses and stroke management training due to regional health trends. Appalachian Regional Healthcare emphasizes these to enhance emergency response effectiveness in Eastern Kentucky’s healthcare environment.