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Appalachian Regional Healthcare

Registered Nurse Tier 2

Company : Appalachian Regional Healthcare

Location : Hyden, KY, 41749

Job Type : Full Time / Part Time

Date Posted : 30 December 2025

Overview

The Staff Nurse is accountable for interpreting the plan of Medical care, assessment of patients clinical decision-making regarding nursing care, assuring nursing care is provided in a safe and competent manner, providing individualized nursing care, and evaluating nursing care for groups of patients.

Responsibilities

Takes report from prior shift and gives report to oncoming shift which includes condition of patients, diagnosis, treatments, procedures given and required and other aspects of the plan of care.

Performs assessments and reassessments of patients.

Reviews ancillary service reports, communicates abnormal results to physicians, and notifies supervisor and physician when ancillary services are not completed.

Interprets plan of medical care, evaluates patients, and devises patient plan of care.

Maintains proper control of medicine, equipment and supplies specific to the assigned unit.

Plans for discharge of patient considering all available resources and continuum of care needs.

Refers patients to chaplain, social worker, and agencies as required.

Provides a safe and secure environment for the patient.

Implements the patient plan of care by assigning tasks to nursing and non-nursing personnel, and continuously assessing and evaluating patient care and patient's responses to nursing care.

Performs nursing treatments and procedures and total patient care which may require expert skill and judgment in accordance with established nursing standards.

May accompany physicians when possible on rounds, communicates pertinent information about patient to the physician, and assists the physician with treatments and procedures or delegate if not possible.

Performs certain special procedures for which specialized training and supervised experience has been received.

Plans for and provides effective patient and family education.

Documents pertinent findings, plan of care and evaluation of care in the medical record.

Assists patients in performing activities of daily living to meet the basic human needs.

Prepares and maintains reports, charts, records, and forms as required by hospital, state, and federal regulations.

May accompany patients who are transferred to another medical facility.

Notifies supervisor, doctor, and/or family/guardian as appropriate when patient's condition changes.

Observes and evaluates work performed by LPNs, Nursing Aides, ORT's and Clerks to validate that treatments and procedures are being performed in compliance with the plan of care and established hospital guidelines.

Participates in teaching activities for other hospital personnel and nursing students.

 Participates in the orientation of new employees.

Participates in committee meetings as requested.

                Attends inservice programs per contract.

Assumes responsibility for personal professional development.

Assists in the development of review and revision of Nursing policies and procedures.

Respects the dignity and confidentiality of all matters relating to the patients.

Performs other related duties as required within the scope of the job classification.

Qualifications

EDUCATION, TRAINING, AND EXPERIENCE REQUIREMENTS:

Graduation from a State accredited or approved school of nursing.

                Licensed in State of employment.

                POSITION PHYSICAL REQUIREMENTS:

Must possess physical abilities to endure prolonged standing and walking and ability to lift, carry, push and pull; exerting 50 to 100 pounds of force occasionally, and/or 25 pounds of force frequently, and/or 10 to 20 pounds of force constantly to move objects.  Physical Demand requirements are in excess of those for Heavy Work.

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Frequently asked questions

A Registered Nurse Tier 2 typically manages more complex patient assessments and coordinates care plans, unlike entry-level nurses who assist primarily with basic patient care. This role demands advanced clinical judgment, leadership in delegating tasks, and thorough evaluation of nursing interventions within healthcare settings like Appalachian Regional Healthcare.

Beyond state licensure, certifications in ACLS (Advanced Cardiovascular Life Support) or PALS (Pediatric Advanced Life Support) are highly valued in Hyden, KY. These credentials demonstrate readiness for acute care scenarios, aligning with local healthcare standards and improving chances of securing a position in regional facilities like Appalachian Regional Healthcare.

In rural areas such as Hyden, KY, Registered Nurse Tier 2s often transition into specialized clinical roles or leadership positions due to the broad scope of practice and community needs. Opportunities may include nurse management, education roles, or advanced practice certifications, reflecting the dynamic nature of nursing careers in smaller healthcare systems.

Factors include the facility’s reputation, the demand for experienced nursing staff in critical care, and alignment with Appalachian Regional Healthcare’s values. Candidates with demonstrated skills in patient assessment, interdisciplinary communication, and compliance with nursing standards tend to be more competitive for Tier 2 nursing roles.

Appalachian Regional Healthcare invests in continuous education through in-service training and encourages participation in committee work. Nurses are supported to enhance competencies, attend workshops, and engage in policy development, fostering growth and expertise within the Registered Nurse Tier 2 position.

Nurses often encounter diverse medical conditions with limited specialist availability, necessitating adaptability and advanced clinical skills. Navigating resource constraints while ensuring individualized care plans is crucial, underscoring the importance of critical thinking and effective communication in this rural healthcare setting.

Registered Nurse Tier 2 salaries in Hyden typically range from $55,000 to $70,000 annually, slightly below urban centers but reflective of the local cost of living. This compensation aligns with regional demand and offers benefits consistent with Appalachian Regional Healthcare’s commitment to supporting nursing professionals.

Hyden’s rural landscape means most Registered Nurse Tier 2 staff experience short to moderate commutes, often under 30 minutes. This accessibility supports work-life balance, but seasonal weather conditions can impact travel, making reliable transportation an important consideration for local nursing staff.

Mastery in patient assessment, medication administration, and care plan implementation stands out. Proficient communication with physicians and interdisciplinary teams, plus the ability to supervise and mentor less experienced staff, are critical skills that enhance effectiveness in the Tier 2 nursing role.

Higher patient acuity and fluctuating census require Registered Nurse Tier 2s to adapt swiftly, balancing direct care with supervisory duties. Efficient prioritization and delegation are necessary to maintain quality and safety standards within the hospital’s structured nursing framework.

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