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Appalachian Regional Healthcare

Registered Nurse Tier 1 ER / Behavioral Health

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.

Special Instructions

The Behavioral Nurse in the Emergency Department will focus on the behavioral health section of the ER. We treat a wide variety of patients that come through the ER for behavioral health services. Some are involuntary and some are voluntary. The behavioral health nurse would be responsible for the assessment, sitting, medication administration and all other duties as assigned in our locked behavioral health unit. They would talk with providers and deal directly with our inpatient behavioral health unit. When there are no patients in the behavioral health are this nurse will step out and help ER staff. These duties may include patient assessments, admission assessments, discharges, medication administration, transporting patients to other units and all other duties as assigned. They will have the same certification requirements as emergency room staff nurses and behavioral health experience is preferred. If there is no behavioral health experience they will orient on the inpatient behavioral health unit for 30 days before coming to the emergency department.

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.

The Behavioral Nurse in the Emergency Department will focus on the behavioral health section of the ER. We treat a wide variety of patients that come through the ER for behavioral health services. Some are involuntary and some are voluntary. The behavioral health nurse would be responsible for the assessment, sitting, medication administration and all other duties as assigned in our locked behavioral health unit. They would talk with providers and deal directly with our inpatient behavioral health unit.

When there are no patients in the behavioral health are this nurse will step out and help ER staff. These duties may include patient assessments, admission assessments, discharges, medication administration, transporting patients to other units and all other duties as assigned.

They will have the same certification requirements as emergency room staff nurses and behavioral health experience is preferred. If there is no behavioral health experience they will orient on the inpatient behavioral health unit for 30 days before coming to the emergency department.

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

To thrive as a Registered Nurse Tier 1 ER / Behavioral Health at Appalachian Regional Healthcare, certifications like BLS, ACLS, Pediatric Advanced Life Support, Trauma Nurse Core Curriculum, and NIH Stroke Certification are crucial. These credentials ensure competency in emergency and behavioral health nursing within Kentucky's clinical standards.

Behavioral health duties in this ER role include patient assessments, medication administration in a locked unit, and collaborating with inpatient behavioral teams. When behavioral cases are absent, the nurse supports general ER tasks like admissions, discharges, and patient transport, blending mental health and emergency care skillsets.

Nurses in this position may advance into specialized behavioral health nurse manager roles or emergency nursing leadership, supported by ongoing training in trauma, de-escalation, and critical care. Appalachian Regional Healthcare fosters professional development aligned with expanded responsibilities in acute and behavioral health nursing.

Yes, nurses without behavioral health background undergo a 30-day orientation on the inpatient behavioral health unit before transitioning to ER duties. This approach ensures safe, competent care and smooth integration into Appalachian Regional Healthcare’s multidisciplinary emergency and behavioral health teams.

Balancing urgent ER care with behavioral health patient management can demand rapid adaptability and strong communication. Nurses must navigate locked unit protocols, involuntary patient care, and interdisciplinary coordination, all while maintaining safety and therapeutic support in a fast-paced Appalachian Regional Healthcare environment.

Prestonsburg's demand for behavioral health RNs is moderate but growing, driven by regional healthcare expansion and increasing mental health care needs. Appalachian Regional Healthcare's integrated ER-behavioral roles attract skilled candidates, though certification and acute care experience significantly improve competitiveness locally.

Salaries typically range from $58,000 to $72,000 annually, reflecting regional cost of living and healthcare demand. Nurses with behavioral health expertise and required certifications at Appalachian Regional Healthcare may command higher pay within this band, aligning with Kentucky’s market standards.

Appalachian Regional Healthcare emphasizes a dual role where nurses manage both emergency and locked behavioral health units, offering a unique blend of experiences. This setup fosters close collaboration with inpatient units and requires versatile certification, contrasting with facilities that separate ER and behavioral health care more distinctly.

The organization encourages continuous learning through mandated trainings like trauma management, de-escalation, and stroke modules. Appalachian Regional Healthcare invests in skill enhancement to ensure its nurses remain proficient in evolving ER and behavioral health nursing practices.

Prestonsburg’s rural setting often involves commutes from neighboring towns, with travel times varying widely. Nursing staff commonly balance the distance by flexible scheduling. The hospital’s location also means candidates weigh commute feasibility alongside the specialized nature of the Registered Nurse Tier 1 ER / Behavioral Health role.

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