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Appalachian Regional Healthcare

Registered Nurse Tier 1 ICU

Company : Appalachian Regional Healthcare

Location : Barbourville, KY, 40906

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

  • 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
  • Operates critical care equipment such as respirators, temporary pacemakers, defibrillators, and other emergency equipment.
  • Set-up, maintains, interprets results of cardiac and hemodynamic monitor required and takes action as indicated by nursing practice and hospital procedures.
  • Perform special procedures such as endotracheal and tracheostomy suctioning; tracheostomy care; extubation; cardio-pulmonary resuscitation; arterial punctures; care of chest tubes and pleurevac; set up and assistance with peritoneal dialysis, paracentesis, thoracentesis.
  • Able to manage specialty drips using approved protocols
  • Prior to assignment to unit as sole RN provider, the nurse must successfully complete critical care course acceptable to the Community Chief Nursing Officer and demonstrate mastery of equipment, diagnostic responsibilities, and procedures required of the critical care nurse. Such course work shall include: • Cardiopulmonary resuscitation and management of an obstructed airway. • EKG interpretation. • Drug therapy, including emergency drug therapy via the I.V. route, or routes normally left to the physician. • Hemodynamic monitoring. • Critical care procedures. The nurse shall be adequately oriented to unit policies, procedures and equipment. Orientation shall include safety procedures, infection control practices, and performance improvement activities.
  •  Completion of the following Competencies: Moderate Sedation Completion of Stroke Modules Restraints
  • Registered Nurse Required
  • Advanced Dysrhythmia/EKG  Required
  • NIH Stroke Certification Required
  • BLS Required
  • Advanced Life Support Certification Required
  • De-Escalation Training within 6 months of hire Required
  • Pediatric Advanced Life Support Certification (recommended) Preferred

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Frequently asked questions

In Barbourville, KY, ICU nurses typically need certifications like BLS, Advanced Life Support, NIH Stroke Certification, and Advanced Dysrhythmia/EKG to handle critical care effectively. Appalachian Regional Healthcare emphasizes these certifications to ensure high-quality patient care and compliance with regional healthcare standards.

At Appalachian Regional Healthcare, a Tier 1 ICU nurse balances patient assessments, medication administration, supervising team members, and critical care procedures. The role demands multitasking between direct patient care and coordinating with physicians, reflecting the dynamic and high-stakes environment of ICU nursing in Barbourville.

Registered Nurse Tier 1 ICU roles often lead to specialization opportunities such as becoming ICU Nurse Managers, Clinical Nurse Specialists, or pursuing advanced practice roles like Nurse Practitioners. Gaining experience in critical care and additional certifications supports upward mobility within healthcare institutions nationwide.

Working in Barbourville's ICU can present challenges like managing high patient acuity with limited local resources and adapting to rural healthcare dynamics. Nurses must be adept at critical thinking and resourcefulness, often collaborating closely with multidisciplinary teams to deliver effective care.

Appalachian Regional Healthcare fosters professional development through mentorship, orientation programs, and participation in performance improvement initiatives. Their structured approach includes critical care courses and certifications to ensure Tier 1 ICU nurses stay current with best practices in Barbourville.

This position involves advanced critical care responsibilities such as managing specialized equipment, performing complex procedures, and leading patient care teams. The role demands a high level of clinical judgment and collaboration, setting it apart from general nursing roles within Appalachian Regional Healthcare.

Registered Nurse Tier 1 ICU salaries in Barbourville, KY, typically range between $58,000 and $72,000 annually, reflecting local living costs and demand. Appalachian Regional Healthcare offers competitive compensation aligned with regional standards to attract skilled critical care nurses.

Barbourville's ICU nursing roles face moderate competition due to the specialized skill set required and rural location. Appalachian Regional Healthcare often prioritizes candidates with critical care experience and certifications, making targeted recruitment and ongoing training key to maintaining staffing levels.

Candidates should emphasize expertise in hemodynamic monitoring, critical care equipment operation, emergency procedures, and teamwork. Proficiency with electronic health records and strong communication skills are highly valued by employers like Appalachian Regional Healthcare.

Appalachian Regional Healthcare offers a supportive environment with specialized orientation, access to advanced critical care resources, and opportunities to engage in clinical committees. This fosters both skill development and meaningful impact in a close-knit community setting.

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