Pediatric Registered Nurse - Intermediate Care

Nexus Health Systems Ltd•Shenandoah, TX

1d•Onsite

About The Position

Nexus Children’s Hospital – Shenandoah is seeking a Registered Nurse with a strong background in pediatric intensive care (PICU), pediatric intermediate care (IMU), or pediatric step-down nursing to join our inpatient rehabilitation team. Pediatric ICU or IMU experience is highly preferred. We are looking for nurses who bring strong assessment skills, confidence caring for medically complex pediatric patients, and the ability to recognize subtle changes in condition and respond quickly. In this role, you will apply those skills in an inpatient rehabilitation environment, helping patients maintain medical stability while rebuilding function, developing independence, and progressing toward their recovery goals. The Intermediate Care RN provides comprehensive, evidence-based nursing care to patients with complex medical, neurological, developmental, and behavioral needs in an inpatient rehabilitation setting. Patients may have traumatic brain injuries, seizure disorders, neurodevelopmental disabilities, autism spectrum disorders, and other conditions requiring vigilant monitoring and coordinated care. The RN integrates skilled medical care with rehabilitation goals, individualized behavioral support, and trauma-informed practices. This position is especially well suited for nurses with PICU or pediatric IMU experience who want to remain involved in complex patient care while supporting patients throughout their rehabilitation journey.

Requirements

Minimum of one year of acute care nursing experience required.
Associate Degree in Nursing (ADN) from an accredited nursing program required.
Current, unrestricted Texas RN license or compact multistate RN license authorizing practice in Texas required.
Current BLS through the American Heart Association or American Red Cross required, valid for at least six months from the date of hire.
ACLS and PALS required per unit requirements, through the American Heart Association or American Red Cross, valid for at least six months from the date of hire.
De-escalation training required within 30 days of hire.
Strong pediatric assessment skills and sound clinical judgment.
Ability to recognize and respond promptly to changes in patient condition.
Confidence managing multiple clinical priorities and complex patient needs.
Effective communication with patients, families, and interdisciplinary teams.
Ability to integrate medical nursing care with rehabilitation and behavioral support goals.
Proficiency in electronic medical records and bedside monitoring technology.

Nice To Haves

Pediatric ICU (PICU) or pediatric intermediate care (IMU) experience highly preferred.
Pediatric step-down or progressive care experience strongly preferred.
Two years of experience in intermediate care, step-down, telemetry, neuroscience, rehabilitation, behavioral health, medical-surgical, or critical care nursing preferred.
Experience with pediatric neurological assessment, airway management, seizure care, enteral feeding, IV therapies, and early recognition of clinical deterioration preferred.
Experience caring for patients with traumatic brain injuries, developmental disabilities, autism, behavioral dysregulation, or complex medical conditions preferred.
Bachelor of Science in Nursing (BSN) preferred.
Relevant specialty certification preferred.

Responsibilities

Perform comprehensive initial and ongoing assessments, with close attention to neurological, respiratory, cardiovascular, and overall medical status.
Recognize subtle changes in patient condition, initiate appropriate nursing interventions, and promptly escalate concerns.
Apply clinical skills developed in pediatric ICU, IMU, or step-down settings to support patient safety and medical stability.
Administer medications, IV therapies, enteral therapies, blood products, and other prescribed treatments according to orders, facility policies, and validated competencies.
Provide care involving airway management, seizure management, wound care, and other complex medical needs.
Respond to medical emergencies and initiate interventions according to established protocols.
Incorporate individualized rehabilitation goals into daily nursing care.
Collaborate with physical, occupational, and speech therapy teams to support safe participation in treatment and reinforce recovery strategies.
Assist with mobility, positioning, daily living activities, and patient education in accordance with the plan of care.
Monitor pain, activity tolerance, medical status, and behavior that may affect rehabilitation progress.
Help prevent falls, pressure injuries, infections, and other complications that can interrupt recovery.
Adapt nursing care to each patient’s age, developmental level, communication needs, and medical condition.
Use therapeutic communication, trauma-informed approaches, and individualized behavioral support strategies.
Partner with families and caregivers throughout treatment, education, and discharge preparation.
Promote patient dignity, comfort, safety, and increasing independence.
Collaborate with physicians, advanced practice providers, therapists, behavioral health clinicians, pharmacists, case managers, and direct care staff.
Maintain accurate, timely documentation of assessments, interventions, patient responses, and changes in condition.
Facilitate safe admissions, transfers, discharges, and transitions of care.
Follow infection prevention practices, patient safety standards, privacy requirements, and facility policies.
Participate in quality improvement, continuing education, and competency validation.
Maintain competency to support other programs and clinical areas as operational needs require.