Pediatric Registered Nurse - Intermediate Care

Nexus Health Systems•Shenandoah, TX

19h

About The Position

Nexus Children’s Hospital – Shenandoah is seeking a Registered Nurse to provide 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. The role is especially suited to nurses with pediatric ICU (PICU), pediatric intermediate care (IMU), or step-down experience who want to support medically complex patients throughout their rehabilitation journey. The RN helps maintain patients’ medical stability while supporting functional recovery, independence, and progress toward individualized goals. The role involves collaboration with interdisciplinary teams and families, accurate clinical documentation, and adherence to patient safety, infection prevention, privacy, and facility standards. Nurses may also support other programs and clinical areas as operational needs require.

Requirements

At least one year of acute care nursing experience.
Associate Degree in Nursing (ADN) from an accredited nursing program.
Current, unrestricted Texas RN license or compact multistate RN license authorizing practice in Texas.
Current BLS certification through the American Heart Association or American Red Cross, valid for at least six months from the date of hire.
ACLS and PALS as required per unit requirements, through the American Heart Association or American Red Cross, valid for at least six months from the date of hire.
Complete required de-escalation training within 30 days of hire.
Keep required certifications current throughout employment.
Strong pediatric assessment skills and sound clinical judgment.
Ability to recognize and promptly respond to changes in patient condition.
Ability to manage 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 is highly preferred.
Pediatric step-down or progressive care experience is strongly preferred.
Two years of experience in intermediate care, step-down, telemetry, neuroscience, rehabilitation, behavioral health, medical-surgical, or critical care nursing.
Experience with pediatric neurological assessment, airway management, seizure care, enteral feeding, IV therapies, and early recognition of clinical deterioration.
Experience caring for patients with traumatic brain injuries, developmental disabilities, autism, behavioral dysregulation, or complex medical conditions.
Bachelor of Science in Nursing (BSN).
Relevant specialty certification.

Responsibilities

Perform comprehensive initial and ongoing assessments, including neurological, respiratory, cardiovascular, and overall medical status.
Recognize changes in patient condition, initiate appropriate nursing interventions, and promptly escalate concerns.
Use clinical skills from pediatric ICU, IMU, or step-down settings to support patient safety and medical stability.
Administer medications, IV and enteral therapies, blood products, and other prescribed treatments according to orders, policies, and validated competencies.
Provide airway management, seizure management, wound care, and other complex medical care.
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 treatment participation 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 may interrupt recovery.
Adapt 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 during 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 and 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.