Key Responsibilities and Required Skills for IVCU Nurse

🎯 Role Definition

We are seeking an experienced IVCU Nurse (Intermediate/Intensive/Step-Down Care Unit Nurse) who delivers high-quality, evidence-based patient care for medically complex and hemodynamically unstable adults. The IVCU Nurse provides continuous cardiac and respiratory monitoring, manages advanced IV therapies and vasoactive drips, performs frequent bedside assessments, collaborates with multidisciplinary teams, and documents care accurately in the electronic medical record (EMR). The ideal candidate demonstrates strong critical thinking, rapid assessment skills, proficiency with cardiac telemetry, hemodynamic monitoring, and a commitment to patient safety and family-centered care.

Keywords: IVCU Nurse, intermediate care nurse, step-down nurse, critical care, telemetry, IV therapy, vasoactive drips, hemodynamic monitoring, cardiac monitoring, ventilator weaning, EMR (Epic/Cerner), ACLS, BLS.

📈 Career Progression

Typical Career Path

Entry Point From:

Med-Surg Registered Nurse (RN) with telemetry experience
Emergency Department (ED) Nurse seeking step-down/critical care transition
Telemetry/Step-Down RN or Post-Anesthesia Care Unit (PACU) RN

Advancement To:

Charge Nurse / Shift Supervisor — IVCU or ICU
Critical Care RN / Medical-Surgical ICU RN
Clinical Nurse Educator / Preceptor for critical care
Nurse Manager / Assistant Nurse Manager
Advanced Practice Registered Nurse (NP) — Acute Care

Lateral Moves:

Cardiac Telemetry Nurse
Case Manager or Discharge Planning RN
Clinical Documentation Specialist

Core Responsibilities

Primary Functions

Provide continuous, high-acuity bedside nursing care for patients in the IVCU, performing thorough head-to-toe assessments every shift and documenting clinical changes in the EMR.
Monitor and interpret continuous cardiac telemetry, identify arrhythmias, and initiate appropriate interventions per protocol and in collaboration with the attending physician.
Safely initiate, titrate, and wean vasoactive infusions (e.g., norepinephrine, dopamine, vasopressin) and report hemodynamic instability immediately.
Manage complex IV therapy including peripheral IV insertion, midline and PICC line care, central venous access maintenance, and administration of blood products while monitoring for complications.
Provide ventilator-associated care for patients on non-invasive support or in transition from mechanical ventilation, collaborate with respiratory therapy for ventilator weaning protocols.
Administer high-risk medications (sedatives, anticoagulants, insulin drips) with accurate calculation, double-checks when required, and verification per medication safety policies.
Conduct frequent neurovascular and respiratory assessments for early detection of deterioration, and activate rapid response or code team when indicated.
Perform and interpret point-of-care testing (blood glucose, arterial blood gases) and use results to guide treatment and medication titration.
Develop, implement, and revise individualized nursing care plans using evidence-based practices and communicate changes during handoff and interdisciplinary rounds.
Lead bedside shift-to-shift handoffs and participate in multidisciplinary rounds to advocate for patient needs, escalation of care, and discharge planning.
Utilize EMR systems (e.g., Epic, Cerner) to document assessments, interventions, medication administration, and communication with providers in a timely, legally compliant manner.
Provide patient, family, and caregiver education about disease processes, IV therapies, medication regimens, and post-discharge care to improve outcomes and reduce readmissions.
Perform sepsis screening, initiate sepsis bundles per hospital protocol, and coordinate timely interventions with the care team.
Implement infection prevention measures including central line-associated bloodstream infection (CLABSI) prevention bundles, hand hygiene, and proper PPE use.
Recognize and respond to ventilator alarms, cardiac monitor alarms, and other device alerts with appropriate troubleshooting and escalation.
Coordinate and prioritize care for multiple high-acuity patients, delegating tasks to assistive personnel while maintaining accountability for overall patient outcomes.
Participate in performance improvement initiatives, quality audits, root cause analyses, and policy/procedure updates to enhance patient safety and operational efficiency.
Ensure safe patient transfers and admissions to/from the IVCU including effective communication with sending/receiving units and transport teams.
Manage pain and sedation using validated assessment tools, collaborate with physicians for multimodal analgesia and sedation plans, and monitor for adverse effects.
Provide end-of-life care and palliative nursing support, including symptom management, family communication, and coordination with palliative care services when appropriate.
Maintain competency in advanced cardiac life support (ACLS) and basic life support (BLS) protocols and serve as a team member during codes and rapid response events.
Supervise, mentor, and precept new staff and nursing students assigned to the IVCU, fostering a culture of continuous learning and professional development.
Escalate medication or equipment safety concerns and collaborate with pharmacy, biomedical engineering, and supply chain to resolve issues promptly.
Document and report adverse events, near misses, and safety incidents following hospital reporting systems and contribute to corrective action plans.

Secondary Functions

Participate in unit-based committees (quality improvement, safety, education) and lead small projects that optimize throughput, reduce LOS, or improve patient experience.
Support pre-admission planning and early discharge workflows to optimize bed availability in the IVCU and hospital-wide.
Assist with orientation and competency validation of new nurses including simulation training, skills checklists, and EMR documentation best practices.
Attend and contribute to ongoing continuing education, in-service training, and mandatory competency updates for critical care nursing.
Actively participate in code and rapid response debriefs to identify learning opportunities and update unit protocols.
Liaise with case management, social work, and rehabilitation services to coordinate complex discharge plans for patients requiring home IV therapy or post-acute care.
Support hospital emergency preparedness by participating in mock drills and mass-casualty response exercises.

Required Skills & Competencies

Hard Skills (Technical)

Advanced cardiac monitoring and telemetry interpretation (arrhythmia recognition and initial management)
IV therapy competency: peripheral IV insertion, midline/PICC care, central line maintenance and dressing changes
Vasoactive infusion administration and titration (hemodynamic monitoring and bedside assessment)
Mechanical ventilation basics and collaboration on ventilator management/weaning protocols
Critical medication administration and safety (drip calculations, high-alert medications, blood product administration)
Arterial blood gas (ABG) sampling interpretation and use in clinical decision-making
Proficient use of electronic medical record systems (Epic, Cerner, Meditech) for documentation and order review
Basic and Advanced Cardiac Life Support (BLS and ACLS) certification and code team participation
Sepsis screening and bundle initiation per evidence-based guidelines
Point-of-care testing (POCT) including glucometers and rapid diagnostic devices
Wound assessment and basic wound care including pressure injury prevention
Familiarity with pulmonary artery catheter, arterial line, and central venous pressure monitoring (where applicable)
Competency with infusion pumps, syringe pumps, telemetry systems, and bedside cardiac monitors

Soft Skills

Rapid, accurate clinical judgment and strong critical thinking under pressure
Clear and compassionate communication with patients, families, and multidisciplinary teams
Prioritization and time-management skills for caring for multiple high-acuity patients
Leadership and mentorship: ability to precept and provide constructive feedback to peers
Teamwork and collaboration across disciplines (physicians, respiratory therapy, PT/OT, pharmacy)
Adaptability and resilience in fast-paced, unpredictable clinical environments
Attention to detail and strong organizational skills for safe medication administration and documentation
Patient advocacy and commitment to dignity, cultural competence, and family-centered care
Continuous improvement mindset: openness to feedback, process improvement, and evidence-based practice
Emotional intelligence with the ability to de-escalate stressful situations and support grieving families

Education & Experience

Educational Background

Minimum Education:

Associate Degree in Nursing (ADN) or Diploma in Nursing with current RN license; equivalent experience in acute/critical care accepted.

Preferred Education:

Bachelor of Science in Nursing (BSN) or higher; Post-graduate certifications in critical care or step-down nursing preferred.

Relevant Fields of Study:

Nursing (ADN, BSN)
Acute Care/Adult Health Nursing
Critical Care Nursing (CCRN preparation or certificate)

Experience Requirements

Typical Experience Range:

1–5 years of professional RN experience, with a minimum of 1–2 years in acute care, telemetry, step-down, or ICU settings.

Preferred:

2+ years of direct experience in intermediate care/step-down or critical care units.
Prior experience with high-acuity cardiac or medical-surgical patients, vasoactive drips, and telemetry monitoring.

Certifications (required or highly recommended):

Active RN license in the state of practice
BLS (Basic Life Support) – American Heart Association
ACLS (Advanced Cardiac Life Support) – American Heart Association
CCRN or Critical Care/Cardiac Telemetry certification preferred when applicable
IV therapy certification or demonstrated competency in IV insertion and central line care

If you are a patient-focused, technically proficient IVCU Nurse with strong critical thinking, proven experience in high-acuity settings, and excellent communication skills, we encourage you to apply. This role offers meaningful clinical responsibility, opportunities for professional growth, and collaborative team-based care in a dynamic hospital environment.