On one shift at a critical access hospital, a registered nurse may triage chest pain in the ER and then admit a pneumonia patient to the inpatient unit. They assess patients, give medications and blood, chart, direct LPNs and techs, and get unstable patients ready to transfer to a larger hospital.
By the HireBus team · Updated · Pay data: BLS, May 2025
We're hiring a registered nurse to care for emergency, inpatient, observation and swing bed patients. In a critical access hospital, one shift can mean triaging chest pain in the ED, then admitting a pneumonia patient to med-surg. You'll assess, give medications, chart in [your EHR], and help stabilize and transfer patients who need a larger hospital.
2. Essential Duties and Responsibilities
Assess, plan and give care to ED, med-surg, observation and swing bed patients within your state's RN scope of practice.
Triage ED patients using [ESI or your triage system], start standing orders, and update the provider when a patient changes.
Give medications and blood products with barcode scanning, and complete controlled-substance counts and witnessed wastes.
Prepare patients for transfer to tertiary centers: give report, send records and images, and complete transfer forms.
Carry out fall, pressure injury and infection prevention: risk scores, turning schedules, hand hygiene and isolation precautions.
Respond to codes and rapid responses, and run the code cart, defibrillator or code record as assigned.
Teach patients and families about medications and follow-up, and work with case management on discharge plans.
3. Key Tasks / Daily Activities
Give and take shift handoff at the bedside using SBAR.
Complete assessments and fall and skin risk scores, such as Morse and Braden, and chart in [your EHR].
Float between the ED and the inpatient unit as census changes.
Check orders and results, and call critical lab and imaging results to the provider.
Delegate to and supervise LPNs and patient care technicians within your state's rules.
Patient ratings of nurse communication: [your target].
5. Required Qualifications and Skills
Active [State] RN license, or a multistate RN license under the Nurse Licensure Compact if your state is a member.
Current BLS. ACLS, PALS and TNCC where your hospital requires, or within [timeframe] of hire.
Associate or bachelor's degree in nursing from an accredited program.
[1+] years of acute care or emergency nursing, or [newly licensed nurses with an extended orientation].
Sound judgment using standing orders and protocols with a small team, with a provider [on site or on call].
6. Preferred Experience
BSN.
CEN, CMSRN or another nursing specialty certification.
Experience in a critical access or rural hospital, including stabilizing patients for transfer.
Skill with IV starts, blood transfusions and cardiac monitoring.
OB, NRP or outpatient infusion experience [if your hospital offers those services].
7. Physical Requirements
Stand and walk for most of a [12]-hour shift.
Lift, turn and transfer patients with lift equipment and a coworker, and push beds and stretchers.
Do chest compressions and move quickly in emergencies.
With or without reasonable accommodation.
8. Work Environment and Schedule
[12]-hour day or night shifts, with weekends and holidays on a rotation: [schedule].
Small night teams: often [two or three] RNs in the building, plus LPNs and techs.
Call-back or on-call shifts: [rotation].
Exposure to bloodborne pathogens, infectious disease and upset patients or visitors, with PPE and safety training.
9. Compensation and Benefits
Pay: [range and hourly or salary basis].
Additional pay: [overtime, bonus or incentive terms, or none].
Benefits: [health, dental, vision, retirement, paid time off, and when they start].
10. Company Culture and Overview
[Two or three sentences on what your company does, the area you serve, and the support a new registered nurse gets in the first 90 days.]
11. How to Apply
[Apply link or email]. Our process: [phone interview, in-person interview, and next steps]. Contact [hiring contact] if you need an accommodation during the application process.
Need help filling this role? HireBus posts the ad, Iris interviews every applicant by phone before you do, and you decide who to hire. Start hiring now
What nursing in a critical access hospital asks for
A staff nurse at a large hospital usually works one unit, with specialists and a rapid response team down the hall. Here, the same nurse may see ER walk-ins, acute admissions, observation stays and swing bed patients in one shift.
One nurse, every kind of patient
Nurses float between the ER and the inpatient unit as the census changes. A night can start with a swing bed patient's evening medications and wound care, turn into a trauma in the ER, and end with getting a stroke patient ready to fly out. A nurse who wants one specialty will usually be happier at a larger hospital, so say plainly in the posting that this job floats.
Some screening exams can fall to an RN
Federal rules let a critical access hospital use an RN with ER training for some medical screening exams. Three things must be true. The RN is on site and free to see the patient right away. The complaint is within RN scope under state law. And your bylaws or rules allow it. Write down which complaints qualify, if any, and make sure every RN who does these exams knows that list. Source: 42 CFR 485.618: emergency services in critical access hospitals.
Small night teams lean on delegation
On nights the building may have just a few RNs, plus LPNs and techs. National guidelines from NCSBN and the American Nurses Association give a framework that applies where a state's nurse practice act is silent. The nurse who delegates a task still answers for the patient. Nursing judgment can't be delegated, and the patient must be stable. Each state sets its own delegation rules, so read your board's before you write the policy. Source: NCSBN and ANA: National Guidelines for Nursing Delegation.
Standing orders carry the first minutes
The provider may be on call rather than in the building. Until they arrive or call back, the RN starts care from the protocols your medical staff approved, such as a chest pain or stroke protocol. A good critical access RN knows exactly where each protocol stops, calls the provider early, and reads back every phone order.
Getting patients to a bigger hospital
Patients who need surgery, a cath lab or intensive care leave for a larger hospital. The RN keeps the patient stable, gives report to the receiving nurse, sends records and images, and fills out the transfer forms, while the provider and house supervisor arrange the bed and the ride. In an interview, have candidates describe the last transfer they sent, start to finish.
How much hospital registered nurses make
Registered nurses who work for general medical and surgical hospitals earned a median of $48.18 an hour ($100,210 a year) in May 2025, according to the Bureau of Labor Statistics. That’s about the same as the $97,550 median for registered nurses in all industries. About 1,902,960 of the 3,379,720 registered nurses in that survey work for general hospitals.
Paid by the hour, with differentials for nights, weekends and holidays, plus on-call and call-back pay. Some rural hospitals add sign-on or retention bonuses; put them in the posting.
General hospitals
$100,210$100,210 median Middle half $81,610–$118,990 10th–90th $76,270–$138,990
All industries
$97,550$97,550 median Middle half $80,330–$112,350 10th–90th $68,940–$137,470
$50k$75k$100k$125k$150k$175k
10th–90th percentileMiddle halfMedianAnnual pay, May 2025. Source: BLS Occupational Employment and Wage Statistics.
Annual pay by percentile
Group
10th
25th
Median
75th
90th
General hospitals
$76,270
$81,610
$100,210
$118,990
$138,990
All industries
$68,940
$80,330
$97,550
$112,350
$137,470
These figures cover general medical and surgical hospitals of every size. Rural hospitals often pay less than city hospitals. Post a real range for your market in the ad.
Skills to hire for, and what you can teach
Hire for these
Sound ER and med-surg assessment, and the nerve to call the provider early
Starts IVs, hangs blood and reads a cardiac monitor without a specialist nearby
Directs LPNs and techs clearly and checks what they report back
Charts as care happens, so the next nurse or the receiving hospital has the full picture
Moves from a trauma to a swing bed patient without dropping either
Teach these on the job
Your EHR and barcode medication scanning
Triage with ESI or your hospital's own system
Your standing orders and protocols
Transfer forms and how to send records and images
How swing bed care differs from acute care
RNs chart in the EHR, scan medications at the bedside, and work with IV pumps, cardiac monitors, defibrillators, glucometers and the code cart. If your ER connects to specialists at a larger hospital by video, mention it; nurses who have done telemedicine visits will see it as a plus.
Hospital registered nurse interview questions
They have their own page: 6 questions that test this job, what strong and weak answers sound like, and a work exercise to run with your finalists.
The template's targets are blank. Pull your own numbers from EHR reports and charge nurse spot checks, and compare nurses who work similar shifts, since an ER-heavy night won't look like a quiet med-surg day.
Medication barcode scanning compliance
Doses where the nurse scanned both the wristband and the medication, from the EHR's barcode report. Read the override reasons; a pattern can point to a broken scanner or a bad label.
Bedside handoff completion
Shift reports given at the bedside with the patient, from charge nurse spot checks or a handoff field in the EHR. Include ER-to-unit handoffs.
ED arrival to triage time
Minutes from ER arrival to documented triage, from EHR time stamps. Look at walk-ins and ambulance arrivals apart, and at nights when one nurse covers both areas.
Charting complete by end of shift
Assessments, medications, intake and output and notes finished before the nurse leaves, from the EHR's late-entry report. Late entries after a code or transfer are expected; track the rest.
Patient ratings of nurse communication
Scores on the nursing questions in your patient survey, read with the comments. With few discharges a month, look at a rolling quarter rather than one month.
Can we hire nurses who live in the next state over?
Yes, but the license depends on where they live. Under the Nurse Licensure Compact, a nurse whose primary home is a member state can hold a multistate license that works in other member states. Someone whose home is in a non-compact state can't get one. If your state is in the compact and theirs isn't, or the reverse, they need your state's own license before the first shift.
How much does a hospital registered nurse make?
Registered nurses who work for general medical and surgical hospitals earned a median of $48.18 an hour ($100,210 a year) in May 2025, according to the Bureau of Labor Statistics. The middle half earned between $81,610 and $118,990 a year. Pay also depends on your local market, experience and overtime.
Does an RN need a bachelor's degree to work here?
Not for the license. BLS says RNs usually take one of three paths: a bachelor's degree, an associate degree or a diploma, and licensed graduates of any of them qualify for entry-level staff nurse jobs. Some hospitals require a BSN anyway. In a small town that can shrink the pool. Hiring associate-degree nurses with a set time to finish an RN-to-BSN program is a middle path.
Which certifications help an RN at a critical access hospital?
BLS is the floor, and the template adds ACLS, PALS and TNCC where your hospital requires them. TNCC is the Emergency Nurses Association's trauma course. Board certification is a plus: the CEN from the Board of Certification for Emergency Nursing, or the CMSRN from the Medical-Surgical Nursing Certification Board, which asks for 2,000 med-surg practice hours over the last three years.
Can new graduate nurses work in a critical access hospital?
Yes, with a longer orientation, which the template allows for. A new nurse here has fewer people to ask at night, so pair them with one preceptor, start them on day shifts, and add ER shifts once they're steady on the unit. Don't count them in night staffing until the preceptor and the nurse manager sign off.
