Mixed Shift | Day and Night Shifts Based on Department Needs Position Highlight Provide high-quality emergency nursing care in a rural Critical Access Hospital where your clinical judgment, adaptability, and ability to respond to a wide range of patient needs make a meaningful difference every shift. This is a mixed-shift position requiring flexibility to work both day and night shifts as department needs dictate . The ideal candidate is comfortable practicing across varying shifts and brings the clinical judgment, teamwork, and adaptability needed in a rural Emergency Department. Position Summary Pagosa Springs Medical Center (PSMC) is seeking a skilled and compassionate Registered Nurse to join our Emergency Department team . The Emergency Department RN provides urgent and emergent nursing care to patients presenting with a broad range of illnesses, injuries, and acuity levels. In this role, you will assess and triage patients, prioritize care based on clinical condition, initiate emergency nursing interventions, administer medications and treatments, monitor and reassess patients, collaborate closely with physicians and other members of the healthcare team, educate patients and families, and accurately document assessments, interventions, and changes in condition. As a Critical Access Hospital , PSMC offers Emergency Department nurses the opportunity to maintain a broad clinical skill set and play an important role in providing essential emergency care close to home for our rural community. Why Join PSMC? Practice emergency nursing in a Critical Access Hospital serving a rural mountain community Care for patients across a broad range of ages, conditions, and acuity levels Work closely with physicians, EMS, nursing colleagues, and other clinical departments Utilize and strengthen emergency nursing skills including triage, cardiac monitoring, IV therapy, airway management, medication administration, stabilization, and patient transfer Join a collaborative team where critical thinking, adaptability, and teamwork are essential Serve a community where access to high-quality local emergency care makes a meaningful difference Live and work in beautiful Pagosa Springs, Colorado, surrounded by the San Juan Mountains and exceptional year-round outdoor recreation Key Responsibilities Emergency Assessment & Triage Perform comprehensive nursing assessments and continuously reassess patients based on clinical condition Triage patients utilizing Emergency Severity Index (ESI) guidelines Assess cardiovascular, respiratory, neurological, hemodynamic, pain, comfort, and mental status needs Recognize changes in patient condition and promptly communicate abnormal findings to the appropriate provider Apply critical thinking and sound clinical judgment in a fast-paced emergency care environment Emergency & Clinical Nursing Care Provide nursing care within the RN scope of practice as defined by the State of Colorado Initiate and manage treatments including IV therapy, oxygen therapy, catheters, NG tubes, orthopedic braces and splints, EKGs, and other ordered interventions Administer medications and IV infusions safely and accurately Monitor patients receiving procedural or conscious sedation and provide appropriate recovery care Provide acute pain and comfort management Perform cardiac monitoring and identify dysrhythmias, taking appropriate action based on rhythm interpretation Support airway management, hemodynamic monitoring, vascular access, and other emergency interventions within applicable scope and demonstrated competency Maintain infection prevention, medical and surgical asepsis, and patient safety practices Patient-Centered Care & Education Provide age-specific, culturally competent, ethical care while protecting patient dignity, privacy, and rights Educate patients and families regarding medications, treatment plans, pain management, follow-up care, and discharge instructions Include patients and designated support persons in decisions affecting the plan of care Identify individual learning needs and evaluate the effectiveness of patient and family education Address psychosocial needs and adapt care appropriately for patients of different cultural and religious backgrounds Care Coordination & Communication Collaborate effectively with Emergency Department physicians, providers, nursing staff, EMS, and other hospital departments Communicate patient status throughout the continuum of emergency care Coordinate transfers of care using established hospital procedures and SBAR communication Ensure provider orders are accurate, complete, and appropriately implemented Coordinate interdisciplinary resources based on patient needs Provide clear and accurate handoff communication when transferring patients to another level or location of care Documentation, Safety & Quality Complete required assessments and clinical documentation accurately in the electronic health record Document medications, treatments, interventions, patient responses, and changes in condition Use appropriate patient identifiers and accurately reconcile medications and allergies Follow National Patient Safety Goals and established PSMC policies and procedures Prioritize patient safety and take appropriate action to prevent potential errors or adverse events Maintain required competencies, continuing education, and Emergency Department clinical skills Teamwork & Professional Practice Communicate effectively with providers, employees, patients, and organizational leadership Remain calm and professional in high-stress, rapidly changing situations Demonstrate adaptability when patient needs or circumstances change Work independently while appropriately utilizing available clinical resources Assist with maintaining clean, appropriately stocked Emergency Department patient care areas Serve as a resource and mentor to other staff and support continuous learning within the department Education High school diploma or equivalent required Graduate of an accredited Registered Nursing program required Bachelor of Science in Nursing (BSN) preferred Experience Two (2) years of Emergency Department nursing experience preferred Licensure & Certifications Current Colorado RN license in good standing Current AHA BLS certification for healthcare providers required Current TNCC certification required Current ACLS certification , or successful completion at the next available course within three months Current PALS certification , or successful completion at the next available course within three months Certified Emergency Nurse (CEN) certification preferred Skills & Technology Basic computer proficiency, including Microsoft Office and electronic health records Strong clinical assessment and critical-thinking skills Ability to communicate clearly and effectively with patients, families, providers, and coworkers Ability to work independently and manage multiple priorities in a rapidly changing environment Ability to remain calm and exercise sound judgment during escalating or high-stress situations What We're Looking For We're looking for an Emergency Department RN who: Is confident assessing, prioritizing, and responding to urgent and emergent patient needs Brings strong clinical judgment and recognizes changes in patient condition quickly Can remain calm, organized, and compassionate in high-pressure situations Is comfortable caring for patients with a broad range of diagnoses, acuity levels, and ages Communicates effectively with physicians, EMS personnel, nursing colleagues, patients, and families Values patient safety, accurate documentation, and evidence-based nursing practice Is flexible and adaptable to the changing needs of a rural Emergency Department Is comfortable working a mixed schedule that includes both day and night shifts Supports colleagues and contributes positively to a collaborative clinical team Demonstrates PSMC's WISER values of Wholeness, Integrity, Stewardship, Excellence, and Respect Schedule & Work Environment This is a full-time, 0.9 FTE position , anticipated to work approximately 36 hours per week This is a mixed-shift position. The RN will be scheduled for both day and night shifts based on department staffing and operational needs. Candidates must be able and willing to work both shifts. Work is performed in a hospital Emergency Department environment where nurses must be prepared for frequent interruptions, rapidly changing patient conditions, and high-stress situations. The position includes potential exposure to blood and bodily fluids, communicable diseases, radiation, chemicals and hazardous materials, and the physical demands associated with lifting, moving, and positioning patients and equipment.
Compensation & Benefits Base Compensation Range:
$38.20 - $47.75 hourly
Shift Differential Pay:
Swing Shift Differential:
Employees who work majority of hours between 2:00 p.m. and 11:00 p.m. receive a Swing Shift Differential of an additional $5.00 per hour.
Night Shift Differential:
Employees who work majority of hours between 6:30 p.m. and 7:00 a.m. receive a Night Shift Differential of an additional $5.00 per hour.
Benefits:
Benefits include generous paid time off, separate sick leave, health, dental, vision, life and AD&D insurance, long-term disability and option for short-term disability, and retirement plan with employer contribution.
Job Type:
Full-time Shift Type:
Mixed shift - shifts will be both day and night shifts, as need dictates. Anticipated End Date for
Posting:
October 31, 2026. The deadline may close sooner due to an unanticipated business necessity, such as an incumbent vacating the role earlier than anticipated. You are encouraged to apply well in advance of the deadline. Pagosa Springs Medical Center is an Equal Opportunity Employer. All qualified applicants will be considered for employment, and we will not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, marital status, or any other characteristic protected by law. Offers of employment are contingent upon successful completion of a pre-employment health and drug screen and background check. About Pagosa Springs Medical Center Pagosa Springs Medical Center is a Critical Access Hospital serving Pagosa Springs and Archuleta County in southwest Colorado. Our Emergency Department provides essential urgent and emergent care to residents and visitors of our rural mountain community. Working in a Critical Access Hospital provides nurses with the opportunity to use a broad clinical skill set, collaborate closely across disciplines, and have a direct impact on maintaining access to high-quality healthcare close to home. Located in the beautiful San Juan Mountains, Pagosa Springs offers an exceptional quality of life with year-round opportunities for hiking, skiing, fishing, mountain biking, rafting, hunting, and other outdoor recreation. At PSMC, you'll join a collaborative team guided by our WISER values: Wholeness, Integrity, Stewardship, Excellence, and Respect. Apply Today If you're an Emergency Department RN who thrives in a dynamic clinical environment, values teamwork, and is ready to provide high-quality emergency care across both day and night shifts, we'd love to hear from you. Join Pagosa Springs Medical Center and help us provide exceptional emergency care to our community when it matters most.