Pediatric Registered Nurse - Intermediate Care

Nexus Children's Hospital; Shenandoah (TX); On-site; USD 75,000 - 105,000; Full time

Job summary

Nexus Children’s Hospital in Shenandoah, TX is seeking a Registered Nurse with PICU/IMU experience to join our inpatient rehabilitation team. The role emphasizes caring for medically complex pediatric patients and coordinating with therapists to support recovery.

The Intermediate Care RN will apply expert nursing skills in a rehabilitation context, ensuring safety, medical stability, and family-centered care throughout the patient’s journey.

Qualifications

• Experience in pediatric ICU (PICU) or IMU or step-down is highly preferred.
• Nurses with strong assessment skills and ability to respond quickly to changes in condition.
• Experience caring for medically complex pediatric patients preferred.
• Current Texas RN license or compact license required.
• BLS certification required; ACLS/PALS per unit requirements.

Responsibilities

• Provide comprehensive nursing care to medically complex pediatric patients in inpatient rehabilitation.
• Perform initial and ongoing assessments focusing on neurological, respiratory, cardiovascular status.
• Recognize changes in condition and initiate appropriate interventions.
• Administer medications and therapies according to orders and competencies.
• Collaborate with therapists to support functional recovery and mobility.
• Coordinate admissions, transfers, and discharges with care teams.
• Maintain accurate documentation and uphold infection prevention and safety standards.

Skills

Pediatric ICU experience

Pediatric IMU experience

Acute care nursing

Neurological assessment

Family-centered care

Education

ADN in Nursing

BSN preferred

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Pediatric Registered Nurse - Intermediate Care

Full Time Professional Shenandoah, TX, US

2 days ago Requisition ID: 2221

Registered Nurse (RN) – Intermediate Care / Inpatient Rehabilitation

Bring Your Pediatric ICU or IMU Experience to Specialized Inpatient Rehabilitation

Nexus Children’s Hospital – Shenandoah is seeking aRegistered 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.

Position Summary

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.

Key Responsibilities

Provide Skilled Care for Medically Complex Patients

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 accelerate 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.

Support Rehabilitation and Functional Recovery

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.

Deliver Developmentally Appropriate and Family-Centered Care

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.

Coordinate Care and Maintain Clinical Standards

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.

Qualifications

Experience

Pediatric ICU (PICU) or pediatric intermediate care (IMU) experience highly preferred.

Pediatric step-down or progressive care experience strongly preferred.

Minimum ofone year of acute care nursing experience required.

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.

Equivalent internal clinical experience may be considered for current employees who meet role‑specific training, competency, performance, and Nursing Leadership approval requirements.

Education and Licensure

Associate Degree in Nursing (ADN) from an accredited nursing program required.

Bachelor of Science in Nursing (BSN) preferred.

Current, unrestricted Texas RN license or compact multistate RN license authorizing practice in Texas required.

Certifications

CurrentBLS 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.

Required certifications must remain current throughout employment.

Relevant specialty certification preferred.

Clinical Skills

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.

Put Your Pediatric Critical Care Experience to Work at Nexus

Bring yourPICU or pediatric IMU experience to a team where your clinical judgment supports both medical stability and meaningful recovery. Help patients move forward through skilled, compassionate inpatient rehabilitation nursing care.