Pediatric Registered Nurse - Intermediate Care

Nexus Health Systems; Shenandoah (TX); On-site; USD 75,000 - 105,000; Full time

Job summary

Nexus Children’s Hospital – Shenandoah, TX is seeking an RN with PICU/IMU experience to join our inpatient rehabilitation team. You will provide skilled nursing care to medically complex pediatric patients, collaborating with rehab therapists to support functional recovery.

The role emphasizes accurate assessments, timely interventions, and family-centered care within an inpatient rehabilitation setting. Texas RN licensure and current BLS are required; ACLS/PALS per unit need.

Qualifications

• Pediatric ICU (PICU) or IMU experience required or highly preferred.
• Minimum of one year of acute care nursing experience.
• Current Texas RN license or compact multistate license.
• BSN preferred.
• BLS required; ACLS and PALS per unit requirements.

Responsibilities

• Provide skilled care for medically complex pediatric patients.
• Coordinate with physical, occupational, and speech therapy teams to support rehabilitation.
• Monitor and respond promptly to changes in patient condition.
• Maintain accurate documentation and coordinate admissions, transfers, and discharges.
• Promote family-centered care and involve caregivers in treatment and discharge planning.

Skills

Pediatric assessment

Critical thinking

Care coordination

Communication with families

EMR proficiency

Education

Associate Degree in Nursing (ADN)

Bachelor of Science in Nursing (BSN)

Tools

EMR systems

Telemetry equipment

Bedside monitors

Job description

Registered Nurse (RN) – Intermediate Care / Inpatient Rehabilitation

Nexus Children’s Hospital – Shenandoah, TX

Bring Your Pediatric ICU or IMU Experience to Specialized Inpatient Rehabilitation

Nexus Children’s Hospital – Shenandoah is seeking a Registered 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 escalat[e] 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 of one 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

• Current BLS 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 your PICU 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.