Registered Nurse – ER Department, MICN

Madera Community Hospital; Madera (CA); On-site; USD 110,000 - 150,000; Full time

Job summary

Madera Community Hospital seeks an Emergency Department Registered Nurse with MICN certification to provide advanced, evidence-based care for patients across all ages in a high-acuity ED.

The role involves real-time medical oversight of prehospital personnel, collaboration with physicians and APNs, and leadership in patient safety and quality initiatives within a fast-paced environment.

Qualifications

• MICN certification required and active at time of hire.
• Active California RN license required.
• ADN or BSN degree required; BSN preferred.
• BLS certification required.
• ACLS certification required.
• PALS certification required.
• TNCC required or must be obtained within 6 months of hire.
• CEN certification preferred.
• CPI or equivalent de-escalation training preferred.

Responsibilities

• Perform rapid assessment and triage of ED patients by acuity.
• Initiate emergent interventions including airway management and IV access.
• Develop evidence-based plans of care with physicians and care team.
• Document assessments and interventions in Meditech.
• Mentor ED staff and support ongoing competency development.
• Lead quality improvement and patient-safety initiatives in ED.
• Communicate effectively with patients, families, and the care team.
• Ensure timely hand-offs during shift changes and transfers.
• Respond to codes and disaster events per protocols.

Skills

MICN certification

CA RN license

BLS

ACLS

PALS

TNCC

CEN (preferred)

CPI (preferred)

Critical thinking

Leadership/mentorship

Education

ADN/BSN (BSN preferred)

Tools

Meditech

Job description

Job Summary

The Emergency Department Registered Nurse provides advanced, evidence-based nursing care to patients of all ages presenting with acute, urgent, and emergent conditions. This position requires current Mobile Intensive Care Nurse (MICN) certification, authorizing the RN to provide direct, real-time medical oversight and treatment orders to paramedics and other prehospital personnel in the field per county EMS Agency base hospital protocols. The MICN-certified ED RN partners with physicians, advanced practice providers, and the interdisciplinary care team to deliver rapid assessment, triage, stabilization, and treatment in a fast-paced, high-acuity environment, while also serving as a base hospital contact for incoming EMS traffic.

Essential Duties & Responsibilities

• Perform rapid, comprehensive assessment and triage of patients presenting to the Emergency Department, prioritizing care based on acuity.
• Initiate and manage emergent interventions, including airway management, IV access, medication administration, and resuscitation, per hospital protocols and scope of practice.
• Develop and implement individualized, evidence-based plans of care in collaboration with physicians, advanced practice providers, and the care team.
• Accurately and promptly document assessments, interventions, and patient response in the electronic medical record (Meditech).
• Serve as a clinical resource and mentor for ED staff, precepting new hires and supporting ongoing competency development.
• Lead or participate in evidence-based practice, quality improvement, and patient-safety initiatives within the department.
• Communicate effectively with patients, families, and the care team, providing education on diagnoses, treatment plans, and discharge instructions.
• Ensure timely, accurate hand-offs during shift change, transfer, admission, or discharge.
• Maintain compliance with Title 22, Joint Commission, CMS, and hospital policies related to patient care, safety, and documentation.
• Respond to codes, rapid responses, and mass-casualty or disaster events per hospital emergency preparedness protocols.
• Take meal and rest breaks as scheduled and clock in/out accurately in accordance with hospital timekeeping policy.
• Perform other duties as assigned by the ED Manager or Director of Nursing.

Education & Certification Requirements

• Mobile Intensive Care Nurse (MICN) certification — REQUIRED / MANDATORY. Candidates without current MICN certification will not be considered; MICN must be active at time of hire and maintained throughout employment in this role.
• Current, active California Registered Nurse (RN) license, in good standing — required.
• Associate or Bachelor of Science in Nursing (ADN/BSN) required; BSN preferred.
• Current Basic Life Support (BLS) certification, American Heart Association — required.
• Current Advanced Cardiovascular Life Support (ACLS) certification — required.
• Current Pediatric Advanced Life Support (PALS) certification — required.
• Trauma Nursing Core Course (TNCC) required or must be obtained within 6 months of hire.
• Certified Emergency Nurse (CEN) preferred.
• Crisis Prevention Intervention (CPI) or equivalent de-escalation training preferred.

Experience Requirements

• Minimum 2 years of Emergency Department or acute care RN experience required; 3+ years preferred.
• Charge nurse, preceptor, or leadership experience preferred.
• Experience with electronic medical record systems (Meditech preferred).

Knowledge, Skills & Abilities

• Strong critical thinking, clinical judgment, and rapid decision-making skills in high-acuity, time-sensitive situations.
• Ability to manage multiple, competing priorities in a fast-paced environment.
• Excellent verbal and written communication skills with patients, families, physicians, and interdisciplinary team members.
• Demonstrated leadership, mentorship, and precepting capability.
• Working knowledge of evidence-based practice and quality/performance improvement methodology.
• Cultural competency and ability to provide patient-centered care to a diverse population.

Physical Demands & Working Conditions

• Ability to stand, walk, and move continuously for the duration of a 12-hour shift.
• Ability to lift, transfer, and reposition patients up to 50 lbs., with assistance as needed.
• Exposure to communicable diseases, bodily fluids, and hazardous materials consistent with an acute care/emergency setting.
• Ability to respond quickly to emergent, high-stress situations.
• Flexibility to work varying shifts, including nights, weekends, and holidays, and to respond to on-call or disaster-response needs as required.