Registered Nurse - Pediatric Intermediate Care - Night Shift

Intermediate Care Registered Nurse (RN) Neuro & Complex Care

Nexus Childrens Hospital Dallas is seeking an experienced Intermediate Care Registered Nurse (RN) to care for patients with complex medical, neurological, developmental, and behavioral conditions who require an intermediate or progressive level of care.

Our patients may have neurodevelopmental disorders, intellectual and developmental disabilities, traumatic brain injuries, autism spectrum disorders, seizure disorders, communication impairments, behavioral dysregulation, and other complex medical comorbidities.

The Intermediate Care RN combines acute and rehabilitative nursing practices with trauma-informed care and behavioral support. This position is ideal for a nurse with strong clinical assessment skills who can recognize subtle changes in patient condition, respond to potential deterioration, and provide compassionate, individualized care within an interdisciplinary environment.

What You Will Do

Intermediate and Progressive Nursing Care

• Provide direct nursing care to patients with complex medical, neurological, developmental, psychiatric, and behavioral conditions.
• Perform comprehensive initial and ongoing assessments using the nursing process.
• Identify patient risks, establish individualized outcomes, prioritize interventions, and evaluate responses to treatment.
• Recognize subtle changes in patient condition and promptly escalate clinical concerns through established pathways.
• Help prevent failure-to-rescue events through vigilant monitoring, critical thinking, and timely intervention.
• Assess and manage patients with neurological and cardiopulmonary conditions, airway needs, seizure disorders, wounds, and other complex clinical needs.
• Safely administer medications, blood products, enteral therapies, intravenous therapies, and other prescribed treatments.
• Monitor and reassess patients following treatments, medications, and clinical interventions.
• Use monitoring technology, early-warning indicators, clinical pathways, and decision-support tools to promote positive outcomes.
• Respond appropriately to escalating medical, neurological, or behavioral conditions and initiate emergency interventions according to hospital policy.

Individualized and Trauma-Informed Care

• Provide age-appropriate, developmentally appropriate, person-centered, and trauma-informed nursing care.
• Adapt care to each patients medical, behavioral, developmental, psychosocial, communication, and rehabilitation needs.
• Apply specialized knowledge of neurodevelopmental disorders, intellectual and developmental disabilities, traumatic brain injuries, autism, and communication disorders.
• Implement individualized behavioral-support and de-escalation strategies while maintaining a safe and therapeutic environment.
• Preserve patient dignity, autonomy, privacy, confidentiality, and self-determination.
• Use interpreters, visual supports, adaptive communication tools, and alternative communication methods when appropriate.
• Promote a respectful and healing environment for patients, families, and caregivers.

Interdisciplinary Collaboration

• Work closely with physicians, advanced practice providers, behavioral health clinicians, rehabilitation therapists, pharmacists, social workers, case managers, and direct-care staff.
• Develop and support individualized plans of care that integrate medical treatment, behavioral interventions, rehabilitation goals, and family involvement.
• Continuously evaluate and revise care plans based on changing patient needs and responses to treatment.
• Facilitate safe admissions, transfers, discharges, and transitions of care using structured communication.
• Participate in discharge planning and coordinate resources that support continuity of care and help reduce preventable readmissions.
• Maintain competency to provide care across programs and clinical areas as patient-care and operational needs require.

Patient and Family Education

• Assess health literacy, learning needs, communication preferences, and cultural considerations.
• Provide individualized education regarding diagnoses, medications, treatments, safety precautions, and discharge plans.
• Encourage patients and families to participate in care planning and discharge preparation.
• Advocate for resources and services that support successful transitions and continued treatment.
• Support patients and families in making informed care decisions.

Quality, Safety, and Compliance

• Maintain accurate, timely, and legally compliant clinical documentation.
• Document assessments, interventions, patient responses, escalation actions, education, interdisciplinary communication, and changes to the care plan.
• Follow applicable federal and state laws, Texas Board of Nursing regulations, accreditation standards, and hospital policies.
• Support initiatives to reduce falls, pressure injuries, medication errors, restraint use, healthcare-associated infections, and behavioral-safety events.
• Report incidents, near misses, safety concerns, and compliance issues according to organizational requirements.
• Participate in quality-improvement activities, infection-prevention initiatives, audits, peer reviews, competency validation, and regulatory survey readiness.
• Promote workplace-violence prevention and a culture of safety, accountability, and respect.
• Use supplies, equipment, and hospital resources responsibly while maintaining high-quality patient care.

Position Qualifications

Education

• Associate Degree in Nursing from an accredited nursing program required.
• Bachelor of Science in Nursing preferred.
• Additional education or training in neuroscience, progressive care, behavioral health, developmental disabilities, or rehabilitation nursing preferred.

Experience

• At least one year of acute-care nursing experience required.
• Two or more years of experience in intermediate care, step-down, telemetry, neuroscience, rehabilitation, behavioral health, medical-surgical, or critical-care nursing preferred.
• Experience caring for patients with traumatic brain injuries, seizure disorders, neurodevelopmental conditions, intellectual or developmental disabilities, autism, behavioral dysregulation, or complex medical conditions preferred.
• Experience with interdisciplinary care coordination and patient or family education preferred.

Equivalent internal clinical experience may be considered for current Nexus employees who demonstrate competency in caring for medically complex patients, successfully complete required training and competency validation, maintain satisfactory performance, and receive Nursing Leadership approval.

Licensure and Certifications

• Current, unrestricted Texas Registered Nurse license or compact multistate RN license required.
• Current Basic Life Support certification from the American Heart Association or American Red Cross required.
• Advanced Cardiovascular Life Support certification required based on unit requirements.
• Pediatric Advanced Life Support certification required based on unit requirements.
• Required credentials must remain current and in good standing throughout employment.
• De-escalation training must be completed within 30 days of hire.
• Specialty certification related to intermediate, progressive, neurological, or rehabilitation nursing is preferred.

Knowledge and Skills

• Strong clinical assessment, critical-thinking, and nursing judgment skills.
• Ability to recognize and respond to clinical deterioration or changes in patient condition.
• Ability to manage patients with complex medical, neurological, developmental, and behavioral needs.
• Knowledge of behavioral de-escalation and therapeutic communication techniques.
• Ability to balance medical nursing priorities with behavioral, developmental, rehabilitative, and trauma-informed approaches.
• Effective communication, collaboration, teamwork, and conflict-resolution skills.
• Ability to organize and prioritize responsibilities in a dynamic healthcare environment.
• Knowledge of patient-safety principles, infection-prevention standards, and quality-improvement practices.
• Proficiency with electronic medical records and bedside monitoring technology.

About Nexus Childrens Hospital Dallas

Nexus Childrens Hospital Dallas provides specialized inpatient care for patients with complex medical, neurological, developmental, rehabilitative, and behavioral needs. Our interdisciplinary teams develop individualized treatment plans that support medical stability, functional progress, patient safety, and improved quality of life.

If you are an acute-care nurse who wants to use your clinical expertise in a highly specialized, collaborative environment, we invite you to join the Nexus team.