Intermediate Care (IMC)

Intermediate Care Registered Nurse

An Intermediate Care (IMC) Registered Nurse at Johns Hopkins Medicine provides high-acuity nursing care to patients who require a level of monitoring and intervention between a general medical-surgical floor and an Intensive Care Unit. This role focuses on the management of clinically complex patients with potentially life-threatening conditions who are stable enough not to require intubation but still need frequent assessment. The IMC RN is responsible for the assessment, treatment, and continuous monitoring of patients with acute illnesses or those recovering from major surgeries. Operating in a high-tech environment, the nurse manages specialized equipment and titrated medications while identifying early signs of clinical deterioration. This position requires strong critical thinking and the ability to act quickly to stabilize patients or facilitate a transfer to a higher level of care.

Key Responsibilities

• Performing frequent physical assessments and continuous cardiac and hemodynamic monitoring.
• Managing patients with specialized needs, such as those requiring non-invasive ventilation (BiPAP/CPAP), high-flow nasal cannula, or stable arterial lines.
• Administering and titrating intermediate-level intravenous drips, including certain vasoactive medications, anti-arrhythmics, and insulin infusions.
• Recognizing and responding to cardiac dysrhythmias and acute changes in neurological or respiratory status.
• Collaborating with a multidisciplinary team of hospitalists, specialists, and respiratory therapists to execute complex care plans.
• Providing post-operative care for patients following vascular, thoracic, or neurosurgical procedures who require close observation.
• Educating patients and their families on complex disease processes, treatment goals, and recovery expectations.
• Maintaining meticulous electronic health records, including intake and output, medication administration, and hourly monitoring data.
• Leading or participating in rapid response calls and stabilizing patients during acute clinical shifts.

Qualifications and Requirements

• A valid and unencumbered Registered Nurse license in the state of Maryland or a recognized compact state.
• Bachelor of Science in Nursing (BSN) from an accredited program is required.
• Current Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) certifications.
• Minimum of one year of experience in an acute care setting; prior experience in a Step-down, IMC, or telemetry unit is highly preferred.
• Progressive Care Certified Nurse (PCCN) or Critical Care Registered Nurse (CCRN) certification is desirable.
• Exceptional analytical skills and the ability to prioritize tasks in a fast-paced, high-pressure environment.
• Strong communication skills for effective hand-offs and interdisciplinary collaboration.

Working Conditions

• Work is performed in an intermediate care or step-down unit equipped with advanced monitoring technology.
• Requires standing and walking for the majority of 12-hour shifts.
• Physical ability to lift, position, and transfer patients and move heavy medical equipment (up to 50 lbs).
• Potential exposure to infectious diseases, requiring strict adherence to infection control and personal protective equipment protocols.
• Participation in a rotating schedule that includes days, nights, weekends, and holidays.

Equal Opportunity Employer: ATC Healthcare Services is an Equal Opportunity Employer. All applicants will be considered for employment without regards to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran or disability status or any other category protected by Federal, State or local law. M/F/D/V EOE