Registered Nurse - 4 East TCV Stepdown Unit

4 East is a 28-bed acute and intermediate care unit caring for UVA Health’s Thoracic, Cardiac, and Vascular (TCV) surgical patient population. Nurses gain exposure to a broad range of complex surgical patients.

Typical nurse-to-patient ratios are 4:1 in acute care , with the ability to flex to 5:1 when appropriate, and 3:1 in TIMU .

4 East is an excellent destination for nurses who want to accelerate their clinical growth. The combination of acute and intermediate-care patients provides nurses with the opportunity to strengthen assessment, prioritization, critical-thinking, and clinical decision-making skills while caring for a highly specialized surgical population.

Key candidate selling points:

- Exposure to complex cardiac, thoracic, and vascular surgical patients
- Blended acute and intermediate-care experience that builds a strong clinical foundation
- Experience with highly specialized procedures, including heart and lung transplantation
- Strong preparation for nurses interested in eventually moving into ICU or other advanced-care environments
- A culture that depends on teamwork, initiative, and colleagues supporting one another
- Significant opportunity to sharpen critical-thinking and prioritization skills
- Variety: this is not a unit where every shift looks the same

Work Schedule, On-Call, Hours, etc.

Nurses work 12-hour shifts :

- Full-time: Three 12-hour shifts
- Part-time: Two 12-hour shifts
- Overtime: Opportunities are typically available for nurses interested in picking up additional shifts

Every six weeks, team members submit their preferred schedules. Leadership and administrative staff then balance those requests with patient-care and staffing needs, with the goal of honoring individual preferences whenever possible while maintaining safe staffing.

The scheduling model gives nurses an opportunity to communicate the shifts that work best for them while maintaining the coverage necessary for this high-acuity patient population.

Day-to-Day Responsibilities

No two days on 4 East are exactly alike.

Nurses provide comprehensive care throughout the surgical patient's journey, including:

- Performing patient assessments and ongoing reassessments
- Monitoring and caring for acute and intermediate-acuity patients
- Providing postoperative care to complex TCV surgical patients
- Documenting assessments, interventions, and outcomes
- Coordinating admissions, transfers, and discharges
- Supporting postoperative protocols and early mobilization
- Educating patients and families
- Recognizing and responding to changes in patient condition
- Prioritizing care across blended-acuity assignments
- Collaborating closely with the interdisciplinary care team

Nurses work alongside providers, PCTs, physical and occupational therapists, speech therapists, case managers, social workers, and other clinical partners .

As a surgical unit, 4 East experiences frequent patient movement and turnover. Nurses have opportunities to become highly skilled in both complex clinical care and efficient patient throughput.

Candidate selling point: Nurses who enjoy being busy, learning continuously, and seeing tangible patient progress following major surgery can find 4 East especially rewarding.

Successful candidates should demonstrate:

- Strong clinical assessment and critical-thinking skills
- Ability to provide or develop competency in caring for postoperative thoracic, cardiac, and vascular surgery patients
- Ability to care for higher-acuity patients in an intermediate-care environment
- Ability and willingness to learn the management of patients following CABG, valve replacement, aneurysm repair, vascular repair, and thoracic surgery
- Clear, professional communication with patients, families, and interdisciplinary team members
- Strong teamwork and collaboration with nurses, providers, technicians, and other support staff
- Effective prioritization across blended-acuity assignments
- Commitment to postoperative protocols, patient safety, and early mobilization
- Adaptability and sound judgment in a dynamic clinical environment

Importantly, candidates do not need to arrive knowing everything. The hiring manager is willing to consider nurses with a solid clinical foundation who demonstrate strong judgment, initiative, learning agility, and the ability to develop more specialized technical skills.

Preferred Skillset:

Competitive candidates may bring:

- 1-2+ years of cardiac stepdown, ICU, progressive care, or closely related experience
- Previous experience with postoperative cardiac, thoracic, or vascular surgery patient pathways
- Experience working in a blended-acuity environment
- PCCN and/or CSC certification
- Charge nurse experience
- Preceptor experience
- Demonstrated resilience and adaptability in a high-turnover surgical environment
- Participation in local or regional professional governance or professional organizations

The ideal candidate is a nurse with approximately 1-2+ years of cardiac stepdown, ICU, progressive care, IMU, or comparable higher-acuity nursing experience .

Previous experience with this exact surgical population is valuable but is not the only pathway to success .

MINIMUM REQUIREMENTS

Education: Graduate of an accredited nursing program required. Bachelor of Science in Nursing required within 5 years of hire.

Experience: 1 year of relevant experience.

Licensure: Licensed to Practice as a Registered Nurse in the Commonwealth of Virginia. American Heart Association (AHA) Health Care Provider BLS certification required.

PHYSICAL DEMANDS

Job requires standing for prolonged periods, frequently traveling, bending/stooping. Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly; Ability to lift/push/pull 20 - 50lbs. May be exposed to chemicals, blood/body fluids and infectious disease.

The pay range for this role is $41.05 - $54.15 hourly. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Benefits

- Comprehensive Benefits Package: Medical, Dental, and Vision Insurance
- Generous Paid Time Off
- Retirement Savings
- Long-term and Short-term Disability
- Health Saving Plans, and Flexible Spending Accounts
- Certification and Education Support

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment .