RN ER Full-time
Dartmouth Hitchcock Medical Center

Emergency Department Charge Registered Nurse (RN) - Emergency Department

Overview

The ED Lead/Triage Nurse is a vital leadership and clinical role responsible for overseeing shift operations in the Emergency Department, ensuring efficient patient flow, safe care delivery, and effective team coordination. This role also involves assessing and prioritizing patients upon arrival through systematic triage, initiating appropriate care pathways, and facilitating communication between healthcare teams.

Responsibilities

Lead Nurse Responsibilities:

Leadership & Oversight

  • Serve as the clinical leader and primary resource for nursing staff during assigned shifts.
  • Coordinate staffing assignments based on patient acuity and unit needs.
  • Manage shift operations, including delegation of tasks and monitoring workflows.
  • Support staff in escalating clinical concerns to providers or leadership as needed.

Patient Flow & Throughput

  • Oversee the movement of patients through the ED, from arrival to disposition (admission, transfer, or discharge).
  • Collaborate with bed management, inpatient units, and ancillary departments to optimize patient flow.
  • Address and mitigate bottlenecks or delays in real-time.

Resource Management

  • Ensure appropriate availability of supplies, equipment, and staffing resources.
  • Initiate and lead code responses, disaster preparedness actions, and emergency protocols.

Communication & Team Support

  • Act as a liaison between ED staff, physicians, other departments, and hospital leadership.
  • Facilitate shift handoff and ensure continuity of care through effective communication.
  • Provide coaching, mentorship, and conflict resolution as needed.
  • Provide coverage for breaks to ensure downtime for our staff.

 Triage Nurse Responsibilities:

 Initial Patient Assessment

  • Perform comprehensive triage assessments using standardized triage protocols (e.g., ESI—Emergency Severity Index).
  • Determine the priority level for care based on patient acuity and resource needs.

Clinical Decision-Making

  • Identify high-risk patients and initiate life-saving interventions per standing orders or protocols.
  • Communicate critical findings promptly to the care team.

Documentation & Data Entry

  • Accurately document triage assessments, vital signs, chief complaints, and other pertinent clinical information in the EHR.

Patient Experience & Safety

  • Provide clear instructions and explanations to patients and families regarding wait times, processes, and care expectations.
  • Ensure infection control and safety measures are adhered to in the waiting area and triage spaces.

Qualifications

  • Education: Graduate of an accredited Nursing Program (ADN or BSN preferred).
  • Licensure: Current Registered Nurse (RN) license.
  • Certifications: BLS and ACLS upon hire.  PALS and AVADE within 6 months of hire. TNCC and NRP within 1 year of hire. ENPC is supported by leadership and optional.
  • Experience: Minimum of 2–3 years Emergency Department nursing experience. Prior leadership or triage experience preferred.
  • Skills:
    • Strong clinical assessment and critical thinking skills.
    • Excellent communication, leadership, and team coordination abilities.
    • Proficiency in electronic medical records (EMR/EHR).
    • Ability to manage multiple priorities in a fast-paced environment.

Required Licensure/Certifications

REQUIRED LICENSE(S):

Licensed RN with NH eligibility REQUIRED CERTIFICATIONS:

(BLS) Basic Life Support

(ACLS) Advanced Cardiac Life Support

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