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Step Down Rn Jobs in Houston, TX (NOW HIRING)

Ehmct

ICU Experienced Registered Nurse

Baytown, TX · On-site

Support safe transitions between ED, OR, ICU, step-down, and transfer destinations. Scheduling and ... Active RN license in the State of Texas or compact RN license in good standing. * ICU experience ...

HCS 247

Travel OR RN

Pasadena, TX · On-site

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

HCS 247

Travel Emergency Department RN

Houston, TX · On-site

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

New

HCS 247

Travel Emergency Dept RN

Cypress, TX · On-site

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

HCS 247

Travel Emergency Department RN

Kingwood, TX · On-site

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

HCS 247

Travel Emergency Department RN

Kingwood, TX · On-site

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

HCS 247

Travel CVICU RN

Houston, TX · On-site

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

New

HCS 247

Travel SICU RN

Houston, TX · On-site

$1.9K - $2.7K/wk

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

HCS 247

Travel L&D RN

Conroe, TX · On-site

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

HCS 247

Travel SICU RN

Houston, TX · On-site

$1.9K - $2.7K/wk

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

HCS 247

Travel Cardiac Cath Lab RN

Houston, TX · On-site

$2.4K - $3.2K/wk

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

HCS 247

Travel Cardiac Cath Lab RN

Houston, TX · On-site

$2.4K - $3.2K/wk

Our clinical coverage includes Registered Nurse specialties such as ER, ICU, Med-Surg, Telemetry, Step-Down, OR, PACU, L&D, Mother/Baby, NICU, Cath Lab, Endoscopy, and more along with a full range of ...

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Step Down Rn information

See Houston, TX salary details

$31

$47

$59

How much do step down rn jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for step down rn in Houston, TX is $47.10, according to ZipRecruiter salary data. Most workers in this role earn between $39.37 and $55.22 per hour, depending on experience, location, and employer.

What is a Step Down RN?

Step Down RNs are registered nurses who work in step-down units, which are transitional care areas between the intensive care unit (ICU) and general medical-surgical floors. These nurses care for patients who require close monitoring and specialized care but are not as critically ill as those in the ICU. Step Down RNs monitor vital signs, administer medications, manage care plans, and respond to changes in patient conditions. Their role is crucial in helping patients recover and transition to lower levels of care safely.

What skills and qualifications are needed to be a Step Down RN?

To thrive as a Step Down RN, you need a strong clinical background in acute and progressive care, typically supported by an active RN license and experience in critical or intermediate care settings. Familiarity with cardiac monitors, electronic health records (EHRs), and advanced life support certifications (such as ACLS) is often required. Excellent critical thinking, communication, and teamwork skills help nurses respond to rapidly changing patient conditions and coordinate with multidisciplinary teams. These competencies are vital to ensure patient safety, timely interventions, and optimal recovery in this high-acuity care environment.

How does a Step Down RN collaborate with other healthcare professionals?

Step Down RNs work closely with a multidisciplinary team, including physicians, respiratory therapists, physical therapists, and case managers, to coordinate patient care. They play a vital role in monitoring patients who require more intensive observation than a general medical-surgical floor but not as much as in the ICU. Effective communication and detailed handoffs are essential, as Step Down RNs often advocate for their patients during care plan meetings and rounds. This collaboration helps ensure that changes in patient status are addressed promptly and that each patient's transition to a lower level of care is safe and well-managed.

What is the difference between Step Down Rn vs Med-Surg Nurse?

AspectStep Down RnMed-Surg Nurse
CertificationsRN license, possibly CCRN or specialty certificationsRN license, often no specialty certification required
Work EnvironmentIntermediate to high-acuity units, closer patient monitoringGeneral medical-surgical units, lower acuity
Patient Care FocusPatients with complex, unstable conditionsPatients with less critical, stable conditions
Typical EmployerHospitals with step-down or progressive care unitsGeneral hospitals, medical-surgical wards

Step Down Rns and Med-Surg Nurses both provide vital patient care but differ mainly in patient acuity and required certifications. Step Down Rns handle more complex cases in intermediate care units, requiring specialized skills and certifications, while Med-Surg Nurses work in general wards with less critical patients. Understanding these differences helps in choosing the right career path or job opportunity.

Do step down RNs get paid more?

Step down RNs typically earn higher salaries than staff RNs due to the specialized skills, increased responsibilities, and critical care environment involved. Their compensation may also reflect additional certifications such as CCRN and experience in intensive care settings.
Step Down Rn jobs near you
Infographic showing various Step Down Rn job openings in Houston, TX as of September 2026, with employment types broken down into 6% As Needed, 55% Full Time, 28% Part Time, and 11% Contract. Highlights an 100% In-person job distribution, with an average salary of $97,963 per year, or $47.1 per hour.

Registered Nurse - Progressive Care / Medical Step-Down - 26-09211

Houston, TX

Compu-Vision - South
See more jobs at Compu-Vision - Southexternal

Full-time

Posted 16 days ago

Job description

Registered Nurse – Progressive Care / Medical Step-Down

Location - Atlanta, GA

Duration - 13 Weeks

Unit: Medical Step-Down / Progressive Care Unit
Experience Required: Minimum 2 Years

Position Overview

We are seeking an experienced Registered Nurse (RN) – Progressive Care / Medical Step-Down to provide high-quality nursing care to patients requiring close monitoring and advanced medical management.

The Progressive Care Unit is a 16–20 bed medical step-down unit with an approximate 1:4 nurse-to-patient ratio. The ideal candidate will have at least 2 years of Progressive Care, Step-Down, Telemetry, or closely related acute-care nursing experience and be comfortable caring for medically complex patients.

Patient Population

The RN will provide care for patients with a variety of acute and chronic conditions, including:

  • Sepsis
  • Heart Failure
  • Hypertensive Emergencies
  • Respiratory Failure
  • COPD
  • Chronic Kidney Disease
  • Type 2 Diabetes Mellitus (T2DM)
  • Substance Abuse
  • Status Epilepticus
  • Encephalopathy
Key Responsibilities
  • Provide comprehensive nursing care to Progressive Care and Medical Step-Down patients.
  • Perform thorough initial and ongoing patient assessments.
  • Closely monitor patients for changes in clinical condition.
  • Recognize signs of deterioration and initiate appropriate interventions.
  • Monitor vital signs, cardiac status, oxygenation, neurological status, and other relevant clinical parameters.
  • Administer medications, IV therapies, and treatments according to physician orders and facility protocols.
  • Provide care for patients with complex medical and respiratory conditions.
  • Monitor and manage patients with sepsis, heart failure, respiratory failure, COPD, and hypertensive emergencies.
  • Provide appropriate nursing care for patients with neurological conditions, including status epilepticus and encephalopathy.
  • Monitor patients with chronic kidney disease and diabetes.
  • Assess patients for complications and promptly communicate changes to the healthcare team.
  • Collaborate with physicians and interdisciplinary healthcare professionals.
  • Provide patient and family education regarding treatment plans, medications, and disease management.
  • Maintain accurate and timely clinical documentation.
  • Follow infection-control, patient-safety, medication-administration, and hospital policies.
  • Participate in patient handoffs and ensure continuity of care.
  • Respond appropriately to emergencies and rapidly changing patient conditions.
Required Qualifications
  • Current, active Registered Nurse (RN) license.
  • Minimum 2 years of relevant Progressive Care / Medical Step-Down nursing experience.
  • Strong acute-care nursing experience.
  • Experience caring for medically complex and high-acuity patients.
  • Strong assessment and clinical judgment skills.
  • Ability to recognize and respond to patient deterioration.
  • Excellent communication and teamwork skills.
  • Ability to work effectively in a fast-paced hospital environment.
Required Certifications
  • BLS – Basic Life Support
  • ACLS – Advanced Cardiovascular Life Support