Important To Note: The Residential Crisis Stabilization Unit is not currently open. We are anticipating opening around July, and are actively looking for staff to onboard and train in preparation for our opening. If you are needing to start employment within the next 30 days, this may not be the position for you.

Position Summary

Why This Role Matters

When someone in Southwest Virginia is in acute psychiatric crisis, our RCSU exists to be a real alternative to an ER bed they don't medically need or a jail cell they shouldn't be in. You are the nurse on the floor making sure that alternative actually works.

You'll be the medical and clinical presence in the unit, managing medications, monitoring for withdrawal and medical deterioration, responding when something escalates, and partnering with the LMHPs, QMHPs, and prescribers who make up the interdisciplinary team. Your shift, your eyes, your judgment, and those are what keep the unit safe and clinically sound.

Key Duties & Responsibilities

What You'll Do

Direct Nursing Care

• Complete nursing assessments at admission and provide ongoing evaluation of physical and behavioral health status under the direction of the Psychiatric NP. (RNs perform full assessments; LPNs gather data and complete assessments within LPN scope, with RN oversight on areas requiring RN-level clinical judgment.)
• Administer prescribed medications and treatments, monitor for side effects, and document all medication administration in the MAR.
• Manage PRN medications for agitation, anxiety, and sleep per protocol.
• Monitor psychiatric medication side effects 
• Conduct withdrawal monitoring using CIWA, COWS, or other validated protocols as ordered.
• Assist prescribers (NPs, MDs, PAs) with psychiatric and medical needs, such as medication reconciliation, lab coordination, ongoing monitoring.

Documentation

• Maintain accurate and timely nursing documentation: vitals, medications, interventions, clinical observations.
• Submit clinical documentation within the 24-hour Virginia Medicaid window.
• Document incidents, medication errors, and safety events per agency policy.

Safety & Emergency Response

• Respond to medical and psychiatric emergencies following agency protocol,  first aid, CPR, emergency interventions.
• Monitor for safety risks: suicide precautions, medical deterioration, escalating withdrawal, agitation.
• Support de-escalation alongside the QMHPs and clinical staff using trauma-informed approaches.

Collaboration & Care Coordination

• Collaborate with LMHPs, QMHPs, peers, and prescribers on integrated care planning.
• Participate in interdisciplinary team meetings and contribute to Individualized Service Plans (ISPs).
• Support discharge coordination,  particularly the medication and medical follow-up handoff.
• Educate clients on medications, physical health, wellness, and self-care.

Medication & Inventory Management

• Maintain inventory of medications, first aid supplies, and controlled substances per agency and regulatory standards.
• Ensure adherence to infection control, medication management, and OSHA requirements.

Compliance

• Maintain compliance with DBHDS, DMAS, Office of Human Rights, OSHA, HIPAA, and 42 CFR Part 2 (SUD confidentiality).
• Report incidents, behavioral concerns, and suspected abuse/neglect per agency protocol.

The Residential Crisis Stabilization is a 24/7 operation. We are looking for nurses to fill the following shifts:

Full-Time:

Monday-Friday 3pm-11pm

Sun, Mon, Tues 7pm-7am

Wed, Thur, Fri 7pm-7am

Part-Time:

Saturday and Sunday 7am-7pm

Saturday and PRN: 7pm-7am

We are also looking for PRN only!

Pay: $27-$30 per hour depending on experience. We offer a $4 per hour shift differential for nights starting at 7pm, and a $2.50 per hour shift differential for for weekends. 

Sign-On Bonus Opportunity:

$2,000 Sign-on and $1500 Retention bonus

Benefits:

• 1 week PTO
• 2 paid Mental Health Days
• Group Health Insurance
• Retirement Plan
• 7 Paid Holidays
• Free CEUs

Qualifications

This position works inside a DBHDS-licensed Residential Crisis Stabilization Unit (RCSU) serving adults in acute psychiatric and behavioral health crisis. Before reading further, please confirm:

• You hold an active, unrestricted LPN or RN license in the Commonwealth of Virginia.
• You have at least 1 year of nursing experience. Experience in behavioral health, emergency services, addiction/SUD treatment, community-based care, or residential settings is strongly preferred. (New nursing graduates: this is not the right first role. Build a year of acute or community nursing experience first, we'll be hiring again.)
• You hold current CPR/First Aid certification (BLS preferred) 
• You are comfortable working shifts that include evenings, nights, and weekends. The unit operates 24/7.
• You have a valid Virginia driver's license.

Salary : $27 - $30