Hi,

I haven't been oriented to charge RN, but what is the role of the charge nurse? The day shift charge RN seems to make assignment, sit at the front desk and gossip, read her email and snaps at me saying she doesn't have time to help when I'm drowning. The day charge RN doesn't even take patients.

Our charge nurse presides over report, checks the assignment(made up by the charge on nights),calls the doctors, checks any orders that need clarification,deals with the manager,sorts out any problems that arise on the floor,helps out on the floor,deals with pharmacy, makes the assignment for the next shift,helps with admissions and discharges, goes to meetings, deals with families.We are fortunate to have a CN that's fair, works hard and knows her stuff. She leads by example and is always cheerful and stands up for her nurses.

It depends on your facility policies, as well as the type of facility that you are working in. At my last place of employment (LTAC),when I was charge nurse, I had a full patient load in addition to my charge nurse duties, which I was paid $1 extra after 4 pm (because the NM was there until 4 pm but didn't lift a finger to help). I could sometimes take a lesser patient ratio if we were fully staffed, which was rare. I had to make out the assignment, was responsible for viewing all labs and noting all orders and making sure that they were given to the other RN(s) (usually one) caring for a particular patient, go on rounds with docs, do all chart checks, crash cart checks, resolve family and ethical issues, etc. Keep in mind that this was a 14 bed facility. Prior to that, I worked in acute care and the charge nurse was only responsible for making out the schedule and dealing with any administrative issues that might come up. And...there could be plenty. She (he) also had a full patient load with one less patient than the other RNs. That arrangement made more sense to me, because it is every RNs responsibility to know the status of their patients. That was on a 64 bed unit. Where I currently work, there are no charge nurses, every nurse is responsible for their own patients (with teamwork from the rest of the nursing staff and the interdisciplinary team). The NM and ANM take the role of charge nurse.

Acute Care (surgical floor) 34 beds. On nights, the charge takes 4 pts and the other RN take 6 (if we are at 31+ pts). She is responsible for making the shift assignment, and the weekly schedule in 4 week blocks. She is available to help with "emergent" or out of the ordinary situations when other RNs have questions. (We have pretty good team work, so if she isn't available, one of the other RNs will jump in to help).

On days, the charge does not take pts, but does help with discharge paperwork. She will round with the MDs, does some of the calls to Drs. Also has to make assignments and schedules.

For the most part, we have a pretty good group to work with, but as it is everywhere there are personality conflicts, etc.

ETA--- Each RN is responsible for 12 hour chart checks, on days the charge will sign off orders, and give a copy of the order sheet to the RN responsible for that pt. I have control issues, and really do not want anyone else check off MY charts. Some of the others don't mind, but I want to see it for myself.

You're charge sits at the FRONT desk? Well, now I just feel cheated.

When I was charge, I did not take any patients. I rounded with the docs, went to a couple bed meetings, relieved secretary and monitor tech for breaks, helped with admits/discharge paperwork, made the assignment for the next shift, dealt with patient/family complaints, assisted the nurse's with complex patients if they needed help, and dealt with bed management. There was no time to just sit around.

I have worked with charge nurse's who did, and it sucked. It's why I left night shift at one place.

Very sorry you have THAT kind of charge nurse. I have been charge in different places for 20 years.

Responsible for the assignment,placement of admissions, transferring patients off the unit to make beds available, Responsible for anything that occurs in a management role. With one less patient within my assignment.

I will always go any nurse I see having difficulties with their duties, and offer to help.

Please .. document the lack of support, make a positive change.

Acute Care (surgical floor) 34 beds. On nights, the charge takes 4 pts and the other RN take 6 (if we are at 31+ pts). She is responsible for making the shift assignment, and the weekly schedule in 4 week blocks. She is available to help with "emergent" or out of the ordinary situations when other RNs have questions. (We have pretty good team work, so if she isn't available, one of the other RNs will jump in to help).

On days, the charge does not take pts, but does help with discharge paperwork. She will round with the MDs, does some of the calls to Drs. Also has to make assignments and schedules.

For the most part, we have a pretty good group to work with, but as it is everywhere there are personality conflicts, etc.

ETA--- Each RN is responsible for 12 hour chart checks, on days the charge will sign off orders, and give a copy of the order sheet to the RN responsible for that pt. I have control issues, and really do not want anyone else check off MY charts. Some of the others don't mind, but I want to see it for myself.

ETA--- I do not think that this is a control issue, but a responsibility issue, which I believe is a good thing. I too, don't want someone else doing my chart checks or signing off my orders. Too many times (paper charts), I have not received a copy of an order (charge or NM just signs them off and does not bother to tell me), and I found it later when doing my chart checks. I find this type of system archaic, dangerous, and just plain stupid. I am so happy that I now work in a hospital that has EMR. My orders for my patients are my orders and responsibility and the EMR tells me when a new order has been placed.

It all depends on the charge nurse. A good charge nurse can make or break your shift just like a good cna can. Many of the charge nurses at my current place are useless. Thankfully tomorrow is my last night there.

So, at my current place the charge nurse takes no patients on dayshift. The night charge nurse usually has 1 patient but can sometimes take a full load if we are short staffed. The charge nurse does have to relieve the secretary, monitor tech, assignment, handling larger issues, etc. The permanent day charge nurse also does the schedule and if you are one of the people she likes you are accomodated. If not, well then you are just SOL. She plays games with many people and not in a nice way. Management knows and she continues to get away with it. Actually, management tells people this is who they really need to make friends with if they want to work their requested days. I believe the charge nurse is someone you should be able to go to if you have an issue. Unfortunately, I'm not able to do that.

On my unit, charge for days & nights is different.

On days, if there are 4 nurses, the charge acts as a resource and doesn't take patients. He/she will take care of assignments/admissions/discharges. We have an out-put area that we also staff and resource will generally take care of those patients as well. They also have a task list of things that need to be done (dressing changes, tubing changes, medi port re-access, blood products, etc.). If there are only 3 nurses, charge takes patients and deals with assignments & staffing.

Charge at night is much the same as it is during the day with 3 nurses, except sometimes I/we will have 6 patients on top of dealing with staffing/assignments/bed placement of admissions.

Hospital charge nurses are responsible for the management and operations of a department or hospital unit. They perform basic nursing assignments and act as a manager by completing various administrative tasks. Hospital charge nurses begin their careers as Licensed Practical Nurses or Registered Nurses and obtain this position after several years of experience.

As night shift charge on a medical floor, I have a full patient load and also do:

bed assignment

staffing assignment

handle complaints- patient, family or staff related

help with difficult patients and tasks

resource for staff - which means they call me about everything

All that for an extra 90cent/hr.

I take charge in the ICU. I am resource for the RN's who need help repositioning their patients, general "go"pher since nurse's are usually too busy to leave the unit, make staff assignments, figure out and record acuities, lunch relief, shift audits, family liason, back-up trouble shooter/problem solver for less experienced RN's as well as what-they-think is a walking nursing encyclopedia (LOL.....sooooooo not!!), call light answerer when the occasion arises, heat shield between begrumpled doc's and my nursing staff, Rapid Response Team leader facility-wide, Cheerleader, Social services, grief councilor for patient's family AND staff, IV alarm fixer, vent alarm responder, putter-on-the-bedpanner, and taker-off-the-bedpanner, hard-IV-start queen, coffee-maker, bed-assignment lady, and on and on.