[pjdRN]

Do you feel you are responsible as the Charge nurse in your unit for the actions of the nurses that work in that unit with you? We had agency nurses working in our unit that only have Tele experience. When the charge nurse balked at giving her an ICU assignment because she didn't want to be resposible if something happened (as well as concern for pt safety), she was told by management she WOULD NOT be ultimately responsible but the nurse accepting the assignment would be???? The charge nurse decided not to give this nurse an assignment and have her swat and help out and tripled 2 other CC RN's. Now she is in trouble with the Manager who felt she was insubordinate by not giving this nurse an assignment as told by the Supervisor. How would you deal with this problem?

[mdslabod]

I would have asked the agency nurse about her/his comfort- zone when assigning patients. (Even seasoned unit nurses get nervous with certain types of patients).
The least critical could go to the least experienced person.

I was an agency nurse and an experinced ICU nurse. When a charge nurse did not ask my credentials and gave me easy patiens, well, easy money and their loss.

MicheleRN

[wendyssmile]

I have been recently oriented to the charge role and have had my eyes opened. First of all I work in a CCU/CTICU and our travelers are usually well qualified to handle an ICU assignment. We have had a few which we had problems with and subsequently recieved chronic vented patients to care for.

As far as being responsible as the charge nurse I had a situatuation with a seasoned nurse not dealing with a patient problem and I felt responsible! But the nurse knew better and was capable of caring for the patient. I learned that as a charge nurse I need to keep an eye out for problems but it is not solely my responsibilty, as a charge nurse I am not there to micromange everyone's patients.

being charge is not something I enjoy and being a new grad in an ICU I avoided it for 3 years

[sockov]

I think the charge nurse for the shift has responsibility on the unit. If something went to court, I would be the charge nurse would be listed on the documents and would have to testify.
But, the nurse manager falls into the same category for being responsible.
It is the managers responsiblitlity to make sure the unit is safe and the staff RN's are competent to take care of the acuity of the unit, so if something "bad" happend.. then that would go to court.
Not sure though. Best to research with the local legal people.
Guess it is good to know the law and protect yourself.

[BadBird]

Ask yourself, in a court of law would I be responsible? You bet you are, and administration will hang you out to dry.

[dv8rn]

I've been a Critical Care Charge Nurse for 16 years, and there is such a thing as vicarious responsibility. It is when you are responsible for what goes on in your abscence. As Charge, I am responsible for the unit while I'm at work. I am not responsible for the actions of nurses outside scope of practice, or deviation from standards. "a reasonable and prudent nurse would": is the buzz phrase to remember.

[passing thru]

A suggestion: As charge, I always ask agency and floaters to consult with me prior to calling the docs, (at 3 a.m.). Usually I can advise and suggest a resolution, provide options that a newbie on the unit is not aware of....e.g., meds that are part of standing orders for the doctor's group that may not even be in the chart or on the MARS. Or, I can write an order for a couple of Tylenol for that low grade temp, and assess I&O, ....oh,? the IV infiltrated 5 hrs. ago...the patient is NPO , and you haven't had time to start another?? Let's not call the doc for the low-grade temp, lets give the Tylenol supp and get some fluids going..(actual problems)

[passing thru]

Or last week, the patient is back in a-fib, wants to call doc...hello? ...look the afternoon beta -blocker was not given.
This could be another thread, we could share tales.

[mattsmom81]

No desire here to do charge anymore, no need to prove myself or take on excess duties after this many years as nurse. Just want to take care of MY patients now.

Charge in ICU is just a double headache IME...as we have our own patient(s), manage the unit, AND are expected to be preceptor/ resource for the less experienced nurses. This gets out of hand in my understaffed part of the world where any warm body can show up in ICU too many nights....

All this for a lousy buck an hour...no thanks.

[rmprn]

At least you get a buck an hour! In my M/S ICU, we all take turns being charge for free (there is no charge nurse on nights right now, hasn't been for at least 6 months)! AND, if there is no charge nurse for either CCU or ICU, we have to do staffing for BOTH units. Plus take a patient assignment.