[midwest40]

I have recently been promoted to Director of PCU, I love the position but am facing problems from staff. The 42 bed unit has been without a director for the last 6 months, there was no monitoring of what the charge nurses were doing (director of m/s was trying to supervise both floors). Orders were missed on a daily basis and we were losing the trust of doctors and patients. We have started a charge nurse report book and I have instructed charge nurses to keep track of labs, procedures, history and any other pertinent information in this book for staff and doctors. I was told this took too much time and kept them at the desk instead of on the floor. Am I wrong, or is this their job! They have been working as overpaid CNA's for the nurses for too long. Secretaries were entering orders and putting the charts away assuming nurses were going through charts regularly and signing off their own orders (doesn't work), there were no checks and balances. I am having a charge nurse meeting next week for current and aspiring charge nurses. I would welcome any thoughts, and would appreciate any resources that spell out charge nurse duties.

Thanx all

[pcumanager]

I have a similar situation in that the role duties are not clear. Do you have a list of expectations? I would find it helpful to know what other charge nurses for a progressive care unit are doing. My charge nurses also are responsible for primary telemetry monitoring.

[Shell5]

These are some of the things I do and I have seen other charge nurses do. I hope this helps:
One of the most important criteria is that the individual be honest, ethical and fair.

*Make sure your unit is covered ie; nurses, aides, clerk. If not, call supervisor.
*Might have to take patients if short staffed
*Assign patients to staff
*Make sure each nurse has a phone or beeper and that the clerk has a copy of the
assignment.
*Communicates pertinent information to the doctors on rounds (advocates for patients)
or changes in conditions or follow up that the primary nurse did so.
*Counts the narcotics
*Delegate to nurses
*May have to start IV if a nurse is busy
*Cover desk when other nurses are at dinner
*Assist with settling disputes among other employees
*Communicate pertinent infomation to the Nursing Supervisor, pharmacy, other floors,
lab
*Make sure patient census is updated
*Assist in crisis ie; code blue, rapid response.
*Deal with family complaints or call in patient relations if needed.
*Deal with narcotic discrepency count according to pharmacy policy.
*Check crash cart.
*Deal with maintenance issues.
*Assist with discharge paperwork
*Assist with checking off charts and noting orders.
*May do rounds with doctors unless dr. wants to do rounds with supervisor or
primary nurse
I'm sure there are others, but I can't think of them right now.

[RN1989]

I made up an entire charge nurse book for my staff. It included the charge nurse competency checklist, the charge nurse performance eval, and various leadership info sheets that I felt had helpful info. I put in quick reference items, p&p for special situations, patient safety, emergencies, care standards, transfusions, central lines, med administration, specifi med info, patient home med info, occurrence reporting, death/DNRs, safe harbor. I left this huge notebook at the desk for the charge nurses to reference anytime. It also had specific duties that I was looking for.

There's too much for me to try to type into a window. If you would like to know more, pm me. I could fax you some of the info that might help you.

[kimmydd]

Can you email a copy of you charge nurse competencies & leadership info? I'm working on re-defining the charge nurse role on my unit & it would be great to see what others are doing. email kimmydd@juno.com

[RN1989]

Kimmy - I only have it in hard copy now since I have left the position that I did this at and did not think I would ever have need to share it. If you would like to pm me a fax number, I will be happy to fax it to you.

[classicdame]

I don't see the point of writing down all the lab and other info. If it is in the chart the charge nurse could just initial it (and the primary nurse as well). No need to take time to re-write.

Another thing: If they have been on their own for a while they have some ideas on what is needed to make the unit work. Discuss those and write them down. Then address them at each meeting (working on it, did it, can't do it because, etc). Ask for more every meeting till they learn you are on their side and respect their input.

[kimmydd]

That would be great! 916-479-8304

[Katnip]

If that's a phone number, you might want to remove it from the thread. This is a public forum and there's no telling who reads it. You can PM the number to the people you want to have it.