Another charge nurse question...

  1. Does charge nurse = "bad guy" where you work? Do you meet with daily arguments from staff about the assignments you made no matter how fair you try to be? Does everyone run when you have an admit coming and give you a million reasons why they shouldn't have to take a patient? I do my best to staff and make assignment based on acuity and experience but some nurses look at numbers only and argue that they have more patients than the next guy. It reminds me of when my kids were little and someone got the bigger/smaller cookie. It is a nightly headache I don't want and wondered if anyone else has to go through this night after night? I have two new graduates that will be precepting on our shift soon and dread their witnessing this constant argument. Don't tell me to go to management because they say work it out, they don't care. (I work the 3-11 shift and they usually go home). Any creative or win win ideas would be greatly appreciated. By the way, for this headache I get a full patient load myself, deal with patient, physician and other problems and get paid a dollar an hour more.
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  2. 7 Comments

  3. by   michelle999
    Try asking them why if you can do the work why can't they. Or, do they have any better suggestions and then when they do make sure you give them a good reason why this is good or bad.
    Alternatively, remind them why you get paid more, its not nice to pull rank but sometimes it is needed. Good luck.
  4. by   tonchitoRN
    What we did re: admissions is everyone got a number i.e. 5 nurses so 1-5. When first admit went to number 1 and 2nd to number 2 etc. The only thing that was rotated was if you are first admit today then tomorrow you are number 5 etc. When they complained about this system then they were reminded how everyone used to fight not to get the admit no matter how many patients they had. Good luck.
  5. by   grnvillechick
    definitely this is a common thing when you are charge..I was asst unit mgr on a 45 bed floor...all pts were " VIP"'s..the govenor,a famous singers' grnadmother...these pts got fine china and steak for thier dinners...and wine too...so it was enough to deal with...and yes, on top of all that I had the " whiners"..those select few who seem to count every single thing as a "job"...the Whiners were a headache for my first six months..and they were usually the ones who had been there the longest...you know the kind..." I know everything..and could have been the charge...but I don't want the responsibility"..they are the unofficial charge nurses...that seem to be able to create much angst among the staff in a blink of an eye....here is my advice.......
    * approach each one individually---make them part of your "management team"..ask for thier input...and use some of it..make them feel valued...and this will encourage OWNERSHIP..once you have that , the unit will runn smooth as silk.
    * find the "Shiny Pennies" in your staff...these are the people who smile and do whatever they need to do...they take the extra pt..or always seem to be right there when there is a crisis...if only to run and get a supply item...they are usually the ones who are quietest..not necessarily the strongest skilled..but do a good job none the less... the Shiny Pennies are the ones to place the new grad with...they can teach the new ones ROUNTINE and STRUCTURE..they can learn all the fancy footwork later..right now the new grad needs LOTS of TLC and organizational skills...I stumbled onto this one night when I had no choice but to pair up a grad with a nurse who I thought at the time was not too quick..and a little under motivated...the next nite, the grad requested to pair up with the same nurse...and the nurse who I thought was un motivated was really shy ...it gave her confidence and she turned out to be a really good ally...
    * FEED YOUR NURSES...I would have " snack nite"...Pot Luck Muck nites...I would place a Hershey bar on the clipboard of the nurse who seemed stressed or who did a great job that nite... this truly breaks the US vs THEM mode...because it shows you too are in the group just as stressed and overworked as they are
    * take team buliding workshops...these really helped me understand the group dynamics...types of personalities , etc...
    * Break up the twosomes that feed off of each other...put them in geographical opposite areas...one down one hall, the other around the corner or whatever...this prevents them from conitnung the saga of martyrdom the Whiners like best..because they are separated ...yes, some can be like children indeed.
    * by planning a strategy, you will have more control..re evaluate prn... it doesn't matter how many-it is the acuity...and that should be your mantra response to those who count heads..or else give them fewer pts ...and a heavier load for a few days and that should cure them......if it doesn't...hey! you have someone to take the heavies for you...
    good luck and please let us know how things turn out...you sound sincere and like you are trying to do a effective enough job!!!!
  6. by   prmenrs
    Boy, those are all terrific ideas, esp grnville chick!

    In our 40 bed NICU, the charge "mama" is a definite factor in making a good shift! Our night shift are party types, any reason for a potluck will be obeyed!

    The charge nurse designates "admits" and "chores" like checking crash cart, point of care testing stuff, transporters and books, etc., checks on assignments, helps everyone, takes admits and goes to deliveries when necessary, arbitrates visitor and other problems and is resource for any and all issues. With 30+ babies, families, ~ 14-18 staff members, 2-3 RT's, 3 Docs to ride herd on, she does not take an assignment unless the admits are taken. If she's a relief, all this honor and glory is hers for an additional $2.50/hr!

    We ALL know how hard they work, and since almost everybody takes a turn eventually, we're nice to them!! She makes the assignments in the ICU section, and the "team leaders" make the assignments in the less acute side.

    Making sure the coffee pot is working is a good thing, too. A 4am/pm feeding of cookies (or whatever) helps give them a boost for the last round of work.

    Good Luck!
  7. by   Mijourney
    Hi. Yes, being in charge can frequently turn into an ugly scene. I agree with suggestions of the previous posters. I think the biggest thing in the mess is the attitude of the charge nurse. There's not much that can be done about the attitudes of the troops. Nanablue2, are you the only charge nurse for your shift?

    One thing that I think needs changing across the board is the charge nurse title. Why not coordinator? Coordinate is actually what the charge nurse does. We all know the impact of words on the psyche.

    Another thing that I thought I read under a previous topic a while back is the rotation of RNs in charge positions. If you have other RNs on your shift, why can't all RNs rotote charge nurse? Or, the RNs can coordinate patient assignments and the LPNs can rotate coordinating all the other assignments. Essentially no nurse gets left out of the opportunity for leadership.

    When I was in charge, I was not required to take any patients so therefore, I was able to lend a helping hand to all the staff. I would make it clear at the beginning of the shift that everyone was expected to help everyone, and I tried to set the example. It worked out fairly well then, and because everyone saw me get my hands dirty, I didn't have alot of problems with cooperation. Today, there are so many more irons in the fire with patient care and departments are so decentralized, I don't see how nurses no matter what position get things done. Best wishes.
  8. by   kaycee
    We call our steady charge nurses, Nurse Clinicians. I am the 3-11 Clinician. Name change and a little more money.
    Anyway I have been steady charge in the ER for a long time. I never ask anyone to do something I wouldn't do.I am very organized and even if we are nuts it goes pretty smooth. I take an assignment and work as hard as everyone else. The folks I work with are team players and we all get along. There are some that are better to work with then others but all are competant. I get along well with all the docs. I like to joke around and have fun. But they also know that I expect everyone to work. If I have a problem with a co-worker I go directly to them and try to work it out. I never report people and the only time the manager becomes involved is if the problem can't be resolved between us or if there's been a problem affecting a pt. I feel a charge nurse should be experienced, confident and easy going. Someone to help and guide not boss and order. That's just my opinion, and it works for me.
  9. by   Huganurse
    ,,,
    Last edit by Huganurse on Jun 30, '02

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