Charge Nurse responsibilities?

catlady, BSN, RN · Dec 10, 2005

I always hated being in charge because it always meant a full or overloaded (meaning 2-3 ICU) patient assignment while having all the responsibilities for the unit. If we ever had the luxury of the charge starting out without patients, the supervisor would usually find a way to float someone away...and that was the end of that. Sometimes they'd pull from our unit so that another unit's charge could give up her patients. The charge often got the sickest patients, too, because she was the most experienced. I only wanted enough charge experience so I could put it on my resume!

Now, of course, I'm in management (but I don't work in a hospital!).

Bipley · Dec 10, 2005

1. Take 1 or no patients.
2. Get Charge to Charge unit report.
3. Make assignments.
4. Schedule breaks/Admission roster.
5. Round on every patient's room. Checking patients status, looking at monitor,
IV sites, Tube feeds, Vents...Basically a mini assesment for each patient in the
unit.
6. Confer with Nurse Manager/CNS for floor report.
7. Enter orders/Answer phones/Watch central monitor console.
8. Be a family liaison.
9. Send secretary on break/other staff on break if other nurses that's
suppose to cover is too busy.
10. Help with admission.
11. Help physically transfer patients if needed.
12. Help go to CT scans/MRI if the primary nurse is busy with other patient.
13. Assesment of ALL the patients on the unit to determine which patients
meets the criteria for transfer, and present it during attending/fellow
rounds.
14. Be a resource for staff nurses.
15. Participate in patient rounds with medical staff, students, dietitian, social
workers, case manager, primary nurse...for ALL the patients in the unit.
16. Be the one to mostly help with turning and changing patients in the unit.
17. Attend hospital bed allocation daily meeting.
18. Respond to Code Blues if the staff nurse you assigned is busy.
19. CHECK ALL THE PATIENTS LAB IN THE UNIT...and remind staff nurse if
there's panic values.
20. Double check ALL charts to make sure all orders are signed/carried out.
21. Decubitus checks/skin assesments for High risk patients.
22. Tons of other QI.
23. Keep peace between the staff in the unit(sometimes the hardest thing to
do).
24. Last hour round again and make sure the staff doesn't need help with
anymore baths or turning.
25. Figure out to staff your own unit by calling agencies/other staff for OT
if someone calls in. All the while making sure the OT is spread equally.
26. Sometimes be a preceptor for a new staff nurse while being in charge.
27. Pick up the other patient from the primary nurse if their other
patient becomes unstable and watch the patient until the nurse
is able to pick up her patient again.
XXXXX I think that's it.....ALL for an extra 1.00 dollar per hour XXXXX
Oh yesss let's not forget, be the unit gofer. Oh and care for your one patient...The wonderful world of charge nursing.

Wow... in an ideal world. :specs:

But not in the hospitals I've worked in.

duck_1978 · Jan 14, 2009

I work at a small hospital and was "appointed" charge nurse 2 months after graduation and only get 50 cents more on the hour. I personally feel you should be properly trained before you take on this responsibility. I have been a nurse now for 1 1/2 years and love working the floor. I would take it any day over charge nursing. Charge nurses on our floor have to take patients even though there are so many other responsibilities. We are a small community hospital and staffing is not the greatest. Anyone heard of the staffing matrix? What a joke!!!!!!!!!!

MIA-RN · Jan 14, 2009

When I am Charge (which is usually) I take a full assignment, room patients, try to finagle moving patients to the floors, check with triaging issues, help the other nurses, be sure everyone gets their break and cover accordingly, keep a general flow of pts in and out, be a resource for just about everyone. And no extra money for it.

nrsang97, BSN, RN · Jan 15, 2009

When I am charge I take one or two ICU paitents. Sometimes I take a sicker pt that has been singled since I am charge. Sometimes I take two stable patients. I get report then charge to charge report. Walking charge rounds. Then during my shift I assign admits. I sometimes have to move a pt out so we can take a pt from the OR/PACU or ER. Assignments for the day shift. I help others, take questions from the new nurses or travel/agency nurses. I oversimplified this because I could go on forever. All this for a stinking dollar extra an hour. We are also called to go help the residents insert EVD's (brain drains) or ICP bolts either in the ER or SICU and heck I have even been called into the OR to help with insertion. I also have to help answer the phone after 11p since we have no clerk. Put charts together for new admits.

The worst part is that we are the only ICU at my facility where charge nurses take an assignment.

duck_1978 · Jan 15, 2009

As I said before, I was put in charge 2 months out of nursing school. What a blow!!! I have been a nurse now for 1 1/2 years and I still don't like it. A friend of mine said her hospital sends you to a class on charge nursing and you have to be employed 2+ years before you take on the position. I am currently in a BS program and I want to write my first paper on whether charge nurses are adequately trained. Any websites/journals would be greatly appreciated.