Charge Nurse responsibilities?

nursemaa · Dec 9, 2005

I think that ideally, whoever is "charge" for the shift should have a decreased patient load so he/she can be available to place and assign new admits, problem-solve with other departments, ensure that tasks get done (like crash cart checks etc), be available to assist others, and generally keep track of what's going on.

In my real world, the charge takes the same assignment as everyone else and about all they have time to do is place admits. Sigh.....

veegeern, BSN, RN · Dec 9, 2005

In our facility, we have a clinical coordinator on each unit from 7a-3p M-F. On our floor, she is also the charge nurse for these hours. We work on a staffing grid. If our census is such that we can have her free without a team, then that is our preference. If not, then she has the same number of pts, and we all have to pull a little closer together to get things done. Evenings and nights...the charge USUALLY has patients. Occassionally (sp?) census and staffing will allow for a CN without pts from 3-11p.

perfectbluebuildings, BSN, RN · Dec 9, 2005

Our charge nurse almost never has patients. She is responsible for placing admits, making assignments for the next shift, and I am sure a much longer list than that of duties which I am unaware of, besides being available to help any and all of the nurses when needed and often does a good part of histories, etc. on admissions who come up soon after the shift has started. She also has to do all kinds of chart audits and things, I think. A lot of paperwork. A rough job I wouldn't want- people complaining from upper management, and staff nurses complaining to you from the other end. Most of them seem to balance things out pretty well, though, despite all the gossipers' talk to the contrary... of course I've only been there a few months, so I can't say for absolute certain but they're almost invariably helpful for me.

allnurses Guide · Dec 9, 2005

Our charge nurses almost ALWAYS take a patient load, although a smaller one. Day shift charge nurse will usually take a small load of preferably easier patients and then assign other patients, do various paperwork, help with admits, etc. etc.. Now on NIGHT shift, the charge nurse generally takes the same number of patients, but probably won't take the first admit or anything.

I have, quite frankly, found the night shift charge nurse designation to be mostly meaningless around here.

RN12345656 · Dec 9, 2005

I am one of the charge nurses on my unit. I work days 7a-7p and DO NOT take pts. I work for cardiac surgery stepdown for a very big teaching hospital. I handle bedflow, staff assignments, help out the nursing staff, enter orders, assist the docs with procedures, worry if the OR is going to scream at me b/c they have no bed in the unit..b/c CVICU needs to transfer a pt to me to free up a bed for them..so I have to quickly discharge a pt from the floor in order to keep the OR/surgeons happy. Then there is handling customer service issues...the list goes on. I very rarely sit down. It is almost impossible to take on pts as well. Now, I have been in charge and had to take pts (very rare) b/c there was not a relief for an 8hr shift...so I take pts for 4 hrs. If we are short nurses..my nurse manager takes charge..and at times our clinical coordinators will as well.

Night shift is a different--the charge nurse has a full pt assignment, however she/he is not responsible for the things the day charge nurse is responsible for. I have placed all the pts and our unit is full. There are no discharges..no families no contend with, no docs/orders to worry about, no fresh postops.

I hope I haven't rambled too much!! Let me hear an "AMEN" from you other charge nurses out there!!! :yelclap:

zacarias, ASN, RN · Dec 9, 2005

A charge should never take patients except in rare emergency cases. There are too many things on their plate and taking even a partial load is unsafe and inefficient.

hrtprncss · Dec 9, 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.

2002MissRN · Dec 9, 2005

I work nights and sometimes the only nurse on the unit with 2 techs with 10 to 18 patients, this is in behavioral health on the adolescent unit. We always have male security and usually 2-4 other males in the hospital. And I don't even get any extra pay. I do all the admits, discharges, chart checks, MARS, pass meds, and draw labs......

veegeern, BSN, RN · Dec 9, 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.

I'm on a medical floor, and I would be really happy if a charge nurse did many of these things when she (we're all females) didn't have patients!

allnurses Guide · 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. Someone like you is a lifesaver. :) :) At my hospital, the charge nurse on the unit doesn't have QUITE that many responsibilities. But then again, the charge nurse generally has more than one patient, though generally less than what the other nurses have.

It all just varies from hospital to hospital, and sometimes even from unit to unit within the same hospital. Like I said, the night shift charge nurse on my unit is practically nothing more than a figurehead who is making a dollar more an hour. The night shift charge nurse generally assigns rooms to new patients, assigns patients to herself or the other two nurses on the floor, makes out the "accuity sheet", and is the goto person if a patient happens to have a complaint at night. That is just, about, it. Now, my hospital is currently going through an overhaul of the whole Charge Nurse position. They are revamping the job description, making it more detailed. I'm not sure that I like it; I like the way things are run on my night shift now as it is. I'm liking it that on my unit at night, if we have 18 patients, we can have three nurses and generally two techs. That's six patients to a nurse, WITH nurse techs, at night. Generally makes for pretty cushy shifts. With the new revamping of the whole Charge Nurse position, our night shift charge nurse WILL have about half the patient load that the other nurses have, if not fewer patients. So, if we have 18 patients, the charge nurse is going to have four, and the other two nurses will have seven.

Wait a minute... that's still not too bad. Never mind. :)

I like where I work.

hrtprncss · Dec 10, 2005

Wow. Someone like you is a lifesaver. :) :)
ohhh noooo this is not me i mean this is what's expected by management for the charge nurses to do....that's why we have to take turns, because no one wants to be in charge...too much headache, too much work, for an extra dollar per hour. I personally would rather take my full load of patients, but there's no choice because they alternate you. I used to be one of the permanent charge and i gave that up because of all that headache and the bi****ng. I'm happy being a staff nurse and taking my patients and being left alone. But sometimes u have no choice cuz no one else wants to take it. I like being a staff nurse much much better no question.