Charge nurses?

  1. Hello! We've been having some discussion on my unit about charge nurse responsibilities. During the week on day shift, our NM and ANM share charge suties. Evenings during the week, we have an ANM that does charge. Nights and weekends, it's staff nurses who step up to the charge position. I have a couple of questions for ya'll now that you have some background...

    1. Does your charge nurse take a full pt assignment? Our day charge RNs rarely do, evenings sometimes, and nights always have between 6 and 8 pts.

    2. What does the charge nurse do? We seem to have no set rules except that they assign beds. When they don't have pts, some of them run around asking everyone else if they are doing okay, need help, etc, and doing whatever they can. Some of them just jump in and do what needs to be done (e.g., if someone wants pain meds, they will just give the pain meds rather than tracking down the nurse and telling them to do it). And then some of them just sit on their tooshies not doing anything, not helping anyone, and never even walking down to the other end of the unit to see what is going on over there. Some have even gone so far as to refuse to help nurses, even when they don't have pts themselves! They sit in the station and read magazines, make fun of the other nurses, etc. What happens on your unit? Do you have a set of responsibilities, or is it just every charge nurse for him/herself?
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  2. 23 Comments

  3. by   crissrn27
    Well, I work in a well newborn nursery and I'm sure we have a p/p of what the charge nurse is supposed to do, but what we really do is this....
    1. make assignments
    2. go to person for problems
    3. check supplies, equipment in LDRs
    4. assign nurses to go to deliveries (a couple of them won't go, since they are charge)
    5. take linen and trash out....I know, I know
    6. chart checks
    They usually will take an assignment but usually not as heavy, when I am charge I will take a full assignment and go to deliveries
  4. by   daisy1972
    our charge nurse do the following:

    1. be the one to give assignments to everyone

    2. carry out dr's orders

    3. check patients for any problems and give prn medications if along her rounds a patient need to

    4. make nurses notes

    5. since we are into primary nursing, our charge is also required to enter dr

    6. follow up supplies
  5. by   JennieJenRN
    I work in an ICU and we do not take assignments on any shift. Non of our ICU's do. The floors tend to take a pt load but it is half. The charge nurse role in the ICU is to make sure everything runs smooth so what ever you have to do. we make assignments, juggle beds and make deals. ( should have been a politician)!
  6. by   Chaya
    Where I work the night charge takes an assignment. During the day/ eve the charge nurse does assignments for the next shift, watches the tele monitors, gets paperwork moving for admissions/ answers phones/ books procedures if there is no UC at the time and just in general oversees that things keep moving along smoothly.
  7. by   cardsRN
    i think it is normal in most places for noc charge to have an assignment, may be a reduced one. that's ok cuz you know, we don't do anything on noc's
    most of the time in addition to beds, charge is responsible for resolving pyxis discrepancies, doing daily checks of emergency equipment and managing staffing (sick calls, assignments). it is my personal opinion that charge on shifts where the role does not have a pt load should help with other nurses' assignments, help people get lunch etc. it is my personal experience that this assistance is rare.
  8. by   Tweety
    I'm charge on day shift and rarely have to take a patient assignment. I'm like an air traffic controller - making sure everything that is supposed to be done is being done.

    I expect my adult staff to come to me if they are in the weeds and need help. I have my own stuff and try to be aware of what's going on around. I will ask if nurses need my help, but would rather they came to me first before things get out of hand. (A long time ago I used to be the one running around, answering call lights, taking all the new admissions, doing secretarial work, never taking a break, while the staff around me were the one's sitting on their butts. I don't let that happen now.)

    Technically speaking the LPNs (usually there's only one or two) on the floor are "under my direction", but basically I just verify their admission assessment, unless a patient goes bad.

    I see all labs and patient orders and make sure the docs are aware of abnormals and that staff are doing their orders timely.

    I do a lot of case management. I attend discharge rounds twice a week as part of a multi-disciplinary team and try to always think ahead "what does the patient need when they are discharged (equipment, Lovenox, home health, etc. rather than wait until the last minute).

    Make assignments. If staff is overwhelmed, I will take the admissions.

    Listen to patient and family complaints, smooth out ruffled feathers. Also listen to staff complaints.

    Do annual evaluations.

    I'll be learning to do the entire staff's schedule.

    Confer/collaborate with MD's. Often MDs have questions about their patients, or need something for the patient that I can supply. Sometimes they are angry that stuff isn't happening to their liking and I listen to their concerns and help when I can. Never has an MD "yelled/screamed" at me.

    Mentor. I want all staff to feel they can come to me and we'll put our heads together to solve a problem. I especially drill this into new grads - you are not alone, let's decide a course of action together.

    On a good day, it's easy and I love being in charge. On a bad day it's crazy and I have my "moments". LOL
    Last edit by Tweety on Apr 27, '07
  9. by   rnin02
    On my old unit, the charge nurse ("team leader") basically had to keep everything together, like Tweety described. Help the staff when needed, count Pyxis, solve descrepancies, deal with staffing issues, assign admissions, check the crash cart & ekg machine, staff evaluations, relieve the monitor tech for breaks, chart audits, med rec audits and some case management type stuff, sometimes. I'm sure there are more paperwork like things I'm missing. The goal is to keep the team leader without an assignment, doesn't always happen, but that's the goal. Even on night shift! When I would do shifts as TL, I usually "rounded" on my nurses every few hours and made sure everyone was okay, I would check with them at the start of the shift to see if they had any potential problem patients that made need closer watching, and after I gave report at the end of the shift I would "round" again to make sure everyone was getting out on time. I always hated it when a TL would leave (unless of course they had to get home or to an appointment) and the rest of us would be stuck there trying to clean up stuff because we didn't get any/enough help. And I always hated seeing that happen to dayshift, I would feel so bad for them. So I never let that happen to people if I can help it.
  10. by   TrudyRN
    Quote from miko014
    Hello! We've been having some discussion on my unit about charge nurse responsibilities. During the week on day shift, our NM and ANM share charge suties. Evenings during the week, we have an ANM that does charge. Nights and weekends, it's staff nurses who step up to the charge position. I have a couple of questions for ya'll now that you have some background...

    1. Does your charge nurse take a full pt assignment? Our day charge RNs rarely do, evenings sometimes, and nights always have between 6 and 8 pts.

    2. What does the charge nurse do? We seem to have no set rules except that they assign beds. When they don't have pts, some of them run around asking everyone else if they are doing okay, need help, etc, and doing whatever they can. Some of them just jump in and do what needs to be done (e.g., if someone wants pain meds, they will just give the pain meds rather than tracking down the nurse and telling them to do it). And then some of them just sit on their tooshies not doing anything, not helping anyone, and never even walking down to the other end of the unit to see what is going on over there. Some have even gone so far as to refuse to help nurses, even when they don't have pts themselves! They sit in the station and read magazines, make fun of the other nurses, etc. What happens on your unit? Do you have a set of responsibilities, or is it just every charge nurse for him/herself?
    How do you know that they are reading mags and making fun of others?

    Why is this allowed to happen, this goofing off and refusing to help others?

    If I had a patient assigned to me and another nurse gave pain meds without at least asking me if it was time or discussing the matter with me, I'd have a problem with that. It's fine for another nurse to help me but that does not include giving PRN's without my input. For all the one jumping in knows, I have already just given something but not charted it yet or I have it ready to give, in my hot little hand. Very dangerous to just jump in as you have described.
  11. by   rgroyer1RNBSN
    Well I work in an ER and SICU, Im the mid noc charge for both of them, but we also have lpn's and generally in SICU I take a full pt. load 2 pts. and in the SICU im charge but we also have another thats an asst.-charge who is usually an LPN who works under my direction, mostly they assist me in the sicu to make sure things are running smoothly like she might make sure the techs and other Lpns do what there supposed to do and work on things for me while Im tending to my pts. and vice-versa I keep an eye on her techs while she tends to her pts. its also the same way in er.
  12. by   miko014
    Quote from TrudyRN
    How do you know that they are reading mags and making fun of others?

    Why is this allowed to happen, this goofing off and refusing to help others?

    If I had a patient assigned to me and another nurse gave pain meds without at least asking me if it was time or discussing the matter with me, I'd have a problem with that. It's fine for another nurse to help me but that does not include giving PRN's without my input. For all the one jumping in knows, I have already just given something but not charted it yet or I have it ready to give, in my hot little hand. Very dangerous to just jump in as you have described.
    Well, when someone is sitting at the nurses's station with a copy of People in their hand turning pages and staring at it for half an hour, you get a pretty good idea of what they are doing. Making fun of others, how do I know? Because she was sitting there talking with the unit clerk about, "who on EARTH is going to be charge tomorrow? Hahaha let's put HP in charge! That would be great - do you think she could manage to get her head out of her butt long enough to check the pager?" etc...hmmm hard to figure that one out too.

    I didn't say she didn't check with the RN before she gave meds. But I agree, I always ask before I do that. We have computerized charting, so if someone DID give a med without the computer (a BIG no no), there could be a potential problem, but if they follow policy, there shouldn't be. I learned never to give a med to a pt who isn't mine without checking with the primary RN first back when I was a tech - a nurse did another nurse a favor by covering a blood sugar, but didn't chart it, and the pt was double-covered. But that's another topic. Maybe I took it the wrong way, but your post seemed a little bit defensive. I don't think I said anything out of line...
  13. by   chenoaspirit
    Our charge nurses won't take ANY patient load, not even one, even if all the floor nurses have 10 patients each.
  14. by   HisHands
    :flowersfo Tweety, Can I come work with you?

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