Do you have a free charge nurse on your unit?

[EllaBella1]

My hospital has recently started implementing some changes, and one of the things that they did was take away having free charge nurses on each unit (i.e. a charge with no patient assignment), and have started requiring that they take a full patient assignment on top of handling charge duties. As you can imagine things have not been going so well since this change. I'm just curious- is this a thing that exists in other places? Every place I've ever worked has had a free charge, except in emergency situations such as extreme short staffing when the charge would take a smaller assignment. If you guys could weigh in with your unit type/specialty, number of beds, and whether your charge is free I would appreciate it! Trying to gauge how realistic it is that all of our staff is so upset with this change.

[firemedic12, BSN, RN, EMT-P]

We had one at the last place I worked. It was great having that resource available, but the idea behind it rubbed me the wrong way. Basically, it was management's way of having a scapegoat while saying they did something good for us.

[firemedic12, BSN, RN, EMT-P]

Charge nurse hat .... check

Patient assignment .... check

Code nurse .... check

RRT nurse ..... check

Tough IV start team .... check

Hmmm which hat to wear this particular moment in time?

My last job I was IV, code, RRT nurse most nights while the charge did her thing. I basically told them on my year anniversary to never orient me to charge. Charge nurse is a position of responsibility, but delegation still has a time and place.

[vintage_RN, BSN, RN]

I work in a large, academic NICU with 67 beds. We have 2 charge nurses on each shift, and neither of them have an assignment. Sometimes they may take one baby if no one else can take it but they have enough to do trying to support the unit.

[BrandNewBabyNurse]

I work in a very large children's hospital NICU. We have 2 charge nurses and 2 resource nurses per shift, and none of them ever take patients. I've seen the second charge admit a couple times while we were hustling to redistribute assignments in the case of crash admissions, but as soon as possible the baby gets passed off to a regularly staffed nurse.

[PICUGuy]

40 bed PICU - 2 charge nurses (one for cardiac side, one for neuro/trauma side) both without assignment. We also have two resource nurses for day shift and one resource nurse for night shift.

[Steph41]

Trauma II hospital. I work ICU. All the floors at my hospital, charge has patients with the exception of ED. my nurse manager would like to redo the matrix to have a charge with no patients. I think it's a way off though.

[CKPM2RN, ASN, EMT-P]

Pretty soon you'll be run just like us in the LTC/SNF community. Admin and corporate just chip away bit by bit waiting until the staff gets used to the new level, then another chip is taken away.

[Steph41]

Ditto

[Pudding212]

When I worked as an aide, one if the nurses (either on the north, or south side) was the charge nurse. On top of their own patient load.

[deflowerkidRN]

I currently work in two places:

A large academic CVICU. Charge is (pretty much) always free, and is there to rotate through and help out with the sick patients that we can take.

The other place I work is a smaller unit and I am the charge nurse. When I started I never had to take patients. I did at times like if we got a rapid and I settled it and passed it off to another nurse. Now we are counted in the numbers, and I have to take patients. That means that some of my other responsibilities get pushed to the wayside (scheduling, PI for the unit etc). I am actually leaving that job and going to the academic center job part time. I do not currently do charge there.

[stdntograd06, BSN, RN]

I work on a PCU unit (cardiac and stroke primarily) with 16 beds. The charge RN on days does not take an assignment unless it is unavoidable, then is only 1. The charge RN on nights takes up to 2. We make $1 more/hr. Some days I think even that is not enough for the extra work we have to do (staffing, pt/family issues, meetings, orders, admissions, discharges, transfers out, etc....).

[AmyLaurette]

I work nights on a 36-bed med-surg unit. Depending on staffing, our charge sometimes takes an assignment (we have a max of 6 patients each). However, since we're a transplant unit, we typically get kidney transplant patients straight out of PACU. They're 1:1 nursing care the day of surgery, so often our charge nurse takes a kidney transplant.