Shift Assignments - Who bugs you the most?

[Tait, MSN, RN]

So I recently have begun to do charge nurse on my floor. For us this basically consists of managing the pager, assigning admissions, communicating staffing to the house supervisors, collecting various data on accuchecks, d/c's blah blah blah, plus a team, blah and MORNING PATIENT ASSIGNMENTS.

Ok well, I am a bit of a perfectionist, and also have a habit of being a bit of a pragmatic controller...does that make sense? Anyway, around 3am I get detailed report on the floor from the nurses, then I sit down and very carefully distribute teams. I look back multiple days to see which patients the oncoming nurses had and try to get patients matched up with familiar nurses. I then review each team deciding if I would be happy with that team and how I would handle it.

Well...sufficed to say, I can take criticism, but I don't take it well when I feel I have done the best I can, and of course at 655am we have...

"The Grumbler"

Barely says hello, acts like you don't exist, grabs her papers and sits in the same exact spot everyday. She filters through her papers and snarls if you have given her too many PCA's.

"The Bi-Polar Shifter"

She comes in much like the Grumbler, however the minute someone from her own shift gets there, she is all excited and chipper, continuing to ignore anyone from night shift. This, combined with the Grumbler, is deadly.

"The Perky Complainer"

Never without a smile this nurse can begrudge her whole team, without even having looked a the summaries. This nurse is never pleased, but she thinks because she says it with a smile, that it doesn't hurt just the same.

"The New Grad"

Sweet and focused, this RN comes in early, grabs up her team and then begins to look panicked and stressed 10 minutes after report is finished. Like the PC, this RN is never satisfied.

"The "Let's Move On"

This RN doesn't care what you give her, and all during report she will make you feel like she doesn't care what you are saying either. She may be varying degrees of "ok, and? ok let's round".

"The Float"

This RN is not from your floor and is really hoping you don't dump her with the incontinent hip fx in 32 with VRE and MRSA. If she can avoid that her day will be fine as she "visits" your floor...remembering not to do anything extra, like stock or clean.

"The Team Player"

This nurse will rip you a new one if you move one person from her team, even if that means she has no isolations and the New Grad has three. Severity varies.

"The 8 Hour"

This RN seems to have gotten grandfathered in somewhere to eight hour shifts. Between your house supervisor, manager and her you have been reminded she is only here for 8 hours a dozen times, and that you have to make sure the oncoming shift knows.

"The Too Many Discharges"

More than two and this nurse will have your head in a whirl for twenty minutes about how this is just unreasonable...too bad there are 12 D/C's and five nurses?!

Now don't get me wrong, I love all my nursing friends, but somedays I just want to grab them, shake them and say "do you realize I spent an hour pouring over your assignments, making micro adjustments to assure you have the best day possible and every day you come in and *****?"

Add your own!

Love always,

Tait

[JB2007, ASN, RN]

Being in charge just sucks. No matter what you do someone is mad at you. Just do what you need to do and ignore the complainers. I love your desciptions and they are so true. I love the perky complainer. That just descibes one of my co-workers exactly. Best of luck with your charge duties.

[AOx1]

I can so relate. The thing is, most of them apparently haven't had the "fun" of being charge yet. In time, you will get a faster hang of what is a fair and balanced assignment and be able to finish more quickly. I think it's great that you're trying so hard to make the assignments fair and familiar. If I've learned one thing, it's that when you manage in any capacity, maybe 1/4 will think you walk on water, 1/4 will think you're the devil incarnate and let you know about it, and the others in the middle either don't care or pretend to like what you do to your face and then complain behind your back.

I think this is largely due to the fact that no one really knows what it is like to do a job until they've done it. How much work goes into doing it well, and how much it sucks when you try really hard and still no one is happy. I remember looking at the charge nurse when I was a new grad and thinking it was an "easy" job. I wanted to eat my words and give back the position as soon as I was placed in charge, of course.

All you can really do is learn to do your best and learn not to be phased by the whining. Unfortunately, in this health care climate, they are probably all right- the assignments are unfair to almost all of us, and some days it really is too much to handle. This is our lovely customer-service oriented, for-profit system in place, where the almight dollar rules over patient safety and staff well-being. Not much you can do really except continue to advocate for appropriate staffing..... and develop a really thick skin all without losing the compassion and desire to do the right think that you obviously have. You've got you're work cut out for you!

PS- one "trick" I've found helpful in some cases is to confront some of this. Show the "too many discharges" nurse how many d/c are scheduled, and that they are evenly distributed. The best manager I ever worked for said on the day she interviewed me "You're not a gossiper or a whiner are you? Because I like to fire them"- kind of surprising in an interview, but she was true to her word. Not only did she fire whiners and complainers, but no one sat on their duffy (including her) until the work was done. I've never met another manager like her. She led by example. I suspect you will too. Keep going. Some people you just can't please.

[EymieICURN]

I can put a face, or two, to all those descriptions!!!

[labcat01, BSN, RN]

I can put a face, or two, to all those descriptions!!!

I'm afraid I might fit into some of those descriptions. Sigh! I'll be sure to give my CN a big hug at work tomorrow and try my best not to complain about my assignment :)

[jschut, BSN, RN]

Our DON provides where she wants everyone, and by the time I get there at 6p, someone on 2nd shift has changed the schedule to suit themselves.....

Happened to me just last week, one of the 2nd shifters changed mine and hers schedules to suit her a bit more, and when I wouldn't change and go to where she thought I should, she grumbled and accused me of wanting to sit on my butt! Haha!

[husker_rn, RN]

That's exactly why being charge doesn't interest me one bit; luckily I work with a couple of nurses who seem to enjoy the job. Was charge nurse in LTC and staffing issues took a good 45 minutes every morning. Did enough of that to last a lifetime. Hopefully it has taught me something about being charge. I just take my team and go; after all they all need care.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

I do not do charge, but I thought of a nurse that meets the description of each. The perky complainer drives me insane, the others not as much...

[lisamc1RN, LPN]

I may not be a charge nurse in a hospital, but as the person who has often been put in charge of mandations, finding coverage, and adjusting schedules and assignments , I feel you. It can be a huge headache. There has been more than once when I walked away feeling underappreciated and unsupported. It's especially difficult when other nurses look at you like you don't know how to do your job right. Recently, I had a nurse who is now doing what I did who told me that she had no clue how difficult it was to do that job until she started doing it!

[pricklypear]

Hey! What's wrong with the "Mellow Drifter?" When I worked resource pool, I always tried to be that. Maybe you're misinterpreting the "she will make you feel like she doesn't care what you saying" part.

You DO have all the characters down to a T, though!!

[nursemike, ASN, RN]

What I hate about charge: when I find myself with a crappy assignment, on at least some level I understand why I have a crappy assignment and why I should have the crappy assignment. Mind you, I'm still gonna whine, but it kinda takes the fun out of it.

My friend who oriented me to charge warned me I would see my coworkers in a different light. She had a point, although I don't think I feel as disillusioned as she suggested. Hmm. Haven't been doing it as long, either...

[Fairemaid]

There is a 11-7 charge nurse on my floor who makes out very unfair assignments for her overnight staff. This has been an ongoing issue for the past year. The 3-11 charge nurse is not even allowed to do the boards for the next shift. Recently 11-7 RN had to split up 5 nurses for 13 pts on one side and 12 on the other. You guessed it, put 2 nurses on the side w/ 13 pts and put herself on the other side w/ 12 pts and 3 RNs. this overnight charge RN will also never take an admission. Last week during low census, there were only 5 pts on one side she assigned new RN just off orientation to that side alone w/ the CNA, and put herself on the other side with 6 pts and 2 RNs.

Personally I have mostly always found my assignments fair on my shift. I have been charge nurse occasionally so I can relate to that. Some days it does not matter how nicely you make out the assignments, some people always complain about it.

Rebecca RN