Charge nurse with less than a year RN experience???!!

Specialties Management

Published

Recently one of the nurses I work with began training to be charge on our 30-bed (very busy!) med/surg unit. But here's the kicker - while she's very pleasant to work with....it hasn't even been a year yet since she graduated from nursing school (not previously an LPN or related field; never worked in medicine before), and has only been off new grad nurse orientation for 6 months. She is the newest and least experienced of the nurses that work her shift. She only oriented once and is already charging on her own.

This just seems ridiculous to me. A nurse who hasn't even been a nurse for a year is not someone I'm going to for help.....she has had litte experience with IVs, foleys, NGs, she has NEVER seen/experienced a code. The charge nurse needs to be someone with experience and good critical thinking skills - something that often a new nurse has not yet mastered. I'm just appalled. Scared. And a little angry that management would think this is a good idea, especially when this particular unit already has an abundant amount of new nurses working it. It's like having the blind leading the blind.

Just needing to vent, or maybe get some replies on why this isn't such a bad idea!

Specializes in CMSRN.

I am another who got thrown into being charge.

The way I found out I was charge was one night a nurse who was pulled from another floor comes into my new admit room to ask if I was aware of a pt going into room 448. I said no, I just got a new admit but I will take another if necessary. He looked confused and said do you know where the beeper is. (We get beeped when a pt is going to be admitted) I said no, I do not even know how to use it. At this time I figured where he was going. Then the inevitable question, "aren't you charge?". All I could do was keep my mouth shut and tell him I will be out in a minute. Needless to say I was fuming. The only other nurse was a LPN and she was furious for me also. I had no idea what to do.

I was only 2 months out of orientation. I called everyone I could think of and let them know what I thought. I made it clear that I could not be responsible.

Since I work nights/weekends not all management was present, you better believe that management got an ear full on Monday though.

I am charge now regularly but got a supposed sufficient orientation to charge. They have not done it again to anyone else.

Specializes in Community Health, Med-Surg, Home Health.

I was left in charge of the eye clinic a few weeks ago. Seemed almost like a set-up to me. Assistant head nurse was on vacation, regular RN called in sick. Each RN that knew eye clinic had either called in sick or was on vacation. Now, it was stated that LPNs cannot take charge in hospitals, cannot triage. I didn't know, I thought when I went that an RN was going to be there. I go, and see another LPN. Walk-in patients are sent to the back for a nurse to triage to figure out if the patient should be seen today, or how soon. I have worked in the eye clinic before, but to do the routine functions, not to triage. I go to the nursing administrator and she told me that she had no RN that knew eye clinic, but that I 'know more than I think I do' and that she 'trusted my judgement better than the other LPN' and to take the situation to their attendings to let them decide whether or not the patients should be seen that day.

I have to say this was the most comical day I ever experienced. I walked over to the doctors and said "I am your float nurse today...I know NOTHING. I want to work with you, we have to collaborate care today because we are both fishes out of water". I have to say that we pulled together just fine, but, no matter how you slice it, we were both triaging patients that day. The other LPN and I had to place pieces of the puzzle together to make the day work. It really didn't matter, to tell you the truth if they did send an RN...she would not have been familiar with the process there to begin with. I have to say, the clerks, managers, eye technicians and even the housekeepers helped us, and laughed at our predicament.

So, in essence, it doesn't matter. Next time, I'll bet they would even pull a CNA to leave her in charge. If I even have a hint that no nurses are available for eye clinic again, I'm picking up the telephone as well.

Specializes in ED, ICU, PSYCH, PP, CEN.

I wonder if the people accepting the charge role realize that the people they are over are working under their license. (did I say that right)

This is one reason why I won't work charge. I know how some of the nurses I have worked with function and I don't want any part of it.

I love having someone to pass the buck to.

"The guy in 5 is crashing I need help"

I have been told by inexperienced charges to go find someone to help me because they were too busy looking up prom gowns on the net to get up.

Welcome to the brave new world.

Specializes in ER/EHR Trainer.

Well technically you take some of the responsibility when you are charge, but nurses aren't working under their licenses, only their own. However in the event of problems, they may bear some responsibility for poor outcomes if the assignment wasn't fair, if they didn't call (whomever) if there were issues, or if someone is tanking and they have not been on top of it. Alot for a newbie.

M

Specializes in Obstetrics & Gynecology,Medical/Surgical.
well i say congratulations to her. im sure she can go to orientation and she will be fine. just because she hasnt been a nurse long doesnt mean she cant develop the skills that is necessary for the job. obviously someone didn't want the job and or she was who they wanted. why arent you being asked to become charge nurse. say something if you are that mad but i doubt you will.

your last statement made laugh out loud, that you would presume that nothing has been said and that you "doubt" i will. as a matter of fact, i spoke my thoughts to the nurse manager last week as soon as i found out, long before posting my vent on here. :) i was thanked for my concern, told that i was actually the second person to come to her with the same concerns, and that was that. plus remember, i stated in the original thread that she only oriented once. it's not a matter of being "mad"; it's a matter of being concerned for our patients.

i have no doubts in this individual's organization skills as far as making assignments and coordinating. it is her clinical experience i don't trust...not because he isn't great at what she has done, but because there is a slew of things she hasn't done or even seen. i still consider myself a "new nurse" (although now with more experience than this young lady), and i need to be able to go to the nurse in charge and give her my scenario, ask what she thinks, which sometimes i feel like i do often! until now, our charge nurses have all had adequate experience in nursing, have "been there done that", and i know i can trust their assessment and advice.

in my unit, no one is "forced" to be charge nurse. we can volunteer, or we are asked, and the choice is ours. we're not at a shortage for charges, so i'm not even sure why she could have been asked. possibly she volunteered for career advancement (which is great), but i'm surprised mgmt would agree at this point so early in her career. it just seems very dangerous for our unit.

Just my two cents here....I would look out for yourself as a licensed practitioner, and of course your patient's well being first. This is a prime example of why I left the hospital setting. The suits in the nice, cushy admin jobs, nurses or not, have forgotten about the rest of their nursing colleagues, the conditions under which they work, and the sacrifices they make every time they take assignment. Do they really consider patient safety? or maybe they just need a licensed "body" to fill the position. I have refused a couple charge positions. It is HUGE responsibility, and the implications can be downright perilous if a person is in over their head. Look out for yourself, your patients, and YOUR license. The facilities will do what it takes to cover themselves, even if it means feeding you to the lions. CYA. Sorry it sounds jaded, but I have seen it before, and it left a bad impression.

It's not new, it's all about money and her willingness and everyone else's unwillingness.

Not sure what you should do except go to more experienced nurses, not her, if you need help and think she can't give it.

did you want the job?

We can't be oriented into a charge position for one year where I work. This is set in stone and works well for us.

I oriented to charge on an inpatient MH unit at 7 months of experience. (I had 25 years of prior MH experience as a non-nurse.) I am not qualified by policy to work charge on another service line. I think that as in everything it depends on prior experieces and acquired skills. I know I have learned a lot more about my staff role through my service as a charge nurse. The worst part about charge is balancing patient assignments by acuity and nurse preference/skills for working with patient populations.

Specializes in Operating Room.

I agree with the OP that this is not a good idea. I say this from the perspective of someone who was put into a similar situation. My employer didn't post my job as a charge position. I found out what I'd be doing once I had started orientation. I'm sure the hospital was leaping for joy when they suckered me into it, because we're union. You start at the scale that matches your experience. Therefore, I was getting paid what a nurse of 1 year made, plus a whopping 1.25 an hour charge pay.

I got far less orientation than most people got. I had staff that wouldn't cooperate and doctors that gave me a hard time because I was young, female and inexperienced. Not saying I blame anyone for being PO'd because it was a bad situation for everyone.

I feel badly for the woman in the OP(the new charge nurse) because I can pretty much guarantee you that she has no clue what she is in for...I'm quite sure administration is just going to throw her to the wolves and they are painting a pretty picture for her right now that will nowhere match reality. I feel badly for the staff, who will pretty much be along for the bumpy ride and I feel bad for the patients because someone may very well get hurt.

In my case, it was a mutual decision to have one of the more experienced nurses take the phone during the busiest part of the schedule..I still do charge but when it's quieter and there are less players involved. This way, I get to go into a room and circulate/scrub which is the part of my job I love the best. I get experience under my belt. All I know is, I in no way got compensated fairly for the crap I put up with when I had the phone the whole shift. The only ones who made out were the administrators.:rolleyes:

I'm a good nurse and an intelligent person. I have critical thinking skills..but experience needs to go hand in hand with intelligence and critical thinking.

Oh and I forgot to mention, not only was I expected to run the board, but I was expected to circulate a room at the same time! This meant that I could be in the middle of checking blood with anesthesia, moving a patient, doing counts, and the secretaries at the desk would get angry if I didn't answer within 3 rings!?! I was expected to be psychic when it came to the staff..meaning I was supposed to know what was going on in every other room while I was circulating and in some cases, scrubbed.

Sheesh, this post turned into a rant! Very therapeutic though! :)

Specializes in Operating Room.
so there has never been charge nurses who have done great with no experience?

"Great" in the eyes of administration and "great" in the sense of safe patient care are 2 completely different things. The PTB in most cases are so far removed from patient care that they wouldn't know decent care if it bit them in their butts.

Specializes in Med/surg, pediatrics, gi, gu,stepdown un.

I feel that all the administrators, nurse managers and director of nursing only care about patient satisfaction. I had to sit for four hours and listen to how are patients have become "customers" We have to give them whatever they want. It is becoming ridiculous. We don't follow doctors orders anymore, we follow patients orders and if we tell them no, we get in trouble for not calling the doctor about some ridiculous request. I think the doctors are tired of it. I feel sometimes the charge nurse is their to solve some of these problems if she has time. It can be overwhelming for a new nurse to have to deal with all the complaints. What it really comes down to is making the nurses happy then everyone, including the patients would be happy with the care.

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