tips on being an effective charge nurse?

Jenny P · Apr 8, 2002

I forgot; but through the years I've worked with several nurses who had "special needs" which would affect how the shift went. It was always necessary to get new moms off to break on time because of the need for them to pump their breast milk before they "leaked." Or that it was necessary to get the hypoglycemic and diabetic nurses off to early supper (and then off for their 15 minute evening snack break!) so we didn't have total chaos by the end of the evening. Cover those nurses for these breaks since it can get pretty ugly if you don't!

I once had made a list of charge nurse duties that were very specific to my unit, but I lent it out and it never came back. It included some of these previously mentioned tips.

My unit now has a charge nurse book that includes all of the info needed to work charge for the unit: the duties of the charge, bedside nurse, HUCs and aides; what to do for the various alerts (codes, disasters, ED closures, etc.) staffing suggestions, phone numbers, what to do if a pt. needed to go back to surgery stat, etc. (it's a CV-ICU unit). It's nice to have everyone basing their charge duties on the same source; so everyone has the same expectations of the charge nurse.

BugRN · Apr 8, 2002

Speaking mainly from experience as an OB charge nurse.

I wouldn't take an assignment, but do all the NST's, labor checks, break all for dinner, pee breaks, etc...I also saw to it that the less experienced nurses got the exciting or more challenging cases if they were up to it, to give them the experience with me as back-up. Some of the other charge nurses would sometimes take the exciting cases for themselves and deprive the newer nurses the learning exp. as well as be out of commition for the rest of the floor! You can't know what's going on if your stuck with a labor patient and don't show your face for the rest of the night. A good charge nurse sees the floor as a whole and takes in the big picture. She/He should be doing as much work as the rest but still make him/herself available to help everyone else.

mattsmom81 · Apr 8, 2002

A good charge nurse rides the fence between staff, other depts, docs, and administration. It's not an easy job; sometimes staff forgets the charge nurse is not just there for 'them' and judges her by how much she does for the staff. There is more to it than that. Every unit is different so there is no universal recipe for what a 'good' charge nurse is or does.....but it has more to do with leadership ability than ability to task, IMHO.

babsRN · Apr 9, 2002

Great words of wisdom by all who have come before me...my addition would be to remember that it is the charge nurse who sets the culture for the unit for that shift. Much of what is accomplished or not is based on successful trusting relationships.

Take the time to compliment your team when they do a good job to your superiors. You will be paid back in diamonds by this staff next time you encounter rocky waters together. All the best...b

RNOCN2311 · Apr 23, 2008

I'm the charge nurse of a outpatient oncology clinic and let me tell you, it's a thankless job! I worked side by side with the staff for 8 years (I've got 10 in the department working with newer staff members), and dispite my work ethic, building "team" processes that the former charge person lacked I am finding that the resentment factor is a hurdle that I can't seem to get over.

I do the please and thank you, good job, and truly appreciate the staff in every way. I try to keep them informed, ask suggestions for processes that are being changed and make sure every one knows a change is coming before it's implemented. I have one staff member with a terrible call off history..... though I always ask if she's feeling better after one of those 4 day weekends she gets. One is diabetic and is poorly regulated and flys off the handle at will. No matter what time I send her to lunch, it's the wrong time, she won't go as scheduled, sugar to high and not eating today, but an extremely poor communicator and never say "I'm feeling I need to eat..... I need to eat at this time.....". She has more seniority in the system but not in our department and I truly think no matter what I do or say she will have problem with it. I take an assignment even though my phone rings off the hook, I manage 4 doctors patient follow ups, make rounds, do charges for deparment and physicians, forgo most lunch hour or take 10 minutes so everyone gets to lunch and generally am the "answer lady" for anything the other staff aren't sure what to do with or don't want to deal with (phone calls from patients). Needless to say, I'm more of the Nurse Manager than a charge nurse.

I'm pretty much ready to resign my position, but know the other nurse can't handle the decision making of the charge person, so I can be paid a small pentence for it or let her be paid and me still make the decisions. My biggest hurdle is management. Make decisions, but don't implement them on your own..... the good old fashion let them get the credit for my ideas. I really don't care who gets the credit, but back it up when you implement it. I hear, "this is stupid... why do we have to time our entry.......excuse me for forgetting", and no support from management in the disapline. I can make the decisions, but can't enforce them. Any ideas on how to get support from upper management? Our Nurse Manager is more hands off, out of sight, 5 hours a day instead of 8 kind of style of over seeing. One more day like today and I will resign.

RNcDreams · Apr 23, 2008

Keep an eye on your newbies :)

We look to you to reassure us that we are doing ok, and we need to you notice when we're drowning.

You are like our parent-- let us flourish, keep us in check, and pick us up when we fall.

That way, we'll turn into strong team members!

Jack43 · Mar 21, 2011

1. Work harder than anyone else and dont be afraid to do the trench work.

2 Dont talk about your private life. Dont joke around. Stay job focused.

3. If you are disliked because you had to get tough you have to really not care. Do not try and get staff who are angry with you to like you.

4. Be polite and smile and above all be fair.

5. You must really care about the staff and want them to succeed. So educate and help and be gentle in correction but enforce the policies and rules. That is why you were hired as a leader.

6. It will be tough for a few months when ou start out. Staff will talk about you behind your back, maybe even lie a little. They will go behind our back and complain to your boss. This is good, you are being effective. Dont defend yourself, your ethics and work quality speak for you. Eventually things will warm up a little, staff will work hard for you and respect you.

7.Know your stuff, admit to mistakes.

8. Lastly, dont be a glory hog. Instead, let the staff get all the credit. Have their back and defend them with fierce loyality

canesdukegirl, BSN, RN · Mar 21, 2011

Wow, this is an old thread, but I am glad it was resurrected. Good tips here.

carolmaccas66, BSN, RN · Mar 21, 2011

Have a plan for the shift. Let everyone else know what is expected of them. Ask for suggestions re some situations, but if anything gets out of hand, take charge and let others know some situations are non-negotiable, ie: that you are the boss, not them. Always respect the patients, carers and other nurses and follow the law. Discipline staff members in private and try to double-check work is done. Always make yourself available to other staff, patients and their families for help or questions.

There is a lot to know as a charge nurse. Some people don't know how to manage things - can this CN go on a course? Or just complain about her. I certainly don't tolerate crap now, and neither should you.