Charge Nurse-ing

  1. Have you had to be "acting" (relief) Charge Nurse AND take a full patient-load AND precept a new-hire, all at the same time?

    With the nursing shortage, I've had to wear the 3 hats several nights & feel like I don't do a good job in any of those roles - either I can't go to the Staffing Meetings or spend more time with my patients' care or accompany my preceptee. In the ICU, with the acuity of care expected, my "lunch-break" consists of covering everybody else's patients while they go on their breaks. AND I still have to stay overtime to catch up on computer charting & giving the day-shift a full report.

    I feel so frustrated I told the Manager I wouldn't do it anymore after a doctor yelled at me "You're not doing your job" - Hah! Which one, I wanted to ask?

    AND it's only about a $1 differential for being Charge and/or Preceptor. Is this insane or what?

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  2. 10 Comments

  3. by   susanmary
    Yes, I've been charge nurse, preceptor, and carried a full patient load -- all of this fun for base salary (do not get extra to be charge nurse or precept.) On my unit, charge nurse is usually not assigned to precept, but sometimes it happens. It's challenging to be charge and carry a full patient assignment especially when you need to fill prescheduled "holes" as well as sick calls, assist other nurses, troubleshoot, make out assignments, etc. We function as assistant nurse managers without the title or extra pay. Often, there is no one else with enough experience to be charge, so I end up being charge most of my shifts. It's unfair to be charge with a full patient assignment, but I'm making the best of it and doing the best I can. Gaining all the experience I can. Have filled out an application for a different position in the hospital & hope to interview next week -- totally different area. Much better hours, no nights/holidays/weekends!!!!! No charge! As I read awhile back on allnurses -- the grass isn't always greener ... it's just different grass. I need a change. Wish me luck.
  4. by   bunky
    Thank God I am not the only one having to do this! I am agency staff and have loved the fact that they'd never make me pull charge again. I had been exclusively charge for a few years and loved the break. Well they did put me back in charge even though I am agency, and not only did I do charge with a full pt load, but I had working with me, one experienced RN who is on orientation, and a new grad, as well as an LVN whose pt's I had to validate all her assessments on. From a staffing point of view, I was the only RN for 16 pt's because the other two weren't supposed to be counted. Guess they figured I am made of silly putty and can stretch myself to incredible lengths?
  5. by   canoehead
    It is physically impossible to do three jobs at once and the reason they assign it to you is you don't say no. If you don't say it's unsafe and refuse then the hospital is justified in thinking that you are able to manage. That's why nurses are overworked, because we've taken on "just one more thing, it'll only take a minute" from management and the duties of other departments with no commeasurate pay or staffing change. No wonder they delegate to us, we are the best deal they have going.
  6. by   bunky
    No Canoehead I am the one who does say no, and I've been threatened with termination several times now due to that fact. I am the so-called "troublemaker" who stops working and calls my agency to report unsafe conditions, and I will continue to do so. I have quit jobs before and am not afraid to do so again if it means keeping my license. I am no one's stooge I can assure you! I didn't feel too unsafe considering the other experienced orientee was a gent with over 20yrs experience.

  7. by   ccunite
    Thanks everyone for the moral support - I don't feel like I was out-of-line when I told the Unit Manager that I did not feel that I was giving safe & complete care when I wore 3 "hats" simultaneously. However, since there is a shortage of experienced nurses, I may still end up being Relief Charge on some nights & face the wrath of prima-donna doctors who bask in more attention than I can give.
  8. by   LLDPaRN
    At my facility, on our tele floors, they got rid of "charge" and now call that person "lead"--they have a patient assignment (albeit small--2 pts on days, not sure about the other shifts). They hired monitor techs to watch the monitors. Many of the nurses I know think that charge/lead having a patient assignment is a bad idea. However, our VP won't budge on this issue (according to our manager). Being per diem, I have not been thrust into the charge/lead role. When I was staff and did charge, I liked it b/c it was a break from patient care, which I think everyone needs once in a while. Granted, charge has its own headaches, and after a few days of charge, I was usually ready to go back to patient care and only being responsible for my 4 patients. I guess that's the biggest thing I miss--a chance for a "breather".

    Just my $.02 worth

    Bunky, glad to hear you're doing well!

    Laurie
  9. by   justanurse
    Yep, did that too. I took over as one of the Charge Nurses in our CCU 3 years ago. For two years, I wore many hats. Many times I had 3 patients right along with everyone else, praying "please, God, no codes today." As of a year ago, I don't have to take patients. Now I just have to charge over our CCU & 27 bed PCU. Oh, more hats. Assistant manager is what it's like.

    When I had to take a patient load, some days most of those hats just had to stay on the rack. First things first, the patient. Other staff usually don't like it, but I'm not going to let someone suffer or die because someone else is wanting my attention. They'll just have to wait. I've tried to spread myself too thin, but I just don't spread in the right spots.

    There are two words that accurately describe any charge nurse positon: IT SUCKS.

    I'm going to check out the grass over there myself, it's a pretty shade of green from here.
  10. by   lkushen
    How about charge, precepting 2 new nurses, and having my own patient load! All for the bargain price of...you got it, nothing extra!

    Our unit calls charge "shift coordinator" for which I lovingly call it sh*t coordinator.

    Being in charge is not so bad if you are working with a good crew. On the other hand, if your not, it can be a nightmare. The other factor has to do with your current patient acuity and staffing issues, as well as the supervisor (some are better than others).
  11. by   imaRN
    No matter what you call it:Unit Cordinator,Bed Babe (our term)or "wearing the big hat" (another term of ours) it all can be very distressing and downright impossible!With the short staffing when you are "in charge" you can't do that and patient care correctly and argue about admissions to the unit,and try to "put out fires" (whether it be with staff or visitors)and in a caring attitude help orient. a new staff,fortunately our manager rotates that ugly job, so it is nice to "share the madness with others." We usually only have to do it on the weekends.As an attempt to help with staffing or the lack of it "they" have closed 2 SICU beds. (Well at least it is an attempt)Oh yea we get 50 cents on hour for the headche. That doesn't even cover the cost of Tums!! It is nice to know we are not drowning alone- though it doesn't make it right!........
  12. by   RN1963
    I used to do charge all the time.A few months ago, Admin. decided to try one cn for both units, North AND South (64 beds). Now, these poor CN's have a cell phone to their ear constantly. ER calls for beds,PACU calls for beds, she has to call employees at home for staffing for the next shift, make out the next shifts assignments (how can you make a fair assignment not having time to know the needs of 64 patients). In addition she often has to either take patients, or be desk clerk, answering phones and entering doctors orders in the computer.Then there are the requests from the staff who are having crisis problems with their patients, can't start an IV, or need input on a patient condition. They have to do it all! All this for .25 extra per hour! Who needs it?

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