Eliminating charge Nurse position - page 2

by lilredmc | 4,196 Views | 19 Comments

Is it legal to eliminate the charge nurse position? It was done in our hospital! Where is the law? Can't find BNE's position on subject! Still looking if anyone knows send link!! Muchos Gracias!!... Read More


  1. 0
    It's not against the law, but a bad idea. My first job, also in OB, didn't have a charge; my current job does. I feel much safer with a charge nurse. My manager keeps trying to get me to train as one, but the pay differential on our busy unit is not worth the risk. I told him I wouldn't consider it until we got a ward clerk or aid...our dept is treated like a red headed step child...
  2. 0
    Yes, another lean and mean idea that comes around every decade. In my hospital, charge was rotated amongst the nurses and they took a full assignment. When the turnover and complaints increase, never fail they will bring back the position again.
  3. 0
    The BNE wrote me back it was a generic answer, but here it is 4 u Texans. ( in summary it is legal 2 illuminate charge)
    Thank you for your inquiry. The Nursing Practice Act (NPA) and Board Rules are written broadly so they can be applied by every nurse to all of the many different practice settings and specialty areas in nursing across Texas. The Texas Board of Nursing (BON) does not have a list of tasks that nurses can perform because each nurse has a different background, knowledge and level of competence. It is up to the individual nurse to use sound judgment when deciding whether to accept an assignment or perform a procedure.

    The BON regulates the practice of nursing and the approval of nursing education programs and does not have purview over certain facility policies such as a facility eliminating a charge nurse position in the ICU. However, nurses are obligated to promote a safe environment for their patients [Board Rule 217.11(1)(B)]. Board staff recommend that you review resource documents in the Nursing Practice section under Scope of Practice, including Rule 217.11 Standards of Nursing Practice and Position Statement 15.14 Duty of a Nurse in Any Setting. The position statement explains the importance of Standard (1)(B) in Board Rule 217.11 in that if you believe patients would be unsafe with current staffing practices, then your duty is to advocate for patient safety. The Frequently Asked Question (FAQ), Staffing Ratios located in the Nursing Practice section of our website may also be beneficial to you.

    In addition, the Texas Department of State Health Services (www.dshs.state.tx.us) regulates hospitals and may be able to provide guidance with your question. The most current version of the Nursing Practice Act and Board Rules and Regulations are accessible in Nursing Law and Rules on the Board’s website, www.bon.texas.gov. I hope you find this information helpful.
  4. 0
    I don't understand how you interpret their response as "yes, it is illegal to eliminate the charge position" when they specifically say "The BON regulates the practice of nursing and the approval of nursing education programs and does not have purview over certain facility policies such as a facility eliminating a charge nurse position in the ICU." The board of nursing does not mandate such things for private facilities.
  5. 1
    Quote from KelRN215
    I don't understand how you interpret their response as "yes, it is illegal to eliminate the charge position" when they specifically say "The BON regulates the practice of nursing and the approval of nursing education programs and does not have purview over certain facility policies such as a facility eliminating a charge nurse position in the ICU." The board of nursing does not mandate such things for private facilities.
    I reread the previous post; they stated it was NOT illegal...the "ill" was from the illuminate (which was for eliminate) from the post...
    psu_213 likes this.
  6. 2
    Quote from LadyFree28
    I reread the previous post; they stated it was NOT illegal...the "ill" was from the illuminate (which was for eliminate) from the post...
    Ah, thank you! I think I got distracted by the text speak.
    psu_213 and Altra like this.
  7. 0
    Quote from lilredmc
    The BNE wrote me back it was a generic answer, but here it is 4 u Texans. ( in summary it is legal 2 illuminate charge)
    Thank you for your inquiry. The Nursing Practice Act (NPA) and Board Rules are written broadly so they can be applied by every nurse to all of the many different practice settings and specialty areas in nursing across Texas. The Texas Board of Nursing (BON) does not have a list of tasks that nurses can perform because each nurse has a different background, knowledge and level of competence. It is up to the individual nurse to use sound judgment when deciding whether to accept an assignment or perform a procedure.

    The BON regulates the practice of nursing and the approval of nursing education programs and does not have purview over certain facility policies such as a facility eliminating a charge nurse position in the ICU. However, nurses are obligated to promote a safe environment for their patients [Board Rule 217.11(1)(B)]. Board staff recommend that you review resource documents in the Nursing Practice section under Scope of Practice, including Rule 217.11 Standards of Nursing Practice and Position Statement 15.14 Duty of a Nurse in Any Setting. The position statement explains the importance of Standard (1)(B) in Board Rule 217.11 in that if you believe patients would be unsafe with current staffing practices, then your duty is to advocate for patient safety. The Frequently Asked Question (FAQ), Staffing Ratios located in the Nursing Practice section of our website may also be beneficial to you.

    In addition, the Texas Department of State Health Services (Texas Department of State Health Services Mobile) regulates hospitals and may be able to provide guidance with your question. The most current version of the Nursing Practice Act and Board Rules and Regulations are accessible in Nursing Law and Rules on the Board’s website, Texas Board of Nursing. I hope you find this information helpful.
    Once again, another weak subjective practice act. "Nurses are obligated to promote a safe environment for their patients......your duty is to advocate for patient safety."

    What exactly is meant by promoting and advocating? and after defining those terms How?!?!?!??!!

    (Nurses have no power, it's not like there is any special emergency staffing company that nurses can call to supply extra workers for free).

    What I've learned from personal experience is that you have to be willing to sacrifice your lively-hood in order to possibly maintain patient safety for that particular shift. (Especially in this economy with the surplus of nurses)
  8. 0
    The Board's response doesn't surprise me. "We have no rules that would help you in any way, but by golly, if something goes wrong we're going to blame you for not advocating for patient safety!"

    I've worked without a charge nurse. When I started, in a small rural hospital's OB unit, we did not have a charge. Everyone had to be motivated to work, and we had to get along. 99.9% of the time it worked. Still not a good idea, though!
  9. 0
    Quote from KelRN215
    I think I got distracted by the text speak.
    WTH???? me 2 lol
  10. 0
    Everywhere I have worked (with the exception of when I was a CNA in LTC) has had a charge nurse (although each place calls it something a little different). However, the role has been different everywhere. What stands out the most was my job on a telemetry unit. The night shift charge was often someone who had no specific training as a charge nurse and did little more than assign patients. Where I work now in the ER, a person is oriented to charge for a number of shifts, before they "go it alone," and how well they perform as charge is monitored by the power that be...and if that person's performance is not up the standards of the unit, they won't get the privilege (and I use the term loosely) of being charge anymore.

    Point is, the duty varies from facility to facility and unit to unit within each facility, and I can't see a legal issue for a facility/unit abolishing the position all together (although that would not be, in my opinion, the best idea).


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