What makes a good OR charge nurse?

[14Gemini]

HI, we have been discussing this and have many "ideas"--most being -"get me out on time", "spread the wealth", "I need lunch"--all of these IF you work in OR you know can be difficult due to circumstances beyond our control. So--what suggestions do you have to someone considering taking on the charge nurse position at a facility they have never worked at as a staff RN?

[Rose_Queen, BSN, MSN, RN]

What shift will you be charge on?

For any shift, communication is key. This means discussing delays, schedule changes, add-ons, etc with the staff involved, preop, anesthesia, and PACU. In the craziness that can happen, make sure all those areas affected by changes are aware. I used to do evening shift charge, and you could almost hear the sigh of relief from the PACU charge at 3:15pm when I did an update- during the day, it wasn't uncommon for an add-on case to get done, PACU would get a call, and not know that the case had even been booked let alone started.

Utilizing resources/staff efficiently. We have one day shift charge nurse who will assign lunch relief to rooms that didn't have cases for 30 minutes- expecting the lunch relief to sit in the room doing nothing when the staff could have gotten lunch without relief. This led to other people not getting lunch until almost the end of the day. If there is a limited number of certain types of equipment, know when and where they will be used so as not to run into conflict.

Keep on top of the schedule. If you find out that there will be more late running rooms than anticipated and there aren't enough scheduled staff and call staff to cover staffing needs at change of shift, get out there early looking for volunteers to stay. No one wants to find out when they aren't relieved that they're stuck until their case or another case finishes.

[14Gemini]

All very good advice--we are looking to hire a day shift full time charge to give some consistency to staff. (Right now it varies and each person has their own style)--also any insights on how to work with CRNAs that believe they are in charge-LOL. The new position is meant to coordinate nursing staff with the anesthesia staff and NOT be directed by anesthesia on nursing staff assignments--right now they (anesthesia charge) like to move our people around on the board. The lunch issue is a big pet peeve here too--any others that you have heard would be appreciated. Issues are easier addressed prior to becoming problems. These are things we need to discuss with who ever is hired as NO ONE here wants the job--surprise-surprise. Thanks RQ!

[Rose_Queen, BSN, MSN, RN]

Anesthesia moving non-anesthesia staff around sounds like something that should be addressed by upper management. That shouldn't be something that staff should have to address.

Another pet peeve that is rampant in my department about lunches is the fact that a lot of people take far longer than the allotted 30 minutes- we have some who will disappear for well over an hour. Make sure people aren't taking longer than they should (an extra few minutes here or there because the line in the cafeteria was monstrous is one thing; routinely taking more than double the time should result in discipline) and those that do should have the issue addressed by management.