Advice for a new charge nurse?

Beatlefan, BSN · Jan 29, 2016

If you figure out how to influence people to listen to you and to do their jobs, please let me know...

lucy100 · Jan 29, 2016

In my experience you first need to have clear direction and support from management. You will be very frustrated if management doesn't back you up. Where i work charge nurses really have no power or real authority. Charge is just used to do staffing and assign admissions.

ED Nurse, RN · Jan 29, 2016

How are you charge as a new nurse? That's interesting.

Karou · Jan 30, 2016

For some reason I get the vibe you work in LTC? Since you don't mention being charge nurse over other nurses, just the aids.

That's also one of the most common situations for a new grad to end up a "charge nurse" since every nurse in LTC just about gets called "charge nurse".

Are you an LPN/LVN or RN, and what setting do you actually work in?

I ended up working as an LVN at the same LTC facility I had worked for as a CNA. It made certain things easier, others more difficult. I was young, and that seemed fine as a fellow CNA, but when I suddenly became the "boss" over my coworkers, relationships at work were awkward for a while. Everyone knew I had zero nursing experience. That's not even factoring in how stressful, busy, and hard it was being an LVN in LTC either.

What helped me was by offering to help any chance I got. Always saying thank you. I would sometimes pay one of the CNA's who was running out to get lunch to get some for everyone. Brought baked snacks for the shift. When people like you personally and view you as a team player, it helps. I never abuse delegation. If I delegated something when I appeared not busy, I would phrase it like "Mrs. Jones really wants to go to bed, can you help her? I would appreciate it, I have to call the doctor for Mr. Smith, but I can try to help you when I am done. Thank you so much!"

Always expressing your gratitude, praising when appropriate, being kind, ect... Are all small things to build rapport and respect.

Karou · Jan 30, 2016

I wanted to add about the difficult coworkers who don't follow direction... Do you have specific examples?

Do they actually care for the patients, and are refusing specific delegated tasks, or do they neglect the patients?

The best way to fix this is to get your supervisors backing you. It needs to be made clear by them to everyone that patient care will not suffer, that people will have to work together as a team and fulfill their job duties to care for the patients. Any refusal to provide patent care should result in disciplinary action or a meeting with a supervisor.

How do these people react when you talk to them and ask them to do something? You could remind them, "hey, I know how busy you are. This really needs to get done though. I am working hard and have things I need to do also. We have to work together for the patients". It's not about me, about you, or if we like each other. The bottom and most important line is that we are here to provide care for patients and ensure their safety.

NOADLS · Jan 30, 2016

How are you charge as a new nurse? That's interesting.

A new nurse as a charge nurse is a red flag that something is wrong with the place of employment.

Don't have any senior nurses willing to take on the task? Likely because they all quit.

And I see this in the OP which confirms my suspicions.

Our staff situation is so tight right now that the higher ups aren't going to fire anyone, if only to maintain PPE.

Take it from me, you landed a great opportunity, OP. Is there more babysitting your subordinates or are you given your share of nursing tasks? How is the job with respect to time? Do you have a lot of downtime?

Karou · Jan 30, 2016

In previous posts the OP states she works in LTC.

It's common for a new nurse to be titled "charge nurse" in this setting. Weather that means she is actually the "charge nurse" over the entire LTC (including other nurses), or in "charge" of a specific group of patients, and the CNA's/medication techs that provide care to that specific group of patients.

tinytrexarms · Jan 30, 2016

I have zero down time. Lol. And yes, in LTC setting I'm the low end of the totem pole as a charge. I'm basically a secretary, babysitter to my aides, and responsible for all treatments and monitoring ADLS. I did score a great position on the skilled/rehab unit in our facility. Its a bit overwhelming, because I am so new, I'm learning on the fly. It's high pressure as this unit has a much higher acute pt volume. Our small town kind of uses us as a step down unit.

A particular aide I have will kind of look at me, and say ok. Then continue to sit on her butt until she feels adequate time has passed and do it. She gets it done eventually, but it's like she's testing me, seeing how far to push.

tinytrexarms · Jan 30, 2016

I have a med aide who is absolutely invaluable to me as a new LPN, and a seasoned 30 yr vet LPN as my evening med aide. (She just got tired of the stress of the floor and now does meds) they are my backbone for the moment. It's my CNAs that are testing me.