Assistance from charge nurse

Tweety, BSN, RN · Jun 12, 2005

The charge nurse should be available to you anytime, especially if you are a new nurse.

The only suggestion I'd like to make right now is check your IVs. Make sure you have a good site before you leave.

stidget99 · Jun 12, 2005

Charge nurse should be avail whenever you need them.

As a nite nurse, my final rounds consist of making sure that:

- patients are medicated for pain/nausea

- IV sites are good, enough fluids up

- patients are clean and dry and turned

- trash is emptied

- water pitcher is full

When I start my shift, nothing is worse then having to go thru and medicate everyone, start IVs, and hang fresh fluids on all of my patients. When I have to do the above, it really sets my whole nite out on a huge negative note. The beginning of the shift is generally busy enough with not having to deal w/ any of the above.

SmilingBluEyes · Jun 12, 2005

A charge nurse is a resource for you and the patients. A good charge nurse is worth his/her weight in gold. Never be afraid to approach him or her for help, assistance or answers. But do be sure to do those things you can for yourself, first. Most "charges" are very busy, and if like where I work, we take our own patient load, as well as "charge" the unit.

Daytonite, BSN, RN · Jun 12, 2005

As a student you should be contacting your clinical supervisor for any questions or help you need.

However, as a new nurse. . .you, hopefully, will have a preceptor with whom you can discuss problems and issues that might come up. I'm assuming that you are worried about getting overwhelmed by work and want to know if its OK to talk with the charge nurse about it. Yes. As a new nurse the charge nurse should be there to answer your questions just like your preceptor did.

As an old night nurse these are things I did to help out the day shift. . .

If you've read any of my old posts, you know I was an IV therapist. . .Make sure every IV has enough fluid in it for the next 2 or 3 hours since the beginning of any shift is hectic. If an IV is going to be completed within a couple of hours I had the next bag of fluid hanging on the patient's IV pole ready to be spiked.

Hang and complete piggybacks before you leave. A lot of saline locks get lost to being clotted off because a piggyback was left for the oncoming shift to finish up. In most places you have a 1 hour window within which to give medications--use that to your advantage.

I always changed the dressings on central lines if the patient was confused or woke up during the night so the day shift didn't have to do it.

If I restarted an IV after about 4am I always checked to see if the patient was to have blood work drawn and I drew it for the lab before I hooked up the IV fluid.

Complete OR checklists as fully as you can for all patients going to OR that day.

Make sure you have a very clear knowledge of who is to be NPO or fasting and make sure you pass that on to the next shift so a mistake doesn't get made. Patients cannot always be trusted to maintain their NPO or fasting status. We were able to double check that our dietary department knew about NPO status. If there's any question as to whether a patient needs to be NPO or fasting it is better to err on the side of making them NPO. You will feel awful if a patient's surgery or a test gets cancelled because the night shift didn't make them NPO.

If you know a patient is going to be transferred the next day, look over the transfer sheet or start it. There are a lot of things you can fill in from information in the chart.

This is not a popular thing with most nurses, but we often did the bed baths and linen changes on a couple of the bed-ridden patients if we could manage it to help the day shift out.

In report, I always addressed any surgery, procedures or tests that patients were going to be having that day. This is important for their RNs to know.

Make it clear with the unit as to who is supposed to give the 7am meds, you or the day shift. If you decide to do the day shift a favor and give a 7am med that they usually give make sure you let them know and that you chart it.

Check all your pockets before you leave your unit to make sure you aren't accidentally walking off with narcotic keys or some other item that needs to stay on the unit. You will have to bring them back. In some places leaving with the narcotic keys results in a formal discipline and the locks being changed on the med cart. You'll only do it once and feel awful.

If you are driving home and realize there is something you forgot to tell the oncoming shift, don't panic, but call the unit as soon as you get home or to a phone and let them know. There is no wrong in forgetting something. Fess up to mistakes and make a mental note to try not to do it again.

Finally, get to know your day shift people and ask them if there are some things you can be doing for them to help them out. Not all responses you get will be reasonable (some nurses would have you do everything for them!). Don't expect that the shift you follow is going to extend the same courtesies to you. It would be nice if they did, but take pride in that you were always a team player and did what you could to help your co-workers.

The fact that you are even concerned about this tells me that you will probably do just fine. The day shift is probably going to want to follow you because you will have things organized and ready for them. When you start hearing comments like, "I love following you," you know you're on the right track!

My best wishes to you as you begin your career.

OntCaRPN · Jun 12, 2005

One other suggestion ... tidy the med cart/room. It is a hectic time and it's tooo frustrating to be hunting around for syringes, med cups, wipes and so on.

Daytonite, BSN, RN · Jun 12, 2005

One other suggestion ... tidy the med cart/room. It is a hectic time and it's tooo frustrating to be hunting around for syringes, med cups, wipes and so on.

You're right! On really quiet nights I cleaned the narcotic drawers and the refrigerator. I'm really anal and I stocked and placed all the syringes a certain way in their drawers so they were nice and neat looking. One night I started looking behind the telemetry units and found gold! I just cannot sit still and do nothing.

jude11142 · Jun 12, 2005

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I am a nursing student with a couple of questions...1) when might a new nurse approach the charge nurse for assistance ? 2) are there things that a night shift can do at the end of the shift to make the day shift's workload a bit easier? Thanks.

i would hope that the charge nurse would be available to you at all times. you should never feel that you are alone. As for night shift, I agree with others, make sure you restock, area is neat,and unless you were swamped, all of your tx's are done, etc...As a nurse who works 2nd and 3rd shifts, we are often left with work that days should of addressed(taking orders,updating md/fam, ordering meds). What makes it difficult, is that days seems to think that nights have it easy. Not so, how many times does a pt go downhill on nights ,or a pt falls etc...? that's all it takes for a bad night. We don't have all the staff days has. Each shift should take responsibility for such.

You should always have somebody that you can go to for help.

JUDE