Charge nurse duties in your NICU?

prmenrs, RN · Jul 14, 2003

In the unit from which I retired, the "Charge Mama" makes assignments, solves problems, keeps track of impending deliveries to which we will be invited, makes rounds for status updates, makes sure assignments in the 'back' nurseries are reasonable and appropriate. She helps out w/critical pts and admissions; if all three admit nurses are used up, she may have to take the next admit, or try to move babies around to free up other nurses. She assigns the "chores"--checking frig temps, meds, transport stuff, calibrationg bedside testing equipment--and makes sure they are accomplished.

She needs to have a lot of patience, good people skills, be able to prioritize in her sleep. She has to work w/medical staff, respiratory, ancillary personnel, and the 14-18 or so nurses, including registry and travelers on the shift.

She staffs for the oncoming shift. That may mean phone calls if we're short. Although there is a staffing office for the hospital, we cannot rely on them to do our staffing.

She sees any incident reports [QA's, whatever] first and writes her input before it goes to the nurse manager.

She does not take a pt. assignment unless there is absolutely NO choice.

I can't think of anything else, but I've probably left something imp't off this list.

NicuGal, MSN, RN · Jul 15, 2003

Our charge nurses don't have an assignment either if we can help it. We make out the assignments, help out, delegate and redelegate, make sure the next shift is staffed, make sure the sign in sheet is done. They check the crash boxes, the intubation boxes, set up admission areas, do kids if needed, check the fridges, tally the invasive lines for risk management.

Go to the attending if there is a problem in the unit, take numerous calls that make you nuts LOL, watch the front desk while the secretary is out.

Most of us are oriented to charge, but not everyone does well at it.

NurseAmy · Jul 15, 2003

Here the charge nurse has a full, which means 3 patients, assignment just like the rest of the staff. Last week we staffed 5 nurses for 15 babies. 3 of which were vented, one trach, 2 with MRSA, numerous Broviacs, a couple with ostomies and two with g-tubes. And 5 preterms on the L&D board.

Sounds fun, doesn't it??

Mimi2RN, ASN, RN · Jul 15, 2003

Amy, that sounds like a tad understaffed. Was this very busy for you, or normal? Is this a management problem, you need more nurses but they won't hire any.....like we are, overbudget and short of trained warm bodies. Our census has increased but the money hasn't.

California's mandated staffing would be 1:2 for you.

cindylouwho · Jul 16, 2003

we can't get people to do charge in our unit because of those reasons.....who wants to take a full assignment...attend all the deliveries...deal with the problems of staffing...take transport calls...for a dollar an hour more?.......enough stress in this unit without adding anymore to it and most people see it that way...

cindylouwho · Jul 16, 2003

our nurse pt. ratio has been 1:4 and 1:5 at times....more than once I've had a 350 gm baby on HFOV...another vented baby.....a new admit with seizures and a grower learning to nipple....?????as predicted...I ended up trying to comfort a grieving family over the death of their premie while taking care of the other 3........and they wonder why I don't want to be a charge nurse?...ha

NurseAmy · Jul 16, 2003

Yes, it would be very nice if the rest of the nation would adopt California's staffing ratio rules. The unit I am referring to is in South Carolina where I am on a travel nurse assignment. My 'home' unit is staffed much better, and the charge nurse never takes an assignment-someone from managment would come in and staff before the charge nurse would take a patient assignment.

nurseiam · Jul 16, 2003

I am a Charge nurse, We call it team leader!!!! We also try not to take an assignment. But one night I was TL, deliveries, with three Special care babies! Talk about the night from hell! We do most of the stuff the others do. We get an extra $2. I like to do it because I can help others, attend deliveries, and be in the middle of most of the action!