charge nurse duties?

Specialties Med-Surg


i was wondering how different med-surg floors utilized charge nurses. if you could share some of the job descriptions and responsibilities, patient load....please mention which shift you are explaining the duties for. on my floor day charge usually takes no patients or a couple that are to be discharged that day, evening charge can take anywhere from the same number of patients as non charge to 1-2 less, midnight charges usually has a full load. some of our charge nurse responsibilities include placing patients when admitting calls, taping report for the whole shift, rounding with the docs.....our floor also does not have a charge nurse job description. do any of your hospitals? and if so could you share? :)


34 Posts

Our job as charge nurse from 7a-7p consists of signing off doctor's orders and putting the orders into the computer. We usually do not take any patients however float between and help the other nurses on the floor. We are a resource for others. We round with doctors, if requested as some like to round on their own. We chart VS, do Accu-checks in the morning, run heart monitor strips and do mainly paperwork throughout the day. It does not sound like much, but between answering phones and callbells, dealing with family members and doctors and all the unexpected in between, it can actually be a lot.


34 Posts

Hello Shannon,

In our hospital we do pretty much what you do. Job descriptions are being revised as we speak.


24 Posts

I am happy to have found this site. I was also wondering about charge nurse duties and responsibilities. I currently and a full time charge nurse on a 34 bed Med/Surg unit. Our patient ratio is 7:1, with no regard for acuity. I start my shift with or without patients, but always end with a full load. I have no more than 2 RNs- regarless of patient numbers, and am responsible for all the LPN duties/patients, as well as bed assignments, hanging of blood, admit assessments, rounding with MDs, being the resource person and advisor, and taking care of my own 7 patients. I am at my wits end with this staffing pattern but have no control over it. I have written more occurence and concern reports than I care to mention, and at the end of each day am completley exhausted. I never sit, use the restroom, eat or drink on an entire 12 hour shift. I leave everyday feeling like I am inadequate, or having the feeling, "if I could have done more". I need to do something, and soon, I just don't know what it is. I have talked to my administrative director time and time again, and cannot get anything done. Any advice?????????


16 Posts

HI, On our 32 bed floor first shift takes 1-2 pts that are going to be discharged that day, they go to hospital report, help other nurses and coordinate admissions. The same is genearlly the case for 2nd shift. I work 12 hr Noc's and we have a full load, coordinate admissions, check code equipment, call in line draws, and do scheduling for night/day shift and the assignments. We also deal with the codes and other emergent situations and the things that come up during the shift. We give report to the Day charge nurse when she comes on. It doesn't seem like alot but no one wants to be charge for the extra 50 cents an hour. I rarely get to sit and also seem to never get everything done for my own patients.

We have an 8:1 ration on NOC's but have had 10-11:1 shifts which is just plain wrong in my opinion, dangerous and reckless for management to even suggest it but it happens. Fortunately we take turns being charge and we all help each other out. It is the best asset on our floor. the teamwork. I work with amazing people but then I think all nurses are amazing, I am so glad to have found this site also and thank you all for your insight and expertise !!!!!!!

plumrn, BSN, RN

424 Posts

12 hr shifts.

Day charge may or may not take pts depending on the # of pts/

staff that day. Usually end up with a couple. At times have had

to take 5 or 6.

PM shift charge takes a full to near full load every night.

Day Charge rounds with the docs. Checks code cart. Makes assignments, does admission paperwork on all pts., checks labs,

IV starts,cardiac drugs, blood transfusions, and anything else only an RN can do.

We have only one RN on the floor, the charge nurse. All other staff are LVNs which makes it quite a busy day for the lone RN if they are taking pts.

Is this common elsewhere, or do you have mostly RN's as staff?


24 Posts

Charge nurse duties is what I was questioning, as in my above post, I am charge of a 34 bed Med/Surg unit. The nurse to patient ratio is 7:1, nights is the same . Our staffing grid states we get a "free" charge nurse for 8 hours on a 12 hour shift. NEVER happens. I come in daily with a patient assignment, and by the end of the shift have 7 patients with the rest of my nurses, as well as all the duties that come with charge nurse. I check code carts, refrigerators, clean equipment, bed assignments, admit and discharge all the patients, IV pushs, blood products, case managment rounds, hang TPN, handle patient problems, rounds with MDs, etc...(I could go on for days). With all of the duties I have, my patients seem to suffer the consequences. I work my ass off and do the best job possible, and sometimes it still is not enough. There is NO charge nurse pay differential. It is assigned, and to me, I am the senior nurse on the floor. Most of the nurses are LPNs, and we all work together, and all work hard, but I am lucky if I get another RN on the floor, and if not, I cannot leave the unit at any time. I wonder all the time, why do I continue to be charge? I am thinking of leaving very soon. Laura

26 bed med-surg unit. 7a-7p charge generally doesn't have pts but depending on census may have anywhere from 2-4. Again, generally none though. Transcribe orders, check the secretary's order entry, call lights, phone, families, resource for tough IV"s, assist staff w/decisions & critical thinking, cover the LVN's for what they aren't allowed to do, assign admits, staffing for next shift, communicate w/supervisor, check crash cart, mediate when staff can't get along...generally whatever comes up. Staff for 24 = 1 charge RN, 5 nurses assigned to pt care, no more than 2 of which can be LVN's,2 CNA's until 3p then cuts to 1, & a ward clerk. # of nurses drops as #of patients drops...we have a matrix that states how many for how many but basically the ratio stays 4or5, 6 max, to 1 nurse. 7p-7a is basically the same except max nurses = 1charge and 4 pt care, no more than 2 LVN's, 1 tech, no clerk. I'm the ACM and, can you believe, I still have nurses who c/o too many pts......reading your posts it sounds like my staff has it good!


142 Posts

Hey Laura when I did charge nurse my duties and load were exactly like yours. That is why I no longer do it.

It was not uncommon to be charge, resource, bed mngt, etc with 8 patients.

I would love to be a charge nurse and really be able to help the other nurses and make their loads easier. That is how I view the role of charge nurse.


1 Article; 1,327 Posts

I guess we have it ealy here...LOL. Our charge nurses DO NOT take patients at all. We have a 22 bed med/surg/ob unit. One RN/charge nurse, three LPNs, and 2 RNs (unless ICU is open or there is a paitent in labor, then we lose an RN for whatever unit is open). So, unless things go totally belly up (and they often do), we rarely have more than 6 or 7 patients. Most of our LPNs have IV certification that allows them to do most IV things (no blood, anti-dysrhythmics, or pediatrics). When there are RNs on the floor, they take a smaller patient load than the LPNs becasue theydo their own RN assessments, rounds, chart checks, etc. I've had up to 14 patients to myself when things just went haywire, but it's rare to have more than 6 or 7.


47 Posts

I did charge for 8 yrs on a busy 49 bed med-surg unit on the 3-11 shift. I took a full load of 8-12 pts, some days no CNA or Secretary. you never had time to round with doctors, if by chance you were in a room when a dr came in, then you heard the plans

I had to check crash cart every day, make sure enough staff for next shift, do iv pushes for LPN's, do hard IV sticks and labs for other nurses on the unit and be the trouble shooter for the floor. Forget the 30 mins before or after for med pass, you did it 2 times a shift and just changed the times for all the medications you gave.

well, I went on vacation to Australia for a month and others had to take turns doing it. When I came back to work, the charge nurse didn't have to take patients any more. Funny that I did it for years and I leave town and no one else is able to do it.


37 Posts

When I was charge nurse on 3-11, I had the same patient load as everyone else, if not more (usually 8-12 but had as many as 17 a few times). I would be expected to take a difficult or extra patient. Might as well take the extra patient since I have to deal with them anyway. I helped new GN's, GPN's, RN's and LPN's. I would precept them to the shift and make sure they were doing well and on task. Also, dealt with admissions and discharges and then assigning the new beds. Dealing with doctors, other staff, patients or family's with complaints or problems. Help staff withcritical thinking and mediate when their are problems. Of course, you know that those kinds of problems with docs, family and staff happens often. Doing assignments for the shift and adjust if needed. Help others with hanging blood, IGG, blood draws, or anything else they needed help with or didn't know what to do. Be aware of any patients going down hill or starting to crash. I could go on and on. I got paid NOTHING extra. I didn't know it was any different anywhere else. I will never do that again!

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