Charge nurse Issues

VickyRN, MSN, DNP, RN · Jul 23, 2005

Fellow charge nurses,
How many of u out there have a patient load while supervising the whole unit? How many patients would u take? Recently I had to charge with 5 patients of my own to look after and at the same time monitor 4 epidurals w/c in hindight I should have taken those patients to save me the stress. On top of that i have to write the report, staffing for the next shift, put orders in the system(no unit secretary) and whatever paperwork needed to be filled out. I was so frustrated that night that i told my supervisor that i was ready to walk out. Since i have to no permanent unit i go to on nights i work, I thought it was unfair and a patient-safety issue as well. Am I over reacting??? Input please. thanx

I agree - majorly unsafe. Put your foot down and don't allow that to happen again. Afterall, it is your patients' safety and your license that is on the line.

Judee Smudee, ADN, RN · Jul 23, 2005

You are being taken advantage of by managment. I guess you get roped in just like we all do. You start out trying to be a team player and only later realized that someone mistook you for a dormat. Most of us learn the hard way not to be used like this. One of the reasons managment always talks about recruitment of new nurses and seldom mentions retention is that they want a steady supply of persons who don't know enough to look out for themselves. Once nurses get a little experince and a little savy they start saying "NO!" It is your time to say no.

grinnurse, RN · Jul 24, 2005

They do that to our charge nurses at night too!! I am a new nurse but I already have a saying down when they ask me to charge later on and that is "NO". Learned that from one of the nurses that I precepted with not too long ago.

That sounds totally unsafe to me and a path to quick burnout.

Sorry I don't have any advice for you.

nursemary9, BSN, RN · Jul 24, 2005

Hi

Major issues here!!! I KNOW WHAT YOU MEAN!!:angryfire

I work nites, too. Listen to this--I work a Med/Surg/Onc unit 34 beds.

We get a complete load of pt's--7 or 8 plus being in charge with the same type duties you describe. I'm told that's how it is. On days the Practice Leader gets

0 patients, on PM's the charge gets 2 or 3. We get 7 -8. How fair is this.

I keep telling them I don't want to be charge, but am told, I have to take a turn.

We get $1.00/ hr.. extra for being in Charge!!

I hate it. Day shift comes in & they complain about the assignments. It's miserable. You always have to be available to help the other people on you shift. When I bring this issue up, I'm a trouble maker!!

Mary Ann

IRN · Jul 25, 2005

Tough situation to be in, but it happens far too often in nursing.

In my first job I was in charge at night and was precepting a new grad. We had a total of 3 RN's on that night, one of which was an agency nurse who had only been on the unit once before. My preceptee and I had 9 or 10 patients. Also we had no patient care techs on that night, so we did EVERYTHING for these patients. We had two codes that night, and almost a third. It seemed like that was getting to be more of a trend than an abnormal situation.

I handed it my resignation later that week. I did not go to school for that long and get my license in order for it to be taken away from me! I discussed it at length with supervisors and coworkers.

Things have since improved on the unit, and I still go back for prn work. (That way I don't have to be in charge).

Genevieve RN · Jul 25, 2005

I am frequently in charge with a full assignment. (I work Peds we get 6-7 pts. max). I'm also precepting a student extern this summer and usually have to be in charge and have the student too (weekends). Finally, on Saturday I spoke to the Nurse Leader (who is usually in charge, no assignment) and asked her to assign another nurse charge as I am busy with patients and the student. She did assign the other nurse.

Just because I am senior nurse on the weekend doesn't mean I have to be charge all the time.

It's too stressful managing the whole unit, a whole pt. assignment and watch a student too. Dealing with staffing issues, problems with families etc., please. I'm exhausted.

dinkymouse · Jul 25, 2005

I was charge in my ltc on Sunday. I had only 3 days of orientation before this. I am talking to the don to say I am not doing this again until I am more comfortable. I had to pass meds to 78 patients.

stidget99 · Jul 25, 2005

At my hosp, it is common practice for the charge nurse to take the same pt load as everyone else (working the noc shift). Recently, it has been an expectation to act as charge nurse and precept a new grad along with sharing a full pt load w/ your preceptee. Also, as charge nurse, you are expected to take the 8th pt (29 beds on our floor and 4 nurses). When we state that we can't do it or that it is an unsafe situation, we are told that if we didn't, we could expect to feel consequences the following day.

Consequently, the preceptees are getting a crappy orientation and leaving the hosp. :banghead:

Tweety, BSN, RN · Jul 26, 2005

Is this the norm, or was it just a bad night?

Our day and evening charge rarely have patients, but night shift has about 2 or 3. There's just two much responsibility to have anymore than that. On days when I had a full load, I just didn't do some of the other stuff, mainly just made the assignment for days, didn't give report to the next charge because "I had a full load and there really wasn't a charge nurse last night". But I tried not to get bent out of shape about it because it was the exception rather than the rule.

No you are not overreacting.

BGgirl · Jul 26, 2005

I work on an ICU stepdown where we take 3 patients on days and 4 on nights. Our dayshift charge nurse rarely has a patient assignment while on nights you have a full load while being in charge.

We only get a whopping 75 cents extra and have to deal with registration calling us patients all night because we seem to get slammed with admissions every night. If you're a nurse precepting it's guaranteed that you'll be in charge. It's usually so they don't have to pay you for both precepting and being in charge.

My first night in charge I ended up in tears I was so stressed out. The stress of being in charge on nights just isn't worth it.