Charge nurse with less than a year RN experience???!!

[RNpandoraRN]

Recently one of the nurses I work with began training to be charge on our 30-bed (very busy!) med/surg unit. But here's the kicker - while she's very pleasant to work with....it hasn't even been a year yet since she graduated from nursing school (not previously an LPN or related field; never worked in medicine before), and has only been off new grad nurse orientation for 6 months. She is the newest and least experienced of the nurses that work her shift. She only oriented once and is already charging on her own.

This just seems ridiculous to me. A nurse who hasn't even been a nurse for a year is not someone I'm going to for help.....she has had litte experience with IVs, foleys, NGs, she has NEVER seen/experienced a code. The charge nurse needs to be someone with experience and good critical thinking skills - something that often a new nurse has not yet mastered. I'm just appalled. Scared. And a little angry that management would think this is a good idea, especially when this particular unit already has an abundant amount of new nurses working it. It's like having the blind leading the blind.

Just needing to vent, or maybe get some replies on why this isn't such a bad idea!

[diane227, LPN, RN]

The first job I had out of nursing school was as charge nurse on 3-11 of a 42 CV pre and post op floor. This was 31 years ago so a lot has changed. It was easy most of the time but I had worked there as a student so making the transition was easy.

Being charge now would be hard for any new grad. The responsibilities now are just to high to have someone who is so inexperienced. I would be interested to know the history behind this decision. Was the position posted? Did others apply? Is this a full time position for her or just a relief position? Are there other nurses on the shift who have more experience that want this position? More info please. Just curious.

[RNpandoraRN]

being charge now would be hard for any new grad. the responsibilities now are just to high to have someone who is so inexperienced. i would be interested to know the history behind this decision. was the position posted? did others apply? is this a full time position for her or just a relief position? are there other nurses on the shift who have more experience that want this position? more info please. just curious.

the position wasn't posted. we had plenty of nurses charging, and to my knowledge, none of them are leaving. i was shocked when i found out, as were others when the news spread. unknown if it's a full time position or just for relief, but we choose our own schedules so those that charge are also able to choose which dates they wish to charge. most choose to charge every time they work (hence why there hasn't appeared to be a shortage). there are definitely other nurses on the shift that have more experience, but i don't know if any of them want the position. this individual truly is the newest and least experienced of those of us that work her shift.

i've since heard a rumor that the young lady was asked if she would like the responsibility. as word spread, some of the other nurses have said that they weren't asked. all of this is why it's so baffling! i just keep thinking, why this, why that? (no, and despite what others may think about it being some sort of jealousy on my part, i was not asked but if i had, i would have declined, based on the fact that i don't feel i have adequate experience for such responsibility! i'm just truly concerned with patient safety and well-being).

[diane227, LPN, RN]

This is very interesting. I think you should go directly to your manager and ask. I would bet that part of what you are hearing is not correct. I go directly to my manager with any question that I have and she is very open and willing to share information. If your manager is going to place her in this position, she really needs to do this young woman a favor and a have a meeting with the staff to introduce her and this plan to the staff. If she just shows up all of a sudden as the charge nurse one day, well this will set her up for major failure and embarrassment and that is not good for anyone. This could be very disruptive to the moral of the department.

We have regular, appointed charge nurses on my floor. I am the regular charge nurse on 3-11. I have been in nursing for 31 years. I have held all levels of management positions from charge nurse to director. I still had to have about three months of orientation when I took this job. You can't just hop from one job to another and be expected to know what to do. Keep me posted about this. I would like to know how it turns out.

[RNpandoraRN]

this is very interesting. i think you should go directly to your manager and ask. i would bet that part of what you are hearing is not correct. i go directly to my manager with any question that i have and she is very open and willing to share information. if your manager is going to place her in this position, she really needs to do this young woman a favor and a have a meeting with the staff to introduce her and this plan to the staff. if she just shows up all of a sudden as the charge nurse one day, well this will set her up for major failure and embarrassment and that is not good for anyone. this could be very disruptive to the moral of the department.

we have regular, appointed charge nurses on my floor. i am the regular charge nurse on 3-11. i have been in nursing for 31 years. i have held all levels of management positions from charge nurse to director. i still had to have about three months of orientation when i took this job. you can't just hop from one job to another and be expected to know what to do. keep me posted about this. i would like to know how it turns out.

diane - i agree; a meeting to introduce her and the plan would have been great, and would especially promote unity! unfortunately, this young lady already just showed up as charge nurse one day, and has since had at least three shifts as such. her orientation consisted of one 12-hour shift. most of us only found out about her taking on charge role because we were looking at the upcoming work schedule and noticed the annotation next to this individual's name; a few others knew because she herself had told them. i may try to ask my manager about it (i've already spoken to her about how i feel) but i'm not very optimistic; unfortunately our manager is not the most receptive and i would be concerned she would just think i am "stirring the pot" - especially if she is the one who requested the new girl be charge!

i guess we'll see how it goes. i just hope it works out! thanks you for your comments (will keep you posted)!

[ZippyGBR, BSN, RN]

is this 'nurse in charge' i.e. shift leading as a staff nurse or the actual first line manager role of Charge Nurse ?

[walk6miles]

Happening in our hospital too. The latest is someone I try not to work with (why? because this particular nurse is angry, angry, angry. His attitude spills over into everything he does). A new grad (14 months) and disappointed because nursing hasn't reached some presumed nirvana he is searching for. Sad - sad - sad!

[pediatricsRN]

This is an unfortunate sign of the times for healthcare which is in crisis in the U.S. This does not surprise me in the least. Nothing against the young and inexperienced, we were all there once, but this practice will increase patient mortality and morbidity for sure. In high risk areas you really depend on the more experienced nurese around you because let's face it, clinicals are a far cry from the real world. I do not know what i would have done without the experineced ones when I was new. This should become a National Patient Safety Goal enforced by JCAHO.

[Henrik]

I believe charge nurse should have over years of experience. One year is too less.

Nothing personal. But, maybe you should ask yourself and other nurses in the unit.

Why no one in the unit apply that position? Or none of nurse in your unit get the position?

[greasy]

I can reply to this from two different sides. This first being,when I first got out of RN school, my first job was being a charge nurse on a Peds floor. I was the only RN with either an LPN or Aide on the floor with me. This all depended on our census. Most pts were high acuity. I had anywhere from 6-10pts at a time. I graduated form a diploma RN school, in which I had alot of clinicals in all areas of nursing. Was I scared ? Yes, but I was more than ready to take on the challenge. Did I maintain a safe environment for my pts? Yes, I would never jeaporadize my pts or my new RN license. Now, coming from a Nursing Educator point of view. It all depends on the new grad. I have students right now that it would be very unsafe for them to be charge nurses right out of school. On the other hand, I have students that would do great and are definitely qualified to take over that position. As an instructor, I get reference check calls from employers regarding this matter. Employers will not put someone in that position, if they are not qualified, based on the reference check.

[jizzi]

When I was a new grad, I was orienting with a seasoned RN. However, one 3-11 shift, she called out sick and I was left in charge because there was no one else to assign to my unit. I was nervous but got through the shift without any problem. I attended one of the best nursing diploma programs and was working at this same institution. I knew to ask the nursing supervisor for help if needed. That was 35 years ago. We had a nursing shortage then, same as we do now. This may not have been the ideal situation, but it truely tests the skills you have acquired.

[swiftdr]

I am currently leaving a Clinical Coordinator position in a 24 Step-Down Unit where for the past two years our turn-over rate was so bad that the only option was to orient those "new grads" with one year or less experience to Charge Nurse role... The improtant caveat to any of this is - "does the relatively inexperienced nurse show initiative and critical thinking skills?"

I look forward to the day when there is enough depth of experience in our profession NOT to do this, but currently it is necessary.

Oh, by the way, I'm at a Magnet Hospital too. Lofty goals get run over by reality sometimes....

[cloister]

I came out of school with my BSN almost 22 years ago. Got the required hospital orientation ("This is a crash cart!"), and then oriented 3 weeks on a 26 bed neurosurgical floor. Had not yet received my license, having taken boards just a week or two prior.

Came in to work one night at 10:15 p.m. and was told, "You're in charge. Make out the assignments."

Not another RN around, 3 LPNs and 5 patients of my own. On top of that, I admitted a patient that night. My preceptor? MOVED TO ALASKA. I kid you not.

Needless to say, the 3 LPNs were not happy (couldn't blame them), and I lost no time screwing up. My manager was a short timer and could have cared less. Not a great experience. Never dawned on me to say no, however. At 22, with a Southern upbringing, my stock response was, "Yes, ma'am." Thank God nobody died that night......

Now, when I started in my present unit, I had been there almost 3-1/2 years when I was oriented to charge, and we had a lot of experienced folks to fall back on. Such a difference.........

Presently, we're not orienting anyone to charge who hasn't been there at least 5 years. It's not a policy, it's just the way it's been shaking out. Thank goodness for low turnover!