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!

[Laboratorian]

*stupid question *

What are the specific responsibilities of a charge nurse?

[pers]

*stupid question *

What are the specific responsibilities of a charge nurse?

Not a stupid question at all! It varies by shift and location. New grads doing charge on my unit at night is not a big deal. The only additional responsibilities of charge is to assign new admits and handle staffing and a new grad with half a brain is perfectly capable of it since 1) admits are assigned by turn and 99% of the time people volunteer the order to take them in and 2) staffing is decided by the supervisor and the charge is only responsible for double checking the accuracy of their info and calling off or putting on call staff that isn't needed for the next shift. They are a resource person as much as any other nurse on the unit but they aren't expected to handle a crisis situation any more than any other nurse. When something happens, we all are expected to help out but the person who is actually in charge of the situation and making the final decision is the nurse assigned to the patient.

Days is quite different. On my unit, the charge nurse does not take patients. They are expected to know what's going on with all patients (they take report on the entire unit). It's their responsibility to note all the orders for the shift and pass that info to the appropriate nurse. They deal a lot with doctors but individual nurses are expected to make and take calls to doctor's regarding their patient's needs as well. They assist LPNs with anything they can't do (per policy) and help out nurses who are struggling and need help as well. Like nights, they also deal with admits (also assigned by turn) and staffing (also decided by the supervisor). They also provide coverage for breaks and lunch. They do tend to direct things more, staying on top of where patients are and where they need to go. They also tend to take on more authority in a crisis situation which can be good or bad depending on if you are the patient's nurse and agree with what's being done or not. Most of our charge nurses consider it more mentally taxing than taking patients but generally easier as well and given the choice they prefer to be charge than take patients.

[DoGoodThenGo]

Not a stupid question at all! It varies by shift and location. New grads doing charge on my unit at night is not a big deal. The only additional responsibilities of charge is to assign new admits and handle staffing and a new grad with half a brain is perfectly capable of it since 1) admits are assigned by turn and 99% of the time people volunteer the order to take them in and 2) staffing is decided by the supervisor and the charge is only responsible for double checking the accuracy of their info and calling off or putting on call staff that isn't needed for the next shift. They are a resource person as much as any other nurse on the unit but they aren't expected to handle a crisis situation any more than any other nurse. When something happens, we all are expected to help out but the person who is actually in charge of the situation and making the final decision is the nurse assigned to the patient.

Days is quite different. On my unit, the charge nurse does not take patients. They are expected to know what's going on with all patients (they take report on the entire unit). It's their responsibility to note all the orders for the shift and pass that info to the appropriate nurse. They deal a lot with doctors but individual nurses are expected to make and take calls to doctor's regarding their patient's needs as well. They assist LPNs with anything they can't do (per policy) and help out nurses who are struggling and need help as well. Like nights, they also deal with admits (also assigned by turn) and staffing (also decided by the supervisor). They also provide coverage for breaks and lunch. They do tend to direct things more, staying on top of where patients are and where they need to go. They also tend to take on more authority in a crisis situation which can be good or bad depending on if you are the patient's nurse and agree with what's being done or not. Most of our charge nurses consider it more mentally taxing than taking patients but generally easier as well and given the choice they prefer to be charge than take patients.

Now I'm confused! *LOL*

Charge nurse is now what was called in my day a "head nurse"? Meaning there is no longer a nurse management position between charge nurse and nursing supervisor of a unit/floor?

[pers]

Now I'm confused! *LOL*

Charge nurse is now what was called in my day a "head nurse"? Meaning there is no longer a nurse management position between charge nurse and nursing supervisor of a unit/floor?

That's the case at my facility. We don't have a nurse management position between charge (which isn't considered management, the position rotates through multiple people without a pay increase) and our nurse manager. Nurse supervisors at our facility are house supervisors and cover the entire hospital while mangers cover one (or two) units. From other posts I know that's not the case everywhere which is why I said it varies by location. Even at my facility, the responsibilities of the charge nurse vary by unit. On some units the charge takes a patient load and on others they never do and then some are like my floor where they do on some shifts but not on others.

[DoGoodThenGo]

That's the case at my facility. We don't have a nurse management position between charge (which isn't considered management, the position rotates through multiple people without a pay increase) and our nurse manager. Nurse supervisors at our facility are house supervisors and cover the entire hospital while mangers cover one (or two) units. From other posts I know that's not the case everywhere which is why I said it varies by location. Even at my facility, the responsibilities of the charge nurse vary by unit. On some units the charge takes a patient load and on others they never do and then some are like my floor where they do on some shifts but not on others.

Thank you for clearing things up.

Soooooo, it appears the duties of a head nurse were split between nurse managers and charge nurses. One assumes the former deal with the "personnel" side of things (hiring, firing, scheduling, and so forth), while the later deal with day to day running of a unit or floor.

House supervisors (day, night, etc) one is familiar with. Always thought they were kind of cool because at least at the facilities one worked, they had tons of keys. If a floor ran out of linens for example, the supervisor had the keys to the laundry or at least clean linen storage and would fetch (rather one went down with her and was given), what was required.

[ZippyGBR, BSN, RN]

first thing to establish is what is meant by 'charge' in this scenario

are we talking about a 'shift leader' of what ever grade / rank/ job title - whose responsibility is to coordinate how the unit runs for the shift or the actual substantive appointment into a Nursing team leader role with the assocaited ongoing responsibilities this entails

?

[oinch97]

More of a "shift leader" Basically a nurse who is in charge of the goings on on the floor for that shift.

[juliannaUT]

I totally agree with you. Your charge nurse should be someone who has been there, done that, and can help you when things come up. I recently quit at a facility where the DON just graduated in May of 2009, and went straight to being the DON. It was hard because I've only been a nurse for 2 years, and she would constantly come to ME with questions...basic stuff that she should know. She's a very nice person, but in my opinion, has no business being in a position like that until she herself has worked the floor. I think it's bad practice.

[canesdukegirl, BSN, RN]

I was asked to train for charge in a large OR. I did have some charge experience at some other hospitals that I had worked in previously. I wasn't excited about doing it, but I understood the reasons they gave me. They also told me that I would be trained along with 4 other nurses. That did not come to fruition. They thought that since I had gotten the swing of things relatively quickly, they would just have me do it instead of training more nurses. That did not sit well with me because that was not the deal when I agreed.

When I was in training, I was trying to make sense of a real mess that I was presented with. There were 4 people waiting to talk to me. I felt frustrated, angry and terribly inept. The charge nurse training me sat behind me with her arms crossed. When one of the Team Leaders asked her what she was doing, she laughed and said that she was "just watchin' the drama." That REALLY cooked my goose! How about being supportive?!?

Good organizational skills and mediation skills are the best tools you can have while being charge. Yes, experience matters a great deal and I completely understand where you are coming from: the charge nurse should be your go-to person. I would lay the blame squarely on management's shoulders for that decision. That poor nurse!

Charge nurse duties entail sooooo much that others don't see. You have to manage EVERYTHING that goes on, and you must do it while some are questioning your ability, giving you attitude, and generally being nasty. They have no idea that you as charge are looking at the entire picture while they just see a snap-shot. It is not easy. I thought they would have to cart me off in a straight jacket my first month as charge!

[canesdukegirl, BSN, RN]

I totally agree with you. Your charge nurse should be someone who has been there, done that, and can help you when things come up. I recently quit at a facility where the DON just graduated in May of 2009, and went straight to being the DON. It was hard because I've only been a nurse for 2 years, and she would constantly come to ME with questions...basic stuff that she should know. She's a very nice person, but in my opinion, has no business being in a position like that until she herself has worked the floor. I think it's bad practice.

It is difficult to have respect for a manager that does not have the experience or the skill that you yourself possess. It IS bad practice!

[diane227, LPN, RN]

When I was a new grad I was fortunate enough to have gone to work in a hospital where I did part of my training. In addition, I had worked at that hospital as a CNA for a year before graduation. During my first job, on a 42 bed post op CV floor I was charge on 3-11. We were staffed with 2 nurses, 2 CNA's and a unit secretary for 42 patients. But things were quite different then and nursing was not nearly as complicated as it is now. I do think that there are people who come along in our profession who have a natural talent for management. The unit where I have worked for the last 5 years was also a large medical surgical unit and I was the charge nurse on 3-11. I have multiple years of management experience and it was sometimes overwhelming for me.

Were I her manager I believe that I would insist that she have a few more years of nursing experience under her belt. This young nurse many have had some management experience in another field before she became a nurse. But the fact is that at a year you do not have the skill and expertise to deal with all you will have to deal with in regard to patient care issues, assignments, staffing, emergencies, customer services issues, etc. And given her circumstances, she is going to meet with a lost of resistance from the staff.

You have a couple of choices here. You can complain to your manager about this and ask her for some reasons behind her decision. You can choose to talk behind her back about what a bad decision this is and try to undermine her at work. Or you can sit back, do your best, offer her support and see how it goes. This young nurse might step up to the plate and to a great job. You don't know until she is given a chance. I have seen a few nurses who were able to do it with great success. Myself, I would say congratulations, let me know if I can help, and keep doing my work, and see how it goes. If she is going to fail, she will do it on her own. This is the perfect opportunity to help a co-worker be successful, even when we don't like the circumstances.

[Aleta boston]

Sounds ridiculous to me! I believe a charge nurse should have at least 3 years experience on the unit they are charging!. Accepting this role as a new nurse is incredibly stupid. Hmph.