Charge Nurse in 6 months?

Nurses Career Support

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Hi all

I started working in a busy ED in NY 6 months ago. This is my first job in acute care. This unit has a very high turnover rate & I still feel pretty new and just starting to get comfortable. They're starting to put me as charge some nights, and even though I say I'm not comfortable with it they dont seem to care. Ive asked for training of some kind for the role & they say its not needed....??? I'm confused as to whether this is the norm in most units...should I look for a new job? Or stick it out? What would you do? Thanks.

Specializes in Pediatrics Retired.
I don't know about the ER but at my PRN gig the med surg, oncology, and ortho floors will make a new grad a charge after 6 months. They do have to attend special training classes, but I still think it's crazy. Most take it as a compliment so they jump at the chance. In reality it's because either we are full of travelers or even newer grads.

How about the nursing homes that hire new grads as the DON?

Specializes in Critical Care.
I appreciate the replies. These past few nights have been rough. I jumped to help in a code only to turn around and notice the rest of the nurses (experienced) have left to see their patients. It was just me, doing CPR, the resident who couldnt figure out what to order, and the attending.The nurse assigned to the coding patient didnt even step into the room until everything was done! The pt survived, but what nurse leaves another nurse alone like that... what kind of nursing practice is this?

I had a pt who crashed, had to mix and start a levophed & dopamine drip, which I havent done on my own. I step out of the room...and not ONE nurse was on the unit. They all left together to get "free holiday meals" from the cafeteria. WTH!?!? They left me alone while my pt crashed!?? I ended up calling pharmacy and asking directions on mixing and hanging the drips.

We have 1 IV pump in our ED, outdated technology, and staff who dont work together. I'm getting burned out quickly but I'm working so hard. Starting to feel as though I'm being taken advantage of. I never complain, get angry, or show I'm overwhelmed. I'm seriously considering leaving and have been applying to other positions.

That sounds like NYC to me. Is this a public hospital, or private?

Specializes in ICU and Dialysis.

Let me just say, I am somehow more concerned about the lack of teamwork in your department than you as charge. No hands on deck in a code? RIDICULOUS. Even if every other nurse on your unit is a day 1 new grad, they are competent to do compressions while you figure out how to save the patient. It's been ages since I did more than a round or two of compressions on a patient, because usually there's a number of BLS certified techs or newer nurses who can pitch that in, even if they aren't yet comfortable mixing drips or pushing meds.

If that had happened somewhere that I was working, I'd be carrying a list of names with me to my supervisor, or their supervisor, or the CEO if it took it. That is so extremely morally wrong by any measure.

This is a small private hospital in NY. Honestly I'm discouraged, because I have never imagined Nursing to be like this. From the comments I'm understanding that it shouldn't be. I have an interview for a case management position in my hospital coming up. I also have an interview for an SICU at a TX hospital. Lets see how they go.

We've been so short staffed at times, that I've had 10 patients at a time some nights. I dont think its safe, or fair. Its so easy to miss something and we only have time to complete orders. Sometimes I dont even know why the pt is getting such and such treatment. I'm so worried for my license at this point.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

OP, you sound like you have a really good head on your shoulders, and you sound very wise and mature for a new grad. Please do not give up on nursing. My instinct says that you are/will be a very good nurse, and a natural leader in time. All places are not like this.

And going back to the CN discussion... no I havent got a clue what CN is supposed to do. I def do not want that responsibility right now in my career & def not trying to lose my license to fix their staffing issues. I wish hospitals would invest in their nurses more & give them the proper training, orientation, and support to succeed, instead of leaving us & using our "BSN" against us when we question something that is unsafe.

Your "coworkers" should be locked up for abandoning you, endangering patients, deserting patients, and just plain evilness (if that's a word). I do hope you let your boss know about this.

Another acceptable punishment would be firing for all of them and reporting them to the Board.

That is really outrageous behavior. Even if there were no other patients at that point, some could have come in. And who was watching the other patients? No one. And who was assisting with CPR, etc.? No one.

Maybe you should have yelled to the secretary to call a code over the paging system so everyone in the hospital, including the House Supervisor, would have known and come to help.

Can you tell I'm truly shocked and steamed about this? I mean it, Girl, report every last one of them if you have not already done so.

I was only saying if the OP was the safest one there, then it makes sense to have her in charge and to look at it that way. The whole system is messed up to even allow this to happen, but she has to mentally come to terms with it in order to keep working there.

Should this happen? No absolutely not! Another facility in her region might be run the exact same way and better for the OP to strive to do the best job she can- and then be able to put it on her resume and maybe leave, but the system will remain the same whether she stays or goes.

It must not remain the same. It has to change for the sake of all patients. Stop being someone who doesn't seem willing to pick up the sword.

You do know how to effect change, right? Just lacking the moral fortitude? I know it's scary and I apologize if I am being too blunt, but after reading OP's post about how all of her "coworkers" abandoned their jobs during a code and she was the only nurse in the whole ER, I am steamed.

YOU must start being the change agent and stop believing YOU can never bring about improvements.

I worked in a small hospital somewhat like this as a new grad. They may just not have the staffing to properly cover everything. I have no idea what was going on with the other nurses and the free meal thing but during the code there could have been other emergencies happening at the same time.

One time as a new grad, I was left on an OB floor with two laboring patients and one on a pitocin drip that I didnt know how to titrate properly. Everyone else had ran down to the OR for a very emergency cesarean. And I was a med/surg nurse at the time.

Just hang in there and learn as much as possible.

Specializes in ICU.

I was charge nurse of a 44 bed telemetry unit 5 days after I graduated nursing school. Just a few days orientation. Back then we could hit the floor running without having to go thru a lengthy orientation. We were taught well in nursing school. These days it seems they expect new nurses to learn nursing "on the job." I have co-workers who were never taught how to give blood products, didn't have to take any surgical classes, and a lot of other stuff that apparently schools no longer teach.

I worked in a small hospital somewhat like this as a new grad. They may just not have the staffing to properly cover everything. I have no idea what was going on with the other nurses and the free meal thing but during the code there could have been other emergencies happening at the same time.

One time as a new grad, I was left on an OB floor with two laboring patients and one on a pitocin drip that I didnt know how to titrate properly. Everyone else had ran down to the OR for a very emergency cesarean. And I was a med/surg nurse at the time.

Just hang in there and learn as much as possible.

How many nurses should have gone to the OR?

How many did?

I think there were three of us nurses and I had floated from med/surg. The other two nurses left. It was a very long time ago and I dont remember much except being terrified and not being able to get the fetal monitor adjusted right and not remembering the math for the pit. They only did like one delivery a week in the place, so to have three laboring at once was very unusual. It was the middle of the night. Small community hospital.

Specializes in ER.

Several trends contribute to the toxic situation you described. 1.) Experience is valued less; a nurse is a nurse and one straight out of college costs less. 2.) Profits are more important that quality care. 3.) Policies protect the institution while insuring the nurse can be blamed when things go wrong. 4.) Charge nurses are no longer the most capable person on a team, just someone who will do it. 5.) Charge nurses spend a huge amount of time distracted fro the flow of the department because they are doing clerical tasks, compiling QA reports, doing call backs, etc.

I've worked in the same ER for 20 years. On some shifts I can add the years of experience in the department and the grand total of the other 6 RN's will still not equal 20. We do put young, new grads in as charge and some do well, as long as the rest of the team does what we are supposed to do. The toxic environment you describe goes way beyond a charge nurse assignment. If you stay, you could be the miracle worker to take a pathetic place and make it work like it is supposed to. The challenge appears to be massive. Anything is possible.

(By the way, I do take charge for limited periods on rare occasions because I work 11am-11pm. I prefer patient care, and a strong core of nurses each holding down their assigned area leaves a CCN little to do.)

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