Charge nurse with patients?

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  1. Does your charge nurse typically take a patient assignment?

    • 11
      Yes, it is a typical ICU assignment
    • 3
      Yes, but it is a light ICU assignment
    • 10
      Yes, but only if absolutely necessary
    • 13
      No

37 members have participated

In my ICU, our charge nurse has typically not had a patient assignment. They will take an assignment if absolutely necessary, but that has been the exception, not the rule.

Our hospital is now changing policy, and saying the charge will be taking a patient assignment. They tell us this is the norm in most places. How are things done in your ICU?

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

We have had charge with a typical assignment since I started in my unit about a year and a half ago. Just recently they've moved to making charge a floating position without a set assignment, and personally, I hate it. I'm charge almost all of my shifts and I like to have patients. And I don't want to necessarily have the easiest patients, I still want to learn and be challenged by patients that need critical care. If I'm charge and they want someone free, I'll often ask if someone else wants to be the resource nurse for me, but we have so many newer people than me, it often still has to be me.

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Specializes in Burn, ICU.

On my tiny (6 bed) unit, charge takes an assignment. Sometimes it's a lighter assignment, or one patient and an empty bed; sometimes they take the sickest patient. Depends on the other staff working, certain skills like CVVH, precepting needs, etc...

In the other ICUs (12 to 16 beds) charge typically does not take an assignment, or takes one patient, or takes boarders who are waiting for med/surg beds. Our normal ratio for ICU patients is 1:2; most of our ICUs also take step-down surgical patients and these might be 1:3.

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I've worked with a float charge, and a charge with a full load. Either can be okay. In small units of 8 or less, it's normally not a big deal to have a charge with patients. Larger units I think NEED to have a float charge. The more ICU patients there are, the more chance someone is going to go bad. It's good to have a float there to focus on helping. It can be tough when there are only two of you and one patient is crashing, but it's normally a rare occurrence. Fortunately my hospital has a collection of small ICUs (4 with 8 beds). We are starting to have a floater for all of them, and it is really nice. Otherwise, we can usually call one of the other places and they can help in a crisis.

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Specializes in ICU.

I work in a small 8 bed ICU and we usually take charge with a patient assignment. I was charge the other day with two intubated patients and titrating drips. It all depends on the unit you work on.

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Specializes in CRNA.

I work in a 24 bed Med-Surg-Neuro ICU that has 3 wings of 6 beds, 7 beds, and 11 beds. So we have 3, 3 or 4, and 5 or 6 nurses on those sides depending on if we are completely full or have any 1 on 1's. Our charge RN will take a pt if absolutely necessary due to staffing but lately, we have had people tripled on the odd sides but the third pt is normally very easy with a move order out of the unit. We are on the verge of adding 6 more beds by the end of the year that will be strictly Neuro so that will bring our bed total up to 30 and add 3 more RN's.

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Our facility has a 10-bed ICU and around 60 (?) med surg beds. We have one charge nurse to cover for all of that. Not to mention that we have no pharmacy to profile meds after 10 during the week and 3pm on weekends (don’t get me started ?) so the charge nurse pulls/overrides all meds (except for us in the unit, we pull our own stuff). The charge nurse only takes patients when absolutely necessary, it’s not a norm by any means.

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My facility has 32 beds and we're a mixed unit.  The charge nurse is also the rapid response nurse, code blue nurse, and also the code stroke nurse.  So we try very hard not to give them patients, but what often happens is that during the shift, an admission comes up which needs to be a 1:1, or maybe a nurse doesn't show up to work, so then the charge nurse ends up having to pick up a patient or even a whole team.  I don't believe that charge nurses should have patients.  They need to be available to their staff, and shouldn't be distracted with caring for their own patients, or vise versa.  If your ICU's are anything like my ICU, the charge nurse is all over the place.  It's not fair to their patients to have a distracted nurse who's constantly leaving the bedside to take care of fires going on everywhere else on the unit, or even on other units.  

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Specializes in ICU.

I'm a clinical supervisor. I don't have an assignment usually, only in emergency-type situations. I have a lot of fires to put out as well as audits. I also cover for Rapid response if they are busy and need help. There is too much stress to have a patient assignment, as well. I would then hand over my phone, which never stops ringing, to the manager. 

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