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Charge nurse with patients?

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by RNHeartNurse RNHeartNurse (New) New

251 Profile Views; 4 Posts

Charge nurse in the ICU

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

    • Yes, it is a typical ICU assignment
      6
    • Yes, but it is a light ICU assignment
      3
    • Yes, but only if absolutely necessary
      6
    • No
      8

23 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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JBMmom has 6 years experience as a MSN and specializes in Long term care; med-surg; critical care.

1 Follower; 853 Posts; 11,975 Profile Views

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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marienm, RN, CCRN has 6 years experience and specializes in Burn, ICU.

212 Posts; 4,193 Profile Views

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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3 Posts; 92 Profile Views

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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Bubbly26 has 3 years experience as a ASN, RN and specializes in Oncology,ICU.

307 Posts; 7,434 Profile Views

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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CowboyMedic has 3 years experience as a BSN, RN and specializes in Medical-Surgical-Neuro ICU.

511 Posts; 11,059 Profile Views

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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835 Posts; 14,125 Profile Views

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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