Charge Nurse

[iloveer]

I am frequently assigned the charge nurse position in my ED. I also take patients. I like this responsibility and feel that I am capable of solving the problems that arise. However, one problem I have is with manangement skills--this is the first time I have had to "manage people." Several of the nurses I work with take offense if I ask them any question about the status of their patient, or ask them to do something. It's like they don't want to be accountable or something. I feel like they do not acknowledge my role as charge. I have a good relationship with the nurses, however, I have been told that I can "be intimidating" at times. I am confident, but I also ask questions when I don't know something. I am not "bossy," perhaps I'm wimpy. I may be stuck in the female role of "I don't want to hurt anyone's feelings, I want everyone to like me." I have approached my director about this subject, and her advice is "if they don't like it or they don't like you- they'll get over it, don't worry about it." So, basically my director is not a resource for me. Also, many of our nurses get away with tardies, sloppy work, and sloppy charting. And with the nursing shortage--especially bad at my hospital--alot of people have the attitude that they won't get fired--and they're right! I would appreciate any suggestions. Thank-you!

[CHUBBY]

Unfortunately, the problem you're having is not umcommon. I don't have charge responsiblities in my present position (due to fact that I'm per diem, even though I have a significant amount of experience) but I have seen the shift charge nurse chewed up by "coworkers". I think people take personal offense to being questioned. They feel as though you're questioning their experience...sometimes it's justified, sometimes not. It's unfortunate that your Nurse Manager doesn't back you up or try

to rectify the situation, but that's another issue altogether.

[dennis4444]

Our ED pays about $1.25/hr for being a charge nurse . We are however going to a designated charge position. I think this will be better. It will be a core group of nurses doing it instead of a rotation of experienced nurses.

Dennis

[Elena L. Webb]

At our hospital we have Clinical Leaders. We have two for each shift. Presently we are one short. I also have a problem with the staff thinking "I am intimidating"! I strongly belive they are intimidated not by me personally but by their lack of knowledge. We have a lot of new staff. Thye are not experienced in emergency medicine. I feel I have their respect. The staff knows that I "tell it like it is"! I don't talk about them to their backs. I always talk to them. I do have a problem with the appropiate tim and place. I am working to improve this! Good luck if you can find a easy answer because there isn't one. You either have to provide good care or try to live with it is it's not. I have to be able to sleep at night. I have to go home feeling good about my patient care and those under my direction.

[scttmd]

firstly, u need to remember that you cannot control there responses or actions - the only thing u can control is how u respond to them...be it their critisism or there work. Secondly, give people a higher regard then your opinion - that doesn't mean compromising on a patient care issue....it means giving a little when u can. Thirdly, give them the benefit of the doubt!. Forth, remember that the attitude with which u view your colleagues will determine to a large extent your perception of how they feel about you!..Finally...Dont get defensive - if your right thats ok - if your not just admit it, apologise and move on (there is still no such thing as a perfect nurse!!), make any conflict a learning experience...also remember that it is not them rather US - u are one of them - i.e. the same team...hopefully moving together for mutual advantage...

BE RELIABLE, APPROACHABLE, REASSURING / AFFIRMING / ENCOURAGING, RESOURCEFUL, ROLE MODEL...most of all congratulations on the great job u are doing in what is a difficult situation...I hope this all helps

Scott

[Cathy RN]

I find myself in this situation as well. Though I do have the respect of my peers we do have a lot of new staff not experienced in ER Nursing. And I have been called intimidating as well which I might add was very upsetting to me as I do not see myself as this, more of a mentor. However if I'm incharge, I'm incharge....you only have to realize how liable you are in this position to understand the responsibility. So if I know I have a sick person in my dept I do check to see things are getting done. Case inpoint recently had a person with DKA on insulin drip when I noticed the RN was not doing chem strips I asked her what the chem strips were, she got the point when she couldn't tell me. Or the Overdose with no NVS done. The fact that ETOH was on board does not preclude NVS. Patients that are in your dept for 8 hrs and no VS yet have recieved IV and Narcotics. No...not good enough. Nurses who are assigned to a certian area who when I ask them how a certian patient in their area is doing and they say, I don't know anything about that person....I do recognize they are new and need to be mentored along. SOmetimes we are so foucsed on new tasks that we really do not see the big picture so I try and remember that. But I guess in that light I may be intimidating. One Nurse may say thanks I didn't think about that while another may get upset. Either way you cna't please everyone, and we are all different. So which is mentoring or intimidation, its in the mind of the reciever.....

[CEN35]

I agree with the last post. It is all in how the person perceives it, not how its said. We have had this problem at our facility also. The problem is, some look at it as a power trip, while others look at it as a responsibility.

It got to the point where our nurse manager said, "I don't care who agres or doesn't agree with the charge person, what they say goes.....the end".

I had the same problems, and its so bizzare......because as a peer people have trouble accepting that one of their own is "in charge". I have always felt like when I'm in charge, every single patient, waiting room, in back, thru care wherever, is my responsibility. That is where I may have been deemed as, "nosey" or "why?" Now that I have moved up to the manager role, except for a few newbies, everybody treats me different? I don't do anything different than I did before. i think its a case of, the charge person is just an "imitation manager"? Thats the only thing I can come up with. Unfortunatly many have no idea about charge responsibilities. We are a 17 bed ER, soon to 21, with a 7 bed peds unit. We see up to 155 pts a day, and the shift can be busy with packed halls, patients complaining, doctors complaining, staff complaining, etc etc. You are left to handle complaints, catch up on the forgotten (mildly to not really injured patients), and cover lunches, etc etc.

It's amazing how turning the reigns over to someone else, on a jam packed night of chaos changes the way they think and feel. it's not for everybody....no doubt.

cen35 (Rick)