Charge Nurses Keep Stalling, What Can I Do?

[Jojen9077]

Hi everyone,

I'm about a month into my new night shift position as a Bed Controller/Transfer Center Rep, and while I know this is just a temporary spot for me while I finish up nursing school, I've been looking at it as a great chance to learn and connect with charge nurses and supervisors across the hospital.

The problem is... I can feel a lot of the charge nurses are kind of testing me or pushing their limits with me since I'm new. After the beginning-of-shift huddle with all the charge nurses, the nursing sup sends me a private message to start bedding some patients and I start calling the units one by one like I'm supposed to. But almost every charge nurse tells me they need to review the patient and will "call me back.” Most of the time, they don't. If I'm lucky, one will assign a bed for maybe one of the three patients I need to place. I'll even call back about 45 minutes to an hour later, only to be laughed at and told the same thing. I totally get they're busy and want to make sure the patient is appropriate for their floor but this back and forth makes my job harder and is making me look bad to the nursing sup who sees the job getting done by my colleagues during the other shifts because they're more blunt and firm and I don't want to come across as rude since I'm trying to establish rapport with everyone. I'm trying to figure out how to build trust with them while still getting the job done.

Has anyone else gone through something like this? What can I say or do to make things run more smoothly without stepping on toes? I'd love to hear what's worked for others.

And on another note, this will be my first time working a full time night shift, including alternate weekends. So any tips and suggestions on how to make this easier because while my mind feels awake, my body just wants to crash right about now. 

Thanks in advance! I really appreciate any advice!

[JKL33]

This is a process problem at your hospital. Getting a bed assignment shouldn't be dependent upon an individual ability or willingness to strong-arm or sweet-talk others in just the right way. It should be an expectation that the empty beds are going to be filled. The floor is being called with the details. I'm a little surprised that any place big enough to have formal bed management staff is still allowing any of this to happen on the receiving end. 

Consider discussing/confirming current expectations with your supervisor. It is very unlikely they will say that throwing a fit is an acceptable response to an admission or that any tactics that significantly delay the admission are acceptable. Now if -your- department is frequently making assignment errors that truly involve assigning an inappropriate bed based on acuity, that is a different issue that requires different solutions. But if that is not a common issue, then the back and forth is completely unnecessary. The patient is coming up, period, here's their details. 

Bottom line is that your job is to know where the open beds are, assign the bed when you learn of an admission, and inform the floor. You should be pleasantly professional with verbiage to that end. "Hello! This is so-and-so from bed management; just calling to get you the details on a patient coming your way." Or some such. 

Good luck! 

[akulahawkRN, ASN, RN, EMT-P]

I see this at my own hospital. The floor managers or charge nurses sometimes drag their feet in getting admissions. Sometimes it really is them looking for appropriate inpatient orders and looking for appropriateness of a patient to be on that floor/unit. Sometimes it's staffing. Sometimes it's that EVS/Housekeeping can't keep up with cleaning rooms/beds. If they have to move patients around, rooms have to be cleaned because they were occupied. That all takes time. 

If you've got 3 med-surg patients and a med-surg floor that should have 5 rooms available, being nosy-but-nice can get things moving. It's pretty much a, "hey, I'm sending you 3, what's the hold-up?" I would suggest you should assign patients to beds and let the floors take the responsibility of rejecting the assignment. If the assignment is rejected, the floor charge can explain to the House Sup why the patient assignment was rejected. 

What's happening is that the floors are steamrolling you, because they can. Any assignment to them that they can delay or avoid means less work/busywork for them right now.

[Nurse Beth, MSN]

Here are some thoughts you could use to talk to your supervisor:

Subject: Request for guidance on bed placement workflow and escalation

I'm about a month into the night shift in Bed Control/Transfer Center, and I'm using this as an opportunity to learn and build relationships with charge nurses and unit leadership. I'm encountering a pattern that's making it hard to finalize patient placements quickly:

After initial outreach, many charge nurses say they will "review the patient" and call me back, but return calls are infrequent. As a result, I'm placing only a subset of patients and falling behind on the day's targets, which reflects poorly on me and the team.

I want to establish rapport and maintain a respectful tone, but I also need to ensure timely patient care. I want to set clearer expectations and a more consistent process.

To improve the workflow, I'm proposing:

A standard follow-up script for CNs

• "I understand you're reviewing the patient, but I need confirmation to finalize placement. Can I expect a callback within 20 minutes?”
• "The nursing supervisor has requested that I move this quickly. Do you have a bed available for patient X, or what's holding up the process?”
• "I've tried multiple times to place patient X and haven't received a definitive answer. Is there someone else who can assist? I'm under pressure to finalize this.”

Documentation 

Log each bed placement attempt (time of initial call, response, follow-up attempts, and outcome).

Note patterns (e.g., which units consistently respond within 20–30 minutes, which routinely delay, whether this correlates with specific shifts or units).

Escalation plan

• If no bed or clear answer is available within a defined window (e.g., 60 minutes), escalate the issue to the nursing supervisor on call, copying the unit charge nurse and the supervisor on the ticket/checklist.
• Define what constitutes a "refusal or delay in patient care" and how it should be documented for accountability.

Notes on tone and language

• Keep statements neutral and observable: describe behavior and its impact without labeling individuals.
• Use "I" statements to own your process and needs (e.g., "I need confirmation to finalize placement”).
• Focus on patient care and workflow efficiency to align with leadership priorities.

I hope this helps a bit. Your supervisor needs to clarify expectations so you can succeed in your job.

Best wishes,

Nurse Beth