Charge Nurses: Share your best tips and advice

After doing charge position for over 75 percent of my career

The absolutely best thing

Step down, avoid the stress , let someone else do it. It is worth the extra pay you get. It isnt worth the extra meetings, it isnt worth all the stress. Stepping down , back to good old staff nursing, smartest thing I ever did. No more phone calls at home asking me about this or that problem. I leave the door of the hospital and I leave all problems at the door.

Just like a new nurse, the process of organizing yourself in the charge role will take some time. Pick a routine and stick with it. I developed charge report sheets at my unit so everyone receives the same information in charge report and knows what is needed to pass on.

The upset family....just listen. They usually want to vent about something that happened a few days ago but the fact that their drink was thrown away while they were gone has thrown them over the edge. Just listen to what they have to say, don't interrupt and keep you tone low and easy. They usually calm themselves down.

I find that the staff will react like the charge nurse. When I am stressed out and frazzled, my staff is stressed out. I try real hard to be an example and leader for the staff and they in turn work hard for me. I have a good reputation in the unit for being fair and hard working. If I help everyone, then they will see the importance and also help out.

When burnout sets in (and it will) make sure to recognize it and go back to the bedside. The bedside is where we remember why we are here doing what we do. A breath of fresh air, so to speak.

What kind of unit do you work in?

I took report in one color and anything new from my shift I wrote in another color.

I physically saw every patient. This was easier in an ICU.

I was visible to staff, patients and families.

Stay calm. Especially in crisis situation. Your staff needs you to be calm, it helps them stay calm.

Stick up for your staff. You are the patients advocate and you are your staffs too. If a doctor is taking a tantrum on one of your peers, stand beside your staff. Nurses need to be supportive of their own. (especially with inappropriate outbursts)

If you expect hard work from your staff, they need to see that you are working hard too. Help them out when ever you can.

When a mistake is made, let your staff know that it is human to make them. Make sure the patient is OK, and learn from the mistake. It was not a wasted mistake if something is learned from it.

The dealing with unhappy persons used to be something I dreaded, but I think its one of my stronger points now...they want you to listen and understand why they're upset. Let them vent and get it all out...don't interrupt and don't try to make excuses...and then apologize and offer a solution. The sooner you know about an upset person, the better...my staff are great about letting me know when they're getting that vibe from a pt/visitor/doc before it actually becomes an issue so that I can go speak with them...its much easier to turn the situation around earlier than later.

I round on the patients every few hours...I definitely do not get to all of them, its more of a random rounding...I go in and ask them if they have any concerns and update them on what's going on...I fluff the pillows, give pain meds, help with bedpan, etc., all the stuff that is important to the patient but not high on the priority list for a busy ER nurse (and I don't expect it to be)

The single most important thing I can say is to get your staff help when they ask for it or if you can tell that they need it. When I see that a staff member is swamped, I am the first one to jump in and do patient care. If they ask me for help, I drop what I'm doing and go help. If I absolutely cannot get away to help (and this is rare), then I find someone who can, whether its another nurse or a tech. You may be only able to give them that extra person for 15 minutes or to start an IV, but sometimes that's all it takes. And it is ALWAYS possible to get some kind of help- I supervise an 85 bed ER that sees >400/day, so if its possible where I work, its possible anywhere!

Don't take things personal, everyone is going to complain about their assignment, you can't make everyone happy. And when dealing with pt.s/families that are not happy, do not get defensive.

What works for you when you're Charge?

How do you get and stay organized?

How best to deal with those unhappy patients, family members, coworkers?

Any advice, tips, or ideas for improvement will be greatly appreciated!

I recently started doing charge. I can't say that I really like it. Nurses can be a whiny bunch of people. I try not to be too whiny.

My advice: develop a thick skin and don't try to be your co-workers'

best friends. Don't let them take advantage of you. Stick to the rules, and don't bend them for whiners.

What kind of unit do you work in?

I took report in one color and anything new from my shift I wrote in another color.

I physically saw every patient. This was easier in an ICU.

I was visible to staff, patients and families.

Stay calm. Especially in crisis situation. Your staff needs you to be calm, it helps them stay calm.

Stick up for your staff. You are the patients advocate and you are your staffs too. If a doctor is taking a tantrum on one of your peers, stand beside your staff. Nurses need to be supportive of their own. (especially with inappropriate outbursts)

If you expect hard work from your staff, they need to see that you are working hard too. Help them out when ever you can.

When a mistake is made, let your staff know that it is human to make them. Make sure the patient is OK, and learn from the mistake. It was not a wasted mistake if something is learned from it.

Great post, great advice.