Charge Nurses, Team Leaders, and other set ups???

Thunderwolf, MSN, RN · May 28, 2005

We rotate the charge nurse position daily on our med surg floor on each shift, so just about every RN has had a crack at it. It sort of is nice in that no one person gets burned out. However, there has been a recent move to have one person in charge on days, possibly will occur on eve shift. But so far, no big issue.

mommatrauma, RN · May 28, 2005

When I worked med-surg we did have a charge nurse that was different every day, every shift...Usually did not take a pt assignment but did assign rooms meals and breaks and what not...Just prior to my leaving it was streamlined to one steady charge for each shift...to be honest it worked out better that way because there was more consistancy shift to shift...Its not for everyone I guess but it worked well for us...

markjrn · May 28, 2005

We're having a rearrangement at our Med-Surg unit at our small community hospital. We are all currently free agents on Med-Surg, but in order to bring some sort of hierachial order to our free wheeling unit, our Manager has said there will be a Charge Nurse, whom she will assign for each shift. The charge nurse will have pts, make assignments, mealbreaks, and have other responsibilites that we are as of yet unaware of.
I agree that we need some order and leadership, but this has created a lot of uproar and resentment. Our manager has OB and Med-Surg, and OB is totally her area of expertise, but management said that she had to run Med-Surg as well. She's been doing the best she can, but she's hardly ever over on Med-Surg, her office is over on OB, and we currently have rather a leadership vacuum. So, we'll see how this all pans out.
So, I'm curious as to how things are run where you all work...

I've seen different things at different places.

Some places, everyone (who is experienced and qualified) takes turns being charge. Other places, there are only a select few who Charge, and they are always in charge, if they are working. Normally, the Charge takes 2 or 3 patients, makes up pt assignements, troubleshoots, helps out when possible, but leaves break times up to the other nurses to take (when they have the time).

On occasion, I have seen a new grad act as Charge and be intimidated and have a rough time. IMHO, you need a little experience and a few battle scars to do it. :)

I can imagine this whole transition will create a little tension. I wish you the best. :)

stidget99 · May 28, 2005

In my experience, the role of "charge" or "team leader" is taken on by the most experienced nurse on that shift. It is not an assigned task. It is decided once everyone gets there but we all know who will be "it" for that shift - it is an assumed thing. Generally, those more experienced nurses end up being "it" every day that they work and they get burned out on it quite fast.

Whomever is "it" generally takes on the same pt load as everyone else in addition to making bed assignments, dealing w/ staffing issues, supervising the CNAs, being a resource person for other nurses, covering for the LPNs on the floor (i.e. doing "RN only" assessments, hanging blood, doing IV pushes, etc) and acting as liaison (sp?) between nurses and house supervisor. S/he gets paid an extra $.50/hour for taking on the responsibility of team leader (most times not worth it at all).

Tweety, BSN, RN · May 28, 2005

We have charge nurses which do not have patients. They make assignments, etc. but do not assigned breaks. Assigning breaks may not be a good idea.

Change is often met with uproar. Good luck.

Long Term Care Columnist / Guide · May 29, 2005

My Med/Surg unit just went from what was an informal democracy to using a 'Resource Nurse' every shift, who functions as charge nurse while taking 2-3 patients. They make out the assignments, place admissions and surgeries, troubleshoot problems on the unit, assign breaks, and basically manage the floor. So far, it seems to be working out OK, although there is a little resentment out there (people can forgive just about anything except a co-worker who rises from the ranks! :uhoh3: ) and other departments keep trying to make the resource nurses take on more of THEIR responsibilities. (PACU now wants them to send someone down from our floor to pick up the post-ops instead of bringing them up to the floor themselves; the ICU wants them to be responsible for taking care of telemetry problems; and ER wants them to come down and get patients who need to be admitted to the floor.)

I was going to volunteer for this job, but after a few weeks of seeing what those nurses are going through trying to manage the unit AND take care of patients AND referee disputes between departments, I'm glad I didn't.......I've already got enough stress, thank you. :stone