charge responsibility?

angel's RN · Jun 16, 2007

Dear gentle,

Is there alot of responsibility that goes with the charge? In my facility, mind you we are a smaller hospital, and my unit is only a 10 bed CCU, there really isn't much to the job, just make assignments and assign beds if we get a patient. Everyone knows what has to be done, and somehow, it just gets done.

But if you are uncomfortable, set up a formal meeting with your supervisior and explain to her that you are uncomfortable taking the charge position, especially if you get to work late. Tell her your concerns, why you are uncomfortable, and just let her know that you don't want to do it. Period. Don't be rude, but you must be firm. Give her valid reasons, not just "so-and-so doesn't like me and she won't listen to what I ask her to do".

Best of luck, I hope that things work out the way you need them to. Keep us posted!!

's RN

12hrnites · Jun 16, 2007

Dear Gentle,

I feel your pain!!! I use to sit charge on my old floor, now I refuse. ( I have only been in charge 2 times in 4 yrs) On my unit the charge nurse is responsable for all 34 Pt's. We make all the Dr. calls, look at all the rhythme strips, and basically handle ALL the problems. Oh yea, and make the assment for next shift and call for staffing.(this list goes on)

Please set up a time to talk with your manger and voice your concerns, And tell her that you are uneasy doing this job.

Your floor should have a charge nurse in place at the start of the shift. When you come in over 1 hour into the shift it is impossible to dig yourself out of that hole

Good Luck

pebbles, BSN, RN · Jun 16, 2007

We have this problem on my unit too - nobody wants to do charge.

IMO, it's not something you should have a choice about. But it IS something you should be trained and oriented for. I think if everybody who has worked there beyond a certain length of time gets oriented to the charge role, the load gets shared more evenly and it's less of a big freaking hassle.

If nobody wants to do charge, it's up to your manager to take the leadership, find out why and change the culture.

If you don't feel comfortable doing charge, explain to your manager why and ask for proper training for the job. That might help you feel better about the whole thing. I think if being in "CHARGE" is made out to be a "big deal", it gets to be a scarier animal than it really is.

BULLYDAWGRN, RN · Jun 16, 2007

In our ER you may be designated the team leader or charge nurese ( or whatever you fancy being called) Usually it's a well seasoned RN asn or bsn, but really someone who knows how the er really works and very astute to pt care as far as er care. They take no pt's per say but will chip in with iv's mixing/hanging drugs. They are notified everytime a urgent/emergent pt is admitted to er, they try not to get bogged down into deep pt care cause they have to be available throughout the er and the fast track side too. They also arange for transporting pt to and out of the er to other hospitals, but in all in a buckett they just make sure the er shift is ran smotthly so the unit manager wont have to deal with anything when he gets to work in the morn so he can sit in his office and play games on the computer all day. I'm very fortunate to work in the er with a couple of real good team leaders, they'er very smart from yrs of tried and true exp. and education, and they are not the type of charge nurses that just sit in the office and play on the computers and are awol half the shift or come up mia during a code or something. There are few things better than coming into work and looking on the assignment board and seeing a good team leader name on there..

Agnus · Jun 16, 2007

If no one wants to be Charge then there is a much more important issue here. There is a reason that no one wants to be charge. That is what should be addressed. Not all hospitals. not all units have this problem. Usually their are people who want it, even prefer it.

So you have much more going on that is stated here.

gentle · Jun 17, 2007

Hi everyone,

Thanks for your feed back. Luckily today, one of the other ladies was charge. but even at that I showed up to work early to decline the offer in case it was made. (Okay, so I'm avoiding this experience.)

Pebbles, I quite agree. If I have to be the team leader, then I think we should all take a turn. Unfortunately, this is not the case. And quite honestly, I do think my manager would be agreeable to me taking the position.

Meanwhile, my other colleagues are either feeling like the "charge nurse whore" or "I only do this because no one else will do it."

I personally cannot handle all the yelling/stress that goes on. The one thing I have noticed is that our charge nurse catches the yelling from all departments and doctors and on occasion our nurse manager. My thought is no thanks. Apparently, some of my colleagues think the same thing, hence our problem.

But alas, Agnus, I do believe you are correct. It seems a bit more issues are present than I thought. It's hard to see when you are in the middle of something.

We have many seasoned nurses. As I recall previous conversations, many of my colleagues and myself just prefer bedside nursing.

Hmmm, well, we can't all walk in and say that we hate the role of charge etc. and I can't very well do that myself -- or can I? How to word this one. Maybe it will come to me later.

Thanks everyone for your feedback, I have been successfully avoiding this issue for a long long time. I wonder what else it is that they want from me and my colleagues?

Oh well, I need to go to bed. off to work tomorrow also.

p.s. sorry if this is so spacey. i'm tired.

And then there is the pay issue. The people who are consistently asked to step in as charge are only paid a bit over $10 in addition to their base pay for the whole shift.

gentle · Jun 17, 2007

Dear Gentle,
I feel your pain!!! I use to sit charge on my old floor, now I refuse. ( I have only been in charge 2 times in 4 yrs) On my unit the charge nurse is responsable for all 34 Pt's. We make all the Dr. calls, look at all the rhythme strips, and basically handle ALL the problems. Oh yea, and make the assment for next shift and call for staffing.(this list goes on)
Please set up a time to talk with your manger and voice your concerns, And tell her that you are uneasy doing this job.
Your floor should have a charge nurse in place at the start of the shift. When you come in over 1 hour into the shift it is impossible to dig yourself out of that hole
Good Luck

Hmm, after reading your post, I should just be glad I didn't work with you. That sounds like abuse to me. There is no way one person could possibly handle all the stuff they threw at you. I'm sorry you had to go through that experience.

We have someone who does the staffing and everyone tries to make their own Dr. phone calls when possible. But yes, I do think we are responsible for all 32 patients, 10 staff members, and everyone else who comes up to our unit. And yes, we are expected to handle problems that come up and solve them, as well as make the bed assignments, breaks, patient assignments, order notation, double check unit secretary for order entry and perform all re-entry/corrections . . . etc.

Hmm, I think perhaps you guys have it much more rough than we do.

teeituptom, BSN, RN · Jun 17, 2007

Ive done Charge nursing for 80 percent of my career

I dont do it anymore

prefer plain old pt care

TrudyRN · Jun 17, 2007

Hi everyone,
Meanwhile, my other colleagues are either feeling like the "charge nurse whore" or "I only do this because no one else will do it."
I personally cannot handle all the yelling/stress that goes on. The one thing I have noticed is that our charge nurse catches the yelling from all departments and doctors and on occasion our nurse manager.
What in the world is a charge nurse whore????? :angryfire
And no one should be yelling at anyone. It is the responsibility of the one being yelled at to hold up her hand, like a stop sign, and say, very courteously but firmly, "I cannot allow you to yell at me. When you are calmer and can treat me with dignity and common courtesy, we can try again to talk. In the meantime, I will be ..." whatever you need to do. It will be uncomfortable for you the first time you do it, especially if you feel that the person can hurt you. Let me assure you, though, that the person will more likely develop some respect for you and some insight into what an orifice he or she is being. You can assert yourself, Gentle. You must assert yourself and advocate for yourself so you gain some self-respect and some respect from the others.
You can also try humor. "Mary" or "Dr. Smith, you are going to blow a gasket if you keep getting so angry. I will be glad to help if you will calm down so I don't have to worry about you winding up as my patient." See which approach feels better and seems to fit the situation better.
Then you can deal with the CN issue. Get an orientation to it, do not take anywhere a full assignment along with charge responsibilities, and learn it and do it.

pebbles, BSN, RN · Jun 17, 2007

We have the kind of climate where people yell. Often the charge nurses.

In my world, a "charge nurse whore" would be someone who likes to be "in CHARGE" because she likes bossing people around and thinks that being put in that role entitles her to do just that. (IMO, bossing staff around is NOT what the role of Charge was created for.)

I really think that the climate of people yelling and bossing others around when they are stressed or because they feel like they are entitled to behave like that - changes only with leadership from the manager. Who is the Boss, after all. These people who yell at others and control the climate in the workplace with their yelling, are NOT "the boss". Bu the real person to tell them that has to be the manager.

In my workplace, I think it's happened BECAUSE the manager has let these people become the controllers, because the manager has not provided involvement and true leadership of her own.

If someone like the OP doesn't want to be in charge in this climate, it's understandable. But it'd be ideal if someone in that situation could tell the manager all of what bothers them about this unhealthy power dynamic and reinforces that they don't want to get yelled at in a professional workplace. If the manager won't act to change things, you can go higher up the chain, etc.

allnurses Guide · Jun 18, 2007

Try offering some solutions:

What are the criteria needed to be designated charge?

Here, it is at least a year's experience, and several shifts of orientation, plus the passing of the charge nurse competency (one page thing of your duties and that you know enough of the policies etc, for admission, who to call for what, blah blah blah)

Have charge duty assigned on the work schedule, so the burden gets spread amoung those capable of doing it. Everyone should know ahead of time when thier turn is. Consistently calling in sick on those days should be a matter of discipline. Being called in to cover a sick call should automatically excuse you from charge duties, charge starts at the beginning of the shift!

Approach the manager about abusive behaviors experienced by the charges, keep a log by date and time, and by whom. Names that consistently come up should be referred to their bosses, the DON or the Medical Director. You all need to come together on this one.

Have a list of designated duties (a charge nurse job description).

No patient load.

Who calls the doctors.

Who makes the assignments for the day, and for the admissions.

Demonstrate the importance of what you do in order to negotiate a higher differential.

Check with your BON, as to whether or not you can be disciplined for refusing charge duties. No nurse is to be required to accept an assignment for which she feels unprepared or uncomfortable with. Since you and others have already been functioning in this role, you may not be able to refuse. If everyone refuses, they might get the point.