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Charge RN

Posted
by elRae elRae (New) New Nurse

Has 2 years experience.

Hi again~for those of you who work in situations where you do not have a dedicated charge nurse, how do you handle the responsibility? On my unit (37 beds), we take turns. The problem is, in addition to being charge, we also have a team of 5-6 tele patients and we no longer have a secretary.  All the calls go to the charge phone, and that is a TON of calls, especially since we still have a no visitor policy in place. Essentially, the charge is doing three full time jobs, charge, secretary, and RN. No surprise that patient care usually suffers. Wondering how other units manage and looking for suggestions to bring to my manager. Staffing is a constant issue and this is probably the number one complaint about our floor. Thanks for the insight! 

mmc51264, ADN, BSN, MSN, RN

Specializes in orthopedic; Informatics, diabetes. Has 9 years experience.

We have a secretary, CN cannot be tied to phone. CN do not have a patient assignment. Too many other responsibilities. Why do all the tele alarms come to CN phone?  We went from central tele to unit tele. All tele alarms go to care nurse, then their buddy and then to CN. 

It is not safe to have an effective CN with that many responsibilities. 

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

Our charge never has patients. We usually have a clerk, but when we don't whoever is by the phone answers. The days with no clerk are definitely harder, especially if you get sucked into a complicated phone conversation that has nothing to do with your patients! I can't imagine answering ALL of those calls, plus having patients! We don't have a tele tech and have central monitoring, but only 10 patients. 

Our charge handles breaks, helps on the floor, and answers the charge nurse phone for staffing/bed assignment phone calls. He/she is also responsible for responding to RRT calls, in which case we lose our charge for however long the call/transfer takes and can't take breaks... not great. But at least it's not an every day thing! How do you guys take breaks? 37 beds is a big unit! I would be totally overwhelmed with 6 tele pts and all the duties of a unit secretary. Are they planning to get a new secretary? That seems stressful and unsafe =( I'm sorry you're dealing with this!

Sour Lemon

Has 9 years experience.

6 hours ago, elRae said:

Hi again~for those of you who work in situations where you do not have a dedicated charge nurse, how do you handle the responsibility? On my unit (37 beds), we take turns. The problem is, in addition to being charge, we also have a team of 5-6 tele patients and we no longer have a secretary.  All the calls go to the charge phone, and that is a TON of calls, especially since we still have a no visitor policy in place. Essentially, the charge is doing three full time jobs, charge, secretary, and RN. No surprise that patient care usually suffers. Wondering how other units manage and looking for suggestions to bring to my manager. Staffing is a constant issue and this is probably the number one complaint about our floor. Thanks for the insight! 

1. I would refuse to be charge.

2. If they dared to give me that phone, I would set it on a desk somewhere and ignore it for the duration of the night.

3. My standard approach, when I'm confronted about not doing something impossible, is to invite my manager to follow me around for a shift and tell me how I can improve.

 

That's a difficult position to be in. It's nice that you want to bring suggestions to your manager but in a case like this the only really viable suggestion is that more help is needed. And they don't want to hear that.

If I had a primary responsibility to a full assignment of patients, my option would be to put the phone on silent and answer about every 5th or 10th call or so. 😂🤷🏻‍♀️ Doesn't sound very nice but what else is there to actually do?

It is simply not legit to tell people to just magically do all the responsibilities you're talking about. 🎩+🐇

Been there,done that, ASN, RN

Has 33 years experience.

 

Silent the charge phone when you are providing patient care. Patients  are priority. Administration and management know what's going on. They have chosen to forego safe patient care to boost their bottom line. Any suggestions will fall on deaf ears. 

I realize these are bad times to change jobs, but you are forced into an unsafe situation. Time to get outta dodge.

 

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

21 hours ago, Sour Lemon said:

1. I would refuse to be charge.

2. If they dared to give me that phone, I would set it on a desk somewhere and ignore it for the duration of the night.

3. My standard approach, when I'm confronted about not doing something impossible, is to invite my manager to follow me around for a shift and tell me how I can improve.

 

I like the idea of inviting management to see the reality and not just the paperwork! My direct manager is great but upper admin insists we don't need a clerk, tele tech, or any help other than our charge. I would like them to experience the heat and tell me what to do when charge is on an RRT, all nurses are busy in pt rooms, MD is asking why you haven't brought your 400lb bed bound pt to CT yet (because no one is free to help you push the bed!), the phone at the station is ringing off the hook and the central monitors are alarming at top volume.

Sour Lemon

Has 9 years experience.

4 minutes ago, LibraNurse27 said:

I like the idea of inviting management to see the reality and not just the paperwork! My direct manager is great but upper admin insists we don't need a clerk, tele tech, or any help other than our charge. I would like them to experience the heat and tell me what to do when charge is on an RRT, all nurses are busy in pt rooms, MD is asking why you haven't brought your 400lb bed bound pt to CT yet (because no one is free to help you push the bed!), the phone at the station is ringing off the hook and the central monitors are alarming at top volume.

They already know. 😉

None have ever taken me up on the offer, but it does stop them from "counseling" me about things. Unfortunately, they usually find some other fool and carry on with what they were doing.

vintage_RN, BSN, RN

Specializes in NICU. Has 7 years experience.

Our charge RN does not take an assignment. We have 2 charge RN per shift (67 bed NICU)...they cant possibly take that many responsibilities effectively!

Jedrnurse, BSN, RN

Specializes in school nurse. Has 29 years experience.

THIS is a prime example of the death of nursing as a profession.

Grengemly, BSN, RN

Has 3 years experience.

I am currently charging nights on a 24-bed unit (med surg/tele/ortho). Although day shift has a dedicated charge nurse and unit sec, nights does not. I am expected to take a full load of patients. That means five on a good night, seven on a bad one (I refused an eighth last week). Between bed requests, family members, tele, lab, and the occasional doc calling, along with staffing matrix, and gathering enough information on the other nurses patients to give charge report, I feel like I am constantly behind and am unable to give my patients even the basic amount of attention they need. Since taking over charge a few months ago, I absolutely dread going to work. I told management I didn't want to charge, was told there was no one else to do it (we currently only have three non-traveler nurses on PM).

I left the charge phone outside one of my Covid rooms last week and listened to it ring twenty two times before the house sup finally gave up. 

I have a job interview tomorrow. Praying I get it.