Charge/Triage RN Position

[Rickbos]

Hi

Does anyone work in an ER where the Charge RN is responsible for the whole ER for their shift, triages all patients, and also has a patient care assignment in the ER? If so what type of patient load do they take, how many patients a day does your ER treat, and how many staff RNs are there on duty besides the Charge RN?

[SummerGarden, BSN, MSN, RN]

This does not happen 100% of the time in my ER but it does happen... The Charge/Triage RN usually takes up to 4 patients. I know, it is crazy.. GL!

[alkaleidi]

I wish our charge nurse did half of that! At this point in time, our charge nurse is responsible for staffing if someone calls in sick, being a resource, "knowing what is going on in the entire ER" (which makes me laugh hysterically being that our ER has 6 beds and 1 trauma room), and floating/helping the primary nurses. A different nurse is assigned to triage. Our average population we see a day is probably 20-40 patients.

I will just say... the charge nurse does a lot of sitting, checking email, texting on cell phone, checking their bank accounts online, etc. Pretending to be busy, yes.

All that responsibility and an extra $ .50 an hour for the added workload.

[Altra, BSN, RN]

I have not worked in an ER where this would be feasible. Rarely, circumstances dictate that the charge RN has to take 1-2 very low acuity patients for a couple of hours, or back up triage for a couple of hours or assist with an emergent crashing patient for a period of time ... but to do anything more would mean that the full-time charge functions would get tossed out the window, and chaos would result.

[Larry77, RN]

Must be a small ED...we see 200 patients a day and there is no way I could take a patient load or cover triage. We have 2 RN's and a tech out in triage...my duties as a charge nurse are to man the radio, make assignments, answer complicated calls, and put out fires to make sure the department keeps running smoothly. We also f/u with RN's who either need extra training or are working through performance issues.

I have seen some small dept's when I used to work agency where the charge nurse did have an assignment but these were 6-12 bed ED's...

[USIJurgy]

As the charge nurse your job is to "man the ship." Typically charge should assign patients to nurses either on a round-robin basis or an acuity basis. Charge should also be responsible for getting a provider to the bedside for the patient who is actively dieing. He or she should also be a resource for all the nurses working i.e.- if no one else can get an IV on somebody your charge nurse should be someone who can get an IV on the diabetic renal hypotensive one-armed patient without batting an eye.

Most hospitals have a triagen nurse to do just that: triage. The triage nurse shouldn't also be responsible for having a patient assignment as they are technically responsible for every patient in the waiting room and at a minimum should be performing "across-the-room assessments" (thats in the ENA core curriculum, I didn't make it up!). There is no way someone could be checking in every front door patient, every EMS patient, supervising a waiting room, and actively providing care for a patient load. Well, I suppose it is possible but I dont think it is safe.

My facility uses 1 triage nurse, 1 ambulance triage nurse, and 1 charge nurse. If staffing/acuity is low the charge nurse may also act as ambulance triage. If staffing is REALLY low then a manager will cover charge so that the charge can cover the triage nurses break.

[Rickbos]

That is exactly how I feel about the safety aspect of having the charge nurse do triage and have a patient assignment. It is a set up for a bad outcome. Thanks for your answer.