Critical Care Charge Nurses

[Forever_a_Student]

As the Team Leader for a 13 bed MSICU I have to wonder-how many ICUs maintain their leadership/charge nurses in staffing with a patient assignment? In my current role I have 2 12 hour shifts out of staffing for administrative duties and the other 4 shifts are required in staffing as charge nurse, maintaining a 'full' patient load of 2 (unfortunately sometimes 3). While this works great for PI, I'm sure...it is often difficult to maintain the sense of leadership that I feel a charge nurse should have.

On a side note I am also the only Clinical Nurse Leader MSN student in our region and I'm frequently attempting to find ways to improve our microsystem for staff and patients. It just makes sense to me to have the charge nurse (whether the team leader or not) be out of staffing to address patient and staff concerns, maintain appropriate flow into and out of the unit, and participate in patient rounding (i.e. take ownership of HCAHPS initiatives) on the unit.

What are your thoughts?

~S~

[Esme12, ASN, BSN, RN]

Depending on the unit....I have done both taken patients and not taken patients. What I think is best....on non administrative days....no patients days, one non critical patient not up for transfer patient evenings. Sometimes 2 at night depending on patients and acuity and finish up administrative stuff.

[Lennonninja, MSN, APRN, NP]

I don't do charge, but on day shift the charge nurse would never ever take a patient. I work nights and we are so short staffed that our charge nurse is frequently the rapid response nurse, charge nurse, and secretary all rolled into one. Very rarely has my night shift charge taken patients and that's only when several of us regular nurses are already tripled.

[Fumanchuesday]

I have 2 jobs. One place that I work, the charge takes the same load as everyone else. The other place that I work, the charge nurse does not take patients unless we are short staffed or get a ton of admits.

[applewhitern, BSN, RN]

I think the charge nurse should not have to take a full load of patients. However, I have known quite a few charge nurses who would play on their phone, laptop, etc., instead of helping the other nurses. It is very disheartening to see the charge sitting on her bum at the desk, instead of helping out. There is ALWAYS something to do, and a good charge nurse would be front and center, checking everything and making sure the patients are safe, etc. I have known too many who just sit and expect you to come find them if you need to ask something, or need help. I work in ICU and we don't have charge nurses, or the need for one, because we work as a team and help each other.

[luckynurse_1234]

On our unit a full patient load is 2 patients. Charge nurse takes 1 patient, does daily chart audits and sometimes acts as the unit secretary in addition to the usual charge nurse stuff.

[ICUNurseG]

Ours don't take pts but they are in charge of all of the ICUs (43 beds). They are also responsible for audits, data entry, f/u event reports, etc. almost more of a managerial position really.