Bad charge nurse, what do I do?

[livinthelife]

I work on a very busy and hectic floor, we are all slammed most of the time, so our charge nurses don't take PT's in order to help out. Sunday night I had two rapid responses back to back, the first one she was there... Sort of, my pt was bleeding profusely so I asked her to page the doctor for me so I could keep applying pressure. 15 mins later she still had not paged him!

Finally we got it under control. Then my other pt crashed, I took the reins this time firing out orders to my co-workers (who are great and I'm so blessed to work with them) once we got the Levo hanging it worked its magic and she was about as stable as she could be. The first time that charge nurse was there, albeit lazy and not doing anything.... The second time, no clue where she was! No one had seen her, knew where she was, or what she was doing. If it weren't for my amazing co-workers pitching in and running in and out like a well oiled machine we would have lost that pt. We all agree that charge nurse is not worth a flip, all she does is play on Facebook for 12 hours...but here's my dilemma... Do I report her? If I do, how do I do that without my emotions getting in the way? I'm not the only one who feels this way, but it seems I'm the only one considering doing anything about it. But what happens if I do?

[jadelpn, LPN, EMT-B]

The only thing you can do is an incident report. That you were involved in a RR that required a call to the MD that you were unable to make due to the situation. And that it was done 15 minutes later, when it was a STAT situation.

The other incident--not sure what the charge nurse would have done other than sorta stand there. In my opinion, you were the primary nurse for this patient, so what you did was appropriate in directing your coworkers.

Sounds to me like this "charge nurse" role is an administrative function. It would be interesting to see if the charge nurse has been a bedside nurse ever--or when the last time was. In any event, the wrong in all of this is that you directed another RN to do something in a RR that was not done in a timely manner, and could have caused harm to the patient. Doesn't matter if the person was "charge" or not--you asked another RN to do this, and it was not done in a safe time frame.

Good time to look at your policies as well. If the charge nurse is an administrative role only, then maybe the direction needs to be that in any and all RR, the role of the charge nurse is to make all of the calls necessary--every time, without having to be directed to do so.

The goal is safe and effective patient care. There are standards that were not met, and need to be clarified.

Best wishes

[livinthelife]

Thank you jadelpn, that really put things in perspective for me... Well said and diplomatic. If you aren't in administration, sounds like you should be