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Discussion

Do your charge nurses have a patient load?

Our hospital was closed down after hurricane Ike, so the nurses were temporarily relocated to a sister hospital. I charged on a 43 bed unit. When adequately staffed, I would have one patient of my own. When short staffed, I would have 5 of my own on top of charging. Now we are back at our old hospital, and I have been moved to full time charge. It is normal to have anywhere from 4-6 patients of your own, on top of charging. Is it the same way at other hospitals????

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my charge nurse has the pt load of the entire ER....

we as non-charge nurses just take care of them....

but... the answer is no.... she takes care of us while we take care of them...

she steps in though and does triage and take rooms to relieve us for lunch or whatever.... I LOVE MY CHARGE NURSES!!!

:cool:

Our charge nurse has no patient assignment of his or her own.

  • Author

I think thats how it should be.....no patient assignment of their own. How can a nurse be in "charge" of the entire floor when she has her own patient load????

I think thats how it should be.....no patient assignment of their own. How can a nurse be in "charge" of the entire floor when she has her own patient load????

Exactly.

Ideally on my floor the charge nurse has no patients... however, I've had as many as 5 while charging before. I like to take 1 or 2 patients sometimes just to make things a little easier for my coworkers, but sometimes it's more helpful to them to just be available to help them out with things.

As part of the ratios, our resource nurse can only have a patient load on nights, and then it's either reduced or absent. Depending on our bed state it's either no load at all or four (half the usual patient allocation).

I worked on a critical care unit for ten years, we always had a full patient load if we were in charge. Maybe not the sickest patient, but a full load.

Charge should never have patients....yet that is often not the case.

Problem is, you can't quantify the incredible support she can provide when bedside nurses are overburdened.

One of our best charges, among many other helpful behaviors, goes around double checking checking drip rates. She once intervened avoiding catastrophic event after a night nurse, overtired, miscalculated.

We all need the extra eyes. But in most hospitals nurses are flying by the seat of their scrub pants.

"Ya just can't quantify it, so management just doesn't care.

Our charge nurse has the same pt load as everyone else, it's insane. Needless to say, no one wants to be put in charge (we rotate equally), at least (many yrs ago) we used to get a whopping $0.30 an hr for the honour, now nothing

I used to be charge on a busy unit and still have to take a full load of my own...usually somewhere between 8 to 10 pts. Imagine having to care for 8 pts PLUS handle the problems of all the other nurses on the floor, including assessments and IV meds for LPNs and handling disgruntled families. Ugh! I came home in tears many, many times. That is only one of the many reasons I do not work there any more.

Our charge nurse has the same pt load as everyone else, it's insane. Needless to say, no one wants to be put in charge (we rotate equally), at least (many yrs ago) we used to get a whopping $0.30 an hr for the honour, now nothing

The only way to change things is to stop taking the charge if you have an assignment. As long as you accept the position, you only perpetuate the problem, and they will be all-too glad to continue the practice.

I try to tell our charges to refuse when they start complaining but , as is too often the case with nurses, no one has the courage to stand up for change.

Until then, we all have ourselves to blame.

  • Author

Ive been advocating for freeing up the charge nurses of patient assignments for over a year. Im not scared to stand up and say something, and when I just recently accepted the full time charge position, I reminded them of that fact, and also got a substantial raise (at my request) for taking on the added responsibility. The difference between charging with one primary patient and 5 was astronomical. With one, I was available to start IVs, deal with crisis, coordinate ICU transfers, deal with difficult family members, do LVN admission assessments. With 5, 99% of my time was taken up with my own patients, leaving very little left to to actually "charge". When our floor is fully opened up, it will be interesting to see what actually happens.....

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