Do your Managers and Charge nurses work on the unit?

Charge in the ER is a full-time job. I have not worked in an ER where charge nurses took an assignment, except briefly on a horrendous day when all hell was breaking loose.

And managing a department is also a full-time job, requiring a different skill set than bedside nursing.

My unit manager is part of a formalized plan to help move patients when we reach certain critical mass (active patients roughly double our bed capacity) -- in that instance she will help transfer admitted patients to the floor, discharge patients, etc.

In every hospital I have ever worked in charge was rotated among more experienced nurses and not a dedicated position. Usually they do not get an assignment on the day they are charge. Nurse managers do not work the floor in my experience. Usually they no longer have the skills anyway.

I have never done ER. But on my OBGYN floor, the charge takes a full assignment. I wish that wasn't the case. There is so much to do when in charge, and it is really hard to do patient care with it.

My nm & ass't nm will cover pts if we're getting slammed really bad in one of those wide-open boluses of pts that do happen. Charge in the er has enough to do fighting fires & doesn't get an assignment (exception: see pt bolus above).

I'm a designated charge RN that works the floor sometimes...we have 3 DCN's on Days and 3 on NOC's and we overlap our schedules. We end up working 2-3 out of our 12 shifts a month on the floor. We do not take patients routinely when we are charge but work as a regular nurse when it's our day to work the floor.

This is something we started a couple years ago because we found that when there were big issues in the department it seemed to involve a less experienced "relief" charge nurse. This way we almost always have a DCN at the desk...consistent leadership has payed off. Plus there is an added bonus for me--I get to play with patients and families that aren't complaining :-)

Our charges work on the floor if they are not working as charge, but they do not take a patient load while charge. I like it that way.

No. Where I work, moving up means moving off the floor.

I am "charge" on my shift and I take just as many patients as the other nurses do. Every hospital and every department is different. Just depends on how big your hospital is and how much staff you have.

I am "charge" on my shift and I take just as many patients as the other nurses do. Every hospital and every department is different. Just depends on how big your hospital is and how much staff you have.

Very true. When my ED is staffed with all of the nurses we are supposed to have, the charge nurse doesn't take a patient assignment until 3 AM when we are down to 3 nurses at that time. If we are working short, all bets are off and we may have to take an assignment, and on (hopefully) rare occasions, maybe more than one.

I worked in a very busy ER and my charge nurse and manager could not take a full assignment because they have to be able to deal with the issues when they arise and be available to go where they are needed when they are needed. With a full load of patients you cannot be the resource you need to be for your nurses.