Do your Managers and Charge nurses work on the unit?

[pilotnurse]

I've recently started work in an ER and have been a little bit bothered by the fact that the Managers and Charge nurses do not ever work on the unit or take a patient assignment. It is kind of strange to me, and I was wondering if this is standard practice in nursing? I worked as a tech during nursing school and on that unit everyone worked as a staff nurse at least once in a while. It seems odd not to, since they are the ones making decisions about how things will run, yet they don't know from experience what is working or not working.

[Altra, BSN, RN]

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.

[PMFB-RN, RN]

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.

[mnbrn]

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.

[emtb2rn, BSN, RN, EMT-B]

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).

[Larry77, RN]

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 :-)

[madwife2002, BSN, RN]

I am a manager and I work the floor on occasions when needed. My job is so busy though that I rarely catch up if I have to work the floor.

[traumaRUs, MSN, APRN]

I worked ER for many years - charge was a designated position and there were several. When more than one designated charge worked - they worked the floor.

NM no because their jobs involved so much more than just the ER, they managed other units too.

[WillowNMe]

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.

[imintrouble, BSN, RN]

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

[applewhitern, BSN, RN]

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.

[GM2RN]

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.