Eliminating the Charge Nurse on a Med-Surg unit

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I'm so frustated right now. The hospital where I work just implemented a new "policy" in order to keep up with the budget. So, now the 7p-7a shift is not going to have a Charge Nurse on the floor if there are less than 20 patients on the floor. How is this a safe measure on a Med-Surg unit!! I understand this might work on other units, but not on a Med-Surg unit! Our patient ratio at night is 7-8 patients per nurse. And the hospital has "Magnet Status"!

Why is everybody always so afraid to speak their minds!!!! Enough is enough!

What can be done about this? Is anybody else going through this same ordeal?

Thanks!

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Specializes in onc, M/S, hospice, nursing informatics.

My first job was a small hospital with 32 beds. We did not have a charge nurse on the floor. However, I can't see it in a larger hospital, especially a Magnet hospital.

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Who will make the dayshift assignments for the next day? Who will manage admissions and decide who takes them?

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Who will make the dayshift assignments for the next day? Who will manage admissions and decide who takes them?

1) The first dayshift nurse to arrive. Like it, or get there earlier.

2) By team agreement, seniority rules, call the house super if you are peeved or swamped or somebody's crashing.

In low census, by definition, there is less work.

No, I did not like it. No, I no longer work there. Yes, it can be done. Yes, I am surprised that a hospital with Magnet status would try this.

Best wishes.

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Wow this sounds like chaos!! I would be looking for a new job. Im sick of more and more demands being placed on us and more and more support being taken away! This cant last.

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Specializes in Critical Care/Coronary Care Unit,.

I wouldn't think that a magnet hospital would do such a thing. I guess management figures nothing happens on a med-surg floor at night...which we all know isn't the case. I guess if all else fails...call your nursing supervisor and use her like your charge nurse.

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Specializes in Med Surg.

At our small facility we technically have a charge nurse at night but he/she also has to cover the ER. We all receive report together and then, based on what we learn there, we figure out the assignments between ourselves. As far as admissions go, we decide who will take the first admission at the start of shift and this decision figures in to how we assign our patient load. All in all we have developed a system that works well for us but I can certainly see how it wouldn't work with five or six nurses and thirty or forty patients. You really need someone to coordinate the chaos.

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Specializes in Hospital, med-surg, hospice.

Where I work the charge nurse is rotated and she takes 1 less pt! Most of the time when it is not assigned they always say "who is the senior nurse today?" Most of us are not new nurses so, it is usually dumped on the same people. The hospital does not want to pay for a charge nurse.

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i work noc. med/surg. we have a charge nurse. wait, we have a nurse who is responsible for making assignments. she has the same amount of patients and does her own admissions, just like the rest of the nurses. whether you have 3 pts or 8pts. everyone has their night. -good day.

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Where I work the charge nurse is rotated and she takes 1 less pt! Most of the time when it is not assigned they always say "who is the senior nurse today?" Most of us are not new nurses so, it is usually dumped on the same people. The hospital does not want to pay for a charge nurse.

This is how it works on my floor, except the charge nurse takes a FULL pt. load, not "one less pt." Exactly as you described, it's "ok, who wants charge today?" And that nurse carries the "charge" phone and makes assignments and assigns admits. You get an extra $1.00/hr. that shift. :-/

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Specializes in ER, ICU.

That sounds crazy. They could at least make the charge take patients and fill a nursing slot. That way there is at least a "person in charge" who is accountable for keeping an eye on everything. Yikes, good luck.

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Thank you for your responses. Reading some of the replies make me realize that most of the work overload that nurses are experiencing nowdays is in part our own fault. When a new procedure is implemented, we need to speak up and voice our concerns. We need to stop taking extra responsibilities or when is this going to end?

For example, starting next year hospitals are not going to get paid for readmissions within 7 days even if the patient comes in with a completely different diagnosis. Lets say a patient comes in with CHF and the same patient has to be readmitted in less than a week with a different diagnosis such as Renal failure, the hospital is not getting paid anything for the second readmission. So, guess what's going to happen. Nurses are going to get more work overload and less pay. The hospital is not going to give you a 3% pay raise if they are not making any money. And even if they tell you "well we'll pay you extra the days that you have to take care of more patients" How is this safe?

We need to grow some balls and say enough is enough!

Some nurses worry about saving the planet, but ignore what's happening right now in Nursing. Think twice.

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