Frustrated Charge Nurse

Asystole RN · Oct 10, 2010

I find this statement

I'm a night shift charge nurse...making me the most experienced on the floor on some nights unless 1 of the LPNs is there.

very odd. You stated you are the charge correct? Shouldn't the charge always be either the most experienced or clinically strongest Nurse on the floor at any given time?

Being a charge myself surrounded in a sea of new RNs and LPNs I can sympathize with your frustration. I have found if I not only delegate tasks but I explain the rationale in detail and follow up my teaching with research or printed websites I have much better success. I MAKE the Nurses perform the task they have questions about in front of me so that the verbal teaching is reinforced with physical actions.

Have patience and keep reinforcing.

opensesame · Oct 10, 2010

I share your frustration. I work in a different setting but we just had probably 1/3 of our staff retire and they were all replaced with less experienced people. Thankfully I am not working with new grads, but I am working with nurses that are new to ICU practice that can be awfully clueless to what seems to me to be really basic things.

There comes a point when you just have to let them go...I'm getting to that point with a few of them. If they keep running to you, show them the resources and let them have at it. (e.g. "Hey, did you know there was a drug book in the med room?" or "You know, I am swamped myself right now, can it wait a couple of minutes?" --- usually in those couple minutes, they figured it out themselves.) They need to make their own mistakes and learn from them. You should keep your eye out for unsafe practice, of course, but if things don't get done the way you would do it, you just have to take a deep breath and let it happen.

You can scream in your head all you want and let your blood boil but you have to stay calm on the outside. I usually do this by reminding myself that I am a better person than the person that could get angry, annoyed, or peeved at the multiple requests. Eventually you do turn into a better person by modeling it for yourself -- fake it until you make it, right?

I struggle with this too, you are not alone.

KneKno · Oct 10, 2010

Are there lots of inexperienced on the unit, or are the new ones just all working on the same night? Could you talk to the manager about spreading them out over the week, so there's a few on every night, not all of them on the same night? Patien't safety being the focus of your concern. If that's not an option, can you tweak your assignment? Take "easier" patients (closer to discharge, more independent, less needy) or take 1 or 2 less than the general assignment? Or, both? Again, with pt safety as the focus. Good Luck!

himilayaneyes · Oct 10, 2010

I'm not a charge nurse so I can't give you any advice as far as that. I know that a lot of times nurses have a lot of experience but don't want the responsibility of being charge nurse, but someone has to do it. As the charge nurse, you are the resource person so these new nurses are doing the right thing by asking you. However, you can also say did you look it up in the drug guide or the policy and procedure manual and make them do it. My advice as someone who has to deal with charge nurses is to be patient and do what asystole said in having them demonstrate in front of you how to do whatever they're asking about. My question is this...do these new grads get any type of training...classroom and on the floor? When there's a procedure they may not know about, do you round them up and show them how to do it on a real patient (i.e., when a patient now needs a cardiac gtt, do you grab the new grads and have one demonstrate while you explain and the others watch)....all of these things were done for me as a new grad and it helped tremendously. Please don't be harsh towards them (I'm sure they can sense and it'll make them not want to ask any questions which can potentially endanger a patient)...offer solutions...not just critiques and I think you'll be ok.

~#new#~ · Oct 10, 2010

Add the most experienced RN with half the new night RNs, and even have an LPN (if one is there) to be the "2nd Head" to help the RN sparingly with half the floor RNs. The next, in line the 2nd most experienced RN to shared sparing the same experienced LVN/LPN with the new grad. RNs. Finally, take the most astute or sharpest or experienced new RN grad. to sparely mentor all the new graduate RNs to reduce the stress of dealing with the "higher authority" or senior RNs (and even LPNs could seen as a threat because I was one myself as well as an CNA one time)

Give them as much independence as reasonably possible, and there is nothing wrong for the new grads to ask questions among themselves and help each other with patient care --- but stress to them that you did not want to micromanage them, and they must take responsibility too (and assignment the stronger skills, even new grads, and staff to improve their RN skills without feeling threatened!

Our problem, even in the non civilian sector such as the military, and VA Hospitals --- is repeating this unfortunate statement: "Nurses eat their own!" Do not discourage the new grads, but assign those mentors to assist them (including other new grads. with strong nursing skills)!

I hope this helps on a big nursing Med./Surg., ER, Psychiatric, Nursing Home, ICU, and other types of acute care floors! Reduce to help proportionally with the other Nurses if you are on a small floor! Remember, if you are hostile, they may avoid you and not ask questions that could be critical at times to give excellent nursing care! I remember, I had a very lousy mentor (because she was bitter with co-workers, lack of staffing, and burned out after working 30 years in almost the same type of Med./Surg. floors at the Fresno VA when I transitioned from RN to BSN (Also, I had the total care experience of 1 years, 8 months from the VA Geriatric/Extended Care Unit which includes AIDS, Cancer, etc. )

Lee Scott, RN, BSN

Been there,done that, ASN, RN · Oct 10, 2010

Have been in charge, actually received a recognition for leadership from a major health system,

you are responsible for all these newbies, It is not acceptable that you are in charge with all other nurses lacking experience,of course u are a little snippy!!!

You must go to management immediately, describe the situation and demand at least 1 other experienced nurse on the shift!

Adminisration will force u to do this impossible task,then hang u out to dry when problems occur,

document the situation,:eek:refuse charge until it changes!

Scarlette Wings · Oct 10, 2010

i certainly understand and empathize with you. it sounds like you are not only "charge" but preceptor as well. new grads are so exciting to work with. is there any way you can talk with the floor/unit director and decrease your patient load? there is still a great deal of one-on-one teaching needed and assessment of their performances that it is not safe nor wise to have your own load of patients.

talk with your director and see if there is a way that your assigned load can be decreased and function in more of a preceptor/float role. good luck.

bubblymom373 · Oct 10, 2010

Eventually this situation will get better as these nurses get more comfortable in their postions at your facility. As a suggestion at my facility we have a "How to" book for the nurses. This book outlines for our facliity what to do for a death , what to do when you send someone to er, basic criteria for when the MD should be called, how to process MD orders etc. This is in addition to the med books and other reference books that are also on the floor. With more materials to reference themselves it may take some of the pressure off of you.

tobesmartt · Oct 10, 2010

It is frustrating when you feel this way and you are human being. How about your supervisor what does he/she say? Your staff should have some type of accountability even though they are new. They need to get the experience like now ! They have a licensed and so do you. YOU HAVE TO PROTECT YOURS and ask for help from you supervisors/and co-workers. Best of luck.

jrkingRN · Oct 10, 2010

I've been (and still am) in that EXACT same predicament. I spoke to my manager about it. Unfortuately, there wasnt much she could do scheduling wise because EVERYONE on nights is a new grad (except me) One night when we all finally had 5 minutes to talk at the desk, I explained how I was feeling. I told them that like them I was very frustrated and I didnt mean to take it out on them. We (as a group) decided that we would split the additional charge nurse duties (all the extra paperwork) and we would work as a team when we got new admissions. It takes 4 nurses 10 minutes each vs. 1 nurse 2hours because she has to find me and ask a million questions. Now I feel like they are a much more cohesive group that utilizes teamwork. They arent scared to ask a question out loud for a group discussion, and we all pick up when someone is in the "weeds". My group of new grads are sweetie pies and I love going to work every night now :)

JenniferSews · Oct 10, 2010

I've been (and still am) in that EXACT same predicament. I spoke to my manager about it. Unfortuately, there wasnt much she could do scheduling wise because EVERYONE on nights is a new grad (except me) One night when we all finally had 5 minutes to talk at the desk, I explained how I was feeling. I told them that like them I was very frustrated and I didnt mean to take it out on them. We (as a group) decided that we would split the additional charge nurse duties (all the extra paperwork) and we would work as a team when we got new admissions. It takes 4 nurses 10 minutes each vs. 1 nurse 2hours because she has to find me and ask a million questions. Now I feel like they are a much more cohesive group that utilizes teamwork. They arent scared to ask a question out loud for a group discussion, and we all pick up when someone is in the "weeds". My group of new grads are sweetie pies and I love going to work every night now :)

This sounds like a great approach! It also may be really difficult right now, but this is your chance as the leader to build a really strong team. I don't know how long you've been on this unit or if you plan to stay. But if you can do something like this poster suggested you might be able to manage your workload better and make things better for you all down the road. Imagine 6 months from now if everyone is well trained and a participating member of a great team.