Frustrated Charge Nurse

Flying ICU RN · Oct 11, 2010

Consider yourself to be implementing the testing/experimentation phase of the scientific method, in proving/disproving your facilities orientation procedure.

Now, take your "evidence based" results to management in the form of a formal memo, if you truly want to effect change.

Leadership requires stretching your neck out on occasion.

Caffeine_IV · Oct 11, 2010

Thanks for all the replies. This is a 32 bed medical unit. I have 2 years experience as an RN and have been doing charge since last May. From management standpoint, they tell me I'm doing a good job but I really don't know.

There are 3 other CNs on nights...one works the opposite schedule of me and has worked this schedule for over 10years so it's not going to change. My ANM said that staff "prefer" me as CN during my eval so if I'm on the schedule for the night, I will be in charge. Of the other 2 nurses one has at least 5yrs exp and the other over 15.

I have a lot of patience and I put forth great effort to be approachable. I AM glad they ask questions and do not want people doing things unsafely because they think I might snap on them.

It's really just at those moments when I'm swamped and I get a call asking if Zofran can be pushed with 1/2NS, then one to see if an IV is infiltrated, and one to hang a tube feeding I'm like 'aaaahhhh'. I feel like I have to be 3 steps ahead of the game so I can help out the new ones. And they are a great bunch but still very new.

I will look into some of your suggestions.

Caffeine_IV · Oct 11, 2010

Consider yourself to be implementing the testing/experimentation phase of the scientific method, in proving/disproving your facilities orientation procedure.
Now, take your "evidence based" results to management in the form of a formal memo, if you truly want to effect change.
Leadership requires stretching your neck out on occasion.

You raise a good point because they have started these "new grad classes" recently and they do not seem any more effective than the prior orientation without the classes.

wooh, BSN, RN · Oct 11, 2010

I've been there. I wasn't all that experienced, we'd have 3 charge nurses in the med/surg area at night, and I'd get all the new grads. And they hired everyone that came out of a crappy and new LPN program, so they weren't even all that well prepared. But I was nicer and better about teaching than the other charge nurses so I kept getting stuck with it.

At some point, you just have to make it clear that while asking questions when unsure is a good thing, that they need to learn what their resources (other than you!) are, and how they can find their own answers. After all, you won't always be there. See about getting management to get a drug guide and maybe a good textbook that has some detailed pictures of how to do procedures available. If they know you're available AFTER they've found some answers in case they still have questions, they'll start being more confident in finding those answers themselves.

Of course, there's also quitting and finding a new job, that's what I eventually did.

Ruby Vee, BSN · Oct 11, 2010

i find this statement 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.

charge often has very little to do with experience or clinical strengths. one icu where i worked often put clinically weak nurses in charge because "they can do the least harm there." granted, that was in the days where anyone with a pulse and a license could be hired, and i'm not entirely sure about the pulse where the night shift was concerned. but in many jobs, charge is a job handed to those who protest least vociferously. or who go after the role with a vengeance because they think it's more important or more prestigious than being at the bedside.

Ruby Vee, BSN · Oct 11, 2010

so i'm a night shift charge nurse and we take a regular patient assignment along with other staff.
we have some new grads and i'm frequently scheduled to work with all of them...making me the most experienced on the floor on some nights unless 1 of the lpns is there.
they are very lovely but i find that they need a lot of hand-holding and it is frustrating me and making my job harder. i want all patients to have safe and very good care but sometimes i feel like pulling my hair out...and you know the charge nurse premium is basically nothing for the amount of responsiblity. recently i have found my tone to be a little more "harsh" when i'm dealing with them and that's not typical for me nor the way i want to be.
any tips on how to deal?

i feel your pain. i've been there, and although i avoid charge like the plague anymore, i'm often the only other experienced nurse working with several newbies who just got off orientation. i'd rather have them ask me questions than do something stupid, but sometimes you just gotta vent somewhere. it keeps you from taking their heads off when they all come to you one at a time to ask the same basic question, or when they cannot muddle through a straight cath without handholding. or when sally refuses to do a procedure because she hasn't done it very often and wants me to do it for her. (that's when having them do it in front of you helps.) i don't get a lighter assignment because i have to babysit the newbies to keep them from harming their patients, and it does get frustrating.

the idea of sitting them down and explaining to them that you love them all, you want to help, you're willing to teach but you're getting frustrated and overwhelmed and behind on your own assignment is a good one. so is the idea of doing things together as a team. many hands make light work and all of that. or if i'm teaching mildred how to set up a balloon pump, maybe sally and sue could be turning my patient or doing my hourly glucose check and vital signs or whatever. or maybe i help sue with her admit and she helps me with mine -- learning by seeing and doing.

if you have the conversation with three or four new grads, the others will hear about it. these days folks are always texting and facebooking, so the other newbies will probably hear about it before the end of your shift! once they know you're on their side, your occaisional sharp response is more easily overlooked.

it's been my experience that many new grads have no idea how much of your time and energy they're sucking up . . . so even if you try to explain it to them, they don't get it. trust me, they will in a few years.

RevolutioN2013 · Oct 11, 2010

Newbie here. It seems to me that your issue is more of a managerial one. I am not a nurse yet, but I have been managing people for 15 years. If you let yourself be a walking filing cabinet of information for your employees then they will treat you as such. The best tool you can give them is to give them the tools to help themselves and then insist kindly, gently, and firmly that they do so. Then if they are really stumped they should come back to you. This helps you as a supervisor know the strengths and weaknesses of your people. Now on the flip side, I can only imagine what it will feel like when my time comes as a new graduate and I'm terrified that I will either kill someone or lose my license. I have to think that a new graduate's primary emotion is fear, especially in a fast-paced intense environment. A previous poster suggested answering questions with questions and I do know that in my non-medical management and training world this is often the best way to get new people to assess the situation and decide for themselves whether or not they really need you to answer the question. It also helps to have them brainstorm together. A lot of times I will hear my staff collaborating on the answer to a question where it would be so easy for me to step in and tell them what needs to be done, but unless they are really going off in left field I let them dialogue it out. They always get to the right place and it's helpful for them to take things through the different options verbally. If I need to step in to provide guidance I do so. This helps grow a staff that is self-sufficient. Again, I'm in a non-medical field right now and I can see how a busy nursing floor that is under-staffed might have a hard time implementing some of these suggestions.

hecallsmeDuchess · Oct 12, 2010

As a newbie on the floor, I'll definitely look at how often I run to the charge nurse with questions. Usually, I'm pretty good at trying to figure out something but if all my lights are going off at the same time and I'm facing something I haven't dealt with since nursing school, I get frazzled and at that point I prefer going to the charge nurse or somebody with more experience because I have found out that there's a good chance that they know a (legal) short-cut to something I need to be shown or talked through.

Sometimes though, I feel guilty not having questions because I'm asked several times during a shift if I need help. Then when I say yes, I feel guilty too because I feel like should be able to remember book stuff from nursing school and be able to apply it in the nursing setting without help.

So dear charge nurse, bear with us. Thanks for your patience with the new ones in your unit, I think the suggestion about telling them how you are feeling and how they can make for a more seamless work by thinking things through first before coming to you is an excellent idea.