Do you have a free charge nurse on your unit?

SquishyRN, BSN, RN · Jul 10, 2017

In the Med-Surg unit I worked the charge would not have an assignment 99% of the time. If we were short, the charge nurse might have to take 1-2 patients, but it was always the easiest patients. In the ED I work the charge never has an assignment and is primarily responsible for patient flow and staff management. It would be ridiculous to have the ED charge take patients.

EDIT: In the Med-Surg units of the hospital in which I work ED, the charge nurses have a full patient load, which I think is absolutely ridiculous. I hope they at least get a charge differential (as we do in the ED).

Jedrnurse, BSN, RN · Jul 10, 2017

The concept of the charge nurse taking either a full or slightly reduced patient (I'm sorry, "customer") assignment is ridiculous. If I'm a licensed nurse, my first priority is to my practice, i.e. MY patients, not unit-based issues. It's just another way of hospital management double-dipping and getting one employee to do two jobs. Here's a radical idea- how about the standard being that nurse managers manage the floor instead of sitting in meetings? (This is not necessarily a criticism of managers, but instead a statement on what the role has evolved into...)

saskrn · Jul 10, 2017

I work night shift, and at every med/surg, tele, stepdown position I've worked, the charge nurse has taken patients. However, this is not true when I've worked critical care areas.

When I've been a charge nurse, I've always taken patients, as per hospital policy.

Quo Vadis · Jul 10, 2017

At my workplace, it depends on the staffing. We've had charge nurses with no patient load because the staffing was sufficient or they had meetings to attend. Sometimes the charge did have minimal patient load of 1-2. I've charged before with a patient load of 1-3, but it really depends on how much work I've got. On Saturdays we have a charge nurse and they take a load of 5 patients.

EllaBella1, BSN · Jul 10, 2017

Wow, so this is a lot more common than I expected to hear. I think in my unit part of the reason that this transition has been hard is that we are a large, high-turnover ICU with high acuity patients and a lot of newer nurses. It was so nice to have a free charge both to manage the unit, and to act as a resource and mentor for other nurses, especially the newer ones. Makes things so much harder to keep flowing smoothly this new way.

Also to answer someone else's question, our charges get a $1 differential, for a whopping $12 per shift.

theRPN2b · Jul 10, 2017

On my old ward,our charge nurse did not take an assignment. Her role had a lot to do with discharge planning,admissions,bed moves. And she was also available for staff to ask questions to and to help them out if needed.

The ward I currently work on is a very small ward,so the charge nurse has to take an assignment (not a smaller one,we all take on the exact same amount of patients). But even then,they are always willing to help out whenever possible because luckily I work with a good team.

hawaiicarl, BSN, RN · Jul 10, 2017

Charge nurse hat .... check

Patient assignment .... check

Code nurse .... check

RRT nurse ..... check

Tough IV start team .... check

Hmmm which hat to wear this particular moment in time?

BedsideNurse · Jul 11, 2017

12 dollars is what we get too; keep the change, right? I used to think, how about I pay $20 not to do it?!

It's too much when stuff is going on. I hardly can get my own work done, much less worry about everything else, but I have no choice. ICU with no secretary, no tech half the time, in charge, tripling up patients. Sick patients, families coming in every few minutes, phone ringing off the hook, transferring, admitting, rapid response, code blues, code grays. It sucks for sure.

puravidaLV · Jul 11, 2017

I am free of charge....I do charge for free basically. I don't get paid to do it. I have 7 patients. I haven't figured out how to piss off management enough yet to stop getting the assignment.

marienm, RN, CCRN · Jul 12, 2017

I work on a tiny ICU in a Level 1 trauma center. There are 6? other adult ICUs and only on our unit does charge take an assignment routinely. Soemtimes it's a lighter assignment, but since the nurses who can be in charge have more experience, sometimes we need to take a sicker/busier patient. At night (when I work) we have no ancillary staff or secretary, so if we're all busy the phone just doesn't get answered! (Not ideal, I know!) It is a small unit so sometimes it is fine, but if we are busy there's no time to do any of the expected paperwork and audits.

Charge does not get extra pay and being a charge nurse is not optional. It's part of the job description for RNs with more than a year of practice. Once the manager decides you should be oriented to do charge, you're expected to do it any shift you work. If some more senior charge nurse is also working, then s/he probably does it instead, but you can't refuse if you're the only one. (I guess your 'privileges' could be revoked, but I feel like that would be a bad place to be.)

Graduatenurse14 · Jul 12, 2017

I used to work med-surg at an 800-bed Level 1 Traum/ Academic hospital and the charge always had a full load. 5:1 daylight but getting to be 6:1 when I left and nightshift 6/7:1. The pay differential was, I think, 75 cents. Oh, and we paid 80.00/month to the do-nothing union that is SEIU.

MaleICURN, BSN · Jul 12, 2017

In a big, teaching hospital, ICU - 33 beds - we had totally FREE Charge Nurse AND frequently a Resource Nurse. They were obviously to help, answer questions. If they were paid for Charging/Resource duty - honestly I don't know.

Now, I'm working in very small ICU - charge has regular assignment and (obviously) not paid extra.