I work in Acute Care (recent name change from Med/Surg
) and there are 3 AC units with an average of 30 beds/unit. We have a Nursing Director who deals a lot with budgets, but also is involved with many other issues (staffing, education, etc.) and under her is the Nurse Manager who deals with all the day-to-day issues on the 3 units; then there's one RN who only does scheduling; there are 2 RN's who are education nurses who deal with making sure nurses pass yearly competencies, do med evals and arrange for/oversee preceptors for newly hired nurses, and keep us current with educational programs and inservices. (There are at least 150 licensed nurses who work everything from prn to pool to casual to part-time to full-time 8 hours to full-time 12 hours-- part of the reason for a scheduling nurse. You couldn't pay me enough to do her job!)
We don't have charge nurses, but they are planning to hire someone to be an admission nurse, just to do admission assessments for the units. I don't think they will initiate careplans or take off orders-- and all that comes with admissions. Just do the physical assessment and the paperwork that entails. They will be extremely busy...
Most of the managers are there during day shift and part of evening shift. I usually see them leave around 4:30 or 5:00. One of the education nurses will sometimes be around on 3-11 shift and sometimes 11-7, depending on whether a new nurse needs a med eval, and she'll spend the shift with them.
There's also an RN who's "above" our nursing director, and an RN above her who I think is VP of nursing. They deal with our hospital's board of directors, CEO, consultants, and are involved with major decisions and any problems on our units and other hospital-wide units.