Honesty is the best policy?

[virgo0827]

I'm a new graduate RN from January 2014, and just finished training (3 days, 3 nights) at an acute psych/chemical detox facility with possible patient ratios of 30+:1 (understaffed). This isn't the dream field, but I wasn't having any luck getting into new grad programs or into hospitals.

Today, my hiring manager asked me if I felt comfortable enough to be Charge RN, and I said no. I do not feel comfortable taking on the role of Charge RN as I do not have any experience in how to deal with situations as my training on days and nights mainly consisted of doing paperwork (admissions, discharges, filing labs, and chart audits). I don't want to risk my patient's safety because I make the wrong decision due to inexperience and I also don't want to risk my license.

To be honest, from the start, I never wanted to be in the position where I was the only RN because I don't feel ready to be in that type of leadership position as my first job; maybe after years of experience, sure. I avoided applying to SNFs for this reason; I will admit that I accepted this job hastily as it was my first job offer after months of searching and I made assumptions about the facility from their website. It wasn't until training that I realized what the facility is like. Had I known this before, I wouldn't have accepted the position.

However, I know that SNFs and other facilities can have higher patient ratios; so I feel like I should have just said yes even though it's a lie. Now, it seems like I've made myself look bad. I'm worried that they may fire me as I am per diem and am not in contract with them - not so much in losing a job that is not the right fit for me, but more so worried about what they will say about me to future job openings. I have already listed them on my resume and application that was submitted yesterday (I only applied as a friend was able to refer me to her nurse manager). Had I known my hiring manager was going to ask about Charge RN, I would've omitted it completely on the application and resume.

Am I alone in feeling like honesty is the best policy? Are there other new grads or RNs who have turned down positions because they do not feel comfortable? Or do you just suck it up and hope for the best?

[firstinfamily, RN]

If you do not feel you are ready to be a charge nurse then you should not be one. The charge nurse has a lot of responsibility and being able to function as a leader for the team is one of these. Making decisions for the staff nurses and the unit in general is a huge responsibility. Your unit manager most likely would not have asked you unless she felt you were ready. See if there is a class held for new charge nurses as that might help eliminate some of your fears. I have never accepted a position unless I felt I was ready for it. Not being a charge nurse might hold up your career for a little amount of time. If you are the most experienced nurse on your unit you will most likely be asked again. Decide what exactly you do not like about being charge nurse for your shift. ajssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss

[virgo0827]

it's the fact that i'm a new grad and this is my first job as a nurse. i am at an independent facility; so its like the sole RN on the floor is the Charge RN while other staff consist of 1 lvn and 1-2 mhw. only if there is a high census and staff available will you have 2 RNs. while i know that i will have to be alone at one point, i just do not feel ready yet. i am just hoping that my decision to be honest does not back fire on me.

[HouTx, BSN, MSN, EdD]

I think you're doing the right thing. My state BON actually restricts new grads from assuming a supervisory/charge role until they have at least a year of experience. They always have to have immediate access to a qualified RN for back-up supervision, even if they're working in a remote location such as Home Care in a patient's house.

A good rule of thumb for professional/clinical decisions... does it pass the 'red face' test? If you were asked to defend your decision to an authority figure (attorney, manager, etc) in the future, could you do it without embarrassment? What if something happened to one of the patients and you didn't have the knowledge/skills to manage it appropriately? Would you be able to deal with that?