How to get mgmt to hire another Charge Nurse?

[2bTraumaRN2008]

I work on a VERY busy med/surg floor, 40 beds with tele. We average 20 admissions/discharges a day, and they are mostly done by the charge nurse because the staff nurses are way to busy to stop from their normal hustle, bustle to even do the d/c's and admissions.

We have repeatedly asked for another charge nurse, we used to have one for each side (20 beds each), but one got promoted to another position and they never replaced her. So instead of hiring a permanent charge nurse so that we have 2 on day shift, they would rather call people to see if they want to come in for OT and receive critical need pay (extra $10.00 hr) on top of what they already make. Does this make sense to you? Certainly doesn't to me and we've asked numerous times for another charge to help us out, but no, they would rather pay out tons of OT and critical pay. I'm stumped!

Any suggestions to take to upper mgmt would be greatly appreciated.

[tokmom, BSN, RN]

OMG, as someone who has a job that mimics your CN, I would pull out my freaking hair to dc that many in a day!! What does your d/c consist of? Ours are a packet and the face to face teaching is roughly 15 min per pt and longer for heart failure. I do 10-12 and I can be overwhelmed.

It's insane they don't hire another nurse for the simple fact that she must be overwhelmed. However, how often is someone called in?

By the time you factor in benefits, it might be less money. On the other hand, it's mangement. Need I say more?

[2bTraumaRN2008]

Some are simple, some are not, like you said education, LTC, etc. Nowadays, someone is called in daily. e.g. time and half = 67.50hr approx for a charge being called in, than an addtl 10.00 on top of that for 12 hours....No wonder they don't turn that down..I would't either. It would make more sense to have another CN and pay them 35/40 hour versus 78hr to call someone in

[classicdame, MSN, EdD]

You have to have facts and figures and you may not have access to all that. Maybe an "admissions/discharge" nurse would sell better. Make a case about quality measures being checked, patient safisfaction improved, therapies being started sooner ---. You might ask case manager for input as to what they would like to see happen so that your facility does not get dinged when inspectors come around, or to be sure core measures are initiated. I would present as a group to the Director and ask the CNO to sit in. In my facility the CNO is very easy to talk to and helps get things done.

[tokmom, BSN, RN]

I agree with classicdame. They know how much it's costing them but it might still be cheaper, because they don't have to pay the benefits.

However, if enough of you complained and stated it was a safety, core measures, etc, that they would at least look at it with a different eye.

For ten bucks more an hour, I would be coming in too!