I need an honest opinion:am I wrong here?

busy-bee · Oct 10, 2007

We all get burned out on taking care of the same patients day after day. However, it would of been professional of her to ask you if this switch was okay with you. If you go over her head with these concerns, and she makes it he** for you, then she isn't professional anyway. As far as care, she should care for the patients she took from you as well as you did, or is there an underlying message here?

VegRN · Oct 10, 2007

I think you are right to be upset here. The charge nurse should not consistently be taking away the easy pts because she "doesn't have the nerves to take care of them any longer". Of course we all have our days that we have our fill of a certain pt and can't take care of them any longer and need a break. The problem is that this is happening consistently.

Why do people say that you shouldn't argue? I would ask them that. Is she just doing it to just you (the newbie) or also to other people? Did people complain in the past and it went nowhere? Do a little questioning with this if you feel comfortable.

I would definitely talk to the nurse manger. Before that however, I would document dates, times a little bit about the pts she took from you so that you have the facts on paper to back it up. ie on Oct 9, I had 6 pts, they had _______ dx's, needed _____cares and she took xyz pts away from me. A patten will start to emerge with good documentation. It doesn't have to be long at all just should contain the above information. I would also do a little checking into the type of care that the pts are receiving with her. Maybe check the charting and what not and if she catches you saying, "Oh I was just checking to make sure I remembered to chart _______. I am glad I remembered" Be observant as well to what she is doing during the course of the day. Is she busy with pt care and charge duties or is she no where to be found/ sitting at the desk furniture shopping/being lazy etc. In my opinion she is either burned out or having some difficulty in her personal life to where taking an average charge assignment is too much for her.

And yes, you may not be miss popular in her eyes for the next few weeks. Focus on doing your job and don't take the bait if she is trying to start something with you. If she is being harassing or giving you unfair assignments, document that and discuss it with your manager. Do you work at a union facility?

Good luck

NurseLatteDNP, MSN, DNP, RN · Oct 10, 2007

Thank you very much for replying. She doesn't do it only to me, she does it to everyone else. I appreciate all the comments.

RN1989 · Oct 10, 2007

The charge nurse should always have a lighter load than other staff. It is prefereable that the charge does not take patients at all due to her patients have a high risk of not being seen for long periods of time when the charge nurse is helping other staff, working with docs/emergencies/etc. The charge nurse is the resource person for the floor. Which means she is responsible for all the patients, not just ones that she has to provide care for personally. If she has a heavy load of patients to provide care for, she will have a more difficult time deciding to care for her own patients or being available to help care for the other patients. It is even worse if the charge has increased duties such as signing off all orders or calling docs, covering LVNs, going to staffing meetings, etc. When you become a charge nurse, you will understand this and will no longer seem unfair.

santhony44, MSN, RN, NP · Oct 10, 2007

If there are longer-term patients who are difficult to deal with, then maybe they could be rotated among all the staff so no one gets "burned out" with taking care of them. Maybe it doesn't do much for continuity, but it sure can help sanity!

Ideally, everyone's assignments should have a balance of "easier" and "harder" patients but that may be a lot more difficult than it was 25 years ago- sometimes it was nice to have patients who were just in for "tests" and were pretty much self-care!

HealingHands327 · Oct 10, 2007

Thank you very much for replying. She doesn't do it only to me, she does it to everyone else. I appreciate all the comments.

I feel for you and think it's unfair. BUT understand she is higher up on the chain of command, even if it's only a little, her position comes with privilages. Also considering your position as a new nurse upper management will favor her more. I recommend just sucking it up and doing what it is you need to do, and if it bothers you that bad, leave peacefully and find another unit or job with a better working environment. If you complain, it will only makes things wors, and you will lose a reference you've already spent time working on. One day when you are charge nurse you can use the same privilages that come with it. Hope it helps = )

Katnip, RN · Oct 10, 2007

The charge position isn't so much a position of privilege as it is of responsibility. I agree charges really shouldn't have a full patient load if any at all because they're so often having to take care of other matters on the floor.

nursemike, ASN, RN · Oct 10, 2007

I think an important question to ask is whether the load you end up with is a manageable one. If you are able to adequately care for the patients you get, I'd suggest just doing that. If it's a strain, then the tough patients need to be spread around a bit. I agree that there are valid reasons for the CN to carry a lighter load, if any. Of course, pts. "getting on her nerves," doesn't sound very valid, but sometimes it does happen, even to good nurses.

I find the "continuity of care" argument a little weak. If it was all that important, we'd never get a day off. It is nice to follow the same pts for consecutive shifts--you can work more efficiently, and it deprives the patients of the element of surprise. But, from the patient's perspective, one nurse ought to be pretty much like another--we should all be doing pretty much the same things.

Ultimately, it's a judgement call. If you're getting dumped on, or getting an assignment you can't manage, it's probably appropriate to take action to correct the situation. But if it's a case that you were getting cushy assignments while you were very new and are now deemed able to handle tougher ones, that's how it should work.

MAISY, RN-ER, BSN, RN · Oct 10, 2007

I have to agree with the charge-although it stinks to lose your easier patients-I don't believe the charge RN should have any patient responsibility. If necessary, they should be the lightest.

Our charge never has patient assignments, however, helps with difficult assignments if she can. Her responsibilities are far reaching, and include all patient assignments including supporting her staff nurses, interacting with physicians, families, triage, ambulance, and other departments. I don't believe the charge's license is safe if she has assignments, nor is the patient completely safe due to a charge's other responsibilities. IMHO, It just isn't a good practice.

Personally, I don't think a few dollars extra per hour is worth it! I think if you consider these other things you'll agree.

Maisy;)

leslie :-D · Oct 10, 2007

i've always known cn's to either have no pts or a very light assignment.

i agree, it has nothing to do w/privilege.

it's being a resource person, and comes with a lot of responsibility.

leslie

allnurses Guide · Oct 11, 2007

If the charge nurse is taking your easier ones and giving you hers, that is wrong. She should have made the assignments reasonable in the first place. Charge nurses should have a lighter load in view of the rest of their duties, but the way to handle it is at the beginning.

Is she waiting until you've done all the routine care, and then giving you hers to do as well? so that she gets patients who are already cared for? Doing double care is too much, you need to document what things you had to repeat doing as well, such as baths, dressings, etc.

The upshot is, make properly balanced assignments to begin with.