I don't want to be Charge!

Do you have the option of opting out? If so I would just do that. 

When I first did charge (many moons ago) it wasnt too bad but I still didn't really like it. I just prefer to do my own thing and not be in charge. Did it for awhile and opted out.

Fast forward after working out of the hospital and then going back. Still didn't want to be charge but was pressured into it. The job had become such a hot mess of paperwork, bed meetings, etc etc it was not nothing that even resembled the previous position.

I feel sorry for nurses who are forced into these positions bc of the (now new) wording in job descriptions, and many before they are qualified and/or ready. 

I completely understand why you may not want to do this. They don't care how many nurses burn out or are put in unsafe conditions. I would just try to opt/worm your way out of it!

Good luck!

2 hours ago, Ioreth said:

But I'm not ready to be charge. I don't have the breadth of experience to be charge. I generally know what to do or who to call in an emergency, but that is according to my experience of 2 years. For more complicated things that aren't a clear emergency, I really don't know that I can be a resource for the rest of the nurses.

If I were put into a charge situation like what you are describing, even with plenty of staff and charge experience, I would limit my sense of responsibility to 1) my patient assignment 2) assistance to other RNs if a patient was not doing well/acute condition change 3) essential house-keeping duties that are generally part of the CN role, like making out shift assignments, etc.

I would not take responsibility for other housekeeping tasks or for supervising patient care by other RNs who have a license just as I do; if they are allowed to independently work the area then they should be able to take basic care of patients. If they're in stages that still require oversight then it is your employer's responsibility to actually provide adequate oversight. Claiming that overseeing beginner nurses is the responsibility of a charge nurse who has a full assignment is just not a legitimate thing and I would tell them exactly that. I do not take on responsibility that rightfully belongs to someone else. It has always really bugged me when nurses literally run themselves ragged and appear to actually believe their sense of self-worth is completely tied up trying to perform these magic tricks that administration demands. I've seen people freaking out because they couldn't find time to do things like some of the audits CNs get assigned or didn't complete CN call-backs. My firm belief is if these things are so crucial then pony up the resources.

There are other resources--especially admin and the house supervisor, who all should be called upon routinely when nurses are struggling due to understaffing. Plus nowadays some people seem to have forgotten that the nurses can and should be consulting with the relevant providers if they have concerns about their patients' conditions.

I agree with JKL, if you are put in an impossible situation with too many tasks for any one person, prioritize patient care. Focus on your assignment and on helping other nurses when needed/you have time. Paperwork last. It sounds like your manager understands that she is asking too much of you but doesn't really have other options, so I hope you wouldn't get in trouble if the paperwork/audits don't get done. I worked on a floor like this, and honestly our charge never even made the assignments. The PM shift would just come in early and fight it out. Not good, but there was literally no time. 

I hope your unit is able to hire and retain some experienced staff and a full time charge (who doesn't have to take patients!), but if not you may have to join the exodus for your own sanity. Are you in Med/Surg? We called a lot of rapid responses because we were all new and didn't know what to do when pts went toward ICU status. Not good, but it did show admin that the unit wasn't safe... =/

Thank you all for the responses. Most of the responses in person that I've gotten is from experienced nurses that say "that's the way everyone becomes charge, it sucks, carry on". Or from nurses just as new or newer than me that think this responsibility is an "honor" and shows that management trusts me. That may be, but it's also an honor I'd rather wait another year to have. I know I'm better off now than being thrown into it sooner, but for all the reasons I wrote about earlier, it is just less safe and contributes to early burnout. 

4 minutes ago, LibraNurse27 said:

Are you in Med/Surg? We called a lot of rapid responses because we were all new and didn't know what to do when pts went toward ICU status. Not good, but it did show admin that the unit wasn't safe... =/

I have noticed that brand new nurses don't want to call a rapid because they want to show that they can handle it. Late newish nurses like me tend to call the most rapids because we tend to recognize a situation beyond our ability to fix but we don't know what to do about it.

We are a weird floor. We used to be considered intermediate care level, but have recently been moved under the med/surg umbrella, which may be better and worse at once. However, we've seen patient acuity go up everywhere in this hospital. It is a unique floor with a very specific patient population. I don't think there is anything like it anywhere else, so to go into more detail would be to state exactly where I work. We do take a lot of general med/surg overflow as well. Transfering to ICU and intermediate care is problematic in my hospital due to lack of beds in both areas, so we tend to hold onto patients beyond our acuity level far longer than is safe. 

I don't think 2 years is too new to be charge.  What I have a problem with is you taking an assignment while charge.  Instead of saying to administration charge should have 3 years experience, it needed to be charge shouldn't have an assignment.  How do you manage bed flow and be charge?

It sounds unsafe and I'd be looking elsewhere to be honest.

2 hours ago, JKL33 said:

If I were put into a charge situation like what you are describing, even with plenty of staff and charge experience, I would limit my sense of responsibility to 1) my patient assignment 2) assistance to other RNs if a patient was not doing well/acute condition change 3) essential house-keeping duties that are generally part of the CN role, like making out shift assignments, etc.

I would not take responsibility for other housekeeping tasks or for supervising patient care by other RNs who have a license just as I do; if they are allowed to independently work the area then they should be able to take basic care of patients. If they're in stages that still require oversight then it is your employer's responsibility to actually provide adequate oversight. Claiming that overseeing beginner nurses is the responsibility of a charge nurse who has a full assignment is just not a legitimate thing and I would tell them exactly that. I do not take on responsibility that rightfully belongs to someone else. It has always really bugged me when nurses literally run themselves ragged and appear to actually believe their sense of self-worth is completely tied up trying to perform these magic tricks that administration demands. I've seen people freaking out because they couldn't find time to do things like some of the audits CNs get assigned or didn't complete CN call-backs. My firm belief is if these things are so crucial then pony up the resources.

There are other resources--especially admin and the house supervisor, who all should be called upon routinely when nurses are struggling due to understaffing. Plus nowadays some people seem to have forgotten that the nurses can and should be consulting with the relevant providers if they have concerns about their patients' conditions.

Very good points. Right now there is very little support from charge to the rest of the floor staff and mostly because they also have a full assignment. I try to keep my charge nurse in the loop as far as changing patient status, but often they can't do a thing to help other nurses or be the resource they need to be. Some of the newer charge nurses try and run their pants off, but most of the experienced charges are just exhausted and have had to let it all go. It really is every man for themselves most of the time. 
On other floors it is expected that RNs will relay needs to charge and the charge will call physicians as needed, bundling calls as much as possible. On my floor, if an RN needs something then they make the call, but it stresses out our physicians and PAs because they get call after call after call from various RNs. Charge is supposed to hold the other nurse's phones for lunch breaks. That doesn't happen either. Charge is supposed to briefly take an RN's patients if they have to accompany a patient elsewhere in the hospital, that also doesn't happen, and those cares and meds are just missed while the RN is off unit. I know that variations of this is happening everwhere, but on my unit it is really a Wild West atmosphere.

I had a patient going downhill fast yesterday (I thought we were going to lose her at one point), another with a critical test result to relay to a physician, and 3 other patients having explosive diarrhea and 1 CNA that wasn't able to keep up with everything. I really needed to step away from the sh*ts and call a couple of physicians, but I couldn't, so care was delayed. In desperation, I asked my charge for specific help and she refused saying that she had a discharge to do. I ended up having to let my phone ring a few times because my hands were covered in poop or I was on the phone with the physician (after far too long delay) and calls ended up going to my charge. She chewed me out saying that these busy mornings were a test to see how I handle stress and that I was failing. She said I can't handle being charge if I can't answer my phone. I'm sure this experience added to my fear of being charge once I found out another charge was quitting.

This was so frustrating because I don't want her job. Also, I know that she failed me that day and I think she knew it, but took out frustration on me with the annoyance of calls going to her. I was drowning, I let her know, she let me drown, then she told me it was my own fault. This is one of many things I'm afraid of, but I know it is inevitable. 

Regarding oversight of new nurses. Ain't no one on this unit have time for that. And it is unfortunate because we're pulling new nurses off orientation before they're ready regardless of how that orientation went. And we have a LOT of grass-green new nurses. However, I do agree that it isn't my job to be their momma. They have their own license and I don't need to pull theirs under mine.

22 minutes ago, LovingLife123 said:

What I have a problem with is you taking an assignment while charge.

Our hospital hasn't had charge nurses without an assignment in years. For the past few months they have tried to leave the ICU charge at large as a unit and house resource. I am charge about 9/10 of the shifts I work, I think I've been at large four times in the past six months. However, our manager frequently tells the upper management people how she supports and ensures that our charge is at large for a resource. Ha. 

OP, I hope that you are able to come to a resolution that you're comfortable with, but it does sound like you will end up being in charge based on the reasons you gave. I would encourage you to use the resources available to you to help as much as possible, including calling rapid responses when you need the support. Your unit sounds very challenging in many ways. I think that you are probably very competent and will make a fine charge nurse, but I realize that doesn't mean you are comfortable with it. 

I'm sorry that your management did not take your feedback seriously. Hearing only what they want to hear is a very common denominator among people in charge, unfortunately. Good luck!

7 minutes ago, JBMmom said:

Our hospital hasn't had charge nurses without an assignment in years. For the past few months they have tried to leave the ICU charge at large as a unit and house resource. I am charge about 9/10 of the shifts I work, I think I've been at large four times in the past six months. However, our manager frequently tells the upper management people how she supports and ensures that our charge is at large for a resource. Ha. 

That was another thing that every nurse present at that roundtable asked: Take charge out of staff, ie. no patient assignments for charge. In our ICU, the charge nurse is also the Rapid Response leader, and I have had a rapid response that was not resolved where the ICU charge had to run back ICU due to an emergency there. It is a problem for every single unit in this hospital.

1 hour ago, JBMmom said:

Our hospital hasn't had charge nurses without an assignment in years. For the past few months they have tried to leave the ICU charge at large as a unit and house resource. I am charge about 9/10 of the shifts I work, I think I've been at large four times in the past six months. However, our manager frequently tells the upper management people how she supports and ensures that our charge is at large for a resource. Ha. 

OP, I hope that you are able to come to a resolution that you're comfortable with, but it does sound like you will end up being in charge based on the reasons you gave. I would encourage you to use the resources available to you to help as much as possible, including calling rapid responses when you need the support. Your unit sounds very challenging in many ways. I think that you are probably very competent and will make a fine charge nurse, but I realize that doesn't mean you are comfortable with it. 

I'm sorry that your management did not take your feedback seriously. Hearing only what they want to hear is a very common denominator among people in charge, unfortunately. Good luck!

That just seems wrong to me.  Our charges never have assignments.  I don’t know how on earth you would manage bed flow on the unit having an assignment and having to chart.

When I read stories on here, it makes me realize how good I actually do have it compared with other hospitals.  I know I personally complain about how I’ve had it with certain things, but truly, I have it better.  

Ioreth said:

On other floors it is expected that RNs will relay needs to charge and the charge will call physicians as needed, bundling calls as much as possible.

As an aside, I know every place is different but this is a program I have never gone along with and never would. I don't feel that reporting patient conditions to a peer who happens to be filling the charge nurse role that day meets the obligations of my licensure. Plus I'm specific in what I report and how I convey my concerns. Wouldn't use the grapevine method unless some unusual situation/emergency. If the providers are getting too many calls there are other things that can help mitigate that, but I'm not leaving it up to the hospital to dictate that I won't speak to a provider about my patient when I think it's necessary.

Ioreth said:

I really needed to step away from the sh*ts and call a couple of physicians, but I couldn't, so care was delayed.

Would start making an exit plan if this is how things usually roll there.

Ioreth said:

She chewed me out saying that these busy mornings were a test to see how I handle stress and that I was failing. She said I can't handle being charge if I can't answer my phone.

She's a piece of work. That's BS.

Ioreth said:

This was so frustrating because I don't want her job. Also, I know that she failed me that day and I think she knew it, but took out frustration on me with the annoyance of calls going to her. I was drowning, I let her know, she let me drown, then she told me it was my own fault. This is one of many things I'm afraid of, but I know it is inevitable. 

Honestly you can't expect anything from a charge nurse that has a full assignment. That's not fair. And I wouldn't put myself in a situation to be charge in a setting like that, either. What you are describing sounds like a circus and also dangerous.

1 hour ago, JKL33 said:

As an aside, I know every place is different but this is a program I have never gone along with and never would. I don't feel that reporting patient conditions to a peer who happens to be filling the charge nurse role that day meets the obligations of my licensure. Plus I'm specific in what I report and how I convey my concerns. Wouldn't use the grapevine method unless some unusual situation/emergency. If the providers are getting too many calls there are other things that can help mitigate that, but I'm not leaving it up to the hospital to dictate that I won't speak to a provider about my patient when I think it's necessary.

Truly I agree with you. It is weird to float and see this done elsewhere. I try to ask around if anyone else needs to talk to Dr. H when I make a call.

1 hour ago, JKL33 said:

Would start making an exit plan if this is how things usually roll there.

With so few CNAs, yes this is frequent. After a very long wait, we finally got approval for 2 CNAs during day shift, but this just doesn't happen with the staffing. Most days we get 1 CNA, but we've been having 0 more often lately because so many are being pulled to be sitters. 

I don't want this to seem like I'm above CNA work. I will happily wipe butts, bathe patients, take vitals (I prefer to get my own first set), and blood sugars. But when something comes up that requires RN intervention, then I need my CNAs to cover the toileting so I can address those things. That's what was so frustrating about this situation. I had a patient I knew would fall if I didn't toilet him promptly and another that was compliant but had serious skin breakdown that I didn't want to worsen. The vast majority of our patients are not able to move independently. One more CNA on the floor during this moment would have helped. 

Yeah, this does stink, and it is probably contributing to staff exodus.

1 hour ago, JKL33 said:

She's a piece of work. That's BS.

She and I generally don't get along, and that's her usual response to someone asking for help. She is very good about moving patients out and in, but not so much about supporting the staff.

1 hour ago, JKL33 said:

Honestly you can't expect anything from a charge nurse that has a full assignment. That's not fair. And I wouldn't put myself in a situation to be charge in a setting like that, either. What you are describing sounds like a circus and also dangerous.

Again, I do agree. I am trying to keep in perspective that I don't know what else was going on in the unit, with staffing, what was on the bed board for admits, etc. But still... her response was that she couldn't help me toilet a patient or hold my staff phone while I called a physician was because she was busy with a discharge. I can only think of 1 discharge in the past 2 years of nursing that was that urgent and couldn't wait long enough for a phone call. But yesterday was a circus, it was particularly bad yesterday, but most days aren't a whole lot better. I don't want to get too stuck on yesterday. It was presented as an example of the unit, and I think my particular frustrations with the events took over.

And days like that do color my perception of the charge role. It is rough right now with my own patients, and even though I'll have a "lighter load" (really just down to our on paper staffing grid patient load), I know this will be going on around me. The paperwork doesn't bother me. Meh. Some of it is unfamiliar but learnable. Bed management is unfamiliar but I can learn. What is worrisome is keeping up with the circus while managing my own patients.