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I don't want to be Charge!

Updated | Posted

Specializes in Ortho-Neuro. Has 2 years experience.

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The title says it all, but I'll unpack.

I've worked at my first job in nursing for just shy of 2 years, 1 year nights and most of the past year days. It has been a ROUGH past year, as I'm seeing everyone is experiencing. I made it through my first year of nursing constantly feeling like I wasn't keeping up, but I've found my groove. I'm still running ragged, but now I recognize that our hospital-wide acuity has increased, folks are delaying hospital services and coming in much sicker than before. Our unit has increased in physical size with a move to a different floor, but we have not increased staffing to match and we can't retain the staff we have. I don't know any different, but generally floating to other floors is a relief, and float pool says our floor is particularly rough due to patient population being minimally mobile and prone to falls, and little to no CNAs.  We are severely understaffed with nurses too, but who isn't? However when I go to other floors and have the same number of patients, I don't feel as exhausted at the end of the day. I know my manager is trying to hire nurses and CNAs, but there's not been enough applicants, and we still bleed staff faster than we can get more.

Few people are trained to be charge nurse, and most often a nurse will be thrown into the charge rotation because the scheduled charge called off and someone had to cover. Well, you survived once, so now you're it. The worst case of this was with a new grad RN with only 3 weeks off orientation (back when we were a much smaller unit).  She did OK, but she eventually left because she was stressed all the time from being charge most of the time while still learning to be an effective and efficient RN. Recently I had to be charge on a day without CNA coverage and I had a more than full load myself with all other nurses having a 1.75 load. It was pretty awful, but fortunately one of the regular charges (a nurse that has been a nurse a little shorter time than me) came in for the last few hours to help me wrap up paperwork and set assignments. 

My manager took some time to train me for charge and the plan was that I would be ready if that happened again. Now one of our full-time day shift charges just quit and I'm terrified that I'm going to be charge every time I work. My manager knows I don't want to be charge, but I don't know who else can do it. For the day shift, there is only one other RN with more experience than me (but less time on this unit and hospital), and the rest are all less experienced and frankly ill-suited for this role. There's a few PRN nurses with more experience, but being PRN means they can't be charge under our pay structure. The experienced full-time RN has charge experience, but doesn't want it any more than I do.

I know I'm a competent RN, but the situation of our staffing and the accuity has made everything so much harder. I frequently have trouble keeping up with charting because I'm doing all the CNA work for total care patients and my load is usually 1.5 to 1.75 of the staffing ratio on our staffing grid.

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. I'm also worried about the patients I have as charge. Generally we give charge the "easy" patients, but I've seen those go downhill fast too, and sometimes there's just no "easy" patients. Our charges also consistently take a full load, while everyone else takes a more than full load. 

I'm not done with my BSN (took the COVID year off and had some delays getting back into the program due to the long break), and I wanted to finish that before moving on to a new job. I do like my work, but I know that it isn't what I want to do forever. The unit I want to go, Oncology, is occasionally hiring, but not as often and not the ideal shifts/FTE for me. My manager is fully aware that this unit is not my forever home and supports my growth towards my preferred nursing goals. I think she even knows that I may leave if she overextends me as charge. And in truth, I am already looking.

We had an open round table with upper management yesterday and I attended after a particularly difficult day. I brought up my concerns of new grads being charge and  all the other nurses at the table from various units chimed in about how dangerous this is and how much faster these new nurses burn out and leave the hospital or nursing all together. The upper management rep reworded the suggestion to "consider not putting new grads in charge position until they are several weeks off orientation". I stopped her and said "No, my suggestion is to not put new nurses in the charge position until they have years of experience, not weeks or months. Ideally these nurses should have 3 years of experience." The suit pursed her lips and didn't amend her notes. This really bothers me. I don't care if this is the way it is done. It isn't safe. I don't care that they don't have the staff. It isn't safe. They should work more on retaining our experienced nurses, not burning out the new nurses, and providing fair pay all around. Finding nurses is their job, not mine, but I am tired of being put into unsafe situations and being told it is normal.

Ugh. I wrote another book, and as usual I'm not looking for any specific answers. Mostly I just want reactions from those that have been there. 

Daisy4RN

Specializes in Travel, Home Health, Med-Surg. Has 20 years experience.

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.

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

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... =/

Ioreth, ADN, RN

Specializes in Ortho-Neuro. Has 2 years experience.

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.

Ioreth, ADN, RN

Specializes in Ortho-Neuro. Has 2 years experience.

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.

JBMmom, MSN

Specializes in Long term care; med-surg; critical care. Has 9 years experience.

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!

Ioreth, ADN, RN

Specializes in Ortho-Neuro. Has 2 years experience.

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.

Edited by Ioreth

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.  

3 hours ago, 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.

3 hours ago, 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.

3 hours ago, 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.

3 hours ago, 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.

 

Ioreth, ADN, RN

Specializes in Ortho-Neuro. Has 2 years experience.

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. 

Edited by Ioreth

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 40 years experience.

I did a lot of relief charge when I worked med-surg.  I often had to take a full patient load which I did not agree with.  Charge is a fulltime job in itself.  When I had to take charge and a load I knew I couldn't do a proper job for my staff or my patients.

I agree with the others that you prioritize keeping everyone alive and the unit running.  That's it.  No audits or other "housekeeping".

I also had a very low threshold for calling in whatever additional resources at my disposal:  my manager, house supervisor, staffing office, rapid response team, etc.  Since I was unionized, I made liberal use of the Staffing Request and Documentation Forms, essentially an official notice of unsafe staffing.

I figured being a nuisance to everyone might:  1.  Make them choose someone else for charge  2.  Get me the staff I needed  3.  Not bother to criticize me for anything that didn't go right.

I was usually able to achieve #3 and if not, I was unapologetic.

Been there,done that, ASN, RN

Has 33 years experience.

"Our unit has increased in physical size with a move to a different floor, but we have not increased staffing to match and we can't retain the staff we have."  I think you are focusing on the wrong problem. You could handle charge just fine... if you weren't forced to do the work of a full patient load, CNA work, AND charge.

Stop beating yourself up. There has to be something better out there. Buff that resume and start searching.

Best wishes,

Curious1997, BSN

Specializes in Psych, Medical. Has 13 years experience.

17 hours ago, Ioreth said:

The title says it all, but I'll unpack.
 

I've worked at my first job in nursing for just shy of 2 years, 1 year nights and most of the past year days. It has been a ROUGH past year, as I'm seeing everyone is experiencing. I made it through my first year of nursing constantly feeling like I wasn't keeping up, but I've found my groove. I'm still running ragged, but now I recognize that our hospital-wide acuity has increased, folks are delaying hospital services and coming in much sicker than before. Our unit has increased in physical size with a move to a different floor, but we have not increased staffing to match and we can't retain the staff we have. I don't know any different, but generally floating to other floors is a relief, and float pool says our floor is particularly rough due to patient population being minimally mobile and prone to falls, and little to no CNAs.  We are severely understaffed with nurses too, but who isn't? However when I go to other floors and have the same number of patients, I don't feel as exhausted at the end of the day. I know my manager is trying to hire nurses and CNAs, but there's not been enough applicants, and we still bleed staff faster than we can get more.

Few people are trained to be charge nurse, and most often a nurse will be thrown into the charge rotation because the scheduled charge called off and someone had to cover. Well, you survived once, so now you're it. The worst case of this was with a new grad RN with only 3 weeks off orientation (back when we were a much smaller unit).  She did OK, but she eventually left because she was stressed all the time from being charge most of the time while still learning to be an effective and efficient RN. Recently I had to be charge on a day without CNA coverage and I had a more than full load myself with all other nurses having a 1.75 load. It was pretty awful, but fortunately one of the regular charges (a nurse that has been a nurse a little shorter time than me) came in for the last few hours to help me wrap up paperwork and set assignments. 

My manager took some time to train me for charge and the plan was that I would be ready if that happened again. Now one of our full-time day shift charges just quit and I'm terrified that I'm going to be charge every time I work. My manager knows I don't want to be charge, but I don't know who else can do it. For the day shift, there is only one other RN with more experience than me (but less time on this unit and hospital), and the rest are all less experienced and frankly ill-suited for this role. There's a few PRN nurses with more experience, but being PRN means they can't be charge under our pay structure. The experienced full-time RN has charge experience, but doesn't want it any more than I do.

I know I'm a competent RN, but the situation of our staffing and the accuity has made everything so much harder. I frequently have trouble keeping up with charting because I'm doing all the CNA work for total care patients and my load is usually 1.5 to 1.75 of the staffing ratio on our staffing grid.

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. I'm also worried about the patients I have as charge. Generally we give charge the "easy" patients, but I've seen those go downhill fast too, and sometimes there's just no "easy" patients. Our charges also consistently take a full load, while everyone else takes a more than full load. 

I'm not done with my BSN (took the COVID year off and had some delays getting back into the program due to the long break), and I wanted to finish that before moving on to a new job. I do like my work, but I know that it isn't what I want to do forever. The unit I want to go, Oncology, is occasionally hiring, but not as often and not the ideal shifts/FTE for me. My manager is fully aware that this unit is not my forever home and supports my growth towards my preferred nursing goals. I think she even knows that I may leave if she overextends me as charge. And in truth, I am already looking.

We had an open round table with upper management yesterday and I attended after a particularly difficult day. I brought up my concerns of new grads being charge and  all the other nurses at the table from various units chimed in about how dangerous this is and how much faster these new nurses burn out and leave the hospital or nursing all together. The upper management rep reworded the suggestion to "consider not putting new grads in charge position until they are several weeks off orientation". I stopped her and said "No, my suggestion is to not put new nurses in the charge position until they have years of experience, not weeks or months. Ideally these nurses should have 3 years of experience." The suit pursed her lips and didn't amend her notes. This really bothers me. I don't care if this is the way it is done. It isn't safe. I don't care that they don't have the staff. It isn't safe. They should work more on retaining our experienced nurses, not burning out the new nurses, and providing fair pay all around. Finding nurses is their job, not mine, but I am tired of being put into unsafe situations and being told it is normal.

Ugh. I wrote another book, and as usual I'm not looking for any specific answers. Mostly I just want reactions from those that have been there. 

Just make sure that main points that you have written here is emailed to yourself and incl that you have spoken to the manager or whomever re especially re safety, short staffing and the level of experience of the others. When things go sideways, you can be dragged into court even if done by someone else. Protect your license. Based on management's responses, you should think about protecting yourself! 

I also think that because there's such a nursing shortage, this is the time to start looking elsewhere or putting your foot down re going to a unit that you like. They may capitulate because they don't want to lose another nurse. Make sure you have a back up job before putting your foot down. 

Edited by Curious1997

Jedrnurse, BSN, RN

Specializes in school nurse. Has 29 years experience.

Not that it makes a difference in how difficult a full assignment + charge is, but are you at least paid for that extra work?

Some of the things you mentioned that charge nurses do should be handled by the nurse manager. I know, I know, that paper isn't going to push itself, nor are the endless meetings going to exist without lab coat wearing "nurses" in attendance, but your first duty as a nurse is to your patient care.

If the charge role didn't involve an assignment, that would be a different story, but...

FolksBtrippin, BSN, RN

Specializes in Psychiatry, Pediatrics, Community, Nurse Manager. Has 5 years experience.

I'm glad you're looking. 

I repeat this a lot, because it's the basic fact of our profession. There are many nursing jobs. But many of them suck. That's why so many nurses are job hoppers. Jobs are abundant, but it's hard to find something good, it's hard to recognize something good, and you often want to leave the thing you're in really badly, so you take something quickly.

I want to add that I am proud of you for making requests at the roundtable. I think the lip pursing was probably about the fact that they can't meet your request of a charge nurse having several years experience. Maybe they can get to a year. But the fact is that there are simply not nearly enough nurses anywhere in the US. In order to get and keep experienced nurses, you already have to have good staffing, and if you had good staffing you wouldn't need them.

We simply are in a shortage in the US, and it's not getting better. Hang in there, the work you are doing is admired and appreciated by many. 

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

I commend you for having the courage to talk to admin about the issues. I worked on a unit with no CNAs and heavy patients (immobile, incontinent, confused, violent), but our charge never had patients. There were, however, days when we had no charge. Those were days when they had only enough nurses for everyone to have a maxed assignment and no one left for charge. House supervisor had to help with all administrative work.

Is it possible you can ask for no charge if no one wants to do it? If everyone refuses they can't force you. You can say the workload is too much and detracts from pt care. Just be careful if you think they may discipline you for being insubordinate =/ They threatened us but we have a strong union plus if they fired anyone they literally wouldn't have enough staff! Do you have a clerk or you also have to answer phone calls? We had no clerk so we had to do our own calls to the doctor. Having a charge with patients ALSO handle everyone's calls sounds impossible. I really feel for you; I know how it feels to need to page a doc but also a high fall risk pt needs help to the bathroom and 3 others are incontinent and need 4 people to clean them... it feels horrible and overwhelming. I hope things improve soon or you can change jobs...