Legalities, Pros, Cons of becoming a charge RN in ER

Trauma Columnist · Apr 11, 2002

I wish you the best. I'm one of the night charge nurses in large (62k/visits) level I. Our problem, as with everyone is the acute staffing shortage. We hire new grads, but a lot leave quickly due to the high acuity/census. We have a mentor program, but I'll be honest, we don't do much with it, because we just try to staff every shift, everyday.

We are probably going to mandatory OT soon. In Illinois, you have to be a trauma nurse specialist in order to care for level I trauma pts and we are losing so many, that soon the charge nurses will be the only TNS's which is scary.

I wish you luck>!

KKERRN · Apr 11, 2002

TraumaRN,

The staffing problems are everywhere and we seem to lose so many new staff members due to it being too busy to train them or show them the ropes. We recently found out that our hospital pays the ICU/CCU RN's more than ER RN's. We are not a trauma ER, but we send ICU?CCU the majority of their patients.

We feel that an ER RN is a speciality all our own- we treat all areas of nursing and send almost every unit patients. We are the backbone of the hospital, but we are recognized as another body part by most of the units when we give them more than one patient in the same shift!!!!

Does your hospital offer any incentives to retain staff?? Some of the area hospitals are giving bonuses and better benefits-NOT mine though!

When you are short staffed does your head nurse or assistant head nurse come in to help?? Ours has a few times but not consistantly? The assistant HN came in and took one our our minor zones from 11p-7a once and she was overwhelmed by just how busy we were at this hour. I think it helps us if they can actually feel and see the stress we are under. In a recent staff meeting the HN announced she is posting a 11a-3p position for lunch time relief for the day shift because the numbers on our hourly stats show this is a need!!! We seldom get 10 minutes out of 12 1/2 hours and usually that is our "bladder breaks".

I wish you the best of luck also!

Thanks for sharing and giving me support!

Karen/KKERRN

Trauma Columnist · May 1, 2002

We go lots of 12 hour shifts w/o breaks too. It is hard. But, you know...at least at our hospital (500 beds), the floor nurses care for 10 pts each...which scares the sh*t out of me!! Its rough all over...

KKERRN · May 6, 2002

Hey everybody,

Just worked my first weekend as charge and luckily for me it was a steady flow, but not balls to the walls! My co-workers have been great in my support. I even had one of the charge nurses offer to come in off the clock just to be there for me and she lives 45 minutes drive away! She was thrown in charge 2 years ago when I was new and I saw how stressed she was and it was why I strongly insisted on some sort of training.

I was really nervous my first night...felt like a fish out of water. Last night seemed to just flow and by the grace of God and good teamwork we made it through. I just need to work on my self confidence and go for it. Thanks for all your support.

Karen/KKERRN

scalper · May 8, 2002

karen

this a great post and has been just what i needed to read. i am a new nurse still a little over 2 years and straight to er out of school. i got all the certs out of the way and then just seemed to be on my way...then i moved from a small level 2 36k/year to big level 2 60k/year. after 3 months of working there i go in one night and they tell me that i'm in charge. at first i didn't believe it but it was true so i did it. the night was hell we had codes, truama's, mi's you name it i had all the call nurses there all night but i made it through. the next morning i gave the room brief to the next charge and went home and crashed. then three days later i was back in charge and i found out that the nurse that morning was bad mouthing me about how the room looked when i left. i was pissed off here they throw me into this spot with no training or warning and then the next charge complains that the rooms were not stocked. it has been 2 weeks now and i have finally got some formal training on charge but still feel a little shaky with the deal. i'm only 24 and male and i'm directing a room and a group of nurses with more experience than me. it is hard and i really don't like the position that i have been put in. i will only have to do it 1-2 a week and for now that is enough. so with this i asked the clinical leader why me when others are far more qualified and she said one that no one else wants to do it or can and two you seem like you will be good at it. thats fair and helps me a lot at this point. i can do it and at this point sort of want to i have been bored with my job and now this seems like the next challenge. there is just so much to take in at first and untill you do it a few times you never really see how much it involves. so as a new charge i would to hear any advice that helps to get over the first few months of doing it.

scalper · May 8, 2002

karen

this a great post and has been just what i needed to read. i am a new nurse still a little over 2 years and straight to er out of school. i got all the certs out of the way and then just seemed to be on my way...then i moved from a small level 2 36k/year to big level 2 60k/year. after 3 months of working there i go in one night and they tell me that i'm in charge. at first i didn't believe it but it was true so i did it. the night was hell we had codes, truama's, mi's you name it i had all the call nurses there all night but i made it through. the next morning i gave the room brief to the next charge and went home and crashed. then three days later i was back in charge and i found out that the nurse that morning was bad mouthing me about how the room looked when i left. i was pissed off here they throw me into this spot with no training or warning and then the next charge complains that the rooms were not stocked. it has been 2 weeks now and i have finally got some formal training on charge but still feel a little shaky with the deal. i'm only 24 and male and i'm directing a room and a group of nurses with more experience than me. it is hard and i really don't like the position that i have been put in. i will only have to do it 1-2 a week and for now that is enough. so with this i asked the clinical leader why me when others are far more qualified and she said one that no one else wants to do it or can and two you seem like you will be good at it. thats fair and helps me a lot at this point. i can do it and at this point sort of want to i have been bored with my job and now this seems like the next challenge. there is just so much to take in at first and untill you do it a few times you never really see how much it involves. so as a new charge i would to hear any advice that helps to get over the first few months of doing it.

scalper · May 8, 2002

karen

this a great post and has been just what i needed to read. i am a new nurse still a little over 2 years and straight to er out of school. i got all the certs out of the way and then just seemed to be on my way...then i moved from a small level 2 36k/year to big level 2 60k/year. after 3 months of working there i go in one night and they tell me that i'm in charge. at first i didn't believe it but it was true so i did it. the night was hell we had codes, truama's, mi's you name it i had all the call nurses there all night but i made it through. the next morning i gave the room brief to the next charge and went home and crashed. then three days later i was back in charge and i found out that the nurse that morning was bad mouthing me about how the room looked when i left. i was pissed off here they throw me into this spot with no training or warning and then the next charge complains that the rooms were not stocked. it has been 2 weeks now and i have finally got some formal training on charge but still feel a little shaky with the deal. i'm only 24 and male and i'm directing a room and a group of nurses with more experience than me. it is hard and i really don't like the position that i have been put in. i will only have to do it 1-2 a week and for now that is enough. so with this i asked the clinical leader why me when others are far more qualified and she said one that no one else wants to do it or can and two you seem like you will be good at it. thats fair and helps me a lot at this point. i can do it and at this point sort of want to i have been bored with my job and now this seems like the next challenge. there is just so much to take in at first and untill you do it a few times you never really see how much it involves. so as a new charge i would to hear any advice that helps to get over the first few months of doing it.

KKERRN · May 10, 2002

Scalper,

I know how you feel because I've seen other nurses be thrown in charge when it was a hell night like you state happened to you. If you read all the replies on my thread you will find it encouraging to some extent. No other nurses will accept this responsiblity at this time either. Not even my friend that got me to go to ER with her in the first place. My head nurse says it takes a certain personality to be able to do charge in an ER and I guess we must show them in the way we have worked and handled the ER experiences for us to be CHOSEN. I hope you have suppportive staff that work well as a team because that makes the difference in a good night or a hell night!!

I just want to do my best at my job no matter what position I'm working. I love all the new learning experiences that we see in the ER.

I will only be in charge about 2 weekends out of 6 I think. I'm waiting for the schedule to come out. Keep me posted on how it goes for you. We can vent to each other at least!

Glad you found this site!

Karen/KKERRN

CEN35 · May 11, 2002

kkerrn,

hey? :confused:

so how goes the charge role? or did you decide against it?

just wondering? :confused:

me :)

KKERRN · May 11, 2002

CEN35,

Last weekend was my first weekend in charge. The first night I had a nurse that has done charge as back up working 7p-3a and I was like a fish out of water! I did all right I guess. It wasn't crazy busy,but steady due to prom and grad weekend. I learned to be checking the computer greaseboard often to keep updated how busy triage was and how each zone was doing. I had only one problem with bed control getting a room. Then, I found out it was the floor that gave bedcontrol a dirtybed because they knew the housekeeper called off! The supervisor found they had a clean one and all went well.

We did have one drunk college kid decide to run after EMT's put him on his cart. Our security was ticked because our attending had us call police to pick him up. Our security can only bring him back if there is a pink slip hold...they can't even help us if a patient becomes violent and fights. We are having this policy reviewed. I wrote a variance report on the incident. Wait and see the outcome.

Overall, I survived bercause it wasn't balls to the walls. I'll try to keep you posted. I'm sure I'll have lots of questions.

Thanks,Karen/KKERRN

CEN35 · May 11, 2002

karen,

glad to hear it went ok. it takes a long time imo, to get comfortable with it. like anything else, in due time you will fit in and find a routine and it will all become second nature.

rick :)