how much experience to perform night charge role for Level 1

[hodgtd]

the situation:

I work in an OR (30+ rooms/Level 1 trauma) in which RN's with little experience are forced into working night charge with very little training. We staff nights with one nurse, one scrub and one support staffer (runner). The RN performs both charge and circulating roles. We have one or two other call teams depending on the night. Our holiday shifts are chosen by those with the most seniority first, least seniority last. Charge shifts are part of the available shifts to chose from so they are usually the last to go. Therefore, this holiday weekend had 3 RN's with little experience in this role (one 2 weeks off of orientation, the others 2 months and 6 months - all of which were new grads coming into the OR). Weeknight call has also meant being called in to perform the charge role due to trouble finding reliable staff for the shift.

Training for the role consists of a one and 1/2 hour course on booking cases (newly instituted and given once) and 4 hours of shadowing the charge early in orientation. The other experience I had was due to begging the charge to let me shadow when census was low (not often, and I'm competing with others who are after the same experience). I've had multiple co-workers tell me it is up to me to continually push for charge shadow experience because there is no formal system to ensure that and RN even know how to book a case. Basically it's motivation by fear of failure.

Is this typical of most OR's of similar size/trauma level? How much experience is necessary before taking on charge responsibilities? Do charge nurses take charge call (ours do not)? Is it expected that every RN should be able to perform all charge duties?

[rbs105, ADN, MSN, RN]

WOW-I had to look at your profile and see if you work where I work!!!

I am also at a level 1 trauma center and I work at night. I was asked for about a month to learn the charge role. I have worked here 2 years. No one wants the job. I was told I needed to learn it because it helps. I was trained for 2-6 hours shifts and now they say I am trained, but they don't ask me to do it. I have nightmares that the charge RN will call off and they will say, ask her, she's been trained, but it will have been 6 mos. since I was trained!!

I am very frustrated because I want to do it because it is a great thing to say you can do. The current charge RN was not thrilled when she found out I was trained, because she says she was just thrown into it. I like what I saw, but it is hard and I fear being able to judge who to put in what room, what to do when multiple traumas come in, if a dr asks to do something, what are the rules and can I really let them do that?

I have found it was helpful in other aspects to be trained to be in charge. Getting the support of your co-workers is tough too-they don't think I know enough about the OR to do it. It is a hard enough job without all that crap on top of it. But I was told it is expected of me to do it eventually. I just know I will show up one day and they'll be shoving the seat at me! Good luck. I wish I had more helpful advice.

rbs105