New Charge Nurse

Specialties Critical

Published

Quick question.

This is my first nursing job and have recently oriented to charge nurse on a critical care floor. I have been charge only one time but I have heard from other nurses that nurses will request to have a new group for a number of reasons. I have personally never done this outside of having a shingles patient (per company policy as I was pregnant). I understand wanting to change assignments due to being burned out by a heavy patient. However some nurses change assignments because they want to be next to a certain nurse or not next to a certain nurse. Sometimes they don't want to get report from a certain person. My first day of charge I had a nurse tell me to not assign them to a patient the next shift before I even had a chance to clock in! Is this normal in other units? Is this okay behavior? Wasn't sure if maybe this is normal and I'll just roll my eyes at it and keep moving like I have been doing.

Specializes in Transitional Nursing.

When I worked as unit secretary I was the go to person for the nurses to find out their sections, and I observed and/or helped the charge nurse make up the assignment, so maybe I can help with this....

It was pretty common for the nurses to be guaranteed their sections back if they worked the day before, and many times if they were only going to be off 1 in the middle of a 5-6 stretch, the charge nurse would make sure a float nurse got their section so they could have it back.

Otherwise, it was only instances where there was a conflict of interest of some kind or an exceptionally trying patient that nurses would be reassigned. Never to be close to a friend etc, IMO that's super unprofessional.

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Specializes in Medical-ICU.
I have worked several places where this happens. When I was a new nurse people would ask me to change with them all the time and I did. Then I started asking people to change with me. Two times in a row I got even worse patients and so I have never again asked. I take what God gives me and it has always worked out for me.

I do ask to float if someone is floating to another unit I will ask if I can go instead and they almost always say yes. I'm comfortable floating to med/surg, ER, PP, EMU and a lot of nurses hate floating so it works out good for all.

Do you have to take pts as the charge?

Unless absolutely necessary, we don't take patients as charge. Some like to do so if it keeps people out of 3 patient assignments (we try to stay 2:1 unless we have a renal replacement and then it is 1:1) but I thankfully haven't had that yet.

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Specializes in Medical-ICU.

Thanks for the responses! It's good to know this just isn't an isolated problem on my unit. I guess I will just let them do their thing and look the other way. However I don't foresee myself changing assignments for social reasons. They can ask the night nurse for those requests!

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hello altra i saw your post on another topic but was unable to reply i wanted to reach out to you about obtaining a copy of packets for studying of metabolic/resp acid/alk

I have a packet with tons of these problems -- if anyone wants a sampler with the answers, just send me a PM. i was unable to PM

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Specializes in Critical Care.

Unfortunately, this behavior continue because...they can get away with with. If you do not feel comfortable denying these requests; enlist the assistance of your manager. She/he can send out reminder that a patient's best interest/acuity is the main priority when it comes to assignments.

....And all the charge nurses need to be consistent about it.

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I worked charge in the ICU and changed assignment all the time. I didn't care what the reason was, if I could accommodate then I would and if I could not I would explain why. A charge spot is not a designation from the heavens and to refuse to change an assignment is not facilitating the nurses. I have been a nurse and asked for a different assignment for the following day usually cause the family wore me out.

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Specializes in Cardiac/Transplant ICU, Critical Care.
Childish, at the very least.

If you ask me to change an assignment, the reason better be related to the patient and/or family.

Hear Hear!!! :specs:

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No, this is not okay behavior.

Assignments should be based on what is best for the patient--who has had this patient before and therefore knows her/him, who has the skills/knowledge this patient needs...etc.

On occasion, we will have a patient in our unit for several weeks with the same nurses caring for her/him. If it is a challenging patient/family, after six or so shifts, an RN will ask for a break, and that is absolutely accepted on our unit.

On occasion, we have had male patients who get belligerent and abusive when assigned female caregivers, and so we staff only male caregivers for that patient.

That's it, as far as staff accommodations.

I am worried by the other information in your post--you are a pretty new nurse and you are taking charge in a critical care unit. That is the reddest of flags that this is a poorly managed unit—they cannot keep enough senior staff or will not offer senior staff the incentive to accept charge position. Further evidence is provided by the fact that RNs on the unit feel free to dictate assignments based on whether or not they can sit by their bestest friends. And they feel free to pressure you because you are new.

I'm sorry that you find yourself in this situation.

Charge nurses, especially in critical care units, need to be able to hear and weigh the needs of both the patients and staff, and to differentiate between needs and wants. They need to make tough and often unpopular decisions.

Does your manager have your back on your assignment decisions? Is she or he present on the floor each day to help you work through difficult decisions? Is she or he aware of repeat assignment demanders,” and does she or he have a plan to curb the behavior?

If not, I suspect that you work in a poorly managed unit, and these problems will continue.

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Wow! You people must have never dealt with some delirious pts! Must be nice. Absolutely nothing wrong for asking for a new assignment the next night. Get over yourself.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Wow! You people must have never dealt with some delirious pts! Must be nice. Absolutely nothing wrong for asking for a new assignment the next night. Get over yourself.

There is absolutely nothing wrong with asking for a new assignment the next night if you've had a particularly challenging run of shifts. But asking for a different assignment because you want to be next to your bestie or because you don't want to be next to your ex is unprofessional. Asking for a different assignment every shift because you don't like chronic patients, you want all the admits, you regard yourself as a superstar or you don't like Susie who has the patient in the next room is a good way to become very unpopular. And it puts an unfair burden on the charge nurse.

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Specializes in Med/Surg, ICU.

If I can make the request work and it still benefits the patient and unit needs, I will usually do it regardless of the reason. If it messes up my ability to match patients with the level of nursing experience they need or puts some kind of burden on the unit as whole then I won't. I won't bump nurses off assignments they had the previous shift to do so. I also would be reluctant to give in to a nurse who is always dictating what assignment s/he wants.

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Dipping out of the bitc@hing discussions. Don't need em at work. Don't need em here either

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