Not ready to be charge

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I have been a nurse for just about a year now on a telemetry unit. I work nights where we have as many as 6 patients a piece & often no tech. to assist. I wasn't here even six months when I began being pressured to be charge nurse. On our unit the charge nurse takes as many patients as any other nurse & is also responsible for the unit as a whole & is also responsible for all the chart preparation for the morning out patient procedures such a 6:00 cardiac cath., repairs of PFO, angioplasty & stenting. The charge nurse is responsible for the next days assignments to the on coming staff & delegating new admits to the staff. Charge nurse also is responsible for verifying that the crash cart is functioning properly. Up until now our unit hasn't had any formal training. Nurses tell stories of just being thrown into it because no other staff nurses were working that night. It seems that a few of the nurses just feel that is the way it should be. Sink or swim kind of thing. That is horrible! Just because one nurse has such a bad experience soesn't mean that should be the norm. My question is this: How long is long enough to be a nurse before you are clinically compitent to be charge nurse? I thought charge was suppose to be the go to resource person? After 11 months of nusring I certainly don't think I qualify to be a resource for anything!

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If you're not ready, speak up. Do NOT let them pressure you into a role you're not prepared for. I found myself suckered into a similiar position because some nights, no one else was willing to do it and I'm one of those "well SOMEONE has to do it so I guess I will" kind of people. It was tough, but I only did it on a fill-in basis.

I can't stress enough... speak up for yourself. Tell your manager you're not comfortable with doing this position at this point without some sort of training for it.

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Specializes in Med-Surg.

Sounds to me like you're aware of what the role is and how to do it.

I think a year of working on the floor you should have good feel about how to take care of the patients on you're units. The "resource" person/charge nurse doesn't have to have all the answers. Often you have to collaborate, put your heads together and decide what to do. You have other resources, such as nurses on the unit and other units, administrator on duty, plus when in doubt you call the doctor for orders.

99.99999% of charge nurses say the same thing when asked to do charge "I'm not ready". You're as ready after a year as you're going to be, because really it doesn't take rocket science to be a charge nurse. Some of the skills like critical thinking, leadership, etc. aren't going to improve if you wait six months or a years until you're more comfortable.

Being in charge isn't for everyone for sure, and it's never easy, but I have a feeling you can handle it.

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Specializes in Oncology.

I was charge for the first time this week and it wasn't half as bad as I expected it would be.

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Specializes in chemical dependency detox/psych.

Perhaps you could take on the assignment with the condition that you would have 1 less patient than normal? I've seen that done on many units.

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Specializes in Acute Care Cardiac, Education, Prof Practice.
Perhaps you could take on the assignment with the condition that you would have 1 less patient than normal? I've seen that done on many units.

And who takes the extra patient?

Tait

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Charge, 6 pts, no tech...I'll get back to you next week on that. (Where'd I put my scientific calculator?)

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Specializes in chemical dependency detox/psych.
And who takes the extra patient?

We always assigned by acuity, so whomever had the higher load also had the lower acuity patients. I've also seen it where the charge had the same number as everyone, but took the lower acuity patients.

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Specializes in Acute Care Cardiac, Education, Prof Practice.
We always assigned by acuity, so whomever had the higher load also had the lower acuity patients. I've also seen it where the charge had the same number as everyone, but took the lower acuity patients.

That is generally how we do it, however we have an odd number of beds on purpose so the charge gets 5, the rest 6 with the charge team being a little "lighter" so she can help at anytime with transfers, difficult patients etc in addition to the general team assignments etc.

In our current model however we are supposed to run 5 nurses at night with the charge out of staffing and without a team, but yeah...that never happens lol.

To the OP: In my perspective I assume you work in a hospital, with acuity as high as ours (we are pretty much step down acuity) therefore your situation seems impossible, and I wouldn't want to charge without the necessary support of techs either.

How is it that you run with no techs? What would you say is the average acuity of your floor? What types of patients are your most common?

For us we run primarily with exacerbated CHF, chest pains (on the light side) and then s/p whipples and other various GI surgeries (on the heavier side) with a smattering of detox and elderly hip fx's.

Tait

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In most places, the charge nurse role is like jury duty. Everyone knows that eventually they will have to be in charge.

How experienced are the other nurses on your floor?

A unit of experienced nurses who work well together is much easier to be in charge of than a unit of new grads, floating nurses, per diem nurses and a few overburdened senior nurses.

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