tips on being an effective charge nurse?

  1. Hello Everyone....just wondering for any nurse that has experience being a charge, what are some things you do or would to be an effective CN and some things you that you would never do? I work in a great place but one of the charge nurses really needs some pointers. Our morale has fallen because of the way she abuses her position as a CN. Thanks to all who take the time to respond:-)
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    About minnib

    Joined: Sep '01; Posts: 83; Likes: 9


  3. by   leeriza
    Know your stuff and know your staff;Don't give orders, suggest;
    Listen; Gain trust and cooperation from the staff by letting them know you are there for them; Last but not the least...DON'T BE A *****!! The more you push, the more they pull.
  4. by   nursedawn67
    Be courteous...I always say please and thank you to my staff no matter what....I try to think how busy are they and how busy am I before I ask them to do anything if I can do it, then I do it myself.....little things like this make the whole night run smoother.
  5. by   CEN35
    along with what the others have already said, there is one more thing you can do!

    to many people look at charge as their oppurtunity to prove themselve's and try to hard. just keep in mind,

    "how would i like to be treated by the charge person".

    realize, it is not always your responsibility to solve issues between employees. this is a big one! remember, there are usually many different personalities. people won't always agree and get along. the key is to make sure they understand, they are adults and need to work their issues out. if they can't then you can make a decision. the bottom line is to throw some of the responsibility back at the staff. you don't have to bear it all, like most people think you do.

  6. by   live4today
    Remember that a Charge Nurse is still one of the staff when it comes to rolling up the sleeves and pitching in to help with whatever needs to be done to make the shift roll like clockwork.

    Keep in mind that how you treat staff as a Charge Nurse may one day come back on you in another capacity of your profession as a nurse, or even in your personal life. Everyone must answer to someone other than themselves at some point in their life, and it's so much better to have a basket of wonderful smelling rose petals fall on your life than a basket of elephant dung (excuse the expression, but had to get the two extremes in there) :chuckle

    I have worked with Charge Nurses who were very professional, very helpful to their staff, kind and not afraid to get their hands dirty. I have also worked with a few Charge Nurses who make me wonder if their heart is beating or not. :chuckle

    Whenever I worked as a Charge Nurse in years past, I took patient assignments like every other nurse, and still managed to do my job as a Charge Nurse. Of course, this always made the other Charge Nurses wonder why I would take a patient assignment AND be Charge at the same time when they absolutely refused to take a patient assignment. Then again, I always wondered what their problem was when they refused to take a patient assignment, so guess we were even in our "wondering". HA! :chuckle

    Last edit by live4today on Apr 5, '02
  7. by   2ndCareerRN
    When I charge, I NEVER leave the floor until all of the people working the shift with me are ready to leave also. That means I help do whatever I can to get them out of there. Of course, I also believe in team nursing as much as possible. I have worked with some charges who look at the clock and decide to hit the road, no matter what else needs to be completed.

    Be fair, listen, say please and thank you to everyone, from the housekeepers, dietary, other floor staff through the CEO.

    Have fun
  8. by   Stargazer
    All good comments--my best advice is to be flexible. The worst charge nurses, in my experience, are the ones who map out a detailed plan for how the shift is going to go and then can't cope when circumstances change. And they always do. Unexpected admits, codes, deaths, nurse or tech has to go home sick, you name it.

    It's a rare shift that ends the way you planned or the way it started. Get a really good feel early in the shift of the relative difficulty or ease of each nurse's assignment, the "bed situation", and know your nurses' individual strengths and weaknesses. Some nurses don't mind an assignment change in the middle of the shift if it's an interesting case; some nurses will get very flustered and you're better off leaving them as they are. Lots of people will whine when you have to give them a new admit regardless--make sure the assignments are as fair as they can be, and help out when you can, but otherwise don't take the whining personally--you can't please everybody.

    It helps to have a good rapport with other depts who are likely to send you admits, also--ER, PACU. You can get early warnings of new admits and negotiate a little wiggle room with transfer times.

    Good luck!
  9. by   Paprikat
    As a charge nurse, I make myself easy to approach. There is nothing worse than a charge nurse that people fear. Fear and respect are a fine line, and I think my care aides respect me. We have one who is a total dictator and I know that care aides are more reluctant to tell her anything, and if there is a problem, won't even deal with her, they go to the DON. Address their concerns as soon as you can. I also realize that the care aides I work with are older than me, and most KNOW their jobs, so I don't step in and tell them what to do, unless I think they aren't, we do have a few slackers. If I need to get a urine spec., I ask kindly and ensure they have the proper equipment. I say please and thank you. I will tell them that they are doing a great job, and so and so looks well cared for. I will also answer bells ad help out if/when I can, I don't see care aides as "below" me. I do have to address other concerns (ie. complaints) and feel that I listen to their side, too. I have seen and reported resident abuse, and have testified against this person. But I know that I am not there to make friends....and I can be firm when I have to. I also have my job to do and don't want to be a babysitter
  10. by   thisnurse
    i was charge yesterday...with 7 patients and a PIA assistant. talk about headaches. and my patient load wasnt that great. its all i could do to get the assignment done WITH help.
    i really hate it because i am so inexperienced.
  11. by   Jenny P
    Working in CV-ICU, charge nurses in my unit don't take patient assignments. They need to be available to run for codes and handle emergencies both on and off the unit. When I have to work charge, I ALWAYS make sure that I make frequent rounds (because I'm supposed to be a "resource" to the rest of the staff) and keep on my toes for possible problems. I try to make out sensible assignments, and try for continuity of care if possible (but it isn't always possible with the different levels of experience when we have very sick patients). I help out with patient cares if necessary; but am careful to observe what is going on in the rooms because I don't want to be tied up if another nurse in the same room isn't busy. I also try to instill "a sense of calm" on the unit; especially if we are very busy. Frayed nerves can ruin an already bad night; so as charge, I try to assist in ways that keep the unit on keel. Words of encouragement, getting the help we need (be it the MDs, the supervisors, or whomever) when we need it, whatever the job is to make the unit run well; THAT is what I see my job as charge is! (And I don't work charge more than a few times a month, because we have a night AHN who does it regularly).
  12. by   KKERRN
    I'm now in training to be an ER charge nurse and I posted questions on pros/cons of being charge in ER. Several responded to my post with some good advice. You can see my post under Emergency Nursing. One that I started already is a charge notebook with resources that I could use, I included some policies that we have recently looked up, procedure for closing to squads, how to call the back up MD, ect.
    I have read all the above posts and they all offer good advice. I will continue to follow you posts for any further advice. Good luck!
  13. by   traumaRUs
    I'm one of the two night charge nurses in a busy ER and I always take pts - with the nursing shortage, this is a must. I also try to be fair with assignments and keep an eye on the more inexperiences nurses to help them along and not be so overwhelmed. I also help get the sickest pts started: IVs, O2, monitor, reuscitation, etc.. I'm certainly the best charge nurse on the face of the earth, but I try hard to help with things and keep the dept running smoothly.
  14. by   Jenny P
    I forgot; but through the years I've worked with several nurses who had "special needs" which would affect how the shift went. It was always necessary to get new moms off to break on time because of the need for them to pump their breast milk before they "leaked." Or that it was necessary to get the hypoglycemic and diabetic nurses off to early supper (and then off for their 15 minute evening snack break!) so we didn't have total chaos by the end of the evening. Cover those nurses for these breaks since it can get pretty ugly if you don't!

    I once had made a list of charge nurse duties that were very specific to my unit, but I lent it out and it never came back. It included some of these previously mentioned tips.

    My unit now has a charge nurse book that includes all of the info needed to work charge for the unit: the duties of the charge, bedside nurse, HUCs and aides; what to do for the various alerts (codes, disasters, ED closures, etc.) staffing suggestions, phone numbers, what to do if a pt. needed to go back to surgery stat, etc. (it's a CV-ICU unit). It's nice to have everyone basing their charge duties on the same source; so everyone has the same expectations of the charge nurse.

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