Charge nurse taking an assignment

Nurses Safety

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The hospital I work for, the charge nurse takes an assignment plus does charge duties. I know in other hopsitals in my area, charge nurses do not take assignments. Sometimes I feel like my time is taken away from my patients, due to charge issues. How does everyone feel about charge nurses having an assignment?

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I need more information. What unit do you work on? Med/surg, long term care, peds, etc? What is the nurse to patient ratio? Does your unit have a lot of admits and discharges each shift? What shift are you working?

What duties does the charge nurse have? Assign new admits, assign lunch breaks, monitor new nurses? Arrange and plan staffing for the next shift? Review policies and procedures, attend meetings, do staff evaluations?

Is it accepted, expected, that as charge you take fewer patients, or take stable patients?

I've worked units where the charge nurse was out on the floor every day, helping out, taking patients, etc. Her replacement was seldom seen, spent most of the shift in the office. I don't know if in the first scenario the charge nurse was not completing assignments, duties, her bosses expected of her and in the second scenario the charge nurse was playing catch up? Or the second scenario the charge nurse was finding excuses to not be on the floor?

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I have not seen it work out well. The CN role itself is piled with duties (now including auditing and data collection and making reports and all sorts of other administrative tasks q shift); when patients are thrown into the mix it seems to mean that either there's not enough time for patients or not enough time to do all the other CN stuff, let alone think about really helping anyone else or being a resource. On a busy unit the CN role isn't one that can just be vacated on and off throughout the day while lengthy patient care is attended. For both CNs and staff nurses, it is difficult to have CNs spread so thin that they really can't keep anything organized or help anyone else. It's a disaster if medium-large percentages of new staff are also thrown into this mix.

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Specializes in Medical-Surgical/Float Pool/Stepdown.

I think it has become a necessary evil as more and more newer nurses no longer want to stay any longer than two years on the floors these days (it seems like to me in my small part of the world anyways).

Being a float nurse that also charges whenever the units need me to usually means that the floor is already short-staffed and I will often have a full load of patients. I guess the flip side to it though is that since I often have years more experience than most of the other floor staff then I should be able to handle/juggle the expectations... :-/

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Specializes in Nursing Professional Development.

Much more information is needed to answer the question as it varies due to so many factors. For example:

At my hospital we have 2 units that maximally hold less than 10 patients. On the average day, they have about 5. So, 2 RN's are plenty to cover the patient care with one of them being designated as Charge. To have 1 Charge nurse + 2 caregiving RN's for only 5 (non-ICU) peds patients would be ridiculous. So, yes, the Charge Nurse takes a patient assignment on those units and everyone agrees that is appropriate.

However ... that same hospital has some really large units. The NICU always has at least 20 RN's working each shift and often as many as 25. They need a Charge Nurse who doesn't take patients to organize/manage the shift. Charge on that unit is a huge job and no one in their right mind would expect the Charge Nurse to also be taking a patient assignment.

So there is no 1, right answer to that question. It depends on the specific situation.

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I work on a med surg unit and our charge nurses still pick up a full load patient assignment (up to 6pts). I charge from time to time and it's tough trying to break free to help others.

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Some nights if we are short on nurses the charge will take 3 patients. Plus they do all of the charge duties. No HUC of course.

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Specializes in Med surg.

I am a charge on a busy cardiac/tele/stroke unit that can see up to 11-12 admissions at night when I am on shift. I always have a full assignment and have to do all the charge duties. It is absolutely unsafe and unfair to my patients to have a charge RN as their primary nurse. I am usually the most experienced RN on the floor as charge and I spend a considerable amount of time supporting my newer nurses, who do great! I am also fighting battles with house supervisors and on-call NPs/PAs to get PCU/ICU orders for crashing people... "We don't have a bed"- sorry, but I'm not keeping a critical monitored bed on my unit when I have 8 bed alarms going off and admits flying in.

I hate feeling like my license is a dangling carrot for a lawsuit bunny to chomp at.

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Specializes in Chemo.

I am writing an article about this topic, I have a poll called "Are hospitals putting nurse’s license at risk?" in this forum. if you could please look for it and fill it out it would greatly helpful and please share any stories if you can or send a privet message thanks

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Specializes in Critical Care Cardiac, Neuro and Trauma.
On 1/31/2019 at 6:44 PM, MegGusta said:

I am a charge on a busy cardiac/tele/stroke unit that can see up to 11-12 admissions at night when I am on shift. I always have a full assignment and have to do all the charge duties. It is absolutely unsafe and unfair to my patients to have a charge RN as their primary nurse. I am usually the most experienced RN on the floor as charge and I spend a considerable amount of time supporting my newer nurses, who do great! I am also fighting battles with house supervisors and on-call NPs/PAs to get PCU/ICU orders for crashing people... "We don't have a bed"- sorry, but I'm not keeping a critical monitored bed on my unit when I have 8 bed alarms going off and admits flying in.

I hate feeling like my license is a dangling carrot for a lawsuit bunny to chomp at.

For any of your that are experiencing moments like this. Cover your ***. Many states have ADO's Assignment Dispite Objection. This clarifies that you will do your best and gives you the opportunity to describe the unsafe conditions. Should anything happen you cannot be held accountable. Not sure which states have them but the documented statement in your charting that a superior has been notified of an 'unsafe' condition also is doing your due diligence.

yes if you work in texas at an HCA hospital, you will find yourself looking for another job in a few week, (so much for whistle blower protections) Dont abuse it and support each other.

I may sound flip but my spirit is truely damaged by the experience and what I have seen during my career. But it's just me paying the bills, and Im too old to change careers that will bring home similar green

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