Eliminating charge Nurse position

  1. Is it legal to eliminate the charge nurse position? It was done in our hospital! Where is the law? Can't find BNE's position on subject! Still looking if anyone knows send link!! Muchos Gracias!!
  2. Visit lilredmc profile page

    About lilredmc

    Joined: Mar '13; Posts: 5


  3. by   wooh
    Why would it be illegal?
  4. by   NurseLatteDNP
    I have never heard of that, that's interesting. I wonder if this has been ever tried at other hospitals. So who makes patient assignments at beginning of shift and with new admits?
    I don't think it's illegal, but probably unsafe, unless you have some other system going on. Our charge nurses make sure that all fall precautions are in place, all discharges get discharged, all core measure patients get what they need, and they round on all patients. Who would take that role on?
  5. by   lilredmc
    We have always gotten 2gether & discussed what is going on w/Pts. It takes about 5min no one fights we get along. The problem the pay was raised 2 $2.50/h & we've had a raise freeze & lost out weekend differential. The charge pay was rotated & it helped some. Occasionally, we have had issues where a floor nurse floats 2 our unit & designated charge felt responsible 4 the safety, of those patients but now who is responsible?
  6. by   Altra
    What law would this change be breaking?
  7. by   xoemmylouox
    I don't think this breaks any laws, but it is a terrible idea. Another loss made due to "cost cutting". Good luck to you.
  8. by   HouTx
    OH NO - not again. This brilliant (sarcasm) idea comes around every once in a while - promoted by the bean counters to reduce the labor budget. The "self-directed work team" was last promoted heavily in the mid '90's... and chaos ensued. See- that's what you need us old bats for, we remember this stuff - and can give you a pretty accurate prediction of what is going to happen afterward because we have seen it a few times.

    I readily acknowledge that 'self-directed teams' can work if all members are at the same peer level (everyone equally competent) but this is rarely the case in most clinical areas where there are always wide variations in expertise and ability. In these instances, the group just looks to an 'unofficial' charge person for leadership, and that's just unfair to the poor sucker that gets stuck with that role.

    The 'charge' nurse role is essential because without a leader, a group is basically a mob - every nurse for him/herself. Someone has to be the tie-breaker, the physician calmer-downer, the 'no, we can't take another admission for at least 2 hours' person, the yell at CS because we are out of stuff person, . . . . etc.
  9. by   KelRN215
    Quote from lilredmc
    Is it legal to eliminate the charge nurse position? It was done in our hospital! Where is the law? Can't find BNE's position on subject! Still looking if anyone knows send link!! Muchos Gracias!!
    I'm doubtful that there IS a law about this. 49 states don't have laws regarding nurseatient ratios, why would there be a law about the presence or absence of a charge nurse?

    During my 5 years in acute care, the charge nurse role was changed considerably. Charge used to not take an assignment and used to be paid a charge differential. Those positions were completely reversed in the last few years- first the differential was eliminated and then they started giving charge full assignments.
  10. by   jmll1765
    I am a charge nurse on a med-surg floor and more often than not I have to take a full group of patients in addition to performing the duties of charge nurse. The powers that be keep coming up with more "tasks" for the charge nurse to perform so having a group of patients and doing charge can spread me pretty thin. I do make a little more on the hour than staff nurses but I'm wondering if it's even worth it.
  11. by   anon456
    Like jmll1765 our charge nurse is more often than not in full count. They try to take generic patients so they still have time to do the admin stuff and room audits. I can't imagine what I would do without a charge nurse! Especially when a difficult family needs extra support or intervention.
  12. by   HeartsOpenWide
    It's not against the law, but a bad idea. My first job, also in OB, didn't have a charge; my current job does. I feel much safer with a charge nurse. My manager keeps trying to get me to train as one, but the pay differential on our busy unit is not worth the risk. I told him I wouldn't consider it until we got a ward clerk or aid...our dept is treated like a red headed step child...
  13. by   salvadordolly
    Yes, another lean and mean idea that comes around every decade. In my hospital, charge was rotated amongst the nurses and they took a full assignment. When the turnover and complaints increase, never fail they will bring back the position again.
  14. by   lilredmc
    The BNE wrote me back it was a generic answer, but here it is 4 u Texans. ( in summary it is legal 2 illuminate charge)
    Thank you for your inquiry. The Nursing Practice Act (NPA) and Board Rules are written broadly so they can be applied by every nurse to all of the many different practice settings and specialty areas in nursing across Texas. The Texas Board of Nursing (BON) does not have a list of tasks that nurses can perform because each nurse has a different background, knowledge and level of competence. It is up to the individual nurse to use sound judgment when deciding whether to accept an assignment or perform a procedure.

    The BON regulates the practice of nursing and the approval of nursing education programs and does not have purview over certain facility policies such as a facility eliminating a charge nurse position in the ICU. However, nurses are obligated to promote a safe environment for their patients [Board Rule 217.11(1)(B)]. Board staff recommend that you review resource documents in the Nursing Practice section under Scope of Practice, including Rule 217.11 Standards of Nursing Practice and Position Statement 15.14 Duty of a Nurse in Any Setting. The position statement explains the importance of Standard (1)(B) in Board Rule 217.11 in that if you believe patients would be unsafe with current staffing practices, then your duty is to advocate for patient safety. The Frequently Asked Question (FAQ), Staffing Ratios located in the Nursing Practice section of our website may also be beneficial to you.

    In addition, the Texas Department of State Health Services (www.dshs.state.tx.us) regulates hospitals and may be able to provide guidance with your question. The most current version of the Nursing Practice Act and Board Rules and Regulations are accessible in Nursing Law and Rules on the Board’s website, www.bon.texas.gov. I hope you find this information helpful.