Our new hire, new grad charge nurse

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Let me ask you guys your opinion on this. They just hired a graduate nurse on our med surg floor and made her the charge nurse. She has zero experience. She is a BSN nurse, and the majority of us are LPNs that have been here a while. I don't have a problem with a grad nurse being a charge nurse, but with no experience at all? Has management in this hospital lost their minds? :confused:

Specializes in Ortho, Peds, ER, MS.

In any supervisory position you should be competent to perform all aspects of the job you are supervising. That is true in nursing as well as any other "charge" role. My hospital hired several newbies to different roles and one being NM. In addition to being immature he couldn't find his head in a hole in the ground. As a nurse working at the facility for 5 years it was very difficult not to have someone who could give answers to my questions, back me up when i needed it, or even post the schedule in a timely manner (before the time sheet starts!!).

Whew.....I no longer work there and boy do I feel better!

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Yet, scope of practice will dictate that even a new grad RN is in a supervisory position with reference to the LPN.

The new grad RN here has a BSN and BSN's do a lot more than an RN, let alone what LPN's are allowed to do. More extensive physical exam's, etc. An RN cannot even check for hepatomegaly, but a BSN RN has learned this at least in clinical. That's just one tiny aspect, imagine all the others . . .

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The new grad RN here has a BSN and BSN's do a lot more than an RN, let alone what LPN's are allowed to do. More extensive physical exam's, etc. An RN cannot even check for hepatomegaly, but a BSN RN has learned this at least in clinical. That's just one tiny aspect, imagine all the others . . .

A BSN is an RN. More extensive physical exams? Please explain this. Also, from what I understand, the difference in degrees is academic. Your clinical experience is only as good as your program and that varies regardless of whether it's ADN or BSN.

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A BSN is an RN. More extensive physical exams? Please explain this. Also, from what I understand, the difference in degrees is academic. Your clinical experience is only as good as your program and that varies regardless of whether it's ADN or BSN.

For a BSN at my college you have 2 more years of Nusing classes (not counting prereq's like foreign language, etc.), so you get 2 years experience working for your clinical hours (and 2 more years experience) and 2 more years of more extensice Nursing classes, which include management, community health, etcm. Yes, an ASN RN can only palpate to 2 cm on physical assessment, never deep palpation anywhere; as I said, that's just one tiny difference for a BSN as opposed to BSN, and ANA recommends all nurses have a BSN at entry level.

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For a BSN at my college you have 2 more years of Nusing classes (not counting prereq's like foreign language, etc.), so you get 2 years experience working for your clinical hours (and 2 more years experience) and 2 more years of more extensice Nursing classes, which include management, community health, etcm. Yes, an ASN RN can only palpate to 2 cm on physical assessment, never deep palpation anywhere; as I said, that's just one tiny difference for a BSN as opposed to BSN, and ANA recommends all nurses have a BSN at entry level.

If you are an ADN and do an RN-BSN program online it is possible to do it in 3 semesters. It is also possible to do it without an additional clinical component, which would mean some BSN nurses have no more hands-on clinicals than their ADN counterparts.

I've never seen any ADN or BSN do deep liver palpations. I thought that was reserved for advanced practice nurses?

I don't believe I've ever seen a difference between BSN and ADN when it comes to direct patient care.

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Specializes in Hemodialysis.
The LTC my mother was in had an LVN as a charge nurse. She was fantastic. It is not against the law. I find that in my state "under the supervision of the RN" is very loosely defined. Being physically in the building was not a requirement. So many people come here and assert that "it's the law" this or that when it might be in their state, but every state has their own Boards of Nursing and scope of practice. I don't doubt that Puerto Rico and the Marshall Islands do as well.

It takes a certain type of individual to be a good manager. The new grad new hire RN shouldn't be completely written off, but in a field like nursing the manager needs to be a resource person. If she has potential to learn the ropes quickly it could work, but only if the experienced staff isn't trying to sabotage her. There are many stories here about nurses I know from their posts on this board are great,(regardless of whether LPN/RN/LVN) who accepted charge positions in LTC and were systematically worn down and eventually terminated from these jobs. I hate it because they usually doubt themselves before blaming the employees they supervise, or even the DON/administrator above them. Why some of these places would hire a person then set them up for failure I don't know. I wouldn't wish that on anyone.

That's exactly what I said. You took it out of context. The OP said this is a hospital, not a LTC facility. I stated that most of the RNs that I know of that have been hired directly to charge positions have been in LTC facilities. There are LPNs "in charge" of the shift (at LTC's) because there isn't an RN anywhere in the building, but when something is beyond the scope of practice for an LPN they have to call the RN in to do the task. In no state that I know of an LPN can be "in charge" of an RN, no matter what their experience level is, so for an LPN to be placed in the position of charge nurse (the OP stated that there were more experienced LPN's) when there is an RN on shift, is not possible, because the LPN has no authority to supervise an RN. It's logistics, not any reflection of the LPN's knowledge base.

It sounds to me this RN was placed in this position by default, for lack of a more qualified, experienced RN to step into the position, which is why I asked how many RN's work on this floor.

Also "charge" is not a universal term. Here a charge is not a nurse manager. There are nurse managers and then there are nurses who are designated the charge for the shift. That charge nurse still has to report to the nurse manager, so she's also got someone to go to if she has a question. The OP didn't detail how exactly her system is set up, so this new grad may also be working directly under the supervision of a very experienced nurse manager.

In any case, I agree that the staff should support her however they can and not try to sabotage her just because she's been stuck in this situation that isn't ideal.

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Well the new charge nurse quit the other night. We all helped and encouraged her. I guess it was just too much responsibility for her.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Livelaughlove09 - you're right -- I responded to the issue speaking in a general sense. I've never seen an LPN as a charge nurse in acute care hospitals either. I've read some posts from people here who were newly hired RNs in an LTC with a LPN as their immediate supervisor. These issues will probably continue due to the new grad RNs not finding work in the specialty they envisioned themselves in while in school.

Well the new charge nurse quit the other night. We all helped and encouraged her. I guess it was just too much responsibility for her.

This is too bad as there were no winners in this situation. Kudos to you and your co-workers for trying to help her succeed. :up:

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Specializes in OR, ER, Oncology, CPC.
The new grad RN here has a BSN and BSN's do a lot more than an RN, let alone what LPN's are allowed to do. More extensive physical exam's, etc. An RN cannot even check for hepatomegaly, but a BSN RN has learned this at least in clinical. That's just one tiny aspect, imagine all the others . . .

I am a Diploma nurse with three years of straight clinicals plus all of my BS required courses. I went through the "diploma" program first because of the intense clinicals and have run an ER with my diploma degree (not as a new nurse though) ! I am not understanding how an RN can not asses for hepatomegaly but a BSN can. :confused:

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Actually I am sorry that the new nurse was not up to the challenge.

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Specializes in Spinal Cord injuries, Emergency+EMS.

do you actually mean Charge Nurse ? or just Nurse in charge ?

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Most healthy care agencies have a policy that some has to have at least one year of experience before placing them in a supervisory position. She has met the minimum qualifications to be an RN by completing a program and passing her boards. The LVN nurse practice act does not state how much education or experience the RN's who supervise them must have. It is unfair to judge a person based on these facts alone. For the patients sake give her the support that she needs. If she does something that causes a concern then be a good patient advocate and report it. There isn't much else you can do.

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