Pre-Op/PACU Charge Nurse?

[WalterWho]

I've been working Pre-op/PACU for two years now and I've always wondered why we don't have any charge nurses. We're a smaller regional hospital with 98 beds, so we don't have extremely high traffic, but we do serve nine counties. My coworkers have always said that we are just too small and that our supervisor should handle the duties of a charge nurse. That's all good and fun, but I can't begin to list all the times that she's been away at a meeting or on important phone calls or whatever else supervisors do that take away from the loop and leave us at a loss of what's going on in our unit. Do any of you work at a similar sized hospital and have a charge nurse or something similar in your PACU?

[brownbook]

Yeah, kinda, sorta, it really varies in the different pre-op PACU settings I have worked in. The last place I worked had a supervisor but she made it a point to be available. In addition to the supervisor being there to help out she assigned a staff nurse to be charge nurse for that day. The charge nurse got something like an additional fifty cents an hour "charge" pay. (I can't remember exactly how much it was.) But she still took a full regular load of patients.

Some charge nurses thought it meant they took as few patients as possible and refused to take any high acuity patients.. Telling staff when to take breaks and lunch, other "petty" stuff. Other charge nurses didn't take their responsibility so seriously, took their regular load of patients reasoning that we were all intelligent adults and could work out lunch and breaks on our own.

What type of situations come up on your unit that leave you at a loss? Perhaps you could make a paper trail, document difficult complex situations that arise on a daily or weekly basis and that the supervisor wasn't available to help. Suggest a charge nurse be assigned for a few extra cents an hour.

[HeySis, BSN, RN]

^^^^ same as brownbook, one of the Rn's is assigned to Charge that day, it rotates between the most senior nurses in the unit. They are basically responsible for keeping track of what's going on in the OR's, deciding when to send people home as OR's close and any changes to amount or times of staff for the next day based on the OR schedule.

Some people take it upon themselves to dictate lunches, cleaning duties and whatever else they feel like.. others are so laid back that you could be down to two OR's and still have five nurses there.. several wanting to go home that finally have to point out what's going on so they can leave.

There's a bit of extra hourly pay when you charge, depending on who you are working with, it's not always worth the slight increase. :)