In our hospital, I believe everywhere in our hospital, the "charge" was just the designated senior nurse. He or she had as many patients as everyone else, and actually usually the sickest. Also was responsible for making assignments, picking up her share of new admits, giving the LPN's pushes, blood, etc. And because of the out-in-the-hall SBAR, the charge really didn't even know what was going on with the floor, since all you ever heard about was your own patient. Terrible system. The nurse managers never, ever, ever, did any patient care. They would have been ostracized by the other managers if they did. I saw one once get begged by a floor nurse to just sit in on a blood transfusion because she had patients crumping. The manager pulled away from her and said she had to go to the cafeteria to serve ice cream for a "social". Uh-huh.