Responsibility for other nurses?

The sad fact is that the charge nurse is responsible for whatever the hospital says she/he is responsible for. Get a clear definition of what the charge duties are and get some basic management/people education to make sure you can handle the job. If the charge position is an official duty of the RN, it does implicate the charge RN toward basic supervision of the flow of patient care. The charge RN can be named with direct care RNs in any negligent action based on the chain of command/supervision/oversight. Check your job description carefully, keep a copy with you and call the NC Board of Nursing. The NC nurse practice act is one of the most comprehensive in the country.

If a "bad" employee is hired by the facility and you are in a charge position, you have a duty to the facility to let them know. As a RN, you have a duty to patients to intervene if there is negligent practice looming by another RN. If you know about something that could cause patient harm and you do not speak up about it through your facility chain of command, you may be held just as culpable for the adverse patient event because you failed to stop that action. Patient duty, Patient advocacy, supervision and delegation are all covered in your practice act. Read it carefully and ask for a Board of Nursing opinion.

chas

Does it not depend somewhat on what on what the definition of a charge nurse it? At my old hospital we had a permanant charge nurse position called facilitator. Those duties as listed by Charles were certainly hers. No wonder they had trouble filling the position. If anything went wrong it was like being monkey in the middle. However, the off shifts had a charge person who was usually a different person every day who was held to different standard. You could hardly expect a person who was charge from two to five days a month to meet such high expectations.

I'm a charge nurse.......LTC. I am responsible for the CNA's who work under me, not other nurses. I guess it is different with hospitals?

I would'nt want to carry my lic. and insurance for other nurses all the time. There is a ton of stress as it is.........

then wouldnt the nursing supervisor would be responsible for all of the nurses in the hospital?

I am in LTC also and I am responsible for everything that goes on, on my unit for that shift. My super is responsible for everything going on in the building. Our employer has our job description listed as LPN Supervisors. Ok. I can deal with that- I know my job. This what I try to express to the new nurses....it's all on you. Your job is keep them alive and well for your shift, it's scary at times. I have fixed errors by other nurses I have found, have had to complete tasks others have 'forgotten' to do or just didn't get around to b/c they didn't want too. I put it in the perspective that my pt's will be better if I get these things done, tests, specimens, tx's etc. But I am starting to get tired of picking up after the shift before me and try to get everything done so the daylight doesn't have to do it. I have apologized to pt's for staff being brusque or hurried, b/c it was on my shift and my staff and I am responsible for their actions. I have been told that I 'know better' when I said I am tired of doing other nurses jobs. I am thinking how did I get to be the responsible one?????? Laura LPN:confused:

Momma_Penguin,

I found your post most refreshing. Thank You.

You take your job seriously. You have a great work ethic, that is seldom seen in LTC. (from my perspective)

I don't have a clue about the legal aspects of lever5's questions, so I can't give any wisdom there. I was just impressed by Momma_Penguin, and wanted to say so. - Wish you worked for my company!

Thanks,

ken

I don't think it is right for the charge nurse to be ultimately responsible for all other RN's, as we all have the same license and should be responsible for our own actions. However, I had an experience at work where I feel that the supervisor put me in a dangerous situation with an unfair assignment (as a new grad working in a busy ER). She gave me 2 critical patients within 5 minutes of each other, and did not offer to help. Did not send anyone to help. When I finally went to her and told her I needed help, she sent me an EMT student (supervisor was busy flirting with medics). Needless to say, it was a disaster. Both pts ended up intubated. I cried the minute I got in my car and didn't stop for 12 hours (until I had to be back at work). I almost quit nursing. In this case, I feel that I did everything I could to ask for help. I guess I should have refused the 2nd patient, but I was new. I could have gone above the supervisor and asked the doctor to let someone know that I needed help, but again, I was new and hindsight is always 20/20. In this case, yes, I feel that the supervisor should have had at least SOME responsibility if anything had gone really wrong.

Originally posted by thisnurse

then wouldnt the nursing supervisor would be responsible for all of the nurses in the hospital?

In a word....yes. The reporting mechanisms of any hospital should clearly indicate that any/all unresolved issues or issues of risk are reported immediately to a manager (unit or house supervisior). This protects the patient, the nurse and the hospital. Just report up the chain of command and you are most likely covered.

chas

Chas,

Naw, you are describing the responsibility of all nurses. If any floor, charge, or unit secretary, sees something that is not copastetic, they better be reporting it. I report these things to my manager, the charge nurse is usually so busy, they don't care.

Curlynurse, you describe a true failure in your system. Consideration of staff ability to handle situations is an important guideline for making assignments. Patient are intubated according to ABG results and distress, not nursing care.

Lighten up on yourself.

Lever, again...just know what your hospital requires and what your nurse practice act allows. You asked the original question about responsibility for others. We do when we know that a patient is getting substandard care. it is a matter of ethics and duty to care

My point is that the hospital would like to make the charge nurse responsible for the practice of other nurses. They allude to ideas of license jeopardy, and this is not part of the nurse practice act. A charge nurse cannot take that responsibility, it burns them out. No one is responsible for my practice but me. I take responsibility for my practice. Most hospitals are not stupid enough to put this assertion of responsibility in a clearly written statement. I have never seen it if they do. They just pass the info on. A charge nurse with a patient load and assignment of admissions and resource is a busy person as it is. She/he would need the cooperation of the team to delegate smoothly. How can she/he be held responsible for the actions of others? In my opinion this is just another way that hospitals try to lay off blame on the staff.

No charge nurse should be held accountable for other nurses who are her equal in license. An RN is an RN, therefore each should be responsible and be held accountable for their own patient assignment. Whenever I worked as a Charge Nurse, I "chose" to take a patient assignment equal to the other nurses working my shift. I only considered myself a "troubleshooter" for things that would crop up on the unit, thereby relieving any other nurse from having to stop her/his patient care to deal with. Other Charge Nurses I worked with preferred not to take a patient assignment, or they would simply do patient admissions, and some would take one or two patients max.