Think I'll be Placed in Charge...

[VioletaRockos]

Hello all! I wanted some feedback on something...

In my very very short 2 year experience as an RN, I don't typically see charge nurses in hospitals (out of all the hospitals I did clinicals at and where I worked as a nursing assistance for 2 years during school). My hospital is one of the few that still has charge nurses on our Med-Surg floor.

I'm been at the hospital for two years now, and got into the groove of things. Our contract says that after a year, we can be placed in the charge position. I was never really approached about it and I kept quiet about it. There are 4 nurses on days that rotate it and it's never really come up.

I've been out of the past 3 months for a knee injury, and called my manager this afternoon to say "Iiiiiii'm baaaaack," and asked what he wanted to do about my schedule.

"How about you come in tomorrow, and orient at the desk a little bit, and kind of help out, and see how you feel/ We can work on your schedule then."

*gulp*

I have anxiety about the desk, I'm not going to lie. I still have doctor anxiety and phone anxiety as stupid as it sounds. I've made my own calls before to doctors, when the charge nurse has been swamped and I needed something immediately, but something about picking up the phone and being interrogated by one doctor about one of the 30 patients on the floor is daunting.

I guess I'm looking for advice, tips or tricks that nurses use to keep themselves organized when dealing with 30 patients in a relatively acute setting as a charge nurse.

Thanks!

[Been there,done that, ASN, RN]

YOU can do this. Familiarize yourself with the SBAR format. You will be able to handle any physician interaction.

If you are not able to answer the request for any additional info....

most likely the doctor is sorely lacking in what they needed to know about the patient in the first place and it's OKAY to tell them..

I don't know, but I'll find out.

Sounds like a great opportunity . Please let us know how it's going.

[guest358111]

Some tips that I hope are helpful:

1. Make sure every patient has a nurse. Write what nurse has which patient on a sheet.

2. Know who has PICC lines, central lines, etc.

3. Know who is a full code and who is a DNR

4. Know who is on telemetry or any other kind of monitoring

5. Know which patients have consults, if there are any without outside Doctors, eg. oncologists, surgeons.

6. Know who is going to the OR at the start of your shift, who potentially can be going to the OR at the start of your shift and make sure the charts are ready

7.Backtrack on new admissions and make sure the orders look right

8. (Should actually be #1) Make sure your crash cart/defib. is checked and ready to go!

9. Be a resource and a troubleshooter, not a nag and a troublemaker...:)

10. And ABOVE ALL-stay calm and professional at all times even when it is crazy. The charge nurse can set the tone. Just do the next best thing, and then the next best thing, and then the next. Delegate when needed, don't try to do it all yourself, but work hard.

I wish you the best!

[Swellz]

I'm a year in and that conversation is coming up a lot. I'm really not comfortable with the responsibility. I also feel everyone with more experience than me should be oriented to charge first, but that is also my hesitation talking lol. Good luck!

[delphine22]

A side question: only the charge nurse is allowed to call docs? I get how it can cut down on multiple calls, but I'd rather be the one, I know the pt best. We did have one doc who insisted on only talking to the charge nurse, lol. We would just lie and say, "Speaking!"

[VioletaRockos]

We do have certain doctors who only ask for the nurse taking care of the patient. And other nurses can make calls, but since each nurse is also responsible for all their baths, walks, med passing, OR/discharge paperwork, going to the charge nurse and saying "Hey, this is my problem with x patient. Can you call and make him aware?" Is easier with the total patient care workload of 5-6 patients, and then the charge nurse doesn't have a patient assignment.

I call if it's something I can deal with on my own, but if it involves a lot of knowledge or something I'm not familiar with, then I ask the charge nurse.

[VioletaRockos]

Oh God, so much things to know! This is what gets me scared. I need a good system. Of knows and not so important information, because I know I can't remember everything.

Thank you!

[VioletaRockos]

That's how I feel! I work with nurses with 10-30 years experience, and feel like they should be oriented first (yes, some of them haven't). And here I am with my two, not knowing certain terms/diagnoses off the top of my head... Not knowing exactly what to do in certain situations. It's just so daunting.