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Thoughts on Charge RN

Posted

HI Everyone,

I am interested in possibly applying for a charge position in CC, but I don't have the CC experience. I have been a Med/Surg, Tele, Neuro RN for 12 years, so I have "general" experience, and I've done relief charge on multiple floors being part of float pool, but I'm not sure if stepping into a charge role w/o Med/Surg/Neuro ICU experience would be a smart move. I do learn very quickly and I'm sure I'd be partnered with the other dayshift charge for training/orientation, but I just want some honest feedback as to whether this would be a good move or not.

Thanks a bunch

brownbook

Has 36 years experience.

In my humble opinion a good charge nurse does not have to be an expert in Critical Care.

I assume you could step in and help out when the *** hits the fan, I assume you could take over the care of a stable patient to free up a nurse when another patient starts crashing.

I assume you could help do an admission assessment, enter orders in the computer, etc.

A good charge nurse stays calm, handles staff disputes. Pitches in to help out.

A good charge nurse know who on her staff is the go to "expert" nurse. A good charge nurse says..."Bed 7 needs help, I will watch your (hopefully stable patient) for you so you can help bed 7" .

Anyway go ahead and apply. Emphasize your all around general nursing experience and knowledge. Emphasize you ability to get along and problem solve, but can be "tough" when the situation calls for it.

I'm sure they'll ask for an example of a difficult situation involving staff or patient's families and how you handled it

I completely disagree....this is a very bad idea/ A good charge nurse must be an expert in whatever unit they are in charge of. The ability to manage people and resources means that you need to be the first line of help for the unit nursing staff, rather than rearranging. You just can't deflect critical care nursing needs to the rest of the unit because you've never done it.

You need to be able to directly care for any patient in the unit at any time......Patient is circling the drain? You need to have a plan for the first 3 steps. Ventilator is alarming and all the nurses are currently in a patient's room? You need to go in and troubleshoot. You also need to be familiar with infrequent unit procedures to help both the RN and MD staff. Patient needs their belly opened at bedside/pulmonary artery cath/bronch/etc? You need to have an idea of what equipment to round up and general steps to assist.

You can't expect unit orientation with even the best charge nurse to teach you how to be an ICU RN and charge simultaneously. I'd be skeptical of any unit willing to have a charge RN without the necessary bedside experience and as a bedside nurse it would be extremely difficul to respect you if I knew you weren't a real resource in a crisis.

I agree with frozenmedic. OP is entirely unqualified and will hurt people if he/she actually somehow gets the job. Orientation will not be nearly enough training to bring the OP beyond the level of a liability in the charge nurse role in an ICU. Forget advising or helping out. You cant prioritize or direct resources effectively if you don't even know what youre looking at (and you won't).

Don't do it. It's a terrible idea.

DesertSky, BSN

Specializes in BSN, RN, CCRN - ICU & ER. Has 8 years experience.

On 4/8/2020 at 8:31 AM, 2bTraumaRN2008 said:

HI Everyone,

I am interested in possibly applying for a charge position in CC, but I don't have the CC experience. I have been a Med/Surg, Tele, Neuro RN for 12 years, so I have "general" experience, and I've done relief charge on multiple floors being part of float pool, but I'm not sure if stepping into a charge role w/o Med/Surg/Neuro ICU experience would be a smart move. I do learn very quickly and I'm sure I'd be partnered with the other dayshift charge for training/orientation, but I just want some honest feedback as to whether this would be a good move or not.

Thanks a bunch

No way. A charge nurse needs to be an expert and a resource on the unit. You are the go-to person to help in a crisis or take a patient assignment if the unit is slammed. Also, if an organization will hire you as a charge nurse in a critical care unit without critical experience, RUN!

speedynurse, ADN, RN, EMT-P

Specializes in ER, Pre-Op, PACU.

The charge nurse should always be the first resource to go to. Generally, the nurses hired into these positions have been staff nurses or relief charges in their specific departments for years and are then hired into that role. As an example, I cannot imagine being a charge nurse in my ED without ED experience. It is such a high level of critical thinking, balancing multiple acuity levels, and serving as a staff resource that it is imperative to be essentially the “expert” in the field.

MountaineerFan57, BSN

Specializes in Critical Care/CVICU. Has 3 years experience.

Sorry, but as a current ICU RN, I cannot imagine if our charge had never actually worked a day in the ICU. At least in my department, the charge nurse is responsible for a lot more than just staffing/assignments. They are a resource for questions/trouble shooting and should be there when a patient is crashing or a bedside procedure needs done.

Do places often hire charge nurses from outside their own unit? I’ve never seen that. And I honestly couldn’t imagine my charge nurse not having critical care experience. On our unit, the charge is our resource. I would think you would need some critical care experience under your belt.

Charge nurses frequently take patients, especially when the unit is short staffed. You would need to be able to pick up a team. Charge nurses are also considered resource nurses which means you are an expert on the unit you're in charge of. If you don't have any critical care experience, then you're not going to be an expert, and will not be able to help or educate anyone on critical care issues. Charge nurses make assignments for the next shift. How will you be able to do that if you don't know which patients are requiring more or less care? Only an experienced nurse will be able to determine which patient is going to need to be a 1:1 or can be paired. Some critical care charge nurses are also required to be on the rapid response team. Bottom line is that you are going to have to be a critical care nurse first before you can lead a critical care team. I would not want a med surge nurse making decisions for critical care nurses. It just won't work. It would be best for you to work in critical care for a few years, and then apply for the next charge nurse position. You would probably love working on the unit.

Delia37, MSN

Specializes in Critical Care. Has 15 years experience.

As mentioned by the previous posts, it just won't work. However, I have to admire the fact you are willing to step out of your comfort zone.

ljo28, BSN

Has 25 years experience.

Stepping into a charge role in an ICU with out any ICU experience is not that good of an idea. If you are leaning in towards leadership, it would be more productive if you try being charge on the floor that you work on. If you are looking to move to a unit, then I'd suggest to apply to an ICU nurse position, and then transition into a charge role once you have a good understanding of the critical care. Charge nurse should be more like a resource nurse, and the staff should be able to look up to the charge. There are a lot of things that go on a regular basis in the ICU for which you need trained and experiences personal to over see.

KR

Specializes in ICU, Agency, Travel, Pediatric Home Care, LTAC, Su.

I have well over a decade in various ICU (staff, local agency, & traveler). 26 bed to 1000 plus bed hospitals. Here is my two cents. #1 Charge Nurses have always had regular patient assignments on top of being charge (theoretically the easiest assignment, but patients can go bad in an instant). #2 One of the roles of the charge nurse in many of the hospitals is to be a "Resource Nurse"/Expert to help the newer staff, float staff, or just another nurse on the team. Yes ICU staff nurses help each other, but depending on the size of the Unit, staff, etc there may be a fair number of newer staff members. I honestly think you would be a great asset as a Charge RN with all your experience after you get some ICU bedside experience. And with as many different areas of nursing that u have worked in, I am sure u would likely pick up on things quick! Either way best of luck to u!