Too Soon to be Charge?

Sour Lemon · Apr 2, 2018

I'm a new nurse and I've been on my unit for 10 months now. It's a surgical Ortho/Neuro floor with some overflow general Med-Surg. Lately we've had a huge shift in staffing and some nights I'm the most experienced nurse on the unit (theres nurses who've been there 3-6 months). Because of this I've been asked to be Charge. I'm good at what I do and I'm "the smart one" I've been told, always jump in with Rapids and Codes and help everyone out, but I can't help but feel that I might not be ready. When is a nurse ready for Charge? What makes a good Charge?

That depends on what the responsibilities of "charge" are on your unit. I was "charge" six months out of school, but I only made the assignment, assigned admissions, and spoke to patients when they had a concern or complaint.

The charge nurses where I work now have vastly different responsibilities and I definitely wouldn't be an ideal candidate at this point, even with eight years of experience. Most of them are 20-30 years in.

KeepingItSterile · Apr 2, 2018

Charges:

-Make Assignments (I already do this some nights because I come in first and some Charges let me)

-Assign Admissions

-Speak to patients and family members

-Make calls for some RNs

-Confirm BedBoard assignments of admissions (infectious pt's can't be assigned to post op rooms, my unit can't take Cardizem gtts, etc)

-Resource for Codes/Rapids

-Resource with other RNs

-If RNs are taking 7-8 pts then the Charge (a good charge) jumps in and starts taking admissions

-Manages the Massimo (our remote heart/pulse ox monitor) and pagers

-Decides when to call the surgical team or the medical team or if it can wait until morning

-Reports to Nursing Supervisor on all the patients and who potential discharges are

Sour Lemon · Apr 2, 2018

Charges:
-Make Assignments (I already do this some nights because I come in first and some Charges let me)
-Assign Admissions
-Speak to patients and family members
-Make calls for some RNs
-Confirm BedBoard assignments of admissions (infectious pt's can't be assigned to post op rooms, my unit can't take Cardizem gtts, etc)
-Resource for Codes/Rapids
-Resource with other RNs
-If RNs are taking 7-8 pts then the Charge (a good charge) jumps in and starts taking admissions
-Manages the Massimo (our remote heart/pulse ox monitor) and pagers
-Decides when to call the surgical team or the medical team or if it can wait until morning
-Reports to Nursing Supervisor on all the patients and who potential discharges are

That sounds similar to what I did, but I had 6-7 patients automatically ...normal was 8. Doing it without patients should be a walk in the park.

Nurseinprocess · Apr 2, 2018

It sounds like if you are already comfortable and smart at your position then being Charge shouldn't be a stretch for you. I was charge before I was a nurse for a year, but it only meant I got one less pt that everyone else and I made the assignment for day shift. I also assigned admits. No pressure. Where I work now the charge only gets 1 pt, handles staffing/assignments, helps run hemorrhages (OB), and is a resource person for any issues that crop up. The charge also gets mini report from all of us about our pts so she knows what we have going on on the unit.

Crush · Apr 2, 2018

I don't think there is a set time per se of when is too soon or anything like that with readiness to take on the "Charge Nurse" role. It sounds like you have seniority on the ward, even though you've only been a nurse 10 months. It sounds like it won't be too bad though w/ no pts. Shoot, even if you had to caryy 1-2 assigned to you, that could still be manageable (once you are more familiar with the role ).

Here is a question. What happened on that unit that they had such a high turnover and lost all their staff?

Nursetom1963, BSN · Apr 2, 2018

I showed up one night and was told "you're charge nurse tonight" I said "OK what do I do, I've never been charge before?" she ran it down for me, and from then on I kinda just made up my own job description of the role, which basically came down to being a resource and floating aide, and whatever was needed to keep the nurses on track and out on time. Same in the ICU where I am now, never did have a formal orientation to Charge, but everyone loves it when I am, because my goal is to support them with whatever they need with pt. care; today I helped transport two patients upstairs on downgrades, and one to CT, run labs, pharmacy runs, relieve everyone for lunches,( and try to enter vitals, or pass meds while Im doing it) and turn and clean. I think it's probably better that management didn't teach me their idea of "Charge", because Im sure that comes down to audits and paperwork BS.

KeepingItSterile · Apr 2, 2018

Everyone, thank you for your feedback. I think maybe I should be more confident in myself and give it a shot.

Crush - There's high turnover on my floor because my floor has the strictest unit manager in the whole hospital. But now she's in hot water for being mean to her staff so other supervisors step in. Is she strict? Yes. Terrible to some? Yeah, but not to me. I was an aide in LTC for three years and I've had WAY worse managers. Bosses are bosses, not always your BFF.