was i unprofessional? (quick story)

[raindrop]

I several years experience as charge nurse and I think I always handle people and situations quite well. However, at my current place of my employment, the first person who shows up for the shift is the charge nurse. Quite fine by me, but I've noticed a couple women who love the power trip of being charge and the other day it finally got to me. I show up for work and noticed that me and another nurse only had 8 patients assigned to us, whereas, the charge nurse assigned herself 11. I also noticed that we had 5 open beds. I voiced my concerns because it was clear to me (as always) that the other nurse and I were going to get the 5 admissions and the charge nurse won't have any, because she was already at her max. She disregarded my concerns and the shift began. Yep. right away, the other nurse and I each got 2 admissions. And then ED called to give us the 5th patient. This is where I put my foot down. I told, yes, TOLD the CN that she would be taking the 5th admission. She said NO, because that would give her 12 patients. I told her she can give me report on one of her current patients as I will take over their care. She huffed and puffed and pouted, but ended up taking it.

So by the end of the shift, I ended up with 11 patient (2 admissions and her spillover patient); the other nurse got 2 admissions = 10 patients....and the charge nurse had to give up a patient to take an admission, for a total of 1 admit and 11 patients.

Was this professional of me to grab the bull by the horns like this? I was very matter-of-fact, yet, professional......if that makes any sense. I wasn't ****** about it. I told my boyfriend about it and he thinks I was unprofessional....

[jesskidding, LPN]

the charge nurse should have as light of an assignment as posssible. period. why dont people get this?

I don't understand why people don't get this either. My CN usually does not have any pts at the beginning of this shift, but as the night progresses if she needs to take one or two new admissions then she will. She usually only takes new admits when the other RN's already have at least 5. None of the RN's on my unit rarely have more than 5 patients.

The CN has a lot to do. Even though it may sometimes seem like it, they don't just sit there at the nurses station twiddling their thumbs! If the OP had CN experience like they claim, they would understand this.

I would be going to the DON or Assistant DON and complaining about the high nurse/patient ratio. I would be livid if I were ever assigned 11 pts.

[anotherone, BSN, RN]

11 patients a nurse? what type of floor is this? a med/surg? that is insane. unless they are all super stable walkie talkies.

[OCNRN63, RN]

A couple more paragrahp spaces would be nice. But yes, as you wrote it, you do come across as a bit unprofessional, at least in what you've written.

And that's coming from a carpenter, if it makes it easier to take.

If you're not a nurse, I don't understand how you can comprehend the situation. Sorry for being blunt, but she's asking other nurses, not the general public.

[raindrop]

Med/Tele. It is insane. We are probably the only hospital in the state offering sign on bonuses for a 2 year commitment....

[OCNRN63, RN]

That nurse to patient ratio is unacceptable and flat-out dangerous.

I don't think what you did was unprofessional. The CN was trying to dodge taking any admissions. But really, when you're charge you shouldn't have a heavy load or need to take admissions. Someone needs to take a long, hard look at your staffing and do something about it. That is ridiculous.

[heron, ASN, RN]

I several years experience as charge nurse and I think I always handle people and situations quite well. However, at my current place of my employment, the first person who shows up for the shift is the charge nurse. Quite fine by me, but I've noticed a couple women who love the power trip of being charge and the other day it finally got to me. I show up for work and noticed that me and another nurse only had 8 patients assigned to us, whereas, the charge nurse assigned herself 11. I also noticed that we had 5 open beds. I voiced my concerns because it was clear to me (as always) that the other nurse and I were going to get the 5 admissions and the charge nurse won't have any, because she was already at her max. She disregarded my concerns and the shift began. Yep. right away, the other nurse and I each got 2 admissions. And then ED called to give us the 5th patient. This is where I put my foot down. I told, yes, TOLD the CN that she would be taking the 5th admission. She said NO, because that would give her 12 patients. I told her she can give me report on one of her current patients as I will take over their care. She huffed and puffed and pouted, but ended up taking it.

So by the end of the shift, I ended up with 11 patient (2 admissions and her spillover patient); the other nurse got 2 admissions = 10 patients....and the charge nurse had to give up a patient to take an admission, for a total of 1 admit and 11 patients.

Was this professional of me to grab the bull by the horns like this? I was very matter-of-fact, yet, professional......if that makes any sense. I wasn't ****** about it. I told my boyfriend about it and he thinks I was unprofessional....

No way to tell for sure until I hear the charge nurse's understanding of her job description. So far, we've only heard that you expect her to carry the exact same load as you but also meet her charge responsibilities on top of it. (No offense intended, but I don't believe that your version of her job is necessarily accurate.) There are times when going strictly by the numbers of patients per nurse is not fair at all.

[JulieCVICURN, BSN, RN]

It was unprofessional. It seems perfectly logical to me for the CN to load herself up with patients so that she doesn't have to take an admission, because she's got additional responsibilities. One of the most time consuming aspects of patient care is doing admission/discharge duties, so setting herself up to avoid that possibility is not only appropriate, but efficient and smart.

The CN, even if you think they don't have many additional duties, is held responsible for knowing the status of her entire unit at all times, not just her own patients, and has to be able to answer for any incidents that occur on her shift. Many places have CN roles that don't take any patient load at all.

[tokmom, BSN, RN]

Holy cow Batman! That is a lot of patients. I do charge full time and I would cry if I had to take any patients period. Of course I do admits, d/c and med recs, not to mention mentor and put out fires.

To be responsible for the floor and take 11 patients? I don't blame her at all! If crap goes down, who is going to take the heat? Most likely her.

I have nurses challenge me. I will at times listen to them, but not all the time. It depends on their attitude.

[roser13, ASN, RN]

A couple more paragrahp spaces would be nice. But yes, as you wrote it, you do come across as a bit unprofessional, at least in what you've written.

And that's coming from a carpenter, if it makes it easier to take.

I find it rather unusual (to put it politely) that you feel a need to critique posts (punctuation, etc.) and answer questions on a nursing forum.

Is it because your wife is a nurse? Is it because you feel that as a carpenter, you can add to the nursing conversation? Is it because there are no carpentry forums?

It's just odd....

[raindrop]

It was unprofessional. It seems perfectly logical to me for the CN to load herself up with patients so that she doesn't have to take an admission, because she's got additional responsibilities. One of the most time consuming aspects of patient care is doing admission/discharge duties, so setting herself up to avoid that possibility is not only appropriate, but efficient and smart.

The CN, even if you think they don't have many additional duties, is held responsible for knowing the status of her entire unit at all times, not just her own patients, and has to be able to answer for any incidents that occur on her shift. Many places have CN roles that don't take any patient load at all.

But she doesn't have additional responsibilities. I've said it 3 or 4 times already.....she is only responsible for making assignments for our shift. I know this for a fact. I know this for a fact because more often than not, I am charge. I am not assuming she doesn't have additional duties....I KNOW she doesn't. And the other nurse knows she didn't either. The charge nurse does not need to know anything that is going on with any of our patients. At the end of her shift, she simply reports off about her patients to the oncoming nurse and LEAVES. Just like the rest of us.

[wooh, BSN, RN]

I think we're all imposing our facility P&Ps on the OP's facility, which isn't necessarily the same thing. I've known of facility's where "charge" is more or less like OP said, and if that's the case, then I think it's perfectly reasonable for her to feel and act as she did. At my facility, there's a lot more responsibility, so we do try to avoid charge taking admits, or limiting them.

But really, once again in a thread, we've got a bunch of people that think what happens in their facility is the truth/law/way it's done EVERYWHERE.

[OCNRN63, RN]

I find it rather unusual (to put it politely) that you feel a need to critique posts (punctuation, etc.) and answer questions on a nursing forum.

Is it because your wife is a nurse? Is it because you feel that as a carpenter, you can add to the nursing conversation? Is it because there are no carpentry forums?

It's just odd....

Glad to know I am not the only one who thinks this is inappropriate.