What exactlly is "Charge Nurse"?

JB2007, ASN, RN · Dec 17, 2009

The facility that I work for is set up basically the same as your facility and everyone refers to the nurse on the cart as the charge nurse of such and such hall. The unit managers are the unit managers. I guess where I work the cart nurse is in charge of what happens on the hall during the shift. We are in charge of the CNA assignments and giving the CNAs the leadership they need. The cart nurse handles the falls, calling the MD, takes orders, sets up appts, and transportation, ect....

The DON comes to me with a lot of questions about what is going on with the residents or any problem that is going on with the hall regardless of what shift it occured on because I am there when she is there. If there is any problems with a resident it will be passed on in report and I will assess the situation myself, so the DON knows that I will be monitoring any changes with my residents.

I do not think that they expect you to be in charge of the hall when you are off of work.

elkpark · Dec 18, 2009

In my experience, the NM or unit manager is always the unit manager and has 24/7 responsibility for the unit; the "charge nurse" is the nurse who is in charge of the unit for a particular, individual shift -- someone has to make sure everything happens the way it's supposed to, deal with problems/issues, etc., for the unit overall from one shift to the next, esp. on the shifts when the NM isn't actually there.

Sandcastles, ASN, RN · Dec 18, 2009

My job is similar to yours.I used to work 3-11 and was referred to as the charge nurse down my hall.I now work 11-7 for the past 5 months and am considered the nursing supervisor for my wing.I found this out when I went to pick up insurance papers and my title was night nursing supervisior.I thought to my self hmmm Im not getting supervisor pay am I??? :coollook: I asked the payroll gal and she said because there are only 4 nurses at night and no night supervisior you each take over that role at night time.But yes it does mean you are responsible for all that goes on down your hall while your on duty.It is normal to be in charge of falls,incidents,appts ect for your hall.For instance this am I had 3 of my patients have appts ,so I had to make sure the CNAs got them up early.Ordered them an early breakfast tray and prepared their paperwork to be ready to go with them.So in a nutshell you are basically responsible for anything that goes on with your residents while you are on duty.If you have a unit manager and she helps awesome but if not its on you.You will get used to it and adjust.Best of luck to you.From one charge nurse to another

jtmonique · Dec 18, 2009

review your job description!!! @ the end of the day that is what you are responsible for.

GooeyRN, ADN, BSN, CNA, LPN, RN · Dec 18, 2009

You sound like a charge nurse... When I worked LTC, every LPN was a charge nurse. You were in charge of your hall. The residents, the CNA's, the calls, the new orders, the treatments, the meds, the charting, the falls, etc. was all on the charge nurse. Once you clock out, that responsibility is transferred to whoever clocks in.

elkpark · Dec 18, 2009

review your job description!!! @ the end of the day that is what you are responsible for.

Every single job description in healthcare I've ever seen, nursing or other, has included a statement at the end along the lines of "and other duties as assigned by your supervisor." That's what creates the big "grey area" of is it your job or isn't it? Basically, if your supervisor tells you to do it and it's not outside the legal scope of your practice, it's your job ...

jjjoy, LPN · Dec 18, 2009

Whether a nurse is assigned 4 patients in acute care or 30 patients in LTC, that nurse is responsible for CNAs, family questions, carrying out orders, dealing with crises etc

- so that alone doesn't seem to merit the job title "charge nurse".

But I imagine the title in LTC might be more of a regulations or policy issue. There might be policy that dictates that there *must* be a "charge nurse" on-site for each unit at all times. If there's only one nurse for an entire "unit" (med cart), then it could be easier to simply designate each of them as a charge nurse.

If day shift nurses are paid as "nurse" and night shift nurses as "charge nurse" (even if pay is the same) then the facility should have clear policy somewhere on their books defining the two different designations. However, in practice, there may be little to no difference and so people brush such questions aside as bothersome and irrelevant.

determine2brn · Dec 18, 2009

The LTC I work at is set up like yours.

The chain of command is:

The Administrator

The DON

ADON

My shift is 3-11 (every shift has their own Unit Managers)

we have 7 halls and 3 unit managers,2 is in charge of 2halls and 1 is

in charge of 3halls. (I dont know what the UMs do, they are always

in the office)

Following the UMs, we have a charge nurses on each hall. Their duties are

to make sure the the CNA do their job, make sure patient get their meds, sign in drugs, order drugs etc.

and for every hall their are 2 CNAs

LuVnLpN08 · Dec 18, 2009

Thanks to all who responded. Of course I understand that when I am on shift, I am responsible for my residents and all that happens! That is to be expected anywhere. I was just wondering about the whole title "charge nurse" because in all honesty it makes me feel uncomfortable to be called that. I am not a big fan of "titles" anyways-I want to just come to work and do my job and know for MYSELF and my residents that i did the best job I could-that is all that matters to me! I cant really explain it, I just dont like "leadership"-something I know comes along with nursing and I am working on that issue. And as someone else pointed out, "i dont think they expect you to be responsible for what happens when your off shift"-actually at my facility, they kind of do. They constantly approach me with questions about everything and every resident, wether the resident is on my hall or not, and wether i was working that shift or not. its frustrating because while i try my best to be aware of everything, i can not be responsible for what happens when im not there! I feel like that should be the unit managers job-to know all the residents and to f/u and be aware of what goes on with each shift, each day.... and the DON is always saying, "well your charge nurse 7-3 thats why we mainly come to you". but they dont hold the other shifts responsible for what happens (or in most cases what does NOT happen) when they are on shift...its very frustrating!!

Anyways thanks for the respones. i hope i dont sound like im complaining too much because I absolutley love my job and am so greatful for it! I guess I like everyone else just get a little frustrated at times.

jjjoy, LPN · Dec 19, 2009

Maybe they do bring such issues to the other charge nurses but if it is resolved then there's no reason for you to be aware of it. Or perhaps they always come to you simply because you are the most helpful/knowledgeable/etc charge nurse that they have on any shift and you get things done. If that's the case, they're not going to let you know that they're asking more of you than others.

justavolunteer · Dec 20, 2009

Where I am 'justavolunteer', our hospital has one nurse on each unit who is charge nurse. She is responsible for making out the assignment for the next shift. When new pts. are sent to the unit, she decides who will take them & what room they will go into. The charge nurse will have less pts than others, but often she will help out the other nurses if they are overrun with patient issues. It's usually a fairly cooperative situation. One day Suzy is in charge, next day Freida is charge nurse. There's no point in being nasty as charge nurse because paybacks would be heck.

The bad days for a charge nurse are when there are lots of discharges and lots of new admissions. The charge nurse is constantly handing out new patients to the others. No one wants to be taking report all day. The charge nurse has to know the relative load of each other nurse when assigning a new patient. She may have to be somewhat charming with the others who have had enough of new patients for one day.

Beside all this the charge nurse is supposed to be aware of pretty much all that is going on during the shift. Sometimes it is not an easy job. My head sometime spins at realizing all that nurses need to know.