What do you expect from your charge nurse?

merellis2009 · May 27, 2008

I expect my charge nurse to:

-make appropriate patient assignments based on pt acuity and RN ability

-act as a resource to me when I have a question

-act as an advocate for the staff nurses if a patient gets into a "sticky situation" and we need to spend extra time with them

-trust that I am doing my very best to get things done not only quickly but safely

-act as a mentor/example of what a good nurse should be

-treat me with respect and dignity

DusktilDawn · May 27, 2008

I expect my charge nurse to:
Be more knowledgable about our patient population then I am.
To try and make sure we have adequate staffing to care for our patients (not always possible, but please make those calls!)
To check my drips without being asked
To monitor acuity and help where most needed, or get the needed help.
To answer call lights if not busy.
To call Drs and let me know the outcome
To advocate for me when needed
To challenge me and guide me into being a better nurse.
To cover my patients for breaks.
What do you expect?

A few questions here:

Would you expect all this if your Charge had a full patient assignment, just like you?

Would you expect all this if your Charge had less than 5 years experience themselves as a nurse?

Have you looked at the description of the Charge Nurse role at your facility?

Have you ever been a Charge nurse?

The role of a Charge nurse can differ depending on the facility you work for. In some facilities the Charge nurse also has a full patient assignment along with the duties of being in Charge, not likely they're going to be covering breaks or be able to keep on top of the acuity level of the whole unit to help where needed or call Drs for you or check drips without being asked or advocate effectively for you. If your Charge has less than 5 years experience, they may not be all that much more knowledgeable about the patient population than you are and likely not be the resource you expect.

I expect my charge nurse to:
-make appropriate patient assignments based on pt acuity and RN ability
-act as a resource to me when I have a question
-act as an advocate for the staff nurses if a patient gets into a "sticky situation" and we need to spend extra time with them
-trust that I am doing my very best to get things done not only quickly but safely
-act as a mentor/example of what a good nurse should be
-treat me with respect and dignity

merellis2009, all nurses should act as mentors/examples of what a good nurse should be AND we should all treat each other with respect and dignity.

My point:

Make sure your expectations about the role of the Charge Nurse is realistic and that they are based on how the facility handles that role and how they describe that role.

FireStarterRN, BSN, RN · May 27, 2008

I expect my charge nurse to:
Be more knowledgable about our patient population then I am.
To try and make sure we have adequate staffing to care for our patients (not always possible, but please make those calls!)
To check my drips without being asked
To monitor acuity and help where most needed, or get the needed help.
To answer call lights if not busy.
To call Drs and let me know the outcome
To advocate for me when needed
To challenge me and guide me into being a better nurse.
To cover my patients for breaks.
What do you expect?

You have high expectations. You expect your charge nurse to check drips, cover your patients for breaks, and do all Doctor calls?

That would only work on a small unit I would say.

Where I'm currently working on an assignment, the Charge only calls in abnormal labs, definately does not have time to cover for breaks, and certainly doesn't check on drips or really enter patient rooms except in unusual circumstances.

She processes the orders, signs them off, troubleshoots problems, helps coordinate care when possible.

I think Charge nurse responsiblities vary quite a bit for hospital to hospital and unit to unit.

allnurses Guide · May 27, 2008

If my charge nurse does not have an assignment, then I expect her to:

--Help me with my admissions, if I'm busy

--Start my IV's for me, if I don't have time or can't get it myself

--be a mentor and help me decide what to do when I'm having trouble with a situation

--be my advocate

--make assignments that are fair and reasonable

--try to get more staff if we don't have enough

Those are really my biggest expectations, off the top of my head. Some of those apply even if she DOES have an assignment, but for the most part my expectations greatly decrease in that case.

I NEVER ask anyone to call the doctor on my behalf, and it's not a policy that the charge nurse call abnomal labs at my facility. I also don't expect the charge nurse to know more about my individual patients than I do, though it's probably not a bad idea for the charge nurse to at least know the basics about every patient. Plus our charge nurse does chart reviews every night and so she learns quite a bit about every patient. She's also supposed to be aware of which patients are fall risk patients and make sure they all have bed alarms on.

LokiM · May 27, 2008

Our charge nurses do not have assignments so I expect more of them then I would if they had an assignment. And yes, I am currently working as an ICU charge nurse. It is policy at our facility that all drips are double checked by the charge nurse so I shouldn't have to ask or remind her.

As for charge nurses with less then 5 years experience, I dont think they should be. But this is not an ideal world. And sometimes nurses are assigned to charge duty without the experience that would make them as "all knowing" as I would like. After 20 plus years as a nurse I am not as all knowing as I would like to be.

Mostly what I am looking for here is what do you find most helpful from your CN? I'm looking for ideas that I can incorporate into what I already do to make life easier for the nurses I am working with.

And yes, I expect a lot but as a charge nurse I do alot. And as ICU are more intimate enviornments then a busy M/S floor my expectations differ. I try to do what I listed as well as draw labs, start lines, assist the docs with procedures, follow up with ancillary departments ie lab, blood bank etc.

I think that I work harder as a CN then I do when I have a patient assignment....and to think that I'm looking for more to do!

Chaya, ASN, RN · May 27, 2008

In a word, I expect the Charge RN to have the Big Picture of what is going on in the unit by timely and ongoing communication with staff members. I expect him/ her to integrate this info into an overall plan for delegating responsibilities and allocating staff and resources for the tasks required, with on-going adjustments as needed. I expect the Charge to communicate relevent info to the appropriate staff (ie: "I just booked a new admission for you" or "I just took a call from the lab on a critical value on one of your patients"). Finally, I expect the charge to function as a resource person for procedures/ info we are less familiar with ( or know how to look up/ access that info).

Whew- that's not much, is it? Yep- nursing: miracles expected every day!

Rae83 · May 27, 2008

I agree that it makes a difference in whether the charge nurse has patients or not. I worked on ICU for about 2.5 years and we did not have just one person that was charge nurse it was usually a different person every day. There requirement was that you had 1 year experience on the unit. The charge nurse had their own patient load and was responsible for making bed assignments and was the first "go to" person in the chain of command. On other units however, the charge nurse may or may not have patients so it depends. We were responsible for making our own Dr calls, checking and rechecking our drips (with the exceptions of insulin and heparin 2 RN's required) and doing our own IV's, labs, admissions, and so on. Not saying there wasn't teamwork, but sure wasn't up to the charge nurse to do it all. But again every facility is different and has different expectations. I would look into your facility's job requirements for the charge role if they are specifically named.

I<3H2O, BSN, RN · May 27, 2008

Wow! On my 35 bed med surg unit, the charge nurse (if she doesn't have patients) does all admissions and discharges (unless she is backed up or we have the time then we do it ourselves). She also notes all orders and helps when asked. The CN also makes room assignments. The CN on my unit makes $1/hr extra for being in "charge". I work as the CN occasionally and if one of my staff nurses expected me to do all that they would be disappointed pretty quickly.

Newbie Nurse SMP · May 28, 2008

I used to be a unit secretary in a hospital and let me tell you about our charge RN. She would have 2 pts a day assigned to her. She would only give them meds, everything else was done by the CNA. but in any case, if she wasn't giving meds she was sitting at her desk, and if things got busy on the unit do you think she went out of her way to help...NOPE! She would just sit there. I remember I was on the line with a Doc and the other line started to ring...she saw I was beyond busy, and instead of helping out she actually said out loud "the phone is ringing" ARE YOU KIDDING ME!! So much for the charge RN taking any "charge"

Dental Hygienist · May 28, 2008

mark.