What does "charge nurse" mean to you?

[notjustanurse]

At my facility (which is very small) it seems to mean very different things to different people. I am one of several charge nurses on our small med-surg unit. I work with both RNs and LPNs, as well as PCAs. Our unit manager has encouraged the charge nurses to stop taking a full load of patients, and scale back to just one or two patients so we can be more available to oversee the floor. So, on my shifts I take usually one patient unless we are slammed, and I do all of the discharges and admissions. This is a ton of paperwork since we have not converted to computer charting yet. I start or resite any IV's, do initial and onging patient assessments, and do all of the end of shift chart checks. I was recently approached by one of the other charge nurses who asked me to stop doing all of those "extra" things because it was putting pressure on the other charge nurses to do them as well as several of the other nurses work with different charge nurses. My manager seems to think I am doing fine, so I plan to continue as I have, but it got me to thinking, what does a charge nurse typically do?

Thanks for any and all input.

[lkwashington]

I agree with your nurse manager. To be a resource to your RN/LPN staff. You are a free charge nurse who works as a float nurse. I have done the same. Every charge nurse do different duties, but there should be certain duties that is required by all charge nurses on a unit. Now if the other nurses are only doing the requirement that is okay. I feel what you do shouldnt affect what they do. It appears to me that you are a great leader continue to work beside your staff and assist them when needed. Let them now you are there for them. Like you said it is a busy unit and you are not letting them drown and frown. Good job!!!

[bigmona]

It sounds like you're an excellent teamworker and I'd love to have a coworker like you. I believe you're doing everything a charge nurse *should* be doing. If some people aren't as hardworking and feel like you're making them look bad, that's on them, not you.

[kayern]

My charge RN is either an assistant nurse manager or a senior staff clinically savvy nurse. They DO NOT take a patient assignment unless there is an inability to cover a sick call. I can easily say my unit has not had a charge nurse with a patient assignment in probably over a year.

The responsibilities include, orchestrating the patient flow on/off unit, resource nurse, expert IV skills, trouble shooting, covering lunches/meetings, scheduling, etc.

[NoviceRN10]

I don't understand how you can be doing the initial or ongoing assessments for other nurses? Doesn't that leave the nurse actually caring for the pt in the dark about their current condition, or do you actually assess and then give the nurses report on each pt? On my unit the charge nurse counts the narcs in the lockbox, makes the shift assignment, takes a full load of pts, and that's about it.

[mykrosphere]

"What does "charge nurse" mean to you?"

not a lot..we have 3, sometimes a 4th, who rotate on my shift.

sometimes a whole night can go by without seeing one of them (unless its to tell us shes going out to smoke).

we havent been able to figure out what they are doing most of the night.

sometimes they help out if someone is drowning and starts making a fuss and freaking out that they are in fact drowning, but we usually have to ask for their help in order to get any help at all.

i depend more on my fellow rn/lpns on the floor, and the cnas if i need help, and i try to return the same favor.

our charge nurses do not take an assignment at all, and if they do have to, its usually the easiest one available with the least amount of patients/ less sick patients.

they do not do any discharges or admissions, and definetly not chart checks.

the only thing i have consistently seen them do is the assignments for the oncoming shift.

i would imagine your doing a fabulous job, because most of us are not privledged enough to have this sort of support!

so thanks for helping us/ them out. i am sure it is much appreciated!

:rckn:

[Leelee2]

Charge nurse to me means team leader, resource person, IV assist, covers breaks, helps problem solve, avail in event of emegency situation to help with whatever is needed, patient assignments, etc. The charge nurses I have worked under (that are really good) did not have any assigned patients, unless we were totally short and they were needed to work the floor (very rare occassion, maybe once or twice a year)

Ummm, just a question what do you think the other charges have been doing with all of THEIR time? I think you sound like you are doing everything you should and more. Kudos to you, I would love to work on your team, you are a great leader!!

[notjustanurse]

To answer NoviceRN10's question, at our facility the RN must assess and chart the LPN's patients. We are blessed with really great LPNs and they do their own assessments, but I like to know what's going on with all the patients on the floor, even if an RN is caring for them.

Thank you for all the kind words. I hope I am a resource for our team, and I continue to learn everyday. Even though I have been a nurse for almost 10 years, most of that time was spent in our little ICU before it was closed down. There we did total patient care on a max of 2 patients. This has been a HUGE adjustment, but I have been blessed with some of the best coworkers you could ever hope for, who have been both supportive and patient.

Leelee2, I have no idea what others do with their time. I'd never really thought about it until that nurse posed that question.

[RosesrReder, BSN, MSN, RN]

At my place of employment, the charge nurse has a full assignment, and if she gets caught up with administrative tasks (bed board meetings, going to ER to start an IV on a kiddo, etc), she actually becomes more of a burden as we have to take care of all her pt's, meds etc. on top of our own. Did I mention we all have to take turns being in charge and get NO EXTRA COMPENSATION?!?

I much rather have a charge with NO patients and able to float (as in my previous job).

[canoehead, BSN, RN]

I'd let the nurse do his/her own admission assessment, but there's still lots of paperwork you can help them with. I think you are doing a great job. If you stop helping you'll just be sitting twiddling your thumbs, and you are there to work.

[notjustanurse]

Thank you! I totally agree, I prefer to be busy.

At our facility, however, the RN is required to do and chart the assessment if the assigned nurse is an LPN.

[Bklyn_RN]

I always think of a charge nurse in legal terms. As in the legal implications that comes with that role. You really are accountable for everything on your tour. If there is a lawsuit, the question becomes, who was in charge on that shift. I have been a charge with a full patient load and all the attending responsibilities of the charge nurse. I was paid an additional $3 per hour extra for the privilege. But i would have rather paid not to have it. Like so much of nursing, its a thankless job. You get dumped on a lot, other nurses defer to you things they can handle themselves, like difficult patients. You have to make sure everyone does everything they are supposed to, and if they do not, then you have to take action. Also, no one is ever happy with the assignment you give them. And management expect you to perform miracles. This have been my experience.