Who You’ll Hear
Kati Kleber, MSN RN CCRN-K – Nurse educator, former cardiac med-surg/stepdown and neurocritical care nurse, author, speaker
Elizabeth Mills, BSN RN CCRN – highly experienced neurocritical care nurse, current Stroke Navigator for a Primary Stroke Center
What You’ll Learn
- Responsibilities of the Charge Nurse
- Pet Peeves
- Final Thoughts
Responsibilities of the charge nurse
- Manage flow in and out of unit
- Know how many beds you have, how many are open, pending discharges, pending admissions
- Assign admissions and make the assignment for next shift
- Have a good grasp of the unit as a whole
- Give and get charge report (going patient-by-patient, a rough idea of what’s going on with each patient and needs/plan for the next shift)
- Know who on the unit is unstable because you are the second set of nursing eyes and hands to help out the primary nurse.
- Deal with customer service issues
- Support preceptors, new nurses, and nurses dealing with a declining patient. Regularly round on nurses (and CNAs) to offer help.
- Ensure you have the supplies and equipment needed
- Deal with unexpected situations (ex: patient has eloped, EMR downtime requiring paper charting, or maybe even a drug deal going down in a patient room!?)
- Be the mediator if your own staff members are having an issue with one another
Sometimes you will be “free” and have no patients, sometimes you may have a full patient load and still need to fulfill the responsibilities of the charge nurse. Being a charge nurse requires excellent time management and delegation.
- Be proactive in anything that you do.
- Make appropriate assignments
- Keep in mind: acuity, busyness, types of patients orientees need, planned discharges/downgrades
- Think ahead about throughput: Where will you put the next patient? Who will it be assigned to?
- If you have to give a charge nurse patients, give them light/stable patients, but not ones that will be transferring/discharging because then that charge will be up for admissions.
- Know your resources and who to call next for help
- Communicate with your staff
- Tell them if they are up next for an admit
- Get updates from them to make appropriate assignments for next shift (acuity and stability, current LDAs, upcoming procedures/interventions)
- When your pager goes off, quickly chart check that patient to make sure they are actually appropriate for your unit.
- Know how to look up policies because ultimately that is what you will need to rely on to justify your actions.
- When offering help, offer to do something specific (pass this med that’s overdue, set up the room for your admission, etc.) because a nurse may be so busy they can’t quickly think of which task to delegate to you.
- When a new patient is pending into your unit, do not say “who wants this patient?” You are in charge, you assign that patient.
- If you have few or no patients as charge nurse, do not kick back at the nurses station all day. Be a role model for your team and frequently offer help to others.
- If you have a full patient assignment, remember that your patients come first and your charge nurse role comes second.
- The best charge nurses are proactive, engaged, and a role model for the rest of their team.
- It may be humbling to admit that you don’t know how to deal with a situation. Your job as charge nurse is to figure it out. Call your supervisor, call a charge nurse from another unit, or call security and ask the questions even if you might feel silly doing so.