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Who You’ll Hear
Kati Kleber, MSN RN – Nurse educator, former cardiac med-surg/stepdown and neurocritical care nurse, author, and speaker.
Elizabeth Mills, BSN RN CCRN – highly experienced neurocritical care nurse, current Stroke Navigator for a Primary Stroke Center
Melissa Stafford, BSN RN CCRN SCRN – highly experienced and currently practicing nationally certified neurocritical care nurse.
What You’ll Learn
- Responsibilities of the Charge Nurse
- Tips
- 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.
Tips!
- 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.
Pet peeves
- 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.
Final thoughts
- 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.
For more on being assertive with kindness and curiosity check out New Nurse Master Class and Breakthrough ICU courses.