When we think about the hospital or clinic visit process, we think about the doctors, nurses, and patients. Some other staff members work behind the scenes, but one of the most important is the charge nurse. This role is valuable in all healthcare settings; however, many do not appreciate or understand the charge nurse role. The charge nurse is not just the experienced nurse, but also an educator and mentor. Charge nurses must verify staff are safely in the right places at the right times. They manage patient care and ensure operations are occurring while monitoring and verifying actions are correct. The charge nurse acts as the communication link and point of contact for doctors, nurses, patients, and their families throughout the shift. Charge nurses schedule staff and are responsible for assigning work and implementing the patient care plan each day. The charge nurse is under a large amount of pressure to provide care while having a listening ear for issues. The charge nurse must be an advanced clinician, have unique leadership qualities, quick decision-making abilities, and emotional strength.
Responsibilities of a charge nurse
A charge nurse’s role is a combination of clinical and managerial aspects. Primarily, they have the oversight of the nurses on that shift, and therefore the responsibility of ensuring the care for the patients is being delivered. Charge nurses typically begin skilled nursing shifts by reviewing staffing of nurses and unlicensed assistive personnel (UAP). The charge nurse has to think about patient acuity, experience level of nurses, and skill level of nurses to assign patients for assignment. In the moment of the nursing shift, charge nurses are the “person” for questions and problems. When their staff nurse is in a state of overwhelming busyness, charge nurses will help out other shifts in those moments until things become calmer. When a physician is requesting information for their patient, it is often the charge nurse who then provides that information. Charge nurses will often answer questions on admissions and discharges, and issues with other departments, and even help troubleshoot immediate issues. Charge nurses are also responsible for documentation and must keep track of inventory levels, report at the end of the shift, manage incident reporting, and ensure communication goes up and down the chain. Charge nurses also ensure communication is occurring with families and establish trust with patients and families. While a charge nurse may still perform direct patient care tasks, their focus is on monitoring the workload of the unit as a whole.
Challenges faced by charge nurses
While being a charge nurse is a rewarding job, it has its challenges. One of the most significant frustrations is working within limitations. Being short-staffed, being limited in supplies, being assigned too many patients, and being told by management to make sure everything stays organized and manageable can make the job of a charge nurse difficult. Charge nurses must not only see how stressed the team is on the floor, but must also try to maintain a positive attitude and high morale during horrible shifts. To get through those shifts requires a combination of situational awareness, emotional intelligence, and leadership. If something goes wrong – whether it is a medication error, an infection outbreak, or missed procedure – those near misses will require the charge nurse to explain what happened and what can be done to try and prevent something from occurring again. Carrying that level of responsibility is mentally fatiguing and emotionally draining.
Why charge nurses are vital to healthcare
Coordination is the single most important element when delivering suitable, safe healthcare. Charge nurses facilitate this coordination on a day-to-day basis in the healthcare system. Without charge nurses, hospital units have significant struggles related to managing workflow, knowing the roles of each staff member, and communicating between the departments of the healthcare system. Charge nurses are the backbone of a nursing unit. Charge nurses enable suitable patient outcomes to improve the performance of staff members, and the efficiency of business operation. When charge nurses are not providing care, the healthcare system is not functioning as it should.
Conclusion
In today’s complicated healthcare system, the charge nurse is a charged leadership position. Their role can involve aspects of the nursing role like the rest of the nurses, but charge nurses are distinguished by their leadership, organization, and management skills under pressure. Charge nurses are the steady hand that ensures operations, patient care, and performance remain organized and managed.