Coworker Perspective: Charge Nurse

The charge nurse can continue to search for an available CNA that could possibly float to the unit. There are several hospitals that do cross training with the CNA’s just in case they are asked to float to another department. The charge nurse can help several ways by helping Brandi with the CAN tasks until help comes, she could care for a patient of Brandi’s, ask if one of the CNA’s could stay an extra hour or so to help with the tasks that need to be completed by 8am. Also, look over any morning tasks that could potentially be moved to a later time. She can possibly redo the assignments on the unit to even out the work load between the nurses until help arrives. We are all a team working together to provide the best care possible, so team

As a nurse manager, I would hold a staff meeting and ask the nursing staff if anyone was willing to volunteer to float to the general medical and surgical units. However, only nurses that could safely practice within their scope of expertise would be allowed to float to particular areas. A unit float register will be created to keep track of nurses who have floated and to what units. This decision will hopefully satisfy the ethical principle of justice and maintain a level of fairness among colleagues.

Julia, a registered nurse, has been run down all week making medication errors and recently one of her patient’s fell out of bed. Julia has eight patients assigned to her due to staffing shortage since the hospital decided to stop using LPNs. Julia is very overwhelmed and is unable to safely take care of her patients. Julia was required to report to her manager’s office the next morning due to her patient neglect and fall. The manager informed Julia the high nurse to patient ratio is not a problem as other floors and nurses are doing fine with it. Recently, I have seen this occur with in my own facility I work for. As of right now it is staffed with fifty percent locums or travel nurses, which leads to increased

First, as the unit managers, we will listen to our employees’ concerns. Next, we will address the specific complaints about working with certain staff members and the lack of supplies available on the unit. We will investigate further to see which employees are not performing to hospital standards and then schedule a meeting to explore their reasons and work together to find a solution to the problems. Next, we will address the lack of supplies available on the floor by scheduling a meeting with the manager of central supply. During this meeting, we will explain that the nurses are often working short-staffed and having available supplies will allow the nurses to manage their time more efficiently. Then, to implement evidence-based

A unit that consists of 70 registered nurses (RNs) who care of (31) beds. Some of the nurses were met by the

I would like to give you some insight as to the daily operation of a major Emergency Department in this city. Not unlike many other “ER’s” the nursing staff is tasked with the triage or assessment of patients in order to sort by priority. The nurse is then tasked with maintaining flow of the department and ensuring the timely care and physician evaluation of patients. This requires clinical nursing judgement and expertise which is tested constantly. To explain this plainly, nurses are faced with a meat grinder which cannot stop. There may be twenty patients in the lobby with ambulances lining up. The room nurses are trying to

While extremely beneficial, this tool can also become a hindrance when supplies are not restocked or are placed in the wrong location. Another important member of this floor is the charge nurse who acts as a liaison between patients, nurses, shifts, and hospital administrators. The charge nurse does not have a set of patients assigned to them specifically, but helps nurses to get caught up when they fall behind and acts in a generalized way to keep the floor functioning. The floor receptionist helps to direct patient calls to the appropriate personnel, but this person is only present at certain times during the day. Also visiting at any given time are physicians, chaplains, respiratory therapists, wound nurses, IV therapists, physical therapists, occupational therapists, and a variety of other hospital personnel. With all of these individuals coming and going, this floor is constantly abuzz with movement as everyone works together to help the patients who populate this floor receive the health care they need.

The literature provided speaks of the nurse’s responsibility in creating a safe environment for the patient and a healthy work environment for individuals of the organization. Part of providing safe and competent care to patients is for the RN to ensure that she is clinically capable of providing care at the skill level necessary for an assignment, especially when she floats to other units. Otherwise, she must decline the duty to care for that patient, make it known to the charge nurse that the assignment is beyond her competency level, and ask for an alternative assignment that matches her skill set (California Board of Registered Nursing, 1998). In addition to knowing the nurse’s

Under the regulations of the California Nurse Practice Act, a Licensed Vocational Nurse has the ability to delegate tasks to unlicensed assisted personnel (UAP) according to individual facility policy. Delegation as stated in Hill & Howlett is defined as, “transferring the authority to perform nursing duties that are in the job description of the LVN charge nurse.” Prior to carrying out this important nursing duty, it is important for the LVN to recognize the difference between assigning tasks and delegating tasks. As explained in an article in the Journal of Nursing regulation titled; National Guidelines for Nursing Delegation. Assigning tasks would involve performing “routine care, activities, and procedures that are within the authorized scope or practice of the LVN or part of the routine functions of the UAP. Delegating tasks on the other hand is defined as “allowing a delegate to perform a specific nursing

The American Nurses Association supports a legislative model in which nurses are encouraged to create staffing plans specific to each unit. This approach will aide in establishing staffing levels that are flexible and can be changed based on the patients needs, number of admissions to the unit, discharges and transfers during each shift (“Nurse staffing plans,” 2013). This model will assist in keeping the unit staffed appropriately and organized in need of a change during each shift. Without an organized plan like this, a nurse may be required to take on a new admission and already have too big of a workload.

When needed, nurses can ask for assistance from their peers or delegate patient care tasks to increase their productivity. Implementing either strategy requires an understanding that with either task there are specific responsibilities and accountability. Nurses must have an understanding

When was the last time you were in the hospital or a loved one was in the hospital, and ever wondered where the nurse is, and they haven 't returned for hours. You finally push the assistance button several times, and they open the door and hurriedly say, “I will be right back”, then you don 't see them for a while again. When they come back to check up on you, you explain to them what you need, and then they send in a less qualified staff member to assist you. At this point, you become very annoyed and frustrated not to mention scared to be admitted in the hospital to begin with. Little do you know, your nurse has ten other patients and other non-nursing tasks that they are responsible taking care of. They have been working a double shift and are extremely exhausted, and a large stack of charts that they will have to do before their shift is over. As a patient, you now become frustrated and are not happy about this; as a nurse, they are just as frustrated as you are, not only because the amount of work they have but more importantly they can 't deliver the appropriate care they long to give. For most hospitals they do not hire enough registered nurses for reasons that are good and bad. This is an issue that needs to be addressed not only locally but nationally and on a constant basis. When there are too many patients for one registered nurse to attend to, nurses become exhausted, mistakes are made, and patients are unsatisfied. A minimum nurse to patient ratio needs to be

On one of my clinical days at San Ramon Regional Medical Center, my classmates and I all had the opportunity to be a student charge on the Med-Surg unit. As I have observed from my work place as well as at our clinical sites, charge nurses are the ones in charge of dividing bed assignments, solving conflicting issues among the staff, helping or coordinating with admissions, and keeping nursing care adequately delivered to patients. Charge nurses also do a lot more including signing doctor’s orders, resource or advisor for others, answering phones and call lights, rounding with doctors, and dealing with family members. I always viewed the role of charge nurse to help other nurses and make their loads easier. As I continue to be exposed to what their role truly is, my views changes through time and experience.

It is no secret that communication is key when providing direct patient care in a skilled nursing facility. However, there is a noticeable lapse in the communication between the care team when providing care to the individual or groups of individuals. Two main parts of any care team are the registered nurse and the certified nursing assistant, as these are the two people whom have the most direct and impactful roles with residents in a skilled facility. The Registered Nurse and the Certified Nursing Assistant play similar roles in providing patient care, but have different roles in its entirety. The role of the Registered Nurse (RN) is defined as having the competency and skill to provide direct and indirect health care to individuals, their families, and communities around them. Services are also provided designed to give out medications, to promote comfort or healing, promote healing, and to also provide the dignity of their patients and patient’s families (American College of Rheumatology, 2015).

After choosing to help my co-worker, to ensure that the client was kept clean and comfortable, I felt that this was my main priority in this situation. As an accountable Healthcare worker it sates within my code of conduct. That I have to make sure that I give care to all clients and treat every person as an individual, with dignity and respect at all times. However, I could still see, and understand why that staff nurse had to explain to me why I had to listen and take instruction.