Confused About the Charge Nurse Role? You’re Not Alone

Charge nurses—as is often the case, there’s the ideal and the reality. Consider a recent blog post at the nursing blog At Your Cervix, which expresses some honest reservations about acting as a charge nurse—both about the challenges involved, and the lack of compensation for the added duties. Here’s an excerpt:

I’m really not so sure about this charge nurse thing. I was told when I arrived on a recent shift that I was to be in charge. I think I’ve done charge (maybe?) three times. Those times were only because there was no one available who did charge, and I was the most likely choice to do it. I haven’t been trained or oriented to do charge. It was kind of a “toss her in there and do it” situation.

If you read the entire post, you’ll learn that this blogger isn’t so sure she wants to take this role on again anytime soon. As it happens, AJN published a CE article back in September of last year (our clinical editor, Christine Moffa, wrote this post about it at the time) on an initiative which took place at the highly respected New York-Presbyterian Hospital/Weill Cornell Medical Center. Its goal was to figure out this charge nurse thing in a more systematic and sensible way.

Like so many roles in so many professions, there may […]

IOM Report: The Evidence Shows the Future of Health Care Rests on the Backs of Nurses

By Shawn Kennedy, AJN interim editor-in-chief

This past Tuesday, I attended the release of the highly anticipated (at least by nursing) report by the Institute of Medicine (IOM) on the future of nursing. Spearheaded and supported by the Robert Wood Johnson Foundation (RWJF), the report provides a review of nursing’s role in health care and details what changes need to occur for the future—not just of nursing, but for the future health of the health care system.

While the findings support what nursing has been claiming all along—that nurses have a critical role in health care and the health care system needs nurses to practice to the full extent of their capability—what is especially important about this report is that it is backed by the IOM’s multidisciplinary panel and an “objective evaluation of evidence according to the robust evaluation processes of the National Academy of Sciences,” said John Rowe, a committee member and professor at Mailman School of Public Health at Columbia University.

The panel at the public briefing for the release of the report included some health care heavyweights who voiced strong support for the findings:

Harvey V. Fineburg, president of the IOM: “One thing shouts out—nurses are critical to the nation’s health and central to the goals of high quality care.”

Risa Lavizzo-Mourey, president and CEO of the […]

Taking Charge Seriously

By Christine Moffa, MS, RN clinical editor      

Most hospitals have charge nurses, although how they’re selected and what they do varies not only between hospitals but often between units in the same hospital. For instance, the first time I was in the role of charge nurse it was because none of the usual suspects were working that day! And my manager’s parting words were, “Looks like you’re getting baptized with fire. Good luck.” Thanks to the work of a quality improvement team, the nurses at New York-Presbyterian/Weill Cornell Medical Center in New York City won’t have to go through what I did.

This month’s Cultivating Quality column, An Evidence-Based Approach to  Taking Charge, “describes the planning, implementation, and evaluation of a charge nurse initiative in a large academic medical center.” After reviewing the literature and identifying issues through the use of focus groups, members signed up for different quality improvement teams to develop solutions and action plans.

            The following are some of the changes implemented by the teams:

  • The development of charge nurse core competencies and a definition of the role to be used hospital wide.
  • A standardized hand-off report to be used between charge nurses going off and on shift.
  • An orientation workshop using interactive case scenarios.

See the full article for a list of the charge nurse core competencies as well as an example of a case study used during the interactive workshop. Here’s a breakdown of the charge nurse role and its responsibilities:

Startling Findings about Men’s Awareness of Male Breast Cancer . . .

and a look at the benefits of dragon boat racing for breast cancer survivors of either sex.

By Sylvia Foley, AJN senior editor

Although breast cancer is far less common in men than in women, being a man doesn’t make one immune to the disease. Yet misconceptions about male breast cancer abound. In this month’s CE feature, Men’s Awareness and Knowledge of Male Breast Cancer, nurse researcher Eileen Thomas reports on a qualitative study of 28 men at higher risk (all had at least one maternal relative who had been diagnosed with breast cancer). The goals were twofold:  to learn more about men’s understanding and perceptions of this life-threatening illness, and to elicit information that might guide clinical practice and the development of sex-specific educational interventions.

The study findings are rather startling. Nearly 80% of the participants had no idea that men could develop breast cancer. Fully 100% of the participants reported that none of their primary care providers had discussed the disease with them. Asked how they thought male breast cancer was detected, most participants could name only one symptom  (“a lump”); one said, “They find it on the autopsy table.” And 43% reported that being diagnosed with breast cancer might cause them to question their masculinity. One participant stated, “I would feel like my manhood was taken away.” […]

Entering the Mainstream? Nursing Research at 25 Years

Logo of the United States National Institute o...

By Shawn Kennedy, AJN interim editor-in-chief

Last Thursday the National Institute of Nursing Research (NINR) held its kick-off event to celebrate its 25th anniversary—and what could be more appropriate than holding a research symposium at the National Institutes of Health (NIH)? Scientists and researchers (nurses as well as others) whose work is supported by the NINR presented highlights of their research. (See here for synopses.)

Why it matters to all nurses. All nurses, researchers or not, should celebrate the growth and accomplishments of the NINR—its establishment provided tangible recognition of the value of the substantial body of research conducted by and/or about the nursing profession. As practitioners, where would we be without research to provide the evidence underlying care interventions or the processes of delivering that care? With the October issue, AJN highlights the NINR’s silver anniversary: on the cover, with a guest editorial by NINR director Patricia Grady, and with a timeline highlighting key milestones and landmark research supported by the NINR (click through to the PDF version to read this article). To give you an idea why nursing research matters, here’s just one entry on the timeline, from 1998:

Nancy Bergstrom, PhD, RN, FAAN, in a multisite study, tests the Braden Scale for Predicting Pressure Sore Risk and finds its predictive capability accurate. The scale is now widely used in nursing homes […]

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