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 […]

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: