- PDFView PDF
Under a Creative Commons license
Open access
Abstract
Background
Emergency department charge nurses are expected to oversee the quality of patient care, direct work, and the allocation of resources. The charge nurse is the unit’s frontline leader, and he/she must have proper leadership training and support to carry out duties effectively. This study explores how charge nurses perceive their role in managing daily work and major incidents at the emergency department.
Methods
A qualitative study based on focus group discussions using a semi-structured interview. Participants were 12 charge nurses from four Swedish emergency departments.
Results
For data analysis, a systematic text condensation method was used. The analysis of data generated four categories: (1) Coping with chaos; (2) Need for further training; (3) Feeling of inadequacy; and (4) Lack of strategies.
Conclusions
The study concluded that the emergency department charge nurse has frontline duties that are diverse, multifaceted, require good leadership qualities, and lack detailed job description. Charge nurses confront many challenges in their daily work, often with little training or the opportunity to develop in their professional. This study provides understanding of the concerns charge nurses hold about working as frontline leaders and that departmental heads must support the education and training of their charge nurses.
Keywords
Charge nurse
Emergency preparedness
Emergency department
Leadership development
Cited by (0)
© 2022 The Author(s). Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia.
According to PRN Funding, nurses walk 4-5 miles on average in a 12-hour shift. Charge nurses may cover even more territory, but the charge nurse role requires more than strong legs.
This guide covers the most important traits for charge nurses to be effective leaders and improve patient outcomes.
What Is a Charge Nurse?
A charge nurse oversees a hospital unit or department. They are the point of contact for nursing staff, physicians, and hospital administration. Along with patient care duties, the charge nurse directs staff members and ensures routines and processes are running smoothly.
Charge nurses plan procedures and patient care that are to be performed during the shift. At the start of a shift, the charge nurse distributes the workload so that staff resources are used most efficiently. This includes considering each individual nurse's knowledge, skills, and abilities. The charge nurse also evaluates patient outcomes during their shift.
The charge nurse is responsible for:
Those interested in the charge nurse role must hold registered nurse (RN) licensure in the state where they practice and have at least three years of hands-on clinical experience. Charge nurses must be able to multitask and stay calm under pressure.
Featured Online MSN Programs
Top 7 Traits of an Effective Charge Nurse
The charge nurse role requires diligence, patience, and skill. While the following seven traits are important to many leadership positions, they are essential for nurses who care for and protect vulnerable patients.
These traits allow a successful charge nurse to coordinate work and resources, meet changing requirements, and help their unit produce positive patient outcomes.
1. Delegation
A charge nurse must understand staff members' skills, abilities, and knowledge to appropriately delegate tasks and procedures. The American Nurses Association identifies the Five Rights of Delegation as:
Right Task: Does the activity fall within the person's job description and skill set? Right Circumstance: Is the patient stable to receive the delegated task? Right Person: Does the person delegated to perform the task hold the right knowledge and skills? Right Directions: Has the charge nurse communicated the correct directions for accomplishing the task? Right Supervision and Evaluation: Is the delegated task monitored and evaluated after completion?
2. Leadership
Leadership encompasses a variety of unique qualities, and a mindful charge nurse recognizes the difference between leading and managing. A leader helps people work toward a goal through:
- Integrity
- Self-awareness
- Learning agility/adaptability
- Empathy
- Courage
- Respect
- Gratitude
- Influence
Using these traits, a charge nurse unites staff members striving for successful patient outcomes.
Charge nurses also encourage professional growth and development among nurses in their unit. A good charge nurse 'knows what to do when they don't know what to do' (learning agility) and treats others with respect. These qualities can strengthen positive relationships throughout the unit.
3. Flexibility
A nurse's workday is unpredictable. Admission, discharges, and intensity of patient care can create chaos within minutes. A strong charge nurse is flexible in distributing resources as the unit's patient population changes. The charge nurse must adapt to new circumstances and navigate or overcome obstacles; they must make the right call without relying on others.
Flexible charge nurses maintain stability in the unit and treat nurses as individuals, accommodating different work styles. Charge nurses also offer feedback when needed or provide more support as necessary.
4. Self-confidence
Every new charge nurse has moments of self-doubt, but they must have the confidence to step out and learn new skills. This may include soft skills for nurses like the ability to motivate others or strong communication. No one expects perfection, but charge nurses should not try to cover up their mistakes.
Remember that the charge nurse role is about leading a group of highly educated, motivated individuals. Self-confident charge nurses are excited when other nurses come up with great ideas. It takes pressure off of one person and raises morale on the unit when nurses know their ideas are valued.
5. Critical Thinker
A critical thinker can apply their knowledge in changing circumstances, "thinking outside the box" to solve problems and evaluate situations. In healthcare, this can mean the difference between life and death.
For example, if a patient's behavior suddenly changes, it's important to determine if they are reacting to something in their personal life, dealing with a fluid imbalance, having a medication interaction, or suffering from an infection. An effective charge nurse uses critical thinking to quickly assess and decide if immediate action must be taken to protect the patient's health.
6. Organization
A hospital unit is often busy as patient care requirements can rapidly change. If a charge nurse relies solely on their clinical skills, it could result in chaos and poor patient outcomes.
Charge nurses can't change the number of hours on the unit, but they can manage how those hours are spent. Individuals in the charge nurse role must recognize and complete essential tasks first.
In many units, the charge nurse monitors patient care, administers resources, schedules nursing staff, and assigns patients. Charge nurses identify problems and solve related issues. The charge nurse role may also include tracking team performance metrics and solving staffing shortages.
Without a leader with strong organizational skills, a unit can spiral into dysfunction and disorder.
7. Humility
Humility is a powerful trait. Nursing staff, patients, and management are more likely to engage with and take advice from a respectful charge nurse.
As a leader, the charge nurse must demonstrate humility as they collaborate with healthcare teams. A humble nursing professional shares their strengths in a result-oriented manner, without creating a platform to elevate their status.
Additionally, a charge nurse should have interpersonal awareness, or emotional intelligence, to deal with different personalities and interact outside of their comfort zone.
Do You Have What It Takes To Be a Charge Nurse?
Stepping into the charge nurse role is a defining moment in an RN's professional life. Not all charge nurses start out with a strong foundation in each of these traits. However, charge nurses must show the willingness to learn and seek out those who can teach them.
For those interested in pursuing this role, it's important to analyze strengths and weaknesses. An honest evaluation can help pinpoint the education, information, and training needed to develop stronger skills.
If a person struggles with organization, interpersonal skills, humility, or nurse burnout, it's time to work on those areas. Seek out peers, other charge nurses, and managers who exhibit effective leadership traits and ask if they are willing to be a mentor.
Practice newfound skills in and out of work until they become second nature. The charge nurse role can lead to advanced nursing positions or other opportunities to improve an individual's management abilities.
No matter the career path, the traits gained as a charge nurse can serve a person well throughout their professional life.
Frequently Asked Questions About Charge Nursing
What is the difference between a nurse and a charge nurse?
A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. Staff nurses assess their patients frequently and report any changes to the charge nurse.
A charge nurse oversees all of the nurses in the hospital unit and is responsible for other administrative duties.
How long does it take to become a charge nurse?
Becoming a charge nurse is often less about education and training and more about ambition, personality, gaining nursing experience, and performance. In general, charge nurses must have at least three years of experience as a staff nurse. Some specialty units require even more time.
Is being a charge nurse difficult?
A charge nurse's role is difficult and often complicated. They address problems that arise in their unit while juggling administrative tasks like scheduling, staffing, and monitoring patient care. Charge nurses need high organizational and critical thinking skills to successfully handle sudden issues that may come up.
How can you find a nurse mentor?
A mentor is an advisor and teacher who can guide an aspiring or new charge nurse. Individuals can find a mentor where they work or by networking with more experienced charge nurses. Those interested may also seek advice and support from online resources, or ask nurses in positions of leadership.
Related Resources
- Nurse Leadership Careers & Salary Outlook
- Best Online MSN in Nursing Leadership Programs
- Nurse Case Manager Career Overview
- Clinical Nurse Specialist (CNS) Career Guide