Following at the same time planning on

Following the Charge Nurse

              Charge nurses oversee and support the nursing staff, at the same time
also care for a limited number of patients. They are responsible for evaluating
other nurses and acting as an educational resource and as well as accountable
for maintaining a high level of patient care. Charge nurses are often experienced registered nurses who not
only display leadership, communication skills and management but also are
responsible for providing administrative support and patient care. Some of the
daily routine responsibilities and actions of the charge nurses include
directing the admissions of the patient and at the same time planning on discharge
treatment and goals. They are in charge of making work schedules and assigning
patients to appropriate staff nurses while prioritizing and being flexible in
cases of emergency.

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Roles and Responsibility of Charge

                Charge nurses work together with
physicians to correlate with patient care concern, interfacing with support
departments and aid management to ensure patients have the required supplies
such as medications and have supportive environment which contributes to the
healing process. Charge nurses must also be familiar with the facility or institutional policies and procedures in order to
steer through what is often a very intricate system
and answer questions regarding protocol. They often take into account Nurse Practice Act and Standards of
Practice when in query of safety and procedures.

 Charge nurses develop and implement training
courses and arrange seminars to aid in educating and training new nurses and
staff. As shift supervisors, charge nurses also document the performance of
nurses, perform evaluations and counsel nurses on unsatisfactory performance.
They also are involved in administrative issues, address and solve problems
among staff. The charge nurses often support with the orientation, training and professional growth of
staff.  They play a crucial role in the competency assessment development
and ensure that the team works as one successfully.

or Situational Resolution

 A conflict-free workplace would be a great place. 
However, it’s just not possible to avoid conflict completely especially in high
stress healthcare environments.  The essential of effectively managing
team conflict should be framed in terms of a patient safety
issue.  An example of conflict that could occur between nurses is
when it comes to prioritizing tasks. Nurses often clash over where to place
attention or what is most important. Another example is work overload due to
staffing shortages. Nurses get exhausted and the patient care quality could be
greatly reduced. In order to reduce most types of conflicts, the charge nurse
must bring the individual together to discuss the problem. Also keep the lines
of communication open and respect difference in attitude, values and behaviors.

Nurse to Patient Ratio

                The staff to patient ratio at the facility I
followed the charge nurse was initially 1:55,
that is 1 nurse to 55 patients on PM shift. Later on it was changed to 1:30 as
previously there were only 2 nurses but now it has been changed to 3 nurses per
shift. The assignment was determined upon the staff
nurses’ employment status. If the nurse is a full time employee, she or he will
be assigned to a permanent team but if the nurse is per diem or part timer than
they would be considered a floater. Assignments were modified when there was
shortage of staff by basically dividing the patients of the absent nurse
amongst the other 2 nurses present who then had increased work load which often
lead to exhaustion, frustration and ultimately low productivity. Critical
factors that should be taken into account when deciding  appropriate staffing is the number of
patients, physical environment, level of training and experience of healthcare
professionals providing care. Together with that, analysis of individual
patient needs including physical and psychosocial should be taken into
consideration as well. When floating between units, there should be an
efficient plan for cross-training to ensure competency and patient safety.

Unexpected or Assignment Modification

                 Most of the time unexpected change in
patients conditions and patient family issues were dealt by the charge nurse. While
following chain of command if the issue is not resolved by the charge nurse
than it is passed along the line to the director of health services and
eventually to the facilities administrator. Critical thinking in
nursing involves more than good problem-solving strategies. Consciously it is
developed to improve patient outcomes. Critical thinking by the nurse is determined
by the needs of the patient and family. Critical thinking in nursing is
undergirded by the principles and ethics of the profession. Nurses who think
critically seek to build on patients’ strengths while honoring patients’ values
and beliefs. An example of critical thinking by the nurse would be asking a patient what pain relief methods,
pharmacological and non-pharmacological, have worked in the past to provide a
better care. It’s mainly stopping, looking at a situation, recognizing a
solution and testing it out. 

Personal Insight

                  Charge nurses are important
in providing the quality patient care, promoting the profession of nursing, contributing
as an agent for change, and maintaining evidence-based practice. If I was a
charge nurse one thing that I would like my staff to possess is being trust
worthy.  Building trust with others and
developing effective communications is important part of this role. Staffs
mostly look up to their leaders for guidance, support and motivation, so in
order to have a successful team the charge nurses need to be mindful of their
actions. I believe the toughest part of being a charge nurse might be taking
accountability of the staffs. If the charge nurse has a trusting relationship
with their staff , there would be no need to micro manage and this will create
less tension in work place in the sense staffs will have freedom and work flow
will be efficient. Some keys factors to successful work environment includes
good communication, appropriate staffing, meaningful recognition, teamwork and
of course most importantly a dependable leader. The skills and knowledge necessary
for these roles is extensive and can be intense to be efficient. Dedication of
individuals in charge nurse roles has a major impact on all of those around
them, as they are vital to the provision of healthcare.