Day in the life of
Charge Nurse – Sandra Crawley, RN, BSN
Currently, I am a Primary Charge Nurse on a Family Birthing unit in a level II hospital. We are a smaller hospital (total of 97 patient beds), so our birthing unit actually encompasses seven units into one. We cover any woman who is pregnant, from triaging, long-term stays, labor/delivery, OR and recovery, postpartum, and nursery. Recently, we have also been caring for gynecological surgery patients also.
In our hospital, most RNs work 12-hour shifts. Specifically, our unit runs two shifts from 7 am to 7 pm and 7 pm to 7 am. As a charge nurse, I am required to clock in a half hour before my shift to get a report from the outgoing charge and make and log patient assignments. When the staff arrives, I am responsible for giving them a shift report, answering any questions, and sometimes adjusting assignments.
Primary charge nurses try to be “non-working” nurses. That means we try not to take a patient load because we are responsible for many different audits. For example, some audits are required by the hospital, such as chart audits, while others are required by the state. As a labor and delivery unit, the amount of data collected for state and national reports is far greater than the other units in the hospital.
Charge nurses have to be available to help staff.. Sometimes a second set of eyes or hands, or in our unit fingers, are needed. It is not uncommon to recheck a patient as they progress through labor, or help a staff member boost a patient up who has an epidural. We also are ready to “catch” babies during a delivery, meaning we act as the nursery staff and make sure the baby is healthy and stable, admitting them and calling the physicians.
There are some difficulties with this job, however. Charge nurses are responsible for pushing issues up the chain of command. You have to be able to work with other supervisors and still fight for your nurses. This can sometimes be a hard place to be. Also, it is up to the charge nurse to make sure the difficult calls to other agencies are being done, or making those hard calls yourself.
Nursing requires never-ending education, however, in the charge position, you will not only keep up with the educational requirements of your license, but also a multitude of meetings, projects, and initiatives. Sometimes you can get lucky and these are scheduled on your day to work, but a lot more often these are scheduled on your off day, so you either need to call in, or go into work.
One of the pros of being a charge nurse is that you are there to support and encourage your staff. Everyone has off days, hard days, or days you are learning something new. Charge nurses are your shoulder to lean on, your ear to vent or troubleshoot to, and your biggest cheerleader when you need them. We are learning how to balance multiple tasks throughout our day, from patient care to being in a position of leadership, with all those responsibilities.
Since our hospital is smaller, the number of specially trained OB staff is also smaller, so sometimes we as charge nurses do take full patient loads. While we try to keep our patient loads smaller, there are times when we take on more to relieve some of the pressure off of the floor nurses. These days are sometimes difficult, because of our other duties, but are also rewarding because we are working at bedside again. We are doing what we trained for years to do.. These days help reignite the passion for our career and remind us why we became nurses to begin with.
assess patient health problems and needs, develop and implement nursing care plans, and maintain medical records. Administer nursing care to ill, injured, convalescent, or disabled patients. May advise patients on health maintenance and disease prevention or provide case management. Licensing or registration required.