Epi 22: Charge Nurse

Epi 22: Charge Nurse

August 30, 2019 1 Comment


On today's episode, we will be talking about Charge nurses. We deal with them every day and some of you may be in a charge nurse position or thinking about becoming one. We are going to talk about the responsibilities of a charge nurse and some qualities of a good charge nurse.

Health News: Stem Cells What are they?

We've recently read an article about stem cells. It was about a 79-year-old lady with age-related macular degeneration (Central portion of the retina called the macula starts to deteriorate). She was part of a clinical study where an implanted a stem cell patch into her eyes and it worked, now she can even see better than her husband.

Stem cells are the body's raw materials — cells from which all other cells with specialized functions are generated. Under the right conditions in the body or a laboratory, stem cells divide to form more cells called daughter cells.

These daughter cells either become new stem cells (self-renewal) or become specialized cells (differentiation) with a more specific function, such as blood cells, brain cells, heart muscle cells or bone cells ex. Osteocyte, myocyte, cardiomyocytes. No other cell in the body has the natural ability to generate new cell types.

Where do stem cells come from?

Researchers have discovered several sources of stem cells:

Embryonic stem cells. These stem cells come from embryos that are three to five days old. At this stage, an embryo is called a blastocyst and has about 150 cells.

These are pluripotent (ploo-RIP-uh-tunt) stem cells, meaning they can divide into more stem cells or can become any type of cell in the body. This versatility allows embryonic stem cells to be used to regenerate or repair diseased tissue and organs.

Adult stem cells. These stem cells are found in small numbers in most adult tissues, such as bone marrow or fat. Compared with embryonic stem cells, adult stem cells have a more limited ability to give rise to various cells of the body.

Until recently, researchers thought adult stem cells could create only similar types of cells. For instance, researchers thought that stem cells residing in the bone marrow could give rise only to blood cells.

However, emerging evidence suggests that adult stem cells may be able to create various types of cells. For instance, bone marrow stem cells may be able to create bone or heart muscle cells.

This research has led to early-stage clinical trials to test usefulness and safety in people. For example, adult stem cells are currently being tested in people with neurological or heart disease.

Adult cells altered to have properties of embryonic stem cells (induced pluripotent stem cells). Scientists have successfully transformed regular adult cells into stem cells using genetic reprogramming. By altering the genes in the adult cells, researchers can reprogram the cells to act similarly to embryonic stem cells.

This new technique may allow researchers to use reprogrammed cells instead of embryonic stem cells and prevent immune system rejection of the new stem cells. However, scientists don't yet know whether using altered adult cells will cause adverse effects in humans.

Researchers have been able to take regular connective tissue cells and reprogram them to become functional heart cells. In studies, animals with heart failure that were injected with new heart cells experienced improved heart function and survival time.

Perinatal stem cells. Researchers have discovered stem cells in amniotic fluid as well as umbilical cord blood. These stem cells also have the ability to change into specialized cells.

Amniotic fluid fills the sac that surrounds and protects a developing fetus in the uterus. Researchers have identified stem cells in samples of amniotic fluid drawn from pregnant women to test for abnormalities — a procedure called amniocentesis.

More study of amniotic fluid stem cells is needed to understand their potential.

The Charge Nurse

Leadership development is an oft-overlooked issue in nursing, so it's no surprise that charge nurses rarely receive the training they need. Many organizations promote nurses into the charge position simply because they are good nurses and no one else wants to do it. But the charge nurse is crucial to the smooth operation of a patient care unit.

Charge nurses fill a unique role. As caretakers, supervisors, liaisons, and point people, these professionals balance the responsibility found in managerial roles with the medical competencies of registered nurses. For those considering a career in this exciting field, here are some useful tips.

Also known as “lead” nurses or “unit supervisors,” charge nurses are frontline managers on the nursing floor. They work in any number of healthcare settings, including hospitals, clinics, and long-term care facilities. The position itself is flexible; charge nurses may serve in temporary or permanent roles.

Specific responsibilities may include some or all of the following:

  • Provide nursing care expected of a standard nurse, including patient assessment, administering medications and treatments, maintaining files and charts, and more
  • Oversee other nurses and mentor them when necessary
  • Monitor staffing needs
  • Create work schedules and assign patients to nursing staff
  • Serve as liaison among nurses, physicians, patients and families, management and other parties
  • Conduct performance evaluations and job interviews
  • Delegate tasks and coordinate patient care
  • Monitor and order medical supplies, medicine and other items
  • Provide daily and intermittent reports
  • Ensure compliance with policies, procedures, and laws; keep up-to-date with policy changes
  • Discipline nursing staff when necessary
  • Oversee patient admissions, discharges, and transfers
  • Assist other nurses in handling challenging patients
  • Investigate patient complaints
  • Sign off on staffing paperwork including competency evaluations and staffing budgets
  • Maintain a safe environment for patient care

For some individuals, working as a charge nurse is a dedicated full-time job, but oftentimes the position is occupied by multiple staff nurses who take turns rotating into the role. Under such a scenario, however, nurses face a rather unique challenge; an individual may give orders one day as a charge nurse, and the next day that same individual might take orders as a staff nurse, from someone he or she managed the day before. In other words, sometimes nurses supervise their peers and their peers sometimes supervise them. Talk about an identity crisis!

What are the qualities of a good charge nurse?

Qualities Of A Good Charge Nurse

1. Assertiveness
    • Need to authoritatively ask for what you need. 
    • Delegation
    • Take charge of urgent situations. Be able to speak up and defend your position.
    2. Humility
      • Just because you are charged does not mean you will always be correct. You need to be able to learn from your mistakes.
      • A lot of facilities are rolling charges which means staff nurses take turns being a charge. You will have more experienced senior staff that you are a charge of and more often than not they'll have more knowledge. 
      • Just because you're charge does not mean you can’t rely on your staff to help you. If you don't know the answer it's completely ok to ask your peers.
      3. Arial perspective
        • You're not managing direct patient care. Your responsibility is with nurses and patients. You’re there for the nurses just as much as the patients. 
        • You have to have a visual of the whole unit. Is someone transferring? What Nurse is going to need some help? Admission? You're there for all 3. Pt going hypotensive and coughing pink frothy sputum? You're there. You help everyone you can plus your paperwork. 
        • Patient care and nursing supervision > paperwork
        4. Interpersonal Awareness
          • You're the negotiator and leader of conflict resolution.
          • Is the patient acting out then you need to go in there and help guide it to a peaceful resolution where the nurse and understand their responsibilities?
          • You are the one that should deal with families. If a family is in conflict with the nurse or the plan of care, then you should be the one leading conversation and satisfying all parties.
          • You should also be the one talking to the families after a code if they are present or if the nurse is busy.
          5. Critical Thinking
            • As the charge nurse, you’ll receive the first phone call, usually being a distraught nurse. If you're charge then it is expected you have a fair amount of experience under your belt, you'll need to think about what has happened with the patient and how to prevent it from going further. At one point or another, you'll be dictating a patient's care when they go on a decline.

            How to Become a Charge Nurse

            All charge nurses must be licensed RNs. They also require a significant background in their field (usually a minimum of three years of experience). Charge nurses earn their positions largely due to a combination of their job history, personality, ambition, and previous work performance. Because these factors are so indefinite, extra credentials may help interested candidates gain an edge in the hiring process, including earning a Bachelor of Science in Nursing (BSN).

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