Observations

Becoming a Charge Nurse

Emerging as a Leader of the Pack (Even When It Is Not Your Thing)

if you become a nurse and do a decent job, you’ll soon find yourself promoted — often without even applying for a new position. In many cases, the change doesn’t include a pay increase, a bonus or even a box of gourmet donuts (I love those!), just a new title: charge nurse.

Some nurses relish the new title and added responsibility, but I never did. When I started on my journey to becoming a nurse, I expected that my patients would be my sole priority. Leadership and management weren’t part of the plan — or of my training as a nurse.

Moreover, on many occasions, the nurses I’ve been in charge of didn’t feel that anyone needed to manage them. Many were older than I, more confident than I or both. They saw no good reason they should defer to me. Sometimes, I didn’t either!  However, when management ordains you as charge nurse and puts that responsibility on your head, you have to sit up straight and get your act together or risk falling behind.

Protocols for Leadership

In leadership situations, as with so many other aspects of the nursing profession, having a clear set of established guidelines in place is essential, especially in unfamiliar, high-stress situations. Here are the rules I fall back on when I’m placed in charge of other healthcare professionals, whether they’re nurses, nurse aides, techs or medical assistants.

Be polite, but firm.

I believe in giving people the chance to do what they know they need to do. However, if they don’t eventually do their job, take care of patients and support the team, I will call them out and ask them to do it. I will do it politely; I will say “please” and “thank you”; but I will do it!

Take one for the team.

Occasionally, those I’m in charge of feel they absolutely must mouth off to me, prove I’m wrong about something (which sometimes I am) or insult me in some way. There are moments when I just let this slide. • Take one for the team. Occasionally, those I’m in charge of feel they absolutely must mouth off to me, prove I’m wrong about something (which sometimes I am) or insult me in some way. There are moments when I just let this slide.  I don’t always know the frame of mind someone may be in at that moment, but I can take a step back and offer them some latitude during a non-critical situation.

Nursing Education

Protect patients at all costs.

If I’m in a charge role, I strive for a balance between protecting my patients and remaining open and considerate to staff. However, negative patient outcomes are unacceptable, as is losing my license over a problem I could have prevented.  If something is unfolding (or about to unfold) that could negatively affect patients or patient outcomes, then I show my horns, even if it risks making the people I lead unhappy with me.

Call for help when you need it.

As a charge nurse, I’m expected to be able to handle a certain amount of chaos and pushback. However, if there’s an issue that can’t be resolved through the above steps, then it’s time for me to contact my leadership for help.

Following these guidelines might not make you love being a charge nurse, but it will help to get you through. In time, you may even add some guidelines of your own to the list.


Nancy Congleton, RN, is a registered nurse and author of Autopsy of the NP: Dissecting the Nursing Profession Piece by Piece, released in August 2018. Learn more at www.nursenancyrn.com.


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