The role of charge nurse is critical for quality patient care, good outcomes, work-life quality for nursing staff and even organizational financial success.
Yet nurses often assume the role is based on clinical skills and may lack other skills that are important to the job. This can be the result of the limited formal training available for charge nurses.
Charge nursing is more complicated than people think. It’s an intellectual process that requires critical thinking, as well as emotional intelligence and social intelligence to deal with people, said Ruth Hansten, PhD, RN, FACHE, an author and healthcare consultant and a speaker for the Nurse.com continuing education course “Charge Nurse.”
“As the name implies, a charge nurse is in charge,” said Maureen Habel, MA, RN, a self-employed nurse writer and speaker for the Nurse.com course. “It’s a first-line supervisory position.”
These nurses are responsible for overseeing nurse teams in hospitals and many other settings — virtually any place where nurses deliver care.
“[The role is] everything from making sure there is appropriate staffing to take care of patients’ needs, solving problems, and dealing with family issues or some of the human resource issues that staff may have,” said Habel, who has held several nursing roles, including that of charge nurse, nurse administrator and nurse educator. “It’s a pretty broad job description.”
Clinical skills vs. leadership skills
Nurses often are promoted into a charge nurse role because they are good clinicians, but that’s not advisable, according to Habel. Good clinicians may be the very best nurses on the unit in terms of care, but it requires a different set of skills than being a supervisor or manager.
The assumption that a good clinician will make a good charge nurse can lead to learning by trial and error at best and legal and reimbursement problems or job loss at worst, Hansten said.
For instance, nurses who come into the job unprepared might not assign patients correctly, which can result in poor patient care or budgetary issues that land the charge nurse in hot water.
Charge nurses also have to understand each staff member’s scope of practice. If they don’t, staff might go beyond their scope of practice, for which the charge nurse can be held accountable, according to Hansten.
Nurses who are considering this role shouldn’t wait to get the job before they get the training, she said.
A good career move
Accepting a position as a charge nurse is a watershed move in a nurse’s career, according to Habel. It’s the difference between a role as a clinician for a particular set of patients and taking on more of a support role for optimizing nursing peers’ delivery of care.
“That’s a very different role and a big step,” Habel said.
Habel has worked with nurses who became charge nurses and remained so for their entire careers. “They like to solve problems, not just clinical and patient problems but they like the decision making and problem solving that the charge nurse role requires,” she said. “They become very good at that, and that’s where they’re happiest.”
It’s a positive career move for nurses wanting to become nurse managers or for those aspiring to be in nursing administration.
“Having that charge nurse experience would be the first step on that ladder,” Habel said.
Career-wise, a move to charge nursing is an ideal path for the nurse who wants to understand how the organization works and how to deal successfully with a larger group of patients, family members, providers and team members, Hasten said.
These nurses learn about organizational fiscal development and the importance of reimbursement, she said.
Having these skills helps
Besides problem-solving and critical thinking skills and a good clinical background, other important qualities for a charge nurse are curiosity and creativity, Habel said. And having a sense of humor always is important if a nurse wants to enjoy any job, she added.
With education, an understanding of the job and the right mentor or supervisor along the way, many nurses could have the opportunity to become charge nurses, Hansten said.
But before pursuing this role, nurses should be clear on what their strengths and weaknesses are and where they need improvement. “If a nurse has trouble handling his or her own assignments and has difficulty with prioritization, then I would recommend they work on that,” Hansten said. “If they have trouble with interpersonal skills, they should work on that, too.”