1. The Charge Nurse Role in Today’s Environment Elizabeth A. Bayere, BSN, RN

2. Introduction   Charge nurses are registered nurses who are responsible for the operations of the nursing unit over a specific time period. The charge nurse must have a strong foundation of clinical knowledge and skills on which to base judgments and make decisions, organizing abilities to direct nursing tasks and operations, and interpersonal skills to facilitate communication and the work of others (ONA, 2016).

3. Overview   Charge nurses are unrecognized heroes in today’s health-care environment. Their nursing leadership is right at the point of care and critical to better patient outcomes (Sherman, 2015).   The charge nurse is the constant in the center of all activities, as his or her role is to oversee the efficient functioning of the department. He or she has a responsibility to the nursing staff to ensure available resources in order to provide safe patient care (Hughes & Kring, 2005).   Charge nurses are recognized for their communication and organizational skills, as well as their ability to delegate, think critically, troubleshoot, and remain proactive. Experts indicate that behaviors the charge nurse may use to gain trust, foster cooperation, and promote job satisfaction include fairness, consistency, support, recognizing individuals for their efforts, and checking with them during their shift (Hughes & Kring, 2005).

4. Review of Literature   In review of studies, Connelly, Miner-Williams, and Yonder (2003) conducted a qualitative study on charge nurse competencies involving 42 nurses signifying all levels of nursing leaders. Fifty-four specific competencies were identified and grouped into the four categories of clinical, critical thinking, organizational, and human relations skills. The study led to the development of a successful charge nurse workshop that was tailored to the needs of the organization (Connelly, Miner-Williams, & Yonder, 2003).   According to Eggenberger (2012), the charge nurse role has become influential in accomplishing safe and effective outcomes. The role remains poorly defined with little focus on charge nurse development. This qualitative study used a descriptive exploratory method. Semi structured interviews were conducted with 20 charge nurses from 4 acute-care facilities. Eight themes emerged to describe the experience of being a charge nurse in acute-care practice. Findings can be used by nursing executives to emphasize the importance of this role to the organization and support leadership development at the charge nurse level (Eggenberger, 2012).

5. Few Roles of Charge Nurse   Charge nurse has accountability to the organization, staff and patients for the care that is delivered.   Charge nurse interacts with physicians related to patient care issues, interfacing with support departments and facilities management to ensure patients have the needed supplies, medications and an atmosphere conducive to healing.   Charge nurse sets expectations for staff and provides support so that staff can carry out those expectations.

6. Charge Nurse Roles Contd.   Evaluating: On an ongoing basis, the charge nurse evaluates individual and collective outcomes of the patient care provided during the shift, compares patient care delivery to accepted standards, adjusts assignment of resources as necessary, and reports changing needs and outcomes to the health care staff.

7. Implications for Nurse Leaders   There is increasing indication in the nursing literature concerning the positive impact of strong work environments on staff satisfaction, retention, improved patient outcomes, and organizational performance. The formation of a strong work environment involves strong nursing leadership at all levels of the organization, but especially at the point of care or unit level where most front line staff work and patient care is provided (Pross & Sherman, 2010).

8. Most Challenging Role   The frequent changes in regulatory requirements related to patient safety, pay for performance indicators, technology, and organizational expectations, charge nurses reported difficulty staying current with policies and processes. There are no problems…. just insurmountable

9. Conclusion   The key to effective survival among the charge nurses is the ability to be flexible with therapeutic communication skills and the ability to negotiate and resolve disagreements. To become an effective leader in today’s healthcare society and within the nursing profession, it is essential to advance current leadership skills that improve patient satisfaction and outcomes, while supporting a healthy work environment (Kiger, Schwarzkopf, & Sherman, 2013).

10. References  Connelly, L., Miner-Williams, D., & Yonder, L. (2003). A qualitative study of charge nurse competencies. MedSurge Nursing, 298-305.  Eggenberger, T. (2012). Exploring the Charge Nurse Role: Holding the Frontline. JONA, 502-506.  Hughes, C., & Kring, D. (2005). Consistent Charge Nurses Improve Team Work. Nursing Management, 16.  Kiger, A., Schwarzkopf, R., & Sherman, R. (2013). What we learned from our Charge Nurses. Nurse Leader, 34-39.  ONA. (2016, August 29). The Role of the Registered Nurse as Charge Nurse. Retrieved from ONA: http://www.ohnurses.org/role-registered-nurse-charge- nurse/  Pross, E., & Sherman, R. (2010, January 10). Growing Future Nurse Leaders to Build and Sustain Healthy Work Environments at the Unit Level. Retrieved from ANA: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPerio dicals/OJIN/TableofContents/Vol152010/No1Jan2010/Growing-Nurse- Leaders.html  Sherman, R. (2015). The Charge Nurse as Team Leader. EmergingLeader, 2.

11. ??? QUESTIONS ???