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Helping Charge Nurses understand their leadership role (Part 1 of 3)


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Editor's note: This is Part 1 in a three part series discussing the importance of charge nurses' knowledge and understanding of their leadership role in their organization.

By Lisette M. Cintron, RN, MSN, CHCQM, CNL, clinical nurse educator

As the amount of patients admitted to hospitals every day increases, it becomes more pressing to ensure front-line leaders—charge nurses—are well aware of their role, responsibility, accountability, and authority.

It is the role of the charge nurse that is the key to providing leadership at the point of care, retention and turnover of staff, ensuring safe and effective practice occurs, and enhancing the patient/family experience by ensuring excellent quality care.

Most charge nurses, when asked about their role, responsibility, accountability, and authority (RAA) within their particular organization, felt confident about three of the four areas.

The charge nurses could state some aspects of what their role and responsibilities are, as well as their accountability. However, they were hesitant to answer what they felt their authority as a charge nurse is.

Despite the fact that the charge nurses received a copy of the job description, they were never formally told what their authority is, let alone receive any formal training on the matter.

This matter brings to the forefront the imperative need for formal charge nurse and leadership training.

After observing the varied levels of charge nurse experience, expertise, and inconsistencies throughout the organization, it was clear there was a need to bring the charge nurses together in a workshop setting.

Workshop beginnings

In this setting, each one can receive the necessary knowledge and tools to better help them in their role as a charge nurse.

To begin developing the workshop, the organization’s leadership team met to discuss the identified concerns and ultimately agree upon the education and training topics.

Discussion on other topics the leadership team deemed in need of improvement and training took place. The leadership team agreed that communication, delegation, mentoring, role modeling, and teamwork were important to include in the education and training workshop for charge nurses.

However, these topics will come after the role and RAA sections and in the same order discussed, as the flow allows for the dialogue that will ensue.

The best way for charge nurses to benefit from the workshop is to take them off campus, and give them a full eight and a half hour day of evidence-based facts pertaining to the topics agreed upon by the leadership committee.

The workshop will also include interactive activities that deal with their fears as a charge nurse, delegation, teamwork, and self-assessments of their communication and conflict management styles.

The decision that the best approach in providing the necessary tools to the charge nurses was to begin with the evidence out in the literature:

  • What the role of the charge nurse is
  • Their RAA demands

The leadership team also wants to allow for the other topics of communication, delegation, conflict management, mentoring, role modeling, and teamwork to flow throughout the discussion. Prior to beginning the discussion on the role and RAA, the charge nurses must answer questions and provide feedback on the topics available in the literature.

Once the discussions have concluded, the leadership team reveals an illustration of the evidence.

It is surprisingly interesting to see that the feedback matches closely with what is out in the literature and confirms to the charge nurses that they are not as "out in the dark" as they think.

Editor's note: Be sure to check back on Thursday for Part 2 of the article.