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Three steps to ensure new charge nurses are successful


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Rebecca Hendren, for HealthLeaders Media, September 28th, 2010

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, and spending time on training and development can reap dividends in organizational efficiency.

At the basic level, charge nurses manage the operations of patient care units during a particular shift. They assign tasks, workloads, and oversee the care provided to patients. But they also provide support, mentorship, and guidance to bedside nurses. For those reasons, it’s important to train charge nurses so they are up to the job.

Tammy Berbarie is an accreditation coordinator at Baylor Jack and Jane Hamilton Heart and Vascular Hospital in Dallas, and a former director of education, who created a charge nurse orientation program for her hospital. Berbarie believes charge nurses are an organization’s untapped resource. She says these frontline leaders—the eyes and ears of the patient care operation—are vital to ensuring patient safety, quality, and satisfaction, and staff retention.

“I believe that most organizations are in an infant stage when it comes to developing their charge nurses,” says Berbarie. “It is important to develop a robust orientation program to give them the confidence to manage the patient units.”

Berbarie recommends organizations provide all charge nurses with an orientation program, which includes a preceptor and leadership development training.

1. Charge nurse orientation. To be effective, charge nurses must know their responsibilities. The best way to outline expectations and ensure competency is to spend time orienting them to their new role.

Orientation can be accomplished in a one day workshop or through a series of training sessions. This is the time to cover the charge nurse role, regulatory requirements, coordination and delivery of patient care, patient safety, quality improvement, and leadership topics.

2. Charge nurse preceptors. Following the workshop, new charge nurses should be assigned a preceptor. Preceptors are routine for newly hired nurses and it’s a technique that works well for any new role. Preceptors not only show new charge nurses the ropes, they also serve as mentors who can support them in their new role.

Berbarie advises the precepted time should last two- to three-weeks and that senior leadership should be active participants and strive to present the preceptees with as many experiences as possible.

3. Leadership development. The third part of the orientation program as a whole is the development of leadership skills. At a minimum, Berbarie says charge nurses should receive training on:

  •  Leadership
  •  Team building
  •  Conflict resolution
  •  Communication
  •  Developing talent

Organizations that do not invest in leadership skills for charge nurses will not get the most from them. The best charge nurses mesh administrative, clinical, and educational expertise with the ability to solve conflicts, reduce nurse-to-nurse hostility, improve communication, and ensure the unit is a collaborative, collegial place to work.