The study I chose is The Effectiveness of Charge Nurse Training on Leadership Style and Resiliency found in The Journal of Nursing Administration. The purpose of the research was to investigate whether a charge nurse training program would be an effective, evidence-based training modality to improve leadership style and resiliency. Before this study, no formal charge nurse training program was available for charge nurses within the healthcare system. Charge nurses play a critical role. They have a demanding and challenging job because of all the various expectations and responsibilities they have. Charge nurses not only ensure the safe delivery of patient care but also influence engagement and participation by staff. The demands of the charge nurse role adds stress to already demanding expectations. Charge nurses are rarely provided the necessary orientation and training when transitioning from the staff role to their leadership position. The study found that a charge nurse pilot training was an effective program that led to improved leadership style and resiliency. There is no formal charge nurse training program at my hospital. I plan on discussing this study with management and hope to implement this program at my hospital.
Attached is my Journal Club Research Article Critique form, PowerPoint presentation, and Fishbone diagram.
Journal Club Research Article Critique
This is a very important aspect of nursing. Charge nurses are vital for the organized functioning of the shift. If the nurses are not given proper training, it will be hard for them to provide adequate leadership to their staff. This can lead to poor patient outcomes, and disgruntled staff.
Hello “camorris6”. Thank you for reading my post. Yes, the success of a unit can be linked to the leadership of the charge nurse. A charge nurse is responsible for managing, supervising, and assisting the nursing staff, as well as providing administrative duties. A charge nurse should have strong clinical knowledge and skills, be able to direct nursing tasks and operations, and have strong communication skills. The charge nurse plans, coordinates, and evaluates nursing activities.
A good or bad charge nurse does effect the mood of the shift they are responsible. As a staff nurse, it is reassuring to know that your charge nurse is willing and able to help in any way they can. When patient scenarios become difficult, the outcome can be made or broke by the quality of the charge nurse and their response.
Hello Ditas,
I think this subject Charge Nurse Training Program is a very important one to research. I work on a busy birth center. We have 28 delivery room, 3 OR’s, triage area and antepartum just on the OB floor. The tower includes 2 floors of M/B, and a NICU. A nurse friend once compared the charge position to an air-traffic controller. It seems as though they are diverting disaster at all times and controlling constant movements of arrivals and departures. The article “Leadership training for charge nurses.” Nurse Leader Insider, January 2, 2020 says that “leadership training is an essential component to training a charge nurse.” They suggest developing a leadership training course that would at a minimum include (1) leadership, (2) team building, (3) conflict resolution, (4) communication, and (5) developing talent.
I do not charge. I’ve been nursing for 36 years and charge is not for me. I do however very much like a strong charge and I have lots of respect for them. I try really hard to not complain and support them as best I can. If I feel unsafe I will say something but for me that is very very rare. I feel like if you go the extra mile for them and they in turn appreciate it and will go the extra mile for your. Sometimes circumstances are just not pretty to put it mildly. I feel like charge tries to make it “pretty” but is not always possible.
Hello Ditas,
I think this subject Charge Nurse Training Program is a very important one to research. I work on a busy birth center. We have 28 delivery room, 3 OR’s, triage area, and antepartum just on the OB floor. The tower includes 2 floors of M/B, and a NICU. A nurse friend once compared the charge position to an air-traffic controller. It seems as though they are diverting disaster at all times and controlling constant movements of arrivals and departures. The article “Leadership training for charge nurses.” Nurse Leader Insider, January 2, 2020 says that “leadership training is an essential component to training a charge nurse.” They suggest developing a leadership training course that would at a minimum include (1) leadership, (2) team building, (3) conflict resolution, (4) communication, and (5) developing talent.
I do not charge. I’ve been nursing for 36 years and charge is not for me. I do however very much like a strong charge and I have lots of respect for them. I try really hard to not complain and support them as best I can. If I feel unsafe I will say something but for me that is very very rare. I feel like if you go the extra mile for them and they in turn appreciate it and will go the extra mile for your. Sometimes circumstances are just not pretty to put it mildly.
At SMMC we have several charges. We have a week-end charge. We do 3 12 hour shifts so that requires at 2 other charges throughout the week and then we have relief charge. I don’t know that they always follow this exactly but the position of charge is posted. Anyone interested applies. The interested person had to go through HR and do “mental health assessment”. Then there is an open meeting that all staff can go to and ask questions of the candidates- one at a time. Finally, the management leaders pick. I spoke with one of those charges for this blog response to see how she thought the process went as she transitioned from staff RN to charge. The hiring process was as I just explained. She got 3 shifts following experienced charge nurse but did not have access to the scheduling process at this time. She said she had to figure that out on her own but did have a notebook that one of the other charge nurses had done on her own-nothing formal. This particular charge did feel like having an orientation plan/process would have been beneficial.
Thanks for sharing,
Loretta Gayle Bergman
Hello Loretta. I like your air-traffic controller comparison. It is a very accurate analogy. A leadership training course with those components are very promising. Conflict resolution is a problem currently at my hospital. Team building would help resolve some of the issues. I will definitely look into that article.
I have learned a lot from peer postings on their facilities about their charge nurse training program. At least your facility provides 3 shifts to shadow an experienced charge nurse. It may not be enough to overcome the learning curve. A charge nurse must be able to coordinate nursing activities, be aware of the legal aspects of nursing, be aware of the policies and procedures of the organization, solve problems or avoid potential ones, have strong clinical teaching experience, have strong communication skills, and ensure that all equipment are functioning properly and that the environment is safe for patients and staff. I can see why you would not want to be charge nurse. Charge nurses have a lot of responsibilities. With 36 years of experience, I’m sure that you would be a great charge nurse. Thank you for reading my post and sharing your outlook.
I have my reservations on the effectiveness of the charge nurse training. Many nurses I work with remain poor in leadership, delegation, and teamwork despite several years of annual training, which may be a result of other factors- intrinsic or extrinsic that affect learning and application of lessons learned.
At my facility, the charge nurse training is compulsory for all nurses because the situation could warrant any staff present to be in charge; this comes with extra percentage pay. In learning, extrinsic motivation is doing something to gain a reward or avoid adverse outcomes. As noted by Silva (2020), studies show that the results of extrinsic motivation are weak, short-lived and can be detrimental in the long run. Individual intrinsic factors also play a role. Note that external factors are not always unfavorable.
Reference
Silva, V. (2020, January 3). Intrinsic and extrinsic motivation: How they affect students’ grades. Retrieved February 25, 2020, from https://www.builtbyme.com/intrinsic-and-extrinsic-motivation-affect-grades/
Hello “cowolawi”. I am learning a lot from other peers about their charge nurse training program. Your organization requires annual training, which seems very plausible and a good idea. Unfortunately for you, this training has not improved the effectiveness and leadership of those charge nurses. Floor staff are often evaluated in their job performance. Thus, it would only make sense that there should be an evaluation of management as well including charge nurses. An evaluation of their leadership, communication, organizational abilities, disciplining style, and patient advocacy should at minimum be included. Thank you for your insight and reading my post.
The charge nurse plays a vital role in the management of the unit. At the hospital I work at, the charge nurses are required to take a class called Charge Nurse Series – which is split into four classes. During this meeting they discuss a book called The Charge Nurse’s Guide to Leadership. I think this is a great requirement to prepare nurses for a leadership position.
“Charge nurses must generally possess excellent skills in communication, organization and leadership. They must also be competent in making quick decisions, evaluating the quality of patient care, resolving conflicts and anticipating problems before they arise” (Berstein, 2017).
My reference was:
Bernstein, R. (2017, August 23). Leadership in Nursing: Becoming a Charge Nurse. Retrieved from http://blog.diversitynursing.com/blog/leadership-in-nursing-becoming-a-charge-nurse
Hello “cdgabel”. This is a great idea to have a Charge Nurse Series class. Including a reading material is another wonderful tool to implement. I have learned a lot about various programs that other organizations use to train their charge nurses. Charge nurses wear many hats including collaborating with administrators and relaying changes in protocol to the nursing staff, in addition to evaluating nursing staff performance and dealing with unsatisfactory behavior. An ineffective leader on the unit could lead to disorganization and inefficiency leading to poor patient experiences and poor nursing care. Thank you for reading my post and sharing your perspective.
I am so interested in this subject. The turnover rate on my unit is over 80% and I was put in charge three months after graduating nursing school. I always wondered why no one trained me or why there wasn’t anything formal. Then I thought about the pros and cons, I don’t know how much money it would cost and whether the company would want to spend it. I did look up a different article and found that in a different study a major positive impact of formal training for charge nurses correlated with increasing HCAHPS! (Nursing Management, 2016) I know every nurse goes home worrying about those scores! Now to be serious, I know that better HCAHPS mean better things for patients and the company and I don’t see any harm in doing some type of formal training for charge nurses, because they do carry responsibility and some methods and techniques for interacting with staff, management and patients would be beneficial. According to your journal article this is an effective way to produce positive outcomes for charges as leaders. On my unit the fighting over position to be charge nurse has now turned into a disaster, so I am going to take your information directly to my manager on Monday morning.
Reference:
Teran, N. (2016, November). The positive impact of Formalized charge nurse training : Nursing Management. Retrieved February 28, 2020, from https://journals.lww.com/nursingmanagement/Citation/2016/11000/The_positive_impact_of_formalized_charge_nurse.11.aspx
Hello “cmatthews3”. Wow, 80% turnover rate is extremely high. And you became charge nurse after only 3 months from graduating nursing school! I do not believe that there would be any harm in a formal training program for charge nurses. There may be a financial set back for the organization because of the training involved but the benefits outweigh the monetary loss. In addition to all the obvious responsibilities of a charge nurse, they also act as role models. They provide training and orientation for new nursing staff and are expected to assist and teach nurses under their supervision. More commonly, charge nurses deal with all the problem situations including difficult patients and families. They look into complaints and mediate any problems between nursing staff and patients. A formal training program is necessary for charge nurses to be a successful leader in their unit. Thank you for reading my post and good luck with implementing a program at your facility as well.
I agree with a previous poster who likened the charge nurse position to that of an air traffic controller! There is no formal charge training program at my hospital either. When I became trained for ICU charge, I followed one of the experienced charge nurses around for one 12 hour shift. I was then considered “trained.” Back then, only certain people were put in charge. Now, our new manager thinks every nurse is capable of being in charge. It is very scary when certain people are assigned. At this hospital, the charge nurse is responsible for staffing and admissions for three ICU units, goes to codes and rapids (there is no Swat nurse here), and assists his/her coworkers. The charge nurse is expected to be very knowledgeable on all types of patients, situations, and ICU “gadgets.” Since we are a teaching hospital, the charge nurse frequently needs to step in when one of the residents orders something for a patient that is inappropriate. Because we are experiencing higher than normal staff turnover, we are running out of nurses that are capable in the charge nurse position. Many of the nurses are new grads. I agree with the original poster that a formal charge nurse training program would be helpful. I also would like to add that people should not be forced into being charge when they are not comfortable in that role.