DiversityNursing Blog

Leadership in Nursing: Becoming a Charge Nurse

Posted by Rebecca Bernstein

Wed, Aug 23, 2017 @ 12:43 PM

Steps-to-Becoming-a-Charge-Nurse-Husson-University.png“Example is not the main thing in influencing others. It is the only thing.”

-Albert Schweitzer

Charge nurses fill a unique role. As caretakers, supervisors, liaisons and point people, these professionals balance the responsibility found in managerial roles with the medical competencies of registered nurses. For those considering a career in this exciting field, here are some useful tips.

Role of a Charge Nurse

Also known as “lead” nurses or “unit supervisors,” charge nurses are frontline managers on the nursing floor. They work in any number of healthcare settings, including hospitals, clinics and long-term care facilities. The position itself is flexible; charge nurses may serve in temporary or permanent roles, depending on the needs of the facility.

Specific responsibilities may include some or all of the following:

· Provide nursing care expected of a standard nurse, including patient assessment, administering medications and treatments, maintaining files and charts, and more

· Oversee other nurses and mentor them when necessary

· Monitor staffing needs

· Create work schedules and assign patients to nursing staff

· Serve as liaison among nurses, physicians, patients and families, management and other parties

· Conduct performance evaluations and job interviews

· Delegate tasks and coordinate patient care

· Monitor and order medical supplies, medicine and other items

· Provide daily and intermittent reports

· Ensure compliance with policies, procedures and laws; keep up-to-date with policy changes

· Discipline nursing staff when necessary

· Oversee patient admissions, discharges and transfers

· Assist other nurses in handling challenging patients

· Investigate patient complaints

· Sign off on staffing paperwork including competency evaluations and staffing budgets

· Maintain a safe environment for patient care

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. Charge nurses are hired as much for personal aptitudes (such as the willingness to solve problems) as they are for their medical expertise. They must demonstrate a great deal of ambition, professionalism and awareness of the larger picture at all times.

How to Become a Charge Nurse

All charge nurses must be licensed RNs. They also require a significant background in their field (usually a minimum of three years of experience). Charge nurses earn their positions largely due to a combination of their job history, personality, ambition and previous work performance. Because these factors are so indefinite, extra credentials may help interested candidates gain an edge in the hiring process, including earning a Bachelor of Science in Nursing (BSN).

According to PayScale, the median salary of charge nurses is $68,911 annually. The role can also be a stepping-stone for additional study and more advanced positions of leadership. Some job titles may include:

· Nursing Director ($90,712 median salary)

· Advanced Practice Registered Nurse ($91,099 median salary)

· Chief Nursing Officer ($123,702 median salary)

The role of a charge nurse is indeed complex. But for those with the interest in becoming exceptional leaders within the nursing field, the position can be a perfect fit.

Additional Sources: Society of Human Resource Management, Advance Healthcare Network

Your Nursing Leadership Future

Nursing has been called “the finest art,” and nowhere is that illustrated better than in the profession’s requirements for management. For those seeking to advance their nursing career, the online RN-to-BSN program at Husson University can train them in a practical curriculum designed to help them succeed. Created for working professionals, the program can be completed in as little as one year.

Topics: nurse leadership, charge nurse

Hospital Impact: Nurse Leadership's Role In Reducing Burnout

Posted by Erica Bettencourt

Thu, Apr 20, 2017 @ 02:52 PM

Nurse-Burn-Out-H-Logo-01-web.pngIn order to provide top quality care to their patients, Nurses must be focused and alert. Burnout in Nurses is worrisome because common side effects are forgetfulness, impaired concentration, anxiety, and depression. As a Nurse leader you want to make sure patient's lives are in good hands and the Nurses are well. 
 
Continue reading below to learn what stressors cause burnout in Nurses and what you can do as a Nurse leader to prevent burnout from happening. 

The problem of nursing burnout has been in a state of evolution for years. For many of these years, the 12-hour shift was the primary focus. However, 12-hour shifts provide nurses time away from the bedside necessary for rest, family time and self-care, allowing for a rested and refreshed start to new shifts.

Several stressors lead to high levels of pressure and nurse burnout. These include:

  • High patient acuity (years ago, these patients would have been in the ICU)
  • High nurse-to-patient ratios (not acuity-based)
  • Multiple discharges and admissions (many nurses will discharge and admit an entire team of patients during their shift)
  • Lack of ancillary support and resources
  • Leaders who assume that nurses “can take one more patient”
  • Physicians who expect nurses to drop everything and attend to their needs
  • Interruptions while on their break
  • The expectation that nurses are all-giving.

However, the most important stressor includes an old mindset held by organizational and nursing leadership: Nurses who voice concerns related to patient safety and workload are viewed as complainers. As nursing leaders, we must recognize the demands placed on our nurses, validate their concerns, and through best practices and common sense, use our leadership to provide support.

The most important skill of a nursing leader is the ability to listen to nurses. The nursing leader must be engaged in the discussions and have a physical presence in the department. Engaging with nurses allows for an open dialogue and a discussion of ideas, and provides validation.

Validation, in turn, lowers nurses’ stress levels because they know they are being heard. Open dialogue provides the nursing leader a forum to foster best practices, find workable solutions for departmental issues, and teach leadership skills through mentoring sessions.

Nursing leaders must hold nurses accountable who are not carrying their load. Modifications in behavior by the nurse will indicate action and support from the nursing leader. In addition, nursing leaders must know, understand and demonstrate a deep caring for their nurses. This is why having a presence on the unit is so important. Actions always speak louder than words, and we must model healthy, professional and supportive behaviors for our nurses.

Staff meetings can be of great benefit and should include discussions regarding new organizational policies, processes and outcomes from higher leadership meetings. One way to engage nursing input in staff meetings is to post an agenda and ask for additional items the nurses would like to discuss or present. Allowing nurses to create ideas, and to volunteer according to their interests and passions, fosters a sense of belonging that is necessary for engagement.

Imagine nurses researching best practices regarding care of a complex patient diagnosis new to your unit. The nurses present their research and provide the education to the nursing staff. Recognition encourages more nurses to contribute to improving the unit.

As nursing leaders, we must teach and empower our nurses to lead. Self-care has become a buzzword in nursing. Nurses are expected to care for themselves, but are sabotaged by the stress and the demands of the patient care environment. However, nursing leaders must provide supportive environments that foster self-care. For example, a competent team can handle discharge and admissions paperwork and patient education, allowing nurses to attend to their patient loads.

Finally, and most importantly, nurses need to be told that it is OK to take care of their own needs during their work shift. They need to feel confident that the nurses who are covering their team are knowledgeable and competent.

Self-care is included in many of the BSN and master’s-level nursing programs. Nursing programs are teaching leadership skills focusing on professional communication and how to achieve self-care in the work environment. Using best practice and leadership practices learned in nursing programs, nurses should present new ideas and evidence-based models to their nursing leadership.

By communicating in a professional fashion with the leadership, nurses will feel empowered and validated by having a voice. This new refreshing outlook is a far cry from the old, when nurses were expected to give up their chairs for physicians.

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Topics: Nurse burnout, nurse leadership

Healthcare Boards Have Many Reasons To Embrace Nurse Leaders

Posted by Pat Magrath

Mon, Jan 16, 2017 @ 03:42 PM

Nurse-leadership.jpgNurses are smart, compassionate individuals with excellent training and creative ideas. With that said, why aren’t there more Nurse Leaders on the board of their place of employment? We know boards are always looking at the bottom line, ways to save money, and grow their business. But think about it, some Nurse Leaders have extensive business experience in addition to their healthcare background. They bring a unique perspective because of their education and experience. They know what’s important to patients and also… what isn’t.
 
A Nurse Leader has first-hand knowledge of where money is being wasted. With his/her input, the board will gain valuable insight and hopefully make decisions to improve quality patient care as well as achieve a healthier bottom line. Is there a Nurse Leader on your board?

In the wake of the 2016 election and a changing context for healthcare decision-making, health systems that expand the scope of board dialogue will have a strategic advantage.

Into what was already a rapidly if not chaotically changing healthcare marketplace, there may be major changes from a new presidential administration. There is no better time to get all the right players at the table. Care providers facing the many changes and uncertainties associated with healthcare during Donald Trump’s administration will need diverse board-level input and timely feedback from their core employee sector, nursing, and its insider’s perspective on the patient experience. 

We view this as an optimal time for health systems to add a nurse leader to their boards because the profession’s caregiving expertise and awareness of patient perspectives is needed for sound strategic decision-making. Drawing on our many years of work together as a former health system CEO and as a nurse executive board member, here’s our short list of ways a nurse with high-level business expertise can help a health system board strengthen profitability and patient outcomes.

Balanced board focus

A nurse who has a strong business background and substantial healthcare experience can offer practical, useful input to improve a health system’s board governance. When Kathy first joined the Alegent board, she urged the board to balance its time equally between finance and quality outcomes, patient safety and quality care.

That was a turning point in the organization’s governance. Prior to her input, board meetings had focused primarily on finance and reviewing financial results because that’s what board members most understood. The board needed to focus on the core business of quality care. As time went on, finance was relegated to a lesser part of board meetings because those reports could be sent in advance and continued to be management’s responsibility.

Rick: Kathy first and foremost earned the respect and trust of the board as a very strong business leader and colleague with substantial healthcare experience. She could stand toe-to-toe with any board member on any topic. She also brought nursing experience and the unique dimension of clinical care, an array of experiences and perspectives our board didn’t have before.

Kathy: Nurses understand what it is to deliver human services and generally find themselves in the role of patient advocate and touchpoint for all activities in a hospital. My perspective was broader because I was a senior vice president of a Fortune 500 healthcare company. In addition to my passion for the mission, my experience was corporate and profit-oriented. My focus was on making sure you deliver care as efficiently and cost-effectively for the best outcomes.  

Return on investment 

To improve quality outcomes, resource utilization and financial metrics, it’s critical that nursing leadership and front-line nurses, executives and board governance are all in partnership. Without that, change is simply not possible. Across the board, Alegent’s measures improved dramatically after it dedicated resources to improving outcomes for direct hands-on care of patients. This core business is affected directly by nursing across the enterprise. At Alegent, we could link a clear set of statistics and graphs for a variety of outcomes to the impact of Kathy’s input and expectations.

Kathy: When I joined the board, we had no board committees working on quality. It was easy to make the case that the board ultimately has responsibility for quality outcomes. A lot of people think having better quality may cost more money. Actually, you get a return on investment if you deliver higher quality, and you can easily reduce your costs.

Rick: We took Kathy’s recommendation to focus on quality patient care very seriously and found the resources to make this happen. We ended up with a strong team of quality experts, physicians, nurses and colleagues with analytical skills—some of whom we hired and some of whom we moved into leadership roles. We became national leaders in quality outcomes. Our company’s quality scores were on par with Johns Hopkins (Health System) and Cleveland Clinic and were ahead of the Mayo Clinic.

Blind spot protection

A board without diverse perspectives risks overlooking uncomfortable yet important issues.

Rick: Kathy could challenge management and the board in ways nobody else could because of her experience and knowledge. She pressed management on quality outcomes when they began to be published publicly. I will never forget the day we reported wonderful quality outcomes scores for our metropolitan hospitals. Our rural hospitals weren’t reporting the same scores. Kathy said,“Our company’s name is on those buildings too. Why aren’t we delivering the same care there?” There was dead silence. That type of feedback—pointing to conversations our board needed to have—was exactly what I needed as president and later CEO. Thanks to Kathy’s input, we put resources and focus on quality outcomes in our rural hospitals and brought them quickly into the top decile nationally with comparable care.

Kathy: We achieved these quality improvements because our hospital administrative leadership team took on this challenge; they creatively led changes in our culture and processes, and committed resources to make it happen.

Pivot to the future

The nursing profession has dedicated itself to empowering people with comparable stature and skills as other board members to share nursing’s valuable perspective on the front-line business. That’s why we joined the American Nurses Foundation’s effort to increase the number of nurses on boards, building on its impact as a founding member of the national Nurses on Boards Coalition.

There is a ready cohort of nurse leaders with the governance and healthcare expertise to be excellent board members. All the board has to do is get them oriented to the organization. This next-generation cadre of nurse leaders is ready for an important task. Their input on behalf of the critical issues and the bigger picture will be essential to protecting and reinforcing the nation’s vital healthcare sector in the coming era.

If you have any questions feel free to ask one of our Nurse Leaders who are always here to help!
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Topics: nurse leaders, nurse leadership

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