Transitioning to Charge Nurse in Long Term Care

• The charge nurse role is a leadership position in which one delegates tasks and supervises other nurses or CNAs. 
• The charge nurse role in a long-term care facility (LTC) looks different than the role within a hospital or ED due to the nature of the LCT being on a rigid schedule. 
• Author, and LPN, Katy Luggar-Schmit, shares her experience and what she learned as being a new charge nurse. 

A little over a year into my career as a Licensed Practical Nurse I was hired for a Charge Nurse position at a long-term care facility. I was excited to start this role, but I must admit I had no prior supervisory experience and this part of the position made me nervous.  

Knowing it would be new and challenging and help me grow as a nurse I went for it and I am so thankful I did. I gained so much knowledge from my time as a Charge Nurse. I wanted to write this article to the nurse who may want to try a Charge Nurse role with little or no supervisory experience. There are a few tips I found helpful during my Charge Nurse position I would like to share. 

The Charge Nurse Role

First, let me explain what a Charge Nurse role is. A Charge Nurse can be either an RN or an LPN.  

LPNs are more commonly hired in this role at nursing homes and assisted living facilities, however, there may be other settings depending on the state or area you reside.  

LPN Charge Nurses can supervise and delegate certain tasks to Certified Nursing Assistants (CNAs). An RN Charge Nurse would supervise and delegate to any LPNs collaborating with them as well as CNAs.  

Charge Nurses oversee the unit or units they are assigned to for their shift. They are responsible for not only the cares they provide but also in overseeing the care the CNAs provide as well.

They can be utilized as a resource for staff to ask questions, pass medications and complete treatments, coordinate care with physicians, physical therapists, pharmacy, social workers, etc.  

Charge Nurse Advice

Now that I have given you a brief description of the Charge Nurse role, let’s get into some of the tips. 

Have Another Nurse Resource

When you have a question you need help with, or an emergent situation occurs such as a resident fall or resident illness; it is helpful to have another nurse you can utilize for assistance during these incidents.

You are not expected to handle everything yourself as a Charge Nurse and nursing relies heavily on teamwork. Having another resource to go to will help ease your mind and keep you calm in chaotic situations.  

Be Proactive and Establish a Routine

Establishing a routine, getting familiar with the residents, and finding a schedule that works for you is especially important for the Charge Nurse role. You always need to be prepared for the unexpected to happen.

Residents can fall or become ill very quickly and the more familiar you are with the residents and their medical history the better equipped you will be when these situations occur.

Help the Supporting Staff

Nursing relies heavily on teamwork and being willing to help the CNAs with their tasks will help them to respect you and appreciate you more. Employees usually favor a supervisor who is not shy about helping them out and gets involved with them. You may also find some of the CNAs look up to you.

It is important to be a resource for them and be someone they can learn from. You may even inspire them to pursue a nursing degree. Giving praise and letting staff know what they do well will also go a long way when assisting them.  

Stay Calm

The ability to remain calm in a chaotic situation will help both the resident and staff involved also remain calm. Remember to maintain confidence in your skills to establish trust with the others which also helps them remain calm in stressful situations.

On the other hand, if you are not sure what to do it is a wonderful way to show them that asking for help is ok and knowing when to ask for it.  

Know the Policies

In the Charge Nurse role especially, it is important you familiarize yourself with facility and state policies in regard to delegation. Make sure you are aware what is within the RN, LPN, and CNA scope of practice, prior to any delegation of tasks. It is important to know that what you are delegating is a task that staff member can complete and has the proper training to do so. 

Lead by Example

Act how you would like your staff to act. Be on time, maintain a cheerful outlook, be a team player. Having all these characteristics will help establish a good relationship with staff and set the standard you expect from them. No one likes to be managed by someone who does not practice what they preach. 

The Bottom Line

In conclusion, being a Charge Nurse can be really rewarding even though it is challenging at times I have found the most challenging positions are the ones that grow you the most. 

If you are considering a Charge Nurse role, I encourage you to not let the fear or uncertainty of the role steer you away from trying it. You may find out it is the perfect nursing role for you. 

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