The importance of charge nurses
Thank you so much for including the article "Redefining 'Charge Nurse' Within the Front Line" by Lorrie Normand, DNP, MS, RN, NEA-BC; Denise Black, MSN, RN, ACNA-BC, APRN; Kathleen M. Baldwin, PhD, RN, ACNA-BC, ANP-BC, GNP-BC, FAACM, FAAN; and Jeannette T. Crenshaw, DNP, RN, NEA-BC, FAAN, IBCLC, LCCE, in the September issue. This article is very timely and informative considering my recent decision to restructure the charge nurse role on my unit.
As a nurse manager on a newly opened progressive care unit, I'm looking for ways to grow and motivate the charge nurses and their role. Charge nurses are leaders at the front line who carry complex daily tasks and greatly impact patient, physician, and staff satisfaction. A strong front line charge nurse is imperative to leadership; they're the key component of driving an organization's outcomes and quality patient care. I'm endeavoring to take a step back and implement a few of the discussed improvements to the charge nurse role mentioned in the article.
The authors did an excellent job analyzing their challenges with nurse turnover. At times, perhaps the wrong people are put into front line leadership roles and this may cause staff turnover. There are nurses who desire leadership roles and those who wish to remain at the bedside to provide direct patient care but due to their clinical expertise, they're forced into the charge nurse role. It's crucial to ensure that the entire team supports and views the front line leader as a strong asset to the team.
Going forward with the restructuring of the charge nurse role, I'll add to the process a 90-day, 6-month, and annual peer evaluation. Constructive feedback is a great way to evaluate strengths and weaknesses, allowing individuals to focus on areas of improvement.
The article "Redefining "Charge Nurse" Within the Front Line" couldn't have come at a better time. Our organization has been struggling to identify the role of the charge nurse in the rehabilitation setting. Defining clear expectations is often overlooked and assumed to be understood by charge nurses. Often, charge nurses are hired due to their strong clinical skills and have little to no experience in team building, conflict resolution, or leadership skills. The development of the curriculum utilized to educate new and current charge nurses is essential to the success of this particular role.
As the complexity of healthcare evolves, this front line role will also be required to evolve. The development of this leadership role can have a direct impact on patient care and your patient satisfaction results. Charge nurses are the front line resource for staff and patients, and the skill set they possess is essential in effectively dealing with patient issues and the care provided. Thank you for identifying the need to develop the charge nurse in healthcare today.
Leadership and trust
It was refreshing to read "A New Leader's 'Trust Barometer'" by Shelley Cohen, MSN, RN, CEN, in the September issue. I've been in nursing leadership for 12 years and have no doubt that trust is an antecedent to successful leadership and followership. I agree that it's very important to tell staff what you'll do and hold yourself accountable for it. The Leadership Challenge law number two is "Do what you say you will do." The nurse leader should always remember that direct reports are constantly watching to gauge credibility.
The author's leadership do's and don'ts list is quite comprehensive, but I would like to contribute something based on my personal leadership experience. Regarding staff accountability, although I agree that a leader should display fairness in most situations, he or she should also apply individualized consideration to different levels of performers. We all expect more from our high performers, which drives them to grow and develop by embracing an organizational culture of continuous improvement. A leader shouldn't minimize expectations for lower performers just so they can meet them.
When it comes to patient care, it's acceptable to raise the bar and be disappointed, but it's never acceptable to lower the bar and be mediocre. Thank you so much for the resource.
Erica "Dawn" Keesee, BSN, RN
Holli Torres, BSN, RN, CRRN
Kelly Ward, BSN, RN, CEN