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Charge Nurse Leadership Education

Nieasha Trotman

Created on February 10, 2026

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Charge Nurse Leadership Education

Wills Eye Hospital Nursing February 2026

Charge Nurse Role

What is this course about?

The Charge Nurse Role!Serves as the frontline clinical leader responsible for coordinating patient readiness and departmental flow. Serves as the unit's operational "quarterback," coordinating complex schedules, personnel, and resources to ensure surgical efficiency. Leading patient safety, and staff support all at the same time.

Charge Nurse Role

Course objectives

Build fair, acuity- based assignments

Define the charge nurse role as a safety and flow leader

Support staff performance, conflict resolution, and teamwork

Use effective communication and esculation

Apply shift management best practices, and documentation

Foster critical thinking

Key Traits

What Great Charge Nurses Do

Click on each concept below.

Multitasking

Forecast

Well- balanced

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Balance patient safety, staff support, and unit throughput.

Anticipate problems before they become emergencies.

Stay calm, organized, and visible on the unit.

Key Traits

What Great Charge Nurses Do

Click on each concept below.

Leadership

Articulate

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Model professionalism, transparency, and accountability

Communicate clearly with staff, providers, and leadership

Core Responsibilities

Admissions, transfers, add-ons; bay/room coordination, and prioritization of resources .

Monitor high risk patients, ensure policy compliance, and esculate concerns early.

Patient Safety

Unit Flow

Acuity-based balancing, support new staff, manage breaks.

Staffing and Assignments

Huddles, handoffs, updates; provider communication; and interdisciplinary teamwork.

Coaching conflict management, culture setting, recognition and morale.

Communication

Leadership

Start- of- Shift Charge Checklist

  1. Review staffing, skill mix, and unit/census acuity
  2. Identify high risk patients (falls, airway, behavioral isolation)
  3. Review pending add-ons
  4. Check equipment readiness (crash carts, suction, oxygen, pumps)
  5. Confirm break coverage plan
  6. Set the tone: quick huddle and priorities

Acuity Based Assignments

Rebalance early when add-ons or delays occur.

Match experience to acuity. Support new nurses appropriately.

Fair is not equal. Balance workload based on aquity. Consider mobility, isolation, behavior risks, and procedure complexity.

"To be 'in charge' is certainly not only to carry out the proper measures yourself but to see that everyone else does so too." Florence Nightingale

Real World Assignment Tips

  1. Protect the newest nurse from the heaviest assignment.
  2. Don't overload your strongest nurse every shift (burnout risk).
  3. Plan for add-ons, leave "space" when possible
  4. Pair complex patients (cases) near experienced staff when possible.
  5. Document staffing concerns

Quick Question

Leadership

'Leadership in nursing is not about being in charge; its about taking care of those in your charge'

Missouri Organization of Nurse Leaders

Communication Tools (SBAR)

Huddles that Work

Closing
Additional volume
How long?
Resources
State today's risks

Escalation and Chain of Command

Chief Nursing Officer Nurse Director- Nurse Manager- Charge Nurse- Staff-

  • Escalate early when patient safety is at risk
  • Use chain of command when concerns are not addressed
  • Request resources: float staff, rapid response, security, supervisor
  • Document key events and who was notified
  • Never normalize unsafe conditions

Coaching and Supporting Staff

  • Be approachable and present
  • Coach in the moment: “Let’s reset priorities”
  • Recognize good catches and strong teamwork
  • Provide psychological safety: questions are welcome
  • Correct unsafe practice promptly and respectfully

"The strength of the team is each individual member. The strength of each member is the team."

-Phil Jackson

Managing Conflict

  • Address issues early and privately
  • Stay factual: describe behavior and impact
  • Set expectations: respectful communication is non-negotiable
  • De-escalate and redirect to patient safety
  • Escalate repeated behavior concerns per policy

Break Coverage and Staff Well-Being

  • Breaks are a safety issue (fatigue increases errors)
  • Make a realistic plan early in the shift
  • Use buddy systems when staffing is tight
  • Rotate support fairly
  • Check in, round on staff: “Who is drowning? Who has bandwidth?”

+ info

Missed breaks are linked to higher exhaustion, increased risk of errors, and reduced job satisfaction.

High Risk Situations to Watch

  1. Rapid clinical decline (cardiac arrest, respiratory failure, hemorrhage)
  2. Falls risk and post-op confusion
  3. Behavioral escalation or elopement risk
  4. Medication safety (high-alert meds, insulin, anticoagulants)
  5. Deteriorating staffing conditions

Leading During Emergencies

  • Assign roles: recorder, runner, medication nurse, compressor
  • Ensure code activation
  • Clear the room and manage crowd control
  • Communicate updates to family per policy
  • Debrief after: what went well, what to improve

DOCUMENTATION AND REPORTING

  • Document significant events, escalation, and staffing concerns
  • Use incident/safety reports for: falls, med errors, near misses, equipment failure
  • Report workplace violence and safety threats
  • Protect staff by documenting facts, not opinions

END-OF-SHIFT SUCCESS

  • Ensure clear handoff and unresolved issues are communicated
  • Confirm critical labs/results are addressed
  • Review pending transfers/discharges, or remaining patients
  • Close the loop on safety events
  • Thank the team — it matters

QUICK PHRASES THAT WORK

  • “What’s your top priority right now?”
  • “Let’s reset and make a plan.”
  • “I’m concerned about safety — I’m escalating this.”
  • “I can help for 5 minutes — what do you need most?”
  • “Let’s step aside and talk privately.”

Summary

  • Charge nurses lead safety, flow, and culture
  • Fair assignments are acuity-based and dynamic
  • Communication and escalation prevent harm
  • Support + accountability builds a strong team
  • Visibility and calm leadership improve outcomes

KEY TAKEAWAYS

Thank you for takingthe course!

Do you have questions?

We are here to help you. If something was not clear or you want to delve into a topic, do not hesitate to reach out to me or your manager. Your curiosity is also part of the learning process.

RECOMMENDATIONS

What you need and by when.

BACKGROUND

Relevant history and context.

4. Know your resources

Identify who to call for what

3. Extra

Identify expected add-ons

Use SBAR for...

Rapid changes, provider calls, transfers, staffing esculations

5. End with...

What do you need from me right now?

1. Time constraints

Keep it short (2–5 minutes)

2. Risks

High acuity, high volume, behavior isolation.

ASSESSMENT

What you believe is happening.

SITUATION

What is happening now?