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The Charge Nurse is a professional practitioner who assesses, manages, directs and provides
nursing care activities for the inpatient units / clinical areas. She/he is responsible for the planning,
organization, delegation and completion of patient and unit activities for a specific shift. The
charge nurse focuses on the quality and outcomes of care and facilitates the role and responsibilities
of the team members.
Position Accountabilities and Performance Criteria
Essential Functions: The following are essential job accountabilities and performance criteria:
1) Accountable for the appropriate use of human, fiscal and other resources.
A) Provides feedback and actions taken to resolve immediate issues/needs to Assistant
Director. This includes, but not limited to clinical performance and teamwork, supply and
environmental issues, system delays, technology failure and other items as indicated.
B) Coordinates staffing for the shift for the designated clinical areas.
1. Reviews staffing plan for the next 24 hours using OptiLink to anticipate and plan for
projected patient care needs.
2. Plans for appropriate skill mix to meet patient needs.
3. Assess staffing needs throughout the shift and continues to monitor and adjust
4. Reports staffing changes (needs/flexing) to Assistant Director, designate.
C) Completes daily staff assignments taking into consideration overall unit activity, patient
acuity, census, staff skills and tenure and ability to supervise new employees.
1. Works with preceptor(s) to facilitate patient assignments that support learning needs.
2. Evaluates need for 1:1 non-suicide precaution patients. Completes "One to One
Patient Request" Form when 1:1 is required for suicide precaution or assessed
3. Assigns departmental functions to co workers; follows up to verify completion.
i. Assigns breaks/lunches. Relieves staff when necessary.
ii. Assists with clerical duties.
4. Assure proper patient assignment for Float and Agency Staff.
5. Enters justification i.e. shift note for changes in staff projections.
D) Completes assignments on PCSS. Completes classification of acuity on all patients.
E) Reconcile reports on PCSS.
F) Completes OptiLink changes for call in's and staff reassignments.
2) Supports an environment conducive to teamwork and customer service.
A) Using Daily Rounding Tool completes patient rounds. Discusses findings with staff;
advises Assistant Director of ongoing issues or significant findings.
B) Rounds with attending physicians as requested, providing follow up communication to staff
C) Coordinates interdisciplinary rounds/prepares treatment plans.
D) Assesses staff needs throughout shift. Assists staff with admissions, discharges, transfers
E) Completes Handoff-Shift to Shift report with oncoming Charge Nurse.
3) Maintains a patient assignment when indicated by patient care needs.
A) Performs comprehensive nursing assessment / reassessment.
1. Performs age-appropriate admission or transfer assessment. Obtains input from
family/guardian when appropriate.
2. Accurately and completely documents findings.
3. Performs assessment of post-op/post-invasive procedure patients.
4. Assesses and documents education and discharge needs of patient and family on
admission and throughout hospitalization.
5. Provides patient reassessment documenting pertinent observations according to the
patient plan of care, changes in condition, status and / or diagnosis, response to
procedures, etc, and standards of care.
B) Establishes, coordinates and evaluates a plan of care based on analysis of assessment data,
patient diagnosis, lab data, tests, procedures, physician orders, protocols and standards of
care and other information as relevant.
1. Identifies short and long term goals based on patient care needs.
2. Formulates nursing interventions to achieve desired patient outcome.
3. Incorporates disease specific evidenced based practice into nursing care plan and
C) Provides and documents nursing interventions based on assessed patient needs, plan of care,
and changes in patient status.
1. Collaborates with appropriate health team members for coordination of daily plan of
care for assigned patients.
2. Provides, coordinates and communicates patient care, including accurate Handoff
3. Administers and documents medications accurately according to policies and
4. Monitors, maintains and documents accurate IV fluids, blood, blood products and
parenteral nutrition according to policies and procedures.
5. Completes referrals as indicated by assessment data.
6. Requests consultation for special needs, equipment, or information for patient and /
7. Restraint Care
i. Initiates / evaluates alternatives to restraint prior to application.
ii. Applies restraints consistent with the approved procedure.
iii. Monitors and assesses patient's response throughout the restraint period at
the appropriate intervals.
iv. Provides specified patient care (toileting, skin care, hydration, feeding, etc.)
on a timely basis.
v. Provides consultation for peers to determine alternatives to restraints and 1:1
vi. Documents restraint use and associated care thoroughly.
8. Provides patient / family education and discharge planning per documentation
guidelines and protocol.
9. Pain Management
i. Follows pain management plan of care, e.g.: administration of pain.
medication, repositioning, massage, immobilization, music therapy etc.
ii. Discusses patient complaints of pain with relevant nursing staff and / or
10. Clarifies all physician orders as warranted.
11. Transcribes and implements physician orders in an accurate and timely manner as
evidenced by documentation in the medical record.
12. Assists physician with procedures/treatments as requested or delegates to Care
Partner as appropriate.
13. Documents "Readback" for all telephone/verbal orders.
14. Takes telephone/verbal orders only in emergency situations.
15. Recognizes changes in patient's condition and takes appropriate nursing actions.
16. Involves the family / guardian when providing care and in decision-making as
17. Recognizes risks for patient and takes appropriate action.
18. Incorporates use of Infection Control Bundles in daily care.
D) Documents and or communicates nursing care an or changes in patient condition.
1. Performs and documents ongoing evaluation of effectiveness of care based on
assessment data, nursing interventions, patient response to medications, treatments
2. Evaluates and documents effectiveness of patient / family education.
3. Evaluates plan of care and modifies as indicated in "A" above.
4. Recognizes significant changes in patient's clinical parameters and reports
immediately to physician and others as indicated.
5. Identifies problems, gathers pertinent data, suggests solutions, communicates using
appropriate lines of authority, and works toward problem resolution.
6. Reports variation from care / treatment following the occurrence reporting policy
7. Completes Patient Fall and Skin Audits per guidelines.
4) Ensures quality of patient care services.
A) Facilitates compliance with regulatory/professional standards, practice guidelines, policies
B) Assists with monitoring and implementation of quality improvement initiatives.
1. Assures that Fall and Tissue Integrity Audit Tools are completed.
2. Ensures compliance with change implementations associated with delivery of care.
C) Ensures input of restraint documentation into MSM on Meditech system.
1. Audits restraints for consistency with Policy and Procedure. Initiates immediate
action to resolve non compliance.
D) Carries telemetry phone and responds to all calls / alarms promptly.
E) Carries Charge Nurse beeper responding to Patient Acceptance and Placement designate.
1. Facilitates patient transfer/movement as directed.
2. Assures that discharges are entered promptly into Meditech and that Tele-Tracking
is accurate as relates to "Ready Bed".
F) Keeps Peers and Coworkers up to date with critical changes and unit events.
G) Verifies accuracy and takes appropriated action on all critical reports i.e. Braden, Morse,
Vaccine, Restraint, CVC, VAP (ICU only) and Foley.
1. Assures all Foley catheters that do not meet designated criteria are discontinued and
those remaining meet all aspects of the Foley Policy.
2. Assures that all components of the CVC policy are met and that lines are removed
when not needed.
H) Reviews completion and documentation of weights and vital signs per order.
I) Completes or assists with eSRM reports.
J) Assists and facilitates activities that support achievement of Balance Score Card Indicators.
5) Develops the skills and knowledge of staff independently and in cooperation with other team
A) Provides, schedules, and facilitates attendance at in-services or other educational events.
B) Supports orientation, RN Residency program, Skills Day, and monthly skills check off.
C) Provides informal coaching and mentoring to all staff. Advises Assistant Director of staff
D) Promotes Saint Louis University Hospitals Shared Governance model.
E) Follows up on mandatory requirements as requested.
Minimum Education: RN licensure in the State of Missouri
Minimum of two years of nursing experience desired.
Satisfactory performance appraisals.
Possesses excellent communication and interpersonal skills.
Demonstrates professionalism in working relationships and during delivery of care.
Possesses good problem solving abilities including follow up and reporting.
Remains calm and is able to handle highly stressful situations.
Possesses excellent organizational skills.
Is available for variable shifts.
Energetic and motivated.
Working Conditions: May be exposed to the risk of blood borne diseases. Exposure
to unpleasant elements (accidents, injuries, and illness). Subject
to varying and unpredictable situations. Handles emergency
and critical situations. May work variable hours
Physical Requirements: Prolonged, extensive, or considerable standing/walking.
Occasionally lifts, positions, pushes, and/or transfers patients.
Occasional reaching, stooping, bending, kneeling, crouching.
Must be able to lift 50+ pounds and pull 100+ pounds.
102-Saint Louis University Hospital - St. Louis, MO
8 Hour Day
Tenet Healthcare - 20 months ago
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