Helping Charge Nurses to Lead During Unstable Times

Helping Charge Nurses to Lead During Unstable Times - Nurse with stethoscope and blue scrubs

The role of the first-level supervisory nurse is critical for quality patient care and overall work quality for nursing staff. The role is also very complicated, especially given that nurses often assume the role based on clinical skills, with limited formal leadership development. Solving problems, understanding staff members scope of practice, and dealing with staff needs is a lot to take on, even when times are not turbulent. And in 2021 we know many nurse teams are dealing with staffing issues and turnover. Many teams are staffed with 50% new graduates, more temp travel nurses, burned out nurses, and high acuity patients. These factors, along with turnover of nurses and senior leadership plus new IT processes, add up to many nursing work teams dealing with a continued challenging time.

So how can nurse directors and leadership help charge nurses, as they lead through a turbulent time?

Be transparent about the key issues

Charge nurses do not expect their managers or directors to have all the answers to problems that arise, but they do want the truth. If you are transparent that there is instability and that the team is going through rocky times, that transparency can be a building block for trust. It can also help solve the issues. When staff members have all the information on a topic, they may devise reasonable suggestions or alternatives to solve or improve a problem. Through transparency, nurse teams can mature more quickly.  A lack of transparency can have long-term detrimental effects and lead to less trust or more turnover.

Offer support from more experienced nurses

Young nurses are not looking for authoritarian leadership; they want coaching to help them learn and grow as professionals. Retaining nurses requires adapting to this generation, so make sure the right experienced nurse is providing the coaching. The right coach/mentor can help a young nurse see how their contributions are valued. Mentors can encourage continuous learning, help young nurses to build networks/join professional organizations, and even help teach young nurses about emotional intelligence. For example, University Medical Center (Texas Tech University) offers senior nurse mentors to new nurse leaders. This helps nurses to think about professional development, clarify skills needed for the new role, and understand the goals of the health system. There is nothing in a textbook that can replace real-life experience of a seasoned nurse who has navigated a full career.

Identify struggling staff and plan for early intervention

Be on the lookout for nurses who are struggling with exhaustion, anxiety, or just the reality of how difficult the nursing profession can be. Help show them time management tricks or talk about where the nurse is struggling. If a nurse has a hard time speaking with physicians for example, help them practice those scenarios.

But if a nurse isn’t pulling his or her weight, or causes unnecessary team stress, find a plan to fix the issue. A charge nurse has enough on their plate, so especially during turbulent times, take as much of the team conflict or struggling staff issues off the table as possible.

Remove common leadership barriers charge nurses face

Even when not enduring turbulent times, there are personal and organizational barriers that can hinder success of frontline nurse leaders. Removing as many of these barriers as possible will setup your charge nurses for success. Personal barriers a new leader could face are an inability to see the big picture, a lack of self-confidence, or not delegating work. Remember that your charge nurses may have never led a team before, so talk through these personal barriers.

Leadership barriers could be organizational. These barriers could include staffing issues, a lack of ancillary or clerical support, or a lack of standard operating procedure. It’s impossible for a charge nurse to effectively complete tasks if he or she doesn’t know what the expectations are. If possible, it would be beneficial for charge nurses to meet with administrative leadership to quickly draft a common list of responsibilities. See our related article, 9 Leadership Barriers that a Charge Nurse Faces.

Offer leadership development to prepare nurses for the charge nurse role

Many nurses in a charge RN role have never led a team before and are serving in it because they have the clinical skills. Going from a nurse peer to a nurse leader can cause stress, as it is hard to delegate work to a friend.  So prepare your new nurse leaders with training that can give the insights, interpersonal skills and business knowledge they need to manage a team. Charge nurse leadership development can help a nurse transition from peer to leader, lead quality initiatives, be confident in communications, and help with conflict management.

HCA, the largest private health system in the U.S., made a strategic decision to systematically prepare future nursing leaders for success.  It developed its Charge Nurse Leadership Certificate program and saw that effective development of frontline leaders can improve retention and the delivery of patient care.

Being a charge nurse during turbulent times is very hard. Whether it is staffing, high acuity patients, or employee stress, the role is harder than ever. And we know that the charge nurse role is a first step into nursing leadership, so it is essential that we encourage these new leaders.  It is a win-win-win for leaders to provide stability, transparency, and inspiration.

“3 Common New Nurse Struggles,”

“Transparency in Nursing Leadership and Healthcare,” Duquesne University School of Nursing, Rose Sherman, April 14, 2020

“Tips on How to Effectively Communicate to Doctors for New Nurses,”

“Mentoring Nurses Toward Success,” Minority Nurse Magazine

“For Nurses – Mentoring,” University Medical Center – Texas Tech website

“Helping Charge Nurses Create Stability When Staffing Is Turbulent,” Emerging RN Leader, Rose O. Sherman, May 6, 2021

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