The Role of the Charge Nurse in the Nursing Home Setting

You're called in emergencies.
i Jupiterimages/Creatas/Getty Images

The charge nurse is in charge. Basically, she’s the one who supervises the medical staff on the floor and makes decisions when no one else is around. The charge nurse in a nursing home reports to the director of nursing and assists with staffing needs wherever they’re needed. Being in charge brings with it a lot of responsibility, from providing direct patient care to making sure the CNAs are doing their jobs correctly.


    The day-to-day supervision of the medical staff, from the medication aides to the other nurses, falls to the charge nurse. Usually the senior nurse on the staff, you’ll have your own section of residents to see, but you’re the one to whom others come when they have a problem or need some direction, especially on second and third shifts when doctors and the director of nursing aren’t working. CNAs and orderlies, med techs and personal aides report to you. As the supervisor on the floor, it’s up to you to periodically go behind less experienced staff to check on the quality and status of their work.


    As the person in charge, you’ll be the one that other nurses and CNAs turn to when they have an emergency. While you may have your own patient load, if there’s an issue with another nurse’s patient, you’ll be called to make any determinations whether a doctor should be called or the resident needs to be taken to the hospital. You’re also in contact with family members when emergencies occur. It’s more efficient when one person handles the calls, giving family members and primary physician offices a single point of contact. Besides, you have the most experience and are best suited to the role.


    The director of the nursing home and your direct boss, the director of nursing, rely on your accurate reporting to fill in their own reports to regulators, family members and the facility’s governing board. In addition to completing charts for your own patients, you’ll be expected to complete a report on any incident that occurred during your shift and to report on any employees who didn’t show up or who were lax in their work. While you may or may not be directly involved in conducting reviews of CNAs and orderlies yourself, your input plays a big role in their final reviews. As with most nursing jobs, you must get used to the paperwork even more when you move into the charge nurse role.


    Your skills are valued on the floor during your shifts when the less experienced nursing staff turns to you for direction. But it’s even more vital when it comes time for the nursing home to set staff limits or build budgets. You are the one who can give managers and the administration the firsthand story about what’s needed on your floors and how many staff members you really need to effectively meet patient demand. You can provide insight into the kinds of training needed by the staff and which CNAs work best with which populations. You are the main link in the process, the liaison between the front lines and the back room.

the nest