Patient Care is the Prime Directive

Once a new student nurse gets minted into the professional health care world with a diploma, he or she can look for work in various institutions like hospitals, long term care, or home health. Once hired, nurses may notice that some nurses move through the ranks faster than others. This isn’t due to some unknowable formula, but success in patient care. This is true the world over in nursing environments.  No other single factor will advance a nurse’s career than skills in direct patient interaction and patient care.
Patient feedback is a good way to proctor your progress as a working nurse. While administrators and preceptors are supposed to train new nurses, it is patients themselves who are the “customers”. In today’s healthcare systems, the daily tasks and medication passing routines lose sight of this fact. Even when charting, nurses should be mindful that family and conservators, and other nurses will read what medical information you write and inform a patient if you are contributing errors into the medical record. These are costly errors to make, and the price for such carelessness could be points against your nursing license.
A patient looks to a nurse for simple things. All of which add to their impression of their nurse. Is your name tag legible? Do you announce what your role is and what your nursing responsibilities are? Is your hair out of your face, do your clothes smell clean, and are your jewelry/piercing/tattoo sleeves arranged in convention with public healthcare norms? Are your scrubs clean and do your hands and arms remain clear of fungible odors or harmful bacteria? The patient-to-patient transmission of certain bacteria is becoming a more common method of patient infection every day. Patients know when a risk is presenting itself in the form of a nurse.
Infection control includes microbe-level cleaning to assist patient’s recovery and everyday well-being. Nursing staff should be guarded against other patients with medical conditions that can affect their patient’s own conditions. Housekeeping staff should notify nurses when regular cleaning routines are disrupted by the patient’s attending-physician consult schedule, appointment schedule, or sleeping schedule. Clean water carafes should be brought by nursing assistants with washed hands and/or gloves. Make sure the charge nurse during each shift orientation stresses the need for room checks and water and linen changes when the patient is usually awake.
A charge nurse must take his or her responsibilities seriously. A good professional nurse should review every aspect of patient care, especially with respect to infection control. If a patient is diagnosed with contamination or a new infection, survey the patient’s environment. Sloppy cleaning or inefficient housekeeping could be a health threat. A charge nurse can order the baths or showers closed and cleaned, completely disinfected. A charge nurse or desk nurse can order new linen provided for the patient, clean towels or pillowcase provided, even assistance bathing or grooming to put the patient in a better frame of mind.
Patient care when equipment and medication administration is involved should be perfect. A nursing student should think about bringing his or her own stethoscope, blood pressure monitor or “bracelet”, and a convenient way to take notes and remember statistics between desk visits. Charting ten or twelve patients at the end of the shift becomes easier or a nurse with notes to look back on. An around-the-neck stick-it holder can help. And many vitals-cart monitors are unusable or to sensitive for regular use. Think about the ease added to the job if you bring your own. A nurse should learn how to use her or his own equipment and derive reliable data from it across different patient samples.
Any hesitation or memory flop during a tube insertion or IV start should be assertively reported and a more competent nurse assigned.

Suctioning and wound packing, dialysis and needle sticks should all be rock-solid before putting the patient’s nerves or skin at risk. These procedures are too important to risk on a nurse that barely remembers the nursing school training or had a poor experience during practicals. Some nursing supervisors during nursing school barely look at what the nursing students are doing. This will not help the professional nurse in the working environment. Nursing students who know they are short on skills should find a way to polish them, rapidly.

Peer review and policing is a responsibility that nurses should consider part of their job. Good relations with oversight and compliance agencies demands fulfillment of these programs. Nurses should review the facility’s Policy & Procedure manuals to inform other staff concerning these norms. If a nurse should notice that Standards of Care Practice regulations are not being observed, the institution nursing administrator or facility manager can schedule an orientation to supplement staff training on the matter. Patient care remains the ultimate quality product in nursing service.

Could You Be a Charge Nurse?

Student Nurses just ready to take qualifying exams are prudently planning their career steps in the years ahead. And suddenly the whole world of nursing occupations is open to them. But the administrative division of a leadership position in any nursing facility or medical institution is the position of charge nurse. Nursing students can focus their study courses on these supplemental electives when possible.

The charge nurse supervises other nursing staff, facility housekeeping staff, manages patient care for a ward or section or entire floor, and/or directs all activities. The nursing supervisor may be the charge at the same time, in smaller nursing homes. Student nurses with excellent grades and high score may be cleared to apply for the charge nurse level employment. The charge nurse is not an entry-level position.

A charge nurse is a multi-tasker on a whole new level. The nursing student preparing to become a new medical nurse will have to be spotless on their practicals, well above average on their anatomy and pharmaceutical knowledge, and excel at learning new tasks as well as retaining endorsements, special instructions, and handling special nursing cases. The charge nurse will perform or supervise and review all admission paperwork, as well as onsite bed placement and endorsement responsibilities.

Often the charge nurse is the only RN on a shift on any given ward or floor for a nursing institution or long term care facility. All emergencies, scheduled treatments, and call light actions fall to the RN on duty whether they are busy or not, whether they are involved in charting, on a break, or even otherwise engaged with another patient.  The new hires in a facility often will be observed for the capability and potential for serving as charge nurse in any institution. The pay rate is higher, and the night service for this function often has a pay differential for the overnight shift.

The charge nurse must be comfortable with supervising other nursing staff, even staff who are over twenty years older than them. In today’s new small business environment, many nursing homes and medical institutions will have a nurse who is barely twenty-three serving as supervisor over other nurses who are over twenty or even thirty years older than they are. This is a psychological challenge that tests the new nurse’s maturity. Hiring managers in nursing will look for skills like autonomy, independent ability to multi-tasks, good attendance and timekeeping, and a professional appearance and demeanor.

How can a student nurse train themselves to be chosen to serve as charge nurse? By preparing across disciplines of study to perform at a higher level of nursing professionalism. The charge nurse will be accountable to the facility for a higher level of performance at al times during their shift. The charge nurse must also be competent to communicate with other hospitals, the pharmacy, law enforcement, the coroner‘s office, and make family relations calls and other communications as necessary.

Any student nurse or new hire in the nursing profession will be working under the supervision of charge nurse. So, if you don’t like your supervisor, the only answer is to become the charge nurse. This can be done by proving yourself in a progressive level of responsibilities and absorbing training commands and endorsement details over time.

A charge nurse must perform their tasks as well as competently supervise med pass nurses, certified nursing assistants, manage any crises that come, and document all other aspects of their shift and endorse the details to the next shift‘s incoming charge nurse. If a student nurse feels their studies are too easy, or they feel they have enough grasp on their material to stop preparing, they need to think again. The practical application of nursing knowledge in the field tests any nurses‘ patience and skills. The test environment is not the same as performing work for hours on end, and meeting every challenge and task with a freshness and attention to detail the work deserves.

Many nursing homes and hospitals do not have time to train new nurses and spend time and energy allowing them to come up to speed without an endgame in view. Many nursing homes and hospitals view any new student nurse hire or new entry into their staff as a potential charge nurse, whether the candidate knows it or not. They may need any member of staff to fill in as charge nurse, when gaps in their nursing staff schedule occur.

In an emergency, a nursing home, assisted living facility, or hospital supervisor will look for the on-duty nurse to assign the charge nurse duties to. If the RN or LVN is not ready to perform at this level, the facility runs the risk of patient safety risks, medication problems, treatment gaps, and documentation errors. These issues put the facility license at risk.

In the new world of budgets cuts, understaffing, and high nursing staff turnover, the LVN often be asked to perform their own tasks at the charge nurse level, and report as such. Thus, any new student nurse must realize that they may be asked to perform at the charge nurse work level, professionally, even though their hiring title is med pass nurse, floater, or desk nurse.

The student nurse seeking work must understand that if the phone doesn’t ring, it’s because their experience and scores, course work and practical training does not measure up to this standard. The interview and review of student nursing experience , testing, skills and education will come under this scrutiny.

Student nurses should train while taking courses and performing internships to qualify for work at this level. Otherwise, they many see their fellow student nurses pass them by in the career path to a future in progressively responsible nursing jobs.  A student nurse could look back at the monetary investment in their nursing school, as well as the energy and effort to prepare for a career in nursing, and wish they had planned better.