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CS57
Building Staff Skills: Learning to Charge
By Tory Schmitz, S. Elchos, & M. Christo, The Methodist Hospital, Houston, TX
For further information, please contact: tschmitz@tmh.tmc.edu
Purpose: To provide consistent training, peer feedback, and ongoing management support to new charge nurses.
Description: How can we help staff move from "Oh no, I don't ever want to be in charge!" to "When can I start learning to charge?" New staff nurses in an ICU are sufficiently challenged in the first year learning to care for critically ill patients. The "big picture" role of charge nurse, with its management, delegation, communication, and problem solving skills, seems daunting. In our 24-bed MICU, we designed a program to facilitate building these skills. First, the manager selects a staff nurse who has met certain criteria to function as team leader, with responsibility for overseeing activity for a portion of the unit. The manager trains and coaches the new team leader. Upon receipt of letters of support from three current charge nurses, the manager begins to instruct the staff nurse in the charge nurse role. The orienting charge nurse trains with the manager for one to two weeks. They review a series of written "What Would You Do If...?" scenarios. The manager assists with collaborative problem solving and discusses options as events occur, or later in a debriefing session. For all charge nurses, a peer feedback form is used to provide them with information about their performance in the role. Also, for all charge nurses, unit managers communicate their support for decisions, as well as suggestions for other possible actions to consider in the future.
Evaluation/Outcomes: Since implementation of this program in 2003, we have oriented ten new charge nurses. The program has been positively received by staff, charge nurses, and managers. Staff nurses are actively involved in requesting advancement. Peer feedback is incorporated in the initial recommendation of new charge nurses as well as the ongoing evaluation of charge nurse performance. Charge nurses feel supported in their training and their approach to resolving problems, and positive about their professional growth.
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