Helping Charge Nurses Create Stability When Staffing Is Turbulent

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

This week I was reminded of how challenging being a charge nurse is in the current environment. Our leadership webinar included 90 charge nurses from throughout the country. Many were brand new in their roles. The dilemmas they discussed included the following:

Teams with more than 50% new graduates both on days and nights.
Continual turnover of both staff and leaders on units.
Many patients and family members commenting on the fragmentation of care.
Travel nurses as part of regular scheduling.
Burned out and stressed nurses.
Acutely ill patients and a lack of experienced nurses to care for them.
An increase in the number of errors and nursing judgment decisions.
Charge nurses being swept into the staffing vortex every day.

For many of these charge nurses, this was the first real development that they had received. While they are relieved that the problems they see in their environment are nationwide phenomena, they also worry about workforce trends that seem to be spinning out of control. They are not alone in their thinking; a recent study released by Avant staffing indicates that executives see these same trends.

Gallup research tells us that what staff value the most in their leaders is trust, stability, compassion, and hope. All are important, but many of these charge nurses struggle to create stability on their teams with the current staffing trends. Our advice to them included the following:

Be transparent about the challenges – the staffing challenges are complex and cannot be swept under the rug. These challenges need to be discussed with nurses and the strategies the organization uses to address them.
Be goal-oriented – at the beginning of each shift huddle, the charge nurse should set three goals for the shift and ask for feedback on how the team can work together to achieve them. Acknowledge when you are short-staffed – your goals may be simple for that shift – 1. our patients get the best care possible 2. we all leave on time. 3. everyone will have a buddy tonight for team backup.
Be proactive in identifying struggling staff – one challenge with getting sucked into the staffing vortex is that it becomes impossible to provide support for your team. Coaching is a key priority for charge nurses in today’s environment.
Be More Yoda and less Superman – charge nurses need to work hard to manage their own stress and anxiety. Fear is powerful and contagious – stay focused and don’t be too reactive at the moment.
Be positive – some leaders thrive in chaos and manufacture even more than already exists. Don’t be one of these leaders – stay within the circle of what you can influence in your role. Thank everyone at the beginning huddle and end huddle. Recognition goes a very long way during times of stress.

Charge nurses today are walking a fine line. Their goal should be to find the balance of providing stability in the moment while giving the nurses who work with them hope and inspiration that the future will be a little less chaotic. This is not easy to do, and they are heroes for doing this work.

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