The Importance of Implementing a Charge Nurse Development Program

The Importance of Implementing a Charge Nurse Development Program

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In today's health care structure with the nursing shortage organizations are using charge nurses as gate-keepers to manage the day-to-day operation of the organization. According to Platt & Foster (2008) the charge nurse role is pivotal to the provision of high-quality care and effective charge management. However, many nurses are promoted to the role with no formal management preparation, or leadership skills, the may be apprehensive and in some cases reluctant to manage. Sherman (2005) suggested that providing a formal and structured educational program would improve leadership skills and confidence, resulting in less frustration and greater satisfaction for staff assuming the charge nurse role. According to McCallin & Frankson (2010) organizations must provide charge nurses with formal support to facilitate management development. Without the necessary preparation and ongoing in-service training these nurses may feel over whelmed, stressed and unsupported. Studies show nurses' become a liability to the institution when placed prematurely in the charge nurse role without proper training (Sherman, 2005). Additionally, they also play a central role in risk management for the organization (Sherman, 2005). Sherman & Pross (2010) state that a healthy work environment requires strong nursing leadership at all levels of the organization, but especially at the point of care or unit level where most front line staff work and patient care is delivered. The purpose of this proposal is to recommend a charge nurse development program that will improve and enhance the leadership and management skills of the charge nurse. The paper will address the following elements: Project objectives, review of literature supporting the need for an ongoing educational program for charge nurses, project methodology, timeline, formative and summative evaluation.

Practicum Objective
The objectives are the specific accomplishments the researcher hopes to achieve (Polit & Beck, 2008). The charge nurse development proposal objectives are:
1. Review three sources of evidence, literature, professional organization standards and
information from networking on charge nurse job description


2. Analyze the organization's charge nurse job description.

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3. Analyze the current role and expectation of the charge nurses through structured

interview with charge nurses and nurse leaders.

4. Compare and Contrast other charge nurse programs through a review of sources of
evidence in the literature review, professional organizations and networking activities.
5. Formulate recommendations for the implementation of a charge nurse competency
program based on synthesis of findings and organizational culture.
Review of the Literature
Historically, the role of the charge nurse has been part of a nursing management structure for many years (Sherman, 2005). Presently, many nurses do not have the essential leadership skills required to address problems, and situation in the charge nurse role. Charge nurses serve on the front line of the profession and they are expected to be responsible for patients, patient outcomes and safety, the well-being of the nursing staff, liability prevention, and managing multi-disciplinary team (Sherman, 2005).
Platt & Foster (2008) describe the outcomes of a Bespoke Charge Nurse Development Program which was designed to enhance the propensity of nurses to management structures. Evaluations from ninety-five charge nurses were obtained using an anonymous questionnaire.
The realistic consequence of the program was that charge nurses were empowered and more focused on resolutions.
Admi & Moshe-Elion, (2010) found that stressors on charge nurses' were specific to role conflict, ambiguity, and lack of support. Admi and Moshe-Elion research showed the need for educational training and ongoing support for charge nurses to develop their leadership skills and competency.
Moore & Hutchinson (2007) describe one organization's successful implementation of a shared decision-making structure that promotes an empowering work environment in which professional fulfillment and personal satisfaction can grow. With support and opportunity, leaders are developed across all levels of nursing. To address the need for leadership development skills, The American Organization of Nurse Executives, the Association of periOperative Registered Nurses, and the American Association of Critical Care Nurses developed a leadership model that identifies competency areas required for nurse leaders, and charges nurses (Sherman & Pross, 2010). The Nurse Manager Leadership Collaborative (NMLC) Learning Domain Framework was developed to cover skills necessary for successful leadership. Armstrong & Hedges (2006) describe the outcome of Stanford and Lucille Packard Children's Hospitals Charge Nurse Program design to improve competency in the role. The staff was expected to reapply for their positions and was given a 3 month trial to meet the new competency expectations. Staff that met the criteria or showed improvement were provided formal classroom training and informal mentoring. The consequences of the program resulted in a more proactive versus reactive approach to problem-solving, smoother unit operation and improvement in staff satisfaction and proficiency in role performance.
Based on the knowledge extracted from the evidence based literature, a decision was made to develop a charge nurse competency proposal.
Project Methodology and Resources
The methodology identifies the process applied to implement the project.
The sources required for this project are mainly human which include selected charge nurses, nurse leaders, and the assistance of the hospital librarian for the literature search, professional colleagues for networking, other shareholder, and the practicum preceptor. The methodology for the Charge Nurse Development project includes the following steps:
1. Conduct a systematic literature review from current literature on charge nurses' job
description and educational programs.
2. Analyze the current charge nurses practice, role and expectation through
structured interviews with charge nurse and nurse leaders
3. Network with professional organizations that have successful programs (American
Association of Critical Care, National League for Nursing, Association National
Association), and resources from Richland Memorial and Providence hospitals.
4. Present the findings from the resources of evidence to the practicum preceptor, nurse
leaders, director of education and other shareholders.
5. Present the proposed recommendations to the nursing management team or other
organizational shareholders as guided by the practicum preceptor.


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