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In Charge (Nursing Leadership Teamwork)

Clint Maun, CSP

Like no other time in history, healthcare organizations rely on critical leadership and team-based skills to accomplish success on a daily basis. This is particularly important in the nursing department since it has the greatest number of employees. Nursing must exhibit effective leadership to ensure success within their departments, which include how the departments relate with everyone in the organization.

Today’s charge nurses, unit managers, nursing coordinators and supervisors must be in a position of leadership for the organization to be successful. We cannot allow charge nurses to be tattletales, snitches, or ombudsmen involved only in nursing-related interventions. The organization needs all individuals involved with "in-charge" activities (including the Administrator, DON, and management team) to inspire everyone to:
  1. Set a positive, productive tone at the start of the shift.
  2. Deal with successful hiring processes.
  3. Achieve intimate involvement in budget and qualitative implementations (this is where we blend together the issues of quality and quantity of work).
  4. Become involved in successful coaching interventions (providing positive and negative feedback).
  5. Develop a sense of "can do" for daily implementation.
  6. Implement detailed discussions with other management team individuals from other departments that affect the day of delivery on that unit.
  7. Provide a sense of leadership around family and resident concerns.
  8. Ensure the documentation is appropriate for the day of delivery on that unit so the organization can receive regulatory compliance and reimbursement success.

The Director of Nursing, Administrator and management team must coach, develop and train charge nurses to take responsibilities as mentioned above. Many charge nurses want to be in charge, but are not allowed because the organizational structure is not designed to let them take on leadership duties. In some situations the DON may not want to relinquish control and involve them in leadership responsibilities. In turn, some charge nurses expect "charge pay", but do not want to be "in charge", except for "nice" employee relations, not tough leadership decisions.

The organization must move toward a charge nursing leadership model that leads them to success from today forward. Discussion needs to begin immediately within small groups to include the Administrator, DON and charge nurses to determine what needs to be implemented for successful leadership by the charge nurses. These small group discussions and training sessions are the most appropriate way to handle this type of leadership involvement. We find that mass training classes for all charge nurses actually does not further the necessary culture change work of leadership development.

Maun-Lemke has developed a leadership video and audio tape series called "In-Charge" that allows the organization a point of reference in where to begin.

Click In-Charge for more information. There are many other reference tools available. What is important, however, is that today's healthcare organizations get busy with this important leadership activity as soon as possible.