Charge nurse development: What does the literature say?

Early Career Nurses' Experiences of Engaging in a Leadership Role in Hospital Settings

BACKGROUND

Early career nurses (ECNs) can be expected to assume shift charge nurse leadership roles quickly upon entering practice. Since the emergence of the COVID-19 pandemic, junior nurses may find their leadership capabilities tested further as the challenges of leadership are made increasingly complex in the context of an infectious disease outbreak.

PURPOSE

The purpose of this qualitative study was to explore early career registered nurses' (RNs) experiences of engaging in shift charge nurse roles in hospital settings.

METHODS

This study used an interpretive descriptive (ID) approach. Semi-structured, in-depth interviews were conducted with 14 RNs across Ontario, who had up to three years of experience and who had engaged in a shift charge nurse role in a hospital setting. Recruitment and data collection took place from January to May 2021 during the COVID-19 pandemic. Interviews were recorded, transcribed, and analyzed following the principles of content analysis.

RESULTS

Content analysis of the 14 participant interviews revealed four main themes: nominated and necessitated into leadership, diverse and demanding responsibilities, factors that help and hinder, and leadership as an impactful experience.

CONCLUSIONS

Study findings provide insights into potential strategies to support ECNs in shift charge nurse roles, during the remaining course of the COVID-19 pandemic and beyond. Greater support for nurses who engage in these roles may be achieved by promoting collaborative unit and organizational cultures, prioritizing leadership training programs, and strengthening policies to provide greater clarity regarding charge nurse role responsibilities.

Ensuring Throughput: Development and Validation of Charge Nurse Competencies for United States Emergency Care Settings

INTRODUCTION

Charge nurses are shift leaders whose role includes managing nursing resources and facilitating appropriate patient care; in emergency departments, the charge nurse role requires both clinical and leadership skills to facilitate the flow of patients, while ensuring patient and staff safety. Literature on orientation and specific training is notably sparse. This study aimed to evaluate the content and process of core competency training and identify evaluation and implementation strategies necessary to improve charge nurse performance in United States emergency departments.

METHODS

A modified Delphi technique was used in phase 1 and a qualitative content analysis method was used in phase 2 to address specific aims of the study.

RESULTS

In total, 427 emergency nurse managers, directors, educators, and charge nurses responded to the initial survey to identify elements, teaching modalities, and evaluative processes; 22 participated in 1 of 2 focus groups to provide further information about the pedagogical approaches to teaching emergency charge nurse competencies. The top 5 competencies were identified as patient flow management, communication, situational awareness, clinical decision making, and nurse-patient assignment, with understanding that each competency overlapped significantly with the others. Low-fidelity simulation and gamification were identified as a preferred method of both training and evaluation.

DISCUSSION

These findings have the potential to support a standardized approach to emergency charge nurse training and evaluation focusing on communication skills, clinical decision making, and situational awareness to facilitate safe and effective nurse-patient assignment and emergency department throughput.

Supporting Ambulatory Nurses Transitioning From Direct Care to Leadership: A Pilot Project

Frontline nurse leadership is foundational to career progression and succession planning, but preparation is often limited. COVID-19 has further complicated this process by limiting access to professional development resources typically available to new leaders. This article discusses the implementation of an innovative onboarding program that combined a web-based toolkit, mentor network, and precepted shadow shifts to navigate challenges associated with the pandemic and overcome barriers to frontline nurse leader preparation in the ambulatory care setting.

Evaluation of a charge nurse leadership development program

A pilot study evaluated the change in charge nurses' perception of their leadership skills after engaging in a 4-month structured leadership program. Based on a self-assessment, multimodal education using authentic leadership tenets and an appreciative inquiry framework increased participants' confidence in their skills.

Scoping review protocol examining charge nurse skills: requirement for the development of training

INTRODUCTION

The charge nurse (CN) holds a position in clinical-administrative management and is essential for improving the quality and safety of care in healthcare institutions. The position requires five essential skills: leadership; interpersonal communication; clinical-administrative caring; problem solving; and knowledge and understanding of the work environment. The scientific literature has not widely examined the importance of providing these skills as part of initial training, nor when CNs begin their duties. This study aims to fill this gap through an exhaustive review of the literature with the aim of developing standardised training for the CN when they start in their position.

METHODS AND ANALYSIS

A scoping review using the Joanna Briggs Institute framework will be conducted. The CINAHL, MEDLINE, Science Direct and Cairn, databases as well as grey literature from ProQuest dissertations and thesis global database, Google Scholar and the website of the Order of Nurses of Quebec will be queried using keywords. Relevant literature in French and English, published between 2000 and 2022 will be retained. The CN is the target population. Outcomes address at least one of the five CN skills, describe how they are operationalised and what their impact is on the organisation of work and quality of care. This analysis will identify essential and relevant elements for the development of standardised, up-to-date and appropriate training for the position of CN.

ETHICS AND DISSEMINATION

Ethical approval is not required, as data does not include individual patient data. The results will be published in peer-reviewed journals, presented at conferences and presented to nursing managers and directors.

SCOPING REVIEW REGISTRATION

Research Registry ID: researchregistry7030.

Role and Training of Emergency Department Charge Nurses: A Mixed Methods Analysis of Processes, Needs, and Expectations

INTRODUCTION

Charge nurses (CNs) are shift leaders who manage resources and facilitate patient care, yet CNs in EDs receive minimal training, with implications for patient safety and emergency nursing practice. The purpose of the study was to describe the experiences of emergency nurses related to training, preparation, and function of the CN role.

METHODS

An explanatory sequential mixed methods design using survey data (n = 2579) and focus group data (n = 49) from both CN and staff nurse perspectives.

RESULTS

Participants reported minimal training for the CN role, with divergent understandings of role, required education and experience, the need for situational awareness, and the acceptability of the CN taking on other duties.

CONCLUSIONS

The ED CN is critical to the safety of both nursing environment and patient care. Nurses in this pivotal role do not receive adequate leadership orientation or formal training in the key areas of nurse patient assignment, communication, and situational awareness. Formal training in nurse-patient assignment, communication, and situational awareness are critical to appropriate patient care and maintenance of interprofessional trust necessary for successful execution of the CN role. ED nurse managers should advocate for this training.

Impact of Evidence-Based Charge Nurse Education on Charge Nurse Skills and Nurse-Specific Metrics

OBJECTIVE

This research study was designed to analyze the impact of an evidence-based charge nurse (CN) education program on novice and experienced CNs' self-confidence and satisfaction with the role, skill competencies, and nursing metrics.

BACKGROUND

Charge nurses are critical to effective daily unit operations. However, executive nursing leadership found that unit performance varied by CN despite experience.

METHODS

University faculty partnering with nurse leaders developed an evidence-based CN education program including a series of classes, coaching in skills and role responsibilities by nurse leaders, and evaluation of skills competencies before and after the CN education program.

RESULTS

The CN program was associated with significant positive changes in CN performance, nurse-specific metrics, hospital-acquired events, and patient satisfaction.

CONCLUSIONS

Interventions targeting frontline leaders positively impact CN performance.

Evaluating the Efficacy of an Evidence-Based Charge Nurse Professional Development Activity at a Highly Complex Veterans Affairs Medical Center

Incompetent charge nurses negatively impact quality patient care. An analysis of a charge nurse professional development activity intervention included pre- and posttests, an activity curriculum evaluation, and staff satisfaction surveys. Posttest scores improved significantly (t = 60, p = .001). All participants rated the professional development activity as highly appropriate and beneficial to their nursing practice.

Exploring the Charge Nurse Role Transition: A Qualitative Study of the Novice's Perspective

The novice charge nurse role transition is not well understood. This article reports on a qualitative descriptive study of the novice charge nurse role transition. Rubin and Rubin's responsive interviewing was used. Fourteen novice charge nurses participated in Zoom interviews. Thematic analysis revealed three phases: taxiing to the runway, takeoff, and reaching cruising altitude, each with distinct themes. Nursing professional development practitioners can use these findings to better understand and support new charge nurses through this transition.

Nursing leadership succession planning: paths for elaboration

OBJECTIVE

To describe the construction of a nursing leadership succession plan for a hospital based on the appreciative reflection of nurses.

METHOD

Descriptive exploratory study with a qualitative approach carried out with nurses in a federal public teaching hospital. Data collection was carried out in two stages. The first was an individual interview, and the second was group mediation conducted based on the 4D Cycle and the assumptions of Appreciative Inquiry. Descriptive analysis of the findings was carried out.

RESULTS

The data showed a highly qualified team of different generations, concerned with succession planning based on scientific evidence, involving teams and carried out carefully for nurses at different stages of their professional careers.

CONCLUSION

The principles of Appreciative Inquiry allowed the construction of a succession plan to enhance leadership development actions in the hospital. The collaborative environment between generations was valued and planning focused on participatory management was created in the process. This aspect can profoundly change the institution's internal policy in several areas and point out ways to implement succession planning in different contexts.

A Charge Nurse Orientation and Development Program: An Evaluation

Role transition from clinical nurse to charge nurse can be challenging. The purpose of this quasi-experiment was to evaluate a charge nurse orientation and development program, designed to increase nurses' confidence regarding this role. Patients' response to care as a result of this program was also assessed. It appears that nurse confidence regarding this transition improves following a formal intervention. Regarding patient satisfaction, charge nurse visits to patients increased as well.

Developing nurse leaders: Toward a theory of authentic leadership empowerment

AIM

The aim of this article is to present a theoretical synthesis of the theory of authentic leadership and the theory of structural empowerment. The new middle-range theory, Theory of Authentic Leadership Empowerment (TALE), is meant to be used as a guide for the professional development of nurses into leadership roles.

BACKGROUND

The Institute of Medicine's Future of Nursing Report calls for nurses across all levels and settings, to develop leadership skills to address the ever-growing complexities in health care. However, the best approach to developing nurse leaders is not known.

DESIGN

Walker and Avant's method for theory synthesis was used. The two theories were critically appraised from a philosophical and theoretical perspective. Then the theories were synthesized by nesting structural empowerment concepts into authentic leadership to arrive at the proposed TALE.

RESULTS

TALE highlights how a nurse's individual history, personal values, ethics, and the organization's structure interact and influence the development of leaders who are authentic.

CONCLUSIONS

TALE offers nurse leaders, nursing professional development practitioners, and other stakeholders concerned with developing authentic leaders a holistic theoretical framework to understand leadership development at the individual level while also accounting for the importance of contextual influences.

The Effectiveness of Charge Nurse Training on Leadership Style and Resiliency

OBJECTIVE

The study objective was to investigate a charge nurse pilot training program as an effective, evidence-based training modality to improve leadership style and resiliency.

BACKGROUND

Leadership is inherent and necessary in the charge nurse role. Little published research about charge nurse leadership training programs exists.

METHODS

A pre-post design, with intervention and comparison groups, was conducted at an integrated healthcare system. A random sample of charge nurses was selected to pilot a standardized charge nurse leadership training program including in-person learning to foster leadership skills and nurture resiliency.

RESULTS

The sample included 19 control participants and 22 intervention participants. Significant improvement was noted in transformational, transactional, leadership outcomes, and resiliency from preintervention to postintervention for the all subjects. Of the 22 intervention participants, the training elicited higher satisfaction with leadership behavior, followed by effectiveness and their ability to motivate. Charge nurses who attended training had higher resiliency scores pre-post intervention.

CONCLUSION

The charge nurse pilot training was an effective program that led to improved leadership style and resiliency.