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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. 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. 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. 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.

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

The global healthcare ecosystem is in chaos, caught in the convergence of pandemic-induced disruption, residual inequities, burnout, and turnover. Nurse leaders can either succumb to the churn or spot—and seize—a rare opportunity for true transfor¬mation. They must thoughtfully consider all aspects of their traditional roles and tack¬le trigger topics such as staffing, schedul¬ing, value-based care, outcome tracking, and more. Informed, empowered nurses can re-envision roles, integrate technolo¬gies, and develop new models to deliver the highest level of patient care. The Innovation Handbook is a pragmatic guide and toolkit that seeks to enlighten nurse leaders as they evolve through the current crisis. Author Bonnie Clipper explains concepts and equips nurses with a knowledge foundation that enhances their innovation skill set, spurs ideas and creativity, and challenges them to think differently and apply new concepts. On the cusp of a once-in-a-generation opportunity to create a better future for nursing and healthcare, this book gives nurses the tools to meet the moment!

Purpose: To describe the development and psychometric testing of the Supportive Supervisory Scale (SSS). Methods: The development of the items of the scale was based on Winnicott's relationship theory and on focus groups with 26 healthcare aides (HCAs) and 30 supervisors from six long‐term care (LTC) facilities in Ontario, Canada. Content validity of the 15‐item instrument was established by a panel of experts. Based on a secondary analysis of data collected from 222 HCAs in 10 LTC facilities in Ontario, Canada, the SSS was subjected to principal components analysis with oblique rotation. Findings: A two‐factor solution was accepted, which is consistent with the theoretical conceptualization of the instrument. Factor I was labeled Respects Uniqueness and Factor II was labeled Being Reliable. Internal consistency of Factor I was .95, and that of Factor II was .91. Discriminant validity was also established. The focus groups revealed that “being available to staff” while “recognizing the HCA as an individual, and taking a moment to get to know them” was essential to feeling supported by their supervisor. Conclusions: The SSS is a reliable and valid measure of supervisory support of supervisors working in LTC facilities. At the core of supportive supervision is the supervisor's ability to develop and maintain positive relationships with each HCA. It is through respecting the uniqueness of each HCA and being reliable that supervisor‐HCA relationships can flourish. Clinical Relevance: Supportive leadership in LTC settings is a major contributor to HCAs’ job satisfaction and retention and to quality of patient care. Therefore, a tool developed and tested to measure supervisors’ supportive capacities in LTC is primal to evaluate the effectiveness of supervisors in these environments.

Master the critical-thinking and test-taking skills you need to excel on the prioritization, delegation, and management questions on the NCLEX-RN®. Over 1,000 questions in the text and on DavisPlus focus only on prioritization, delegation, and management of care issues pertaining to individual and multiple clients with an emphasis on alternate-format-item questions. Three sections provide you with three great ways to study. In the first section, you’ll find individual and multiple client care-focused scenario questions organized by disease process with rationales and test-taking hints. The second section features seven clinical case scenarios with open-ended, NCLEX-style questions. The third section is a comprehensive, 100-question exam.

Background Charge nurses are considered as part of the front line managers in healthcare system. The aim of this study was to explore charge nurses’ perceptions of competency. Methods This qualitative study with content analysis approach has been done with 17 semi-structured and deep interviews with 9 Charge Nurses (CNs), 2 matrons, 3 supervisors and 3 head nurses. The deep interview has been collected based on openended questions and if necessary, the exploratory questions and the ones extracted from the nurses’ real experiences in the clinical setting. The content analysis has been done using Zhang (2009) Qualitative Content Analysis Method. Results The data analysis has resulted in extracting 5 themes, 10 categories, 30 subcategories and 166 main codes. Five themes include: selfmanagement, others’ management, clinical competency, professional-legal competency and perceptional-cognitive competency. Conclusion The present study derived results can be used by the on-job training planners so that to promote the CNs’ competency as quickly as possible through executing the short-term training programs and prepare them better for management and clinical responsibilities. BJMS, Vol. 24 No. 03 July’25 Page : 931-937

The mental health of nurses participating in patient care is under threat amid the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify the mental health status (depression, anxiety, and stress) and its influencing factors on nurses who provided patient care at a specialized hospital for COVID-19 in South Korea. Of the 180 nurses who participated in this study, 30.6% had moderate or higher levels of depression, 41% had moderate or higher anxiety levels, and 19.4% had moderate or higher stress levels. In this study, stigma influenced nurses’ mental health, such that the higher the stigma, the higher the nurses’ depression, anxiety, and stress. Depression was higher in female nurses than in male nurses, and stress was higher in charge nurses than nurses in other job positions. Therefore, a management program should be designed to improve the mental health of nurses during the current pandemic. In particular, a solution to reduce stigma is required, and the mental health of female nurses and nurses in leadership roles requires special attention.

Introduction. Little is known about how shifting hospital visitor restrictions issued by national health authorities were communicated, managed, and adapted by hospital charge nurses during the COVID-19 pandemic. Aims. To describe the shifting visitor restrictions and the passing on of restrictions from the national authority level to charge nurses and secondly describe charge nurses’ management of the restrictions and their challenges when enforcing them. Methods. The study consisted of a document analysis and a cross-sectional survey including open-ended questions. Descriptive statistics and qualitative content analysis were used. The survey was distributed online to 88 charge nurses in somatic units in a Danish university hospital from March 2020 to April 2021. Results. Restrictions were communicated from national authority level in an effective administrative cascade. The charge nurses led their enforcement in each unit. In total, 71 charge nurses (81%) responded to the survey. For 70%, the wording of the restrictions was clear, while 31% found them challenging to handle. On a weekly or daily basis, 68% of the charge nurses deviated from the restrictions. They identified both upsides and downsides to the absence of relatives. Communication, collaboration, and leadership were experienced as key tools in the ongoing processes of adapting to shifting restrictions. Conclusion. During this severe health crisis, essential information was passed on through well-defined management levels in an effective communication pathway. Charge nurses and their professional values were challenged when balancing shifting national restrictions against individual needs of patients and relatives. Implications for Nursing Management. Charge nurses serve as vital intermediaries between national authorities and frontline nursing practice in managing shifting visitor restrictions during a pandemic. Their experiences can contribute to further qualifying nurse managers’ considerations when designing family-centred hospital visitor policies for the future. Also, they may strengthen the handling of future sudden major organizational changes.

When emergency department staffing is inadequate, patient care may be missed. Information regarding the association between missed care and staffing is lacking in the emergency department setting. This study aimed to explore considerations for and configurations of staffing patterns and their relationship to missed care, missed decompensation, and delays in care. This study used an exploratory qualitative approach with data derived from focus groups and analyzed using qualitative content analysis. A total of 39 emergency nurses in varied roles attending a national conference were recruited. The Consolidated Criteria for Reporting Qualitative Research checklist was used to guide the reporting of this study. Participants reported information grouped into 5 major categories: ratios, staffing patterns, work ethic, role of administration, and missed care. Both staff and charge nurses reported a preference for a 1:3 nurse-to-patient ratio, with higher patient ratios described as leading to missed care, missed decompensation, and delays in care. The individual and institutional elements of staffing decisions may have a significant impact on patient outcomes in the form of missed care, missed diagnoses, and delayed care. Staffing decisions may also affect the psychological health of emergency nurses by fostering burnout. Across roles, nurses perceive a disconnect between the ED environment and staffing plans generated by persons outside the department. Future research should focus quantitatively on relationships between staffing patterns and patient and nursing outcomes.

The ultimate goal for Doctor of Nursing Practice (DNP) leaders is to develop skills that will support their ability to lead effectively through complex challenges-such as working within the constraints of tight budgets, initiating health care policy change to eliminate health disparities, and improving health care outcomes at all levels of care. This text is an invaluable instructional guide for nursing graduate students who are developing the skills needed to fulfill this new and emerging role of clinical leadership. With this book, nurses can develop leadership skills that will ultimately transform health care practice by incorporating innovative professional models of care. It provides critical information and practical tools to enhance leadership, drawing from the works of experts in business and health care leadership. This book is an important resource for DNP students, nurse practitioners, and current clinical leaders dealing with the challenges of health care for the next generation.