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If you are a registered nurse (RN) looking to step into leadership, becoming a charge nurse allows you to both oversee patient care and manage nursing teams. This role requires strong communication skills and the ability to handle various challenges. Are you up for it? Here’s a look at skills and steps needed for this position.��

As the name implies, charge nurses are the nurses in charge. You may also hear them called the lead nurse, nurse leader, head nurse or the nurse in charge. They make real-time decisions for both nurses and patients, serving as the authority figure and advocate for their unit or department. They oversee the nurses, patients, schedules, activities and equipment within their unit.

Quite a few responsibilities fall under the jurisdiction of a lead nurse. For starters, they oversee and report on patients and attend patient rounding. For example, if they notice a patient’s bed alarm is continually going off, they consult with the bedside nurse to see what’s going on and collaborate on the nursing care plan.

Additionally, they serve as a sounding board for nursing decisions, providing guidance to bedside nurses. In this capacity, they act as mentors to new staff, and as a liaison between nurses and doctors, nurses and managers, and nurses and supervisors, all while advocating for both nurses and patients.

Other key charge nurse duties and responsibilities include managing patient admissions and transfers, ensuring they are appropriate for the unit and nurse-patient ratio. (Charge nursing requires collaborating and coordinating with lead nurses on other units when transferring patients.)

These nurses also manage scheduling, including creating the nurses’ patient assignments, calling off nurses for shifts, requesting on-call or per diem nurses, sending nurses home early or assigning nurses to float to other units.

The head nurse is responsible for performing safety checks on equipment, such as ensuring the crash cart is stocked and requesting replacement trays or medications. If the unit has controlled substances, they perform medication counts with another nurse before the end of the shift. Other duties vary depending on the unit and nursing specialty.

Depending on where you work, head nurses may have their own patient assignments in addition to their charge nursing responsibilities, although that load is usually reduced to accommodate leadership duties. For example, when I worked as a charge nurse in the ICU, I would occasionally have one patient when short-staffed.��

Other common charge nursing duties include assisting with hands-on care and providing dressing changes and wound care.

When doctors, patients or family members are upset, they often turn to the nurse in charge. Same goes for nurses themselves. For these reasons, the head nurse must be prepared to have difficult conversations, mediate conflicts and de-escalate tense situations. Strong interpersonal skills are essential to handle these situations with grace and tact.��

Some nurses pursue basic life support (BLS) certification, which certain employers may . Depending on the unit and specialty, an aspiring head nurse may also need an advanced cardiac life support (ACLS) and/or pediatric advanced life support (PALS) certification. Remember, these nurses serve as the lead nurse, so they need to be prepared to act and make decisions in emergencies.

Some facilities offer additional training for head nurses, and hospital or facility policy may even require it before a nurse can take on this role.��

When looking to prepare for a leadership role like this, you may wish to seek continuing education courses that focus on leadership, communication, legal and ethical dilemmas, time management, and patient safety and quality care.��

To begin your charge nursing career, you must first become an RN whether via a nursing diploma, ADN, ASN or prelicensure BSN program, then passing the NCLEX exam and receiving your RN license through one of the state boards of nursing. After that, gaining hands-on clinical nursing experience is essential.

While your specialty choice isn’t critical, working in a unit aligned with your goals, such as a neurological unit for nurses interested in neuro-ICU, can be beneficial. Generally speaking, starting in the medical-surgical unit or emergency department provides broad experience, often with diverse patient populations, which is valuable for future head nursing roles.

Once you have an RN license and clinical experience, connect with your nursing manager and fellow lead nurses to discuss the steps needed to advance to a lead nurse position. Their guidance can help you understand any additional skills, training, industry certifications or experience required by your facility.��

Several fields, such as critical care, oncology, pediatrics and telemetry, offer specialization opportunities for charge nursing. Specializing can allow you to develop expertise in a particular area, which may open up additional career paths.

Remember, as the nurse in charge, others will look to you for advice and guidance. To excel in this role, you will have to stay up to date on best practices within your specialty and may even have to pursue a specialty nursing certification. This in-depth knowledge of specific patient populations or treatment protocols will give you valuable experience that can be applicable in other roles.��

As the lead nurse, you will learn how to navigate complex situations and balance competing needs, such as supporting bedside nurses while considering hospital budgets. These experiences provide the problem-solving and decision-making skills essential for higher leadership roles, in which you’ll apply similar abilities to different challenges.

Additionally, having charge nursing experience can support your nursing career portfolio, showcasing your ability to manage teams, make critical decisions under pressure and support both staff and patient needs. Having this level of experience can demonstrate your readiness for more advanced roles and makes you a strong candidate for jobs.