Training Nurses for Charge Nurse Duties through Simulation

Purpose:

A charge nurse  is responsible for  patient safety, quality of care and team functioning during the shift. Also, the charge nurse must care for some  patients in addition to performing management duties. Every Israeli registered nurse is expected to function as a charge nurse after about  two years of nursing experience. Commencing performing charge nurse duties is a stressful situation for a novice nurse. The anxiety and uncertainty that novice charge nurses feel stem from lack of experience in managing other staff members, the multitask nature of the job and the required on-going, sometimes critical, decision making.  This stress is aggravated by more complex in-patients and shortage in manpower which may avert rapid yet quality response to emerging needs. Traditionally, novice nurses learned to perform effective shift management through trial and error. In order to diminish this stress and increase effectiveness, the novice nurse should be specifically prepared for charge nurse duties.

It is suggested that a specific workshop, based on simulations that portrayed real world situations in a controllable format, may provide an effective nurse's preparation for successful performance of the charge nurse duties.

Methods:

 The present study is a prospective and comparative with a convenience sample of 40 registered nurses during their first year of charge nurse duties' performance. 24 of them were trained for the charge nurse position by simulation-based workshop , while  the others were prepared by lectures only. Both the groups were comparable in regard to age, gender and ethnicity. The study was based upon observations by the shift supervisors on the novice charge nurse's accomplishment of shift management's tasks . Each observation was scored by checklists that were developed and validated by the researchers. In addition, the Script Concordance Test , evaluating decision-making and self-confidence was performed by the novice charge nurses 6 month after commencing shift management. The questions were developed by researcher and validated by the expert judgment.

Results:

The results indicate significantly higher performance levels of simulation group.  Levels of decision-making  and self-confidence are significantly higher amongst simulation group.

Conclusion:

Simulation techniques provide a realistic yet safe learning environment that more closely represents clinical care, efficiently prepare novice nurses for shift management tasks and improve their self-confidence.