You are a great nurse and you know it. You are right at home on your unit and work reasonably well with your colleagues. You have found decent middle ground within which to co-exist with most of the doctors and you’re an unlikely target for bullies. 

You notice process gaps or administrative errors and jump in to fix them without being asked. You attend employee meetings, have served on committees, and genuinely believe your health care organization performs a beneficial and needed service to the community.

Perhaps you have trained in new nursing graduates along the way or won an award for great patient care. You’ve mastered the new electronic health record software recently implemented. Your performance reviews are positive and you have decided that all the sacrifices you endured during nursing school were worth it.

Know what this means? It’s time to shake things up a bit and expand your comfort zone! Take a moment and visualize yourself as a charge nurse.

A charge nurse does much of what you are already doing in terms of providing direct patient care. It’s nursing — taken up a notch — to actually coordinate the activities of the unit and directs, organizes and assigns work to the nursing staff either on a particular unit or during an assigned shift.

According to Salary.com, the average median salary for a charge nurse in the U.S. is $72,564 as compared to R.N.s nationally at $66,713. The average rate of pay is higher in San Francisco ($87,657), New York City ($84,610) or New Orleans ($73,507) and a bit lower in Boise, Idaho ($70,042), Pensacola, Fla. ($64,437) or Roswell, N.M. ($41,797). Most charge nurses have between 5-15 years nursing experience but in high-demand areas with a bit of previous supervisory experience and advanced education, such a promotion can happen inside of two or three years.

Here are 6 tips to become an effective and successful charge nurse.

  1. Familiarize yourself with the business side of health care. Always remember that you are in the business of health care first, a nurse second. Keep an eye on the bigger picture of your unit and beyond. As physicians David A. Asch and Kevin G. Volpp of the Harvard Business Review blog pointed out last year in What Is the Business of Health Care? (9/13/12), people don’t want health care, they want health. Furthermore, the authors claim that traditionally unquestioned trust in health care professionals has eroded as “we're getting much better at identifying, measuring, reporting, and targeting health outcomes.” That includes the outcomes of your patients, of your nursing. So brush up on evidence based nursing practice literature. Take a stab at understanding your organization’s annual report while you’re at it, as well as keeping an eye on health care issues in the news. For a more day-to-day approach, remember that one of the best hats you can wear is that of “above and beyond customer service representative” to patients and their families and friends. Reputation management of your organization is in your hands and you will make or break patient referrals. There is a great deal of best practices information available on this topic. Stay informed.
  2. Continue your education. Already have your R.N. license? If not, move forward on attaining this increasingly minimum requirement. Look at earning your BSN or MSN, specialize. Along the way, intentionally choose continuing education courses that focus on nursing leadership. Don’t scoff at anything that doesn’t have CEUs attached. Join AONE: The Voice of Nursing Leadership, for example. Check out the array of books available through Nursing Knowledge International and STTI. Watch daily for great articles related to continuing education on NurseTogether.com.
  3. Determine your leadership style. Are nurse leaders born or made? That debate could rage on without end so focus instead on how to develop your own natural leadership traits into a well-respected force to be reckoned with (emphasis on the well-respected part). If you are not sure what kind of leader you are, simply Google ‘leadership styles’ to quickly get up to speed on the topic. You can also Google ‘leadership styles in nursing’ for truly spot-on advice. Keep in mind that there can be a marked difference between the type of leader you want to be as compared to the type of leader you actually are (or think you are). About.com has a great quiz titled ‘What's Your Leadership Style?’ which is based on the work of Kurt Lewin's 1939 study in which he identified three major leadership styles. Much of the research on leadership styles conducted since then is rooted in his early great charge nursework. Look for those leadership styles in action when youconduct informational interviews with current and former charge nurses as you plot the next steps in your career.
  4. Start thinking (and acting) like a supervisor. This starts by being a role model to those around you. In other words, personify the traits of a model employee and team player. Walk the talk. Look/dress the part with scrupulous attention to the dress code. Being a supervisor starts with thinking and acting like a true professional. Professionalism (and its counterpart, graciousness) is that value-added component you bring not only to the job but to the benefit of those around you. Realize the effect you have. You alone can make or break morale on the unit during your shift. Think you’re short-staffed now? You don’t want to add to it by driving your fellow nurses right out the door in search of greener pastures.
  5. Engage in brutally honest self-reflection. Ask questions of those who know you at various levels (including your boss and his/her boss) and solicit honest feedback. Take that feedback to heart. What makes you a great nurse? In what ways are you still rough around the edges or downright inflexible? Do you demonstrate the healthy habits you preach to others? Which natural nursing leadership traits have you exhibited? Are you consistently genuine and sincere in your interactions with others? Have you been intimidated or bullied by others? Hopefully not, but if you have or even suspect as much, take control of your work life! Self-improvement starts with self-awareness and a commitment to positive change.
  6. Thicken your skin. This can mean a number of things including not taking things personally and being able to withstand (sometimes harsh) criticism from below, above and all around you. Being in a supervisory position can make even the strongest of souls just a wee bit paranoid from time to time. Realize that you won’t be immune from negative assumptions, yours or others. As Fred Kofman blogs about on LinkedIn (with a highly appreciative fan following), there is an essential quality of being ‘response-able’ which is how you choose to live, work and respond based on the choices that you recognize as available to you. If you’re feeling stuck, chances are you’re not seeing the bigger picture. So, tune up your attitude, straighten your backbone and thicken your skin to get through the tough days and appreciate the good ones. 

Ultimately, a charge nurse is a leader. It is what you set your mind to accomplish. Career development requires clear goals (Charge Nurse), a timeline (within the next 12 months) a measurable plan of action (see above) and your supervisor’s support. Now, imagine where you might go from there!