3. Should charge nurses be included in the bargaining unit? CASE STUDY 5-1 Oakhurst Hospital, an acute care hospital with 257 licensed beds, has approximately 181 staff registered nurses (RNs) who provide direct care to patients in 10 patient care units. The patient care units are behavioral health, emergency room, intensive care, intermediate care, medical/

surgical east, medical/surgical west, operating room, pain clinic, post-anesthesia care/recovery, and rehabilitation. The RNs report to the on-site nursing manager, clinical managers, clinical supervisors, and assistant clinical managers—all supervisors.

In providing patient care, RNs follow the doctors’ orders and perform tasks such as administering medications, running blood tests, taking vital signs, observing patients, and processing admissions and discharges. RNs may direct less-skilled employees to perform tasks such as feeding, bathing, and walking patients. RNs may also direct employees to perform tests that are ordered by doctors for their patients.

Many RNs at the hospital serve as charge nurses. Charge nurses are responsible for overseeing their patient care units, and they assign other RNs, licensed practical nurses (LPNs), nursing assistants, technicians, and paramedics to patients on their shifts. The charge nurses do not assign employees to the shifts; that function is done by a staffing office at the hospital. Charge nurses also monitor the patients in the unit, meet with doctors and the patients’ family members, and follow up on unusual incidents. Charge nurses may also take on their own patient load, but those who do assume patient loads will sometimes, but not always, take less than a full complement of patients. When serving as charge nurses, RNs receive an additional $1.50 per hour.