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Students and nurses new to the experience of the “charge nurse” role experience challenges stemming from variances in the quantity and quality of training and supervised practice offered to adequately prepare them for the responsibility.  In nursing schools, training opportunities for management and delegation of patient care assignments is limited.  This aspect of clinical leadership incorporates elements of critical thinking, effective communication, and clinical judgment.  Although students are developing these skills, there is often little opportunity to formally train in the role of charge nurse and to practice the delegation techniques used to make safe and effective patient assignments.
This poster describes one exercise to simulate the activity of the charge nurse/shift coordinator in creating patient assignments in a postpartum unit.  Using a virtual cast of nurses and patients, undergraduate nursing students create assignments and discuss rationales for their choices.  The profiles of the virtual nursing staff were designed to capture the diversity of skill mix and personal temperament that might be found in a real-life unit.  The patients in the unit on “The Shift From Hell” were designed to provide the charge nurse –in-training with sufficient challenge to invoke critical thinking and logical reasoning based on emerging knowledge and experience in the postpartum area.  Students are then challenged to justify their patient assignments using rationale that incorporates both the unique needs of the patient population as well as the professional and interpersonal capabilities of the nursing staff available in the scenario.  Additional dimensions such as physical layout of the unit and ancillary resources enter the discussion (which is facilitated by the clinical instructor) and augment the problem-solving nature of the activity.  This exercise is considered a low-fidelity simulation, however, the rich imagery of the patients and nurses involved are engaging.  This exercise had been used with 3^rd year baccalaureate nursing students during their maternal-newborn clinical rotation who report (anecdotally) that the activity increases their awareness and appreciation of the charge nurse role.
Participants attending this poster session are encouraged to try their luck as charge nurses on “The Shift From Hell”, and to discuss and debate the assignment decisions they make.  This exercise, and variations of it, may be useful learning tools for training in aspects of the charge nurse role.