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Int J Older People Nurs. 2019 Dec;14(4):e12259. doi: 10.1111/opn.12259. Epub 2019 Jul 12.

Unpacking the multiple dimensions and levels of responsibility of the charge nurse role in long-term care facilities.

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Toronto Rehabilitation Institute University Health Network, EnCOAR Team, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Toronto Rehabilitation Institute University Health Network, Toronto, Ontario, Canada.
Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.



The charge nurse in long-term care facilities (LTCFs) performs a multiplicity of tasks that range from oversight of the entire facility to directly assisting residents in activities of daily living. In order to refine resident-centred care strategies and to increase the quality of care provided in LTCFs, this study aims at gaining a more nuanced understanding of the different dimensions of the charge nurse role as a central figure in these institutions.


Data were generated through semi-structured interviews. A purposive sample of ten Registered Nurses in a charge nurse role, diverse in experience, age, gender and background, was recruited from five LTCFs in Ontario, Canada. The study used a combination of conventional and direct qualitative content analyses.


All tasks performed by the charge nurses were categorised in four dimensions: clinical, supervisory, team support and managerial. Administration was a cross-cutting sub-dimension which has gained presence over the years. Depending on the shift worked and the organisational structure of the facility, each dimension gained or lost weight as part of the overall role.


These findings suggest that the charge nurse role is in a state of flux and lacking standardisation within and across facilities. LTCFs would benefit from increasing recognition of the role according to the wide range of tasks performed and responsibilities assumed, and by recruiting their charge nurses accordingly.


The proposed conceptual framework could be used to map and assess charge nurses' workloads and responsibilities, in order to enhance staff satisfaction and resident-centred care in LTCFs.


charge nurse; long-term care; nursing homes; organisational structure; qualitative content analysis; registered nurse

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