Which nurse typically leads ED operations as the relief charge during a shift?

• A. The orienting ED nurse
• B. The relief charge nurse
• C. The nurse who has floated between ED and ICU
• D. The nurse who would like to cross-train

Answer: (B)

Leading ED operations during a relief shift is the responsibility of the relief charge nurse. This person steps in when the regular charge nurse is unavailable and takes charge of the department’s flow, overseeing bed availability, patient assignments, and staffing decisions for that shift. They coordinate with other units, direct throughputs, and ensure safety and policy adherence while quickly problem-solving to prevent crowding. This role requires situational awareness, decisiveness, and the authority to reallocate staff and resources as needed.

The orienting ED nurse is focused on onboarding and learning the unit, so they typically don’t hold the operational authority to lead the entire ED during relief. The nurse who has floated between ED and ICU may have broad experience, but without a designated leadership role for that shift, they aren’t the formal leader of ED operations. The nurse who wants to cross-train is a learner and not the person assigned to run the ED during a relief period.