From Shift Pressure to Structured Response: Applying RUISAⓇ as a Conceptual Framework for Charge Nurse Operational Coordination

Charge nurses occupy a central coordination role in acute care settings. Existing literaturesuggests that charge nurse work involves communication, situational awareness, clinicaljudgment, nurse-patient assignment, patient-flow management, and frontline leadership underpressure. Related research also indicates that handover quality, staffing conditions, burnout,and care coordination influence safety and operational performance. This paper argues that thecharge nurse role can be usefully understood not only as a leadership position, but also as areal-time operational coordination function. To support this interpretation, the paper appliesRUISA®—Roles, Users, Information, Situation, and Actions—as a conceptual framework forexamining how fragmentation may emerge in charge nurse work and how support systemsmight be designed more coherently. RUISA® is presented here as an interpretive andtheory-building framework rather than as an empirically validated predictive model. The paperproposes that visibility, continuity, readiness, and response are four practical domains throughwhich the charge nurse role can be examined and strengthened. It further argues thatpractice-informed frameworks may be useful in surfacing operational realities that are oftenexperienced in frontline care but insufficiently organized in formal role descriptions.Keywords: charge nurse; operational coordination; handover; patient flow; staffing; situationalawareness; RUISA®