Unit secretaries a must

truern · Oct 15, 2006

Our unit secretaries almost always process the new orders.....if I did my own I'd still have to find another RN to red sign. The secretaries include a printout of the online orders so we can verify that it was indeed entered correctly. I have enough to learn!! LOL

Pediatric Critical Care Columnist · Oct 15, 2006

Not a new grad, but would ABSOLUTELY love it if our unit secretaries did something (anything!!) other than answer the phone, print patient labels and drop the lab results printouts on the overbed table for me to file...

GeminiTwinRN, BSN · Oct 16, 2006

as an icu tech while in school, i can tell you that when i work as US, i not only take off ALL orders, i also attach labs to the fronts of all charts, load supply carts, take all the labs to the lab at least 6 times a day (on the even hour) plus all stats, assist with anything else that needs to be done as well. of course, being in a busy icu for the am-pm 12's, most of my time is spent taking off orders.

i'm surprised this isn't the norm!

cardiacRN2006, ADN, RN · Oct 16, 2006

I have enough to learn!! LOL

No kidding!

If it is something as simple as a single med or two, then I'll transcribe them myself over on the MAR for no other reason than I don't want to be without my chart for so long. But, I need the unit clerk! They are lifesavers!

EricJRN, MSN, RN · Oct 16, 2006

I've tried to get in the habit of doing them myself and I can now get them knocked out faster that way, but if I'm getting slammed I don't have a problem taking the orders to the unit secretary.

RainDreamer, BSN, RN · Oct 17, 2006

Our Unit Secretary is a lifesaver! When one of our Unit Secretaries can't make it in, we have a nurse that knows how to run the desk fill in because our unit is just so busy to not have someone solely running the desk.

I'm not sure what you mean exactly by "processing the orders". We note all the orders and let the secretary know if things need to be ordered (i.e. x-ray, ultrasound, echo, MRI, consults, etc) and she will order those through the computer. Also she orders all or our labs. However, we do our own meds. We note the med orders, copy them onto the MAR, and then scan down a copy of the order to pharmacy so the new meds will be printed on the next days' MARs. We just do our own meds since we need 2 RNs to verify the order and sign them off anyway.

The hospital I worked at before, in the well-baby nursery, ended up getting rid of the unit secretaries on night shift and it was an absolute nightmare!! On the nights we were busy (which was just about every night), it was insane to have admits coming in one after the other, we'd have to get the charts ready, call in the admission information, send in all the paperwork, make the labels, get the labs ordered, etc, etc. ....... along with taking care of our other patients ...... it was insane.

I wouldn't mind learning how to do my own orders and such if I needed to, but I definitely don't take the unit secretaries for granted!

youngatheart · Oct 17, 2006

I work at nights 7p-7am. We have a secretary until 11pm then after that we process our own orders which is fine with me. During the day it would be really hectic to do your own orders.

MIA-RN1, RN · Oct 18, 2006

I like having our secretaries available to take off orders and to get the charts organized but I tend to do it myself simply because then I don't have to double check it and because I am just obsessive enough to worry it won't be done right. Some of the secs are awesome and I have no worries but some make mistakes that can be frustrating.

Gompers, BSN, RN · Oct 18, 2006

I think our unit secretaries are going to be phased out eventually. Well, we need them to answer the phone and greet visitors, but because we do almost everything on the computer now, there is nothing much for them to do.

Our docs enter ALL our orders on the computer. Then we nurses see the orders, hit a key to acknowledge them, and then we can implement them. Pharmacy, blood bank, radiology, respiratory therapy, etc. - everyone gets their orders off the computer so the secretary has nothing to process. This is great because there is no waiting and it's MUCH more safe because there isn't a non-medical staff member trying to decipher physician orders. It's also great because it happens at the same time - while you are reading an order for a new medication, pharmacy already has the info and has started preparing it. Or X-ray is already on the way up before anyone has even picked up the phone to call them. It's great!

But in hospitals where technology hasn't taken over, and most of the orders are hand-written and need to be processed - then yes, there is a definite need for at least one unit secretary at all times. Nurses don't have time to be doing all that.

RainDreamer, BSN, RN · Oct 18, 2006

I think our unit secretaries are going to be phased out eventually. Well, we need them to answer the phone and greet visitors, but because we do almost everything on the computer now, there is nothing much for them to do.
Our docs enter ALL our orders on the computer. Then we nurses see the orders, hit a key to acknowledge them, and then we can implement them. Pharmacy, blood bank, radiology, respiratory therapy, etc. - everyone gets their orders off the computer so the secretary has nothing to process. This is great because there is no waiting and it's MUCH more safe because there isn't a non-medical staff member trying to decipher physician orders. It's also great because it happens at the same time - while you are reading an order for a new medication, pharmacy already has the info and has started preparing it. Or X-ray is already on the way up before anyone has even picked up the phone to call them. It's great!
But in hospitals where technology hasn't taken over, and most of the orders are hand-written and need to be processed - then yes, there is a definite need for at least one unit secretary at all times. Nurses don't have time to be doing all that.

Wow, that would be great to have the docs just enter the orders on the computer and then they get sent to whoever (x-ray, pharmacy, etc.). I wonder why we don't do that ....? We do all our charting on the computer. The unit secretary orders everything on the computer. So I wonder why they aren't doing it how you described. Hmmmm .....

grentea · Oct 20, 2006

Usually, my floor has to go begging for a unit secretary on my shift. If we have a gaggle of admissions, we'll get one for an hour or two from a another floor to help us with admissions. Every once in a while, we get lucky and have one for half of our shift which is really all we need. If a hospital doesn't do physician order entry, I think a unit secretary is necessary. I do not really have time to run out patients' rooms to answer the phone, process orders, and coordinate communication between doctors, in addition to passing my meds, doing my assessments, changing dressings, and everything else I'm supposed to do. Ever since our secretary has been gone, I've spent way too much time being a secretary. Oh and don't even get me started on the whole thing where one doctors wants another doctor to call him or her while I have three bells going off and my meds are late. I just politely say, "Well do you have their number? Here it is. Call them." Plus I've been encountering a lot of chicken scratch on physician's orders in addition to MDs clearly not looking at meds or labs the patients ALREADY got or had ordered. A fairly commonplace one (since I've seen this situation a few times in the past month) is to order Lasix (first dose to start "now") without realizing that patient ALREADY got Lasix in the AM. I call up the doc asking, "Did you really want the pt to get 80 mg of Lasix IV today?" Nine times out of ten the answer is no. ARGH. It takes up so much of my time! Ok well I feel better now. Sorry about the rant that got a little off tangent, but really if my floor had a secretary things would be a little better. And physician order entry is a looooong way away at my hospital. *sigh*