Putting in your own orders

[SoundofMusic]

How often do you do this?

We have a few nurses on our unit who seem to put in a LOT of their own orders, just to either lighten the load on the secretary, or coddle her, one of the two. I know the secretaries work hard, but we have one who hassles ME because I don't put in a lot of my own orders.

I'm sorry, but I feel this is ludicrous on the part of the secretary AND these nurses who are just inviting adminstrative staff to push back work onto the nurse. We nurses are chained to our charts and computers ENOUGH, without now having the expectation of putting in our own orders. I can see if the secretary gets sick, or pulled to another floor or whatever, but if he/she is THERE -- I feel I have every right to expect that they DO put in my orders!

I got a really nasty poke from one of our secretaries the other day to "take a hint" and put in my orders myself like the "like nurse so-and-so does." This while I'm getting a new admit who had just received meds in the ER and was on the BSC every five minutes as soon as she arrived to the floor. What am I supposed to do? Leave the patient in need and sit at a desk putting in orders so this secretary can reduce her stress level?? We have another secretary who has NEVER expected this of me and puts in every order that's put in front of her, and quickly.

I do put in labs here in there, or the simple routine orders if I get a second -- but I'm NOT going to get roped into putting in 3 pages of new admit orders while I'm busy helping a patient, admitting them, assessing them, and helping a patient in need who is new onto the floor!

Are they units nuts or what?? Should I mention this to my manager or just let it go? I was SO mad at being digged for this, I almost wanted to cry.

[NurseKatie08, MSN]

I put in my own orders about 95% of the time---pages of new admit orders included. Of course that's because in my setting (sub acute rehab 3-11pm) we have no unit coordinator after 4pm. Usually the unit coordinator takes care of any labs that need orders before she leaves, but if labs and x rays are still pending we're on our own. Also we put in all of our admission orders (with nearly all admissions arriving on 3-11, mostly between the hours of 3 & 6), unless the unit is absolutely slammed with admissions, then the house supervisor will put them in for us.

I wish we had a unit coordinator after 4! But, in response to the OP, I don't see anything wrong with putting in your own orders in your setting if you are not dealing with patient care issues...if things were that hectic that the UC really needed your help, were you working with an aide that could have helped the pt on the BSC?

[chevyv, BSN, RN]

I work in ltc and have to do my own orders. Takes a long time. I agree that sooner or later if nurses keep doing the HUC's job, then the higher ups will make it mandatory. I would go as long as I can before putting orders in. Why do we as nurses complain about our work load and then do 'extra' work? Just wait until they make the nurses do it. The complaining will really start.

[canoehead, BSN, RN]

I'm in the ED and the secretaries can be buried, if you hand them a chart they may have 3 others going, and it may be 30min or more before they get to mine. If it's time sensitive, if I'm not as busy as the secretary, or if it's just one easy thing I'll go ahead and pop it in.

[rn4ever?]

On my shift (days), we don’t have to put in our orders because the secretary does that. If it’s a STAT order, they even have to chase down the RN and it’s their responsibility to let the RN know that the order is STAT. I know that your task as an RN can already be overwhelming. Sometimes, I know that even if we are already overwhelmed, we still help out with putting in some orders. However, it shouldn’t be expected that we would put it in. Why not talk to your NM about it and clarify this issue.

[Batman25]

Our US put in all orders when they are on shift. If we have an extra second we try and help out, but it's rare as we are so swamped. You certainly shouldn't be made to feel guilty for not doing their job. Sounds like they are taking advantage. I would talk to your CN.

[PostOpPrincess, BSN, RN]

I put in my own orders when there is no secretary.

Otherwise, she does it.

[pennyaline]

I haven't worked in a setting with a unit secretary for more than a decade (frankly, I figured they were extinct in most healthcare settings). My coworkers and I put our own orders in all of the time, and do everything else too.

Looks to me like your secretary wouldn't mind extinction. If that's the case, keep doing her job and she will disappear.

[nurturing_angel]

I work weekend option and don't have a unit secretary to put orders in. Fortunately, our computer charting allows our doctors to put their own orders in and they rarely ask us to do it for them. Its a wonderful system.

[zofran]

We have full on computer charting and the docs put their orders in themselves. I love this!

Although there are still a few docs who will write a bunch of orders under the MD to RN communication section....then I have to go through and enter them right. Our secretaries are not allowed and are even unable to order meds, consults, or treatments. They can order a diet or some things like abd binders or scd's.

I believe RN's should NOT have to enter pages and pages of orders. That is insane. We have too much to do as it is. I don't mind putting in a few orders now and again but I don't have time to enter all the orders and complete them too!

Try not to feel bad about this woman hinting that you should be doing this. I would just flat out tell her that you just don't have time to do it. The thing that sucks about being an RN is that you can do the aid's job and the unit secretary job but they cant do yours.

If your unit is anything like mine, your secretaries and aids leave right on time when the shift is over but you are stuck there charting! Because you have been doing EVERYBODY elses job all darn day. "sigh" :stone

[sasha1224]

I have yet to have a UC on my shift. All our orders are taken off by the nurses. We have a UC on days, however, the UC can't take off medication orders. So the nurses have to do this. Basically, the only orders the UC can do are consults, lab, dietary and xray. Most of these are day orders. If needed on noc, the nurse calls them. If you have a UC after hours, be thankful. If you have a day shift UC, be thankful. Having anybody to take off orders is a boon.

[CathyLew]

you should know how to enter your own orders--for when soemone else is swamped...but we use it as a double check system. One person, usually the Ward secretary, puts in the orders, and the RN checks the orders. if you put them in and are the one checking them off, there isn't a second set of eyes looking at the orders until 24 hr chart check. Having one person put them in and the nurse checking them off-- its just a better way of checks and ballances.