Bossy Unit Clerks

  1. Does anyone else here have a problem with bossy Unit Clerks?

    The unit clerks at my telemetry unit seem to add to the already unbearable stress levels. I don't know how to deal with them because they do have a job to do but they don't seem to understand that I have priorities.

    Yesterday when I came on duty I was told that a patient would be transferring to another hospital. I assessed her, talked to her about the surgery and her fears, then began assessing my other FIVE patients. It seemed I was running into some big problems because I had a lady with chest pain and one with dyspnea, and one with BS of over 500. Every time I passed the nurses station this unit clerk would crab at me about getting the first patient transferred. I was on the phone with a doctor and she SLAMMED the papers down in front of me and said "they're downstairs waiting!"

    Figuring the ambulance was downstairs waiting, I went ahead and filled out the 15 pages of paperwork and handed it to her. She them said "Good, now I can call for an ambulance!" I said "What do you mean? I thought they were downstairs waiting?"
    "I meant ER had another patient waiting for the room" was her reply.

    I'm generally meek but I have gotten courage from this forum! I asked, "Is there ANY reason that patient in ER who is stable could not have waited until I assess all my patients this morning?" Another nurse then piped up, "Your patients are all FINE! I had them YESTERDAY!" So as you can see I had no support here and the unit clerks continue to harrass the nurses.

    How do the rest of you handle this kind of thing?
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  2. 70 Comments

  3. by   mattsmom81
    She sounds like a bully. You did the right thing by standing up to her. Sounds like you have some 'staff splitting' going on and people taking sides which is always a pain to deal with too..

    My advice is to stay professional (as you did) and make sure she knows YOU are in control of your group of patients (not her or the nurse who had them yesterday) and YOU will direct their care. And that you will appreciate her help in the future rather than her troublemaking or interference. (use your own word here...these may be a bit too confrontational for your unit....as I don't know the climate there)

    Another way to handle a bossy, demeaning coworker (if speaking directly to her doesn't work or is not something you want to do) is to ask for a meeting with her and your mutual boss and confront the person in front of your boss. Present the problem WITH a solution ie the clerk should not coordinate transfers before speaking directly to the nurse and getting the OK, and not before 9am unless it is an emergency, etc.

    This is how I would handle it...others may have better ways....good luck to you! Bullies on the job are always a challenge.
  4. by   BadBird
    I think we have all worked with bossy unit clerks, and god help you if they did not like you all your charts would be the last to have orders taken off. Management is well aware of them but they feel as long as a body is in the seat the work will get done, usually it means the nurse fills the role of the secretary too.
  5. by   VickyRN
    I went ahead and filled out the 15 pages of paperwork and handed it to her
    Nancy, it sure would have helped your situation (and might have helped circumvent this confrontation from occurring) if night shift had ALREADY filled out the reams of paperwork for you.
    I would approach your unit manager for a private meeting with her to discuss this situation (bossy unit clerk, demeaning coworkers, lack of coordinated help from night shift).
  6. by   OBNURSEHEATHER
    Originally posted by NancyRN
    Another nurse then piped up, "Your patients are all FINE! I had them YESTERDAY!"
    Well, you just handle it. I used to be pretty meek too. You just reach apoint where you can't do it anymore, or people will walk all over you and leave big ugly footprints!

    I start by being civil. Remind them that when 1 is busy, that usually means we're all busy. After that, all bets are off. I can be just as rude and nasty and have the potential to make their day just as difficult as they sometimes try to make mine!

    I quoted a particular part of your post because it struck me as odd. If that nurse had your patients yesterday, shouldn't she have taken them back again that day? Is continuity of care not a concern at your facility?

    Heather
  7. by   h2ogoddess
    Oh my I'm a Ward Clerk, I sure hope I don't add problems, I really try to help and remind the staff of things we need to do. But I try to know what is going on, , because I feel the patients are first.
    I will go ahead and do what I can and try to start what I can and then the staff can finish what they need to do.
    I do tell folks I work with you know how I am sometimes, if I get out of hand, remind me to get a grip!
  8. by   funnynurse
    If you don't get along with your unit coordinator, your day can and will be hell. I have been fortunate to have wonderful unit coordinators who always help me out tremendously! When I was a new grad, they saved my but plenty of times(you need this, that etc.) God bless them when they are good. One day we did not have a unit coordinator and I had to do it for four hours, well you can guess how that situation turned out, I refused future requests!!! When you are the coordinator, you are right there in the line of fire of everyone(nurses, md's, tech, families!) No where to hide you are just stuck:imbar
  9. by   SKM-NURSIEPOOH
    i would ask your nm to set-up a staff meeting (as this will involve & affect other clerks/nurses including those who have to routinely float) in order to incorporate some sort of protocol that can be established regarding transferring moving patients. i would also suggest that the paperwork could be more stream-lined (filling out 15 pages is far too much paper work for any nurse or unit clerk to have to do)...if one spent just one minute per page...well do the math & i know that there are days when several patients (having the same nurse) are transferred on the same day/shift....just think of the time being taking away from the patients filling out all of that paperwork....geezzzssh

    i know that this clerk seems pushy (& only you can be the judge of her attitude) but she also has a job that she's expected to perform which includes moving patients in order to admit more...& she's expected to do so in a timely matter (i'm sure this is one thing unit clerks are evaluated on at the time of their annual evaluations). unit clerks have to coordinate the patients' comings & goings among other tasks...they are vital in the operation of the unit.

    you see, this unit clerk was probably pushing you because she has experienced, sometime in the past, where she has been put-off by other (maybe not as nice as you) nurses & got the impression that her job isn't as important as theirs...so she seen an opportunity to flex her muscle with you (taking advantage of your nice personality). i'm not taking sides here...i just wanted to offer why she did what she did to you.
  10. by   NancyRN
    I knew I could count on all of you here to have some creative solutions for me! Thanks for the fast replies. A meeting sounds good but I don't think that'll happen. I can't get my Nurse Manager to even return a phone call. She's just never around. Being new-ish, its hard for me to know just how to react to these situations.
  11. by   adrienurse
    Our ward clerk is a saint. She's on holidays, boy did i have a crappy day! She is definately the brains of the operation!
  12. by   ageless
    I would kindly tell her that you appreciate all her help meeting the priorities of your patients, but make sure she understands that you set the priorities based on your assessment.
  13. by   prmenrs
    I wonder if it might have helped to communicate status on the other pts to her and/or the other nurse, bless her pea-pickin' heart, so that they might have realized your priorities?

    I've worked w/GREAT clerks, and not great ones. But it's true, ancillary help can make or break your day. Compliment the good ones, cajole the obstinate, and thank them when appropriate.
  14. by   knapejc
    One of my jobs in staff development was to work with unit secretaries/clerks and their education needs. A universal concern they had was that nursing was not aware of the multiple inputs clerks have to deal with, often without information that would make prioritizing those tasks easier. (For example, which patient is more stable? Why is assessment a priority ahead of a transfer that others are pressing forward? Which tests should be ordered before other orders are taken off? When to deal with a patient request versus calling a tech or the nurse? ) We seldom provide all the information necessary, yet we expect the individuals who fill these roles to fly by the seat of their pants, usually with a much lower educational level than our own. We have a bad habit of forgetting what they do not know.
    I would agree that this particular clerk was wrong. And for that matter, so was the other RN. And standing up for yourself is always correct. But conflict management skills here are critical if this isn't to be a repeat event. Ask the clerk to help you sort out why the problem occurred. . . they may have insight to a future solution. This also gives you an opportunity to educate about the importance of patient assessment in the kind of environment you describe. Otherwise you may only get short term defensiveness and continued bossiness in the long run.:kiss

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