Bossy Unit Clerks

[NancyRN]

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?

[thisnurse]

we have a secretary that is absolutely AMAZING. she knows in her HEAD.. most of the phone extensions in the hospital. she knows policy and procedure better than any of us. she gets EVERYTHING done. and she is the person i go to for help.

i am truly awestruck by the way she does her job.

[mattsmom81]

I guess nursing school should include a course on "How to work with difficult people" to prepare our new nurses for the world they are entering, eh?

I had a manager who 'punished' staff too....... everytime one of us asked for a meeting she took the opportunity to collect dirt to throw at us. It's like 'don't bother me or I'll make you regret it.'

I wish I had all the answers on how to deal with nasty people on the job. I do know it's important to develop a stone face and calm, professional responses....totally nonemotional....to avoid becoming a victim of these jerks who enjoy upsetting others. Standing up for ourselves professionally and calmly confronting all the mixed messages we get on the job is a good start...like 'so boss, do you want me out on time OR do you want every scrap of paperwork completed??? I cannot do both...

I had a day shift US who came in 45 minutes early every morning to 'move into her space' at the desk. I was night charge on a busy unit AND without a secretary, and I was assembling last minute lab works, calling docs, wrapping up the last details of my shift as well as making day shift assignments, etc. and she delighted in getting in my way....never helping, just 'moving her stuff in for the day', making personal calls, sitting in my chair, etc... I took her aside and told her it must stop, that she was disrupting my change of shift routine and there was no reason for her to be there at that time of the morning, and I would be glad to take this to the Critical Care Director if this practice did not stop.

She was always very careful around me after that...but she ran roughshod over the day shift charge nurses who did NOT stand up to her.

[Padawan-Nurse]

I work with one of those Bossy Unit clerks, and she is in charge of me! I am a male unit clerk in a Trauma ICU, and I have seen that she treats the RN with respect, but plays queen bee with the other Unit Clerks. I offer run to other side of the unit to work. And the bad thing is they know that she is a bad unit clerk, but they put up with her behavior due to the fact that she knows all...I have only one year to wait until Nursing School. Our jobs as unit clerks are stressful in a different way that our jobs and I think that I would rather be a Nurse than a unit clerk.

[KaraLea, LVN]

Originally posted by NancyRN

"Your patients are all FINE! I had them YESTERDAY!"

Oh, really? They were fine? What was pt #1's chest pain level yesterday? What was pt #2's respiratory rate yesterday? What was pt #3's Blood sugar yesterday? AND, just why do you not have the same assignment today that you had yesterday? Maybe we should switch assignments and you can take care of all of these "FINE" patients...

[ratchit]

Those patients were all fine yesterday? I think we've all had patients who were fine 30 seconds ago, they're seizing or in VT NOW. If you dealt with 15 pages of paperwork before seeing the patients who you took report on and are responsible for, would your management back you up if a patient died because you were checking boxes on forms? Doubt it. And was this a surprise transfer that was ordered within the last hour? If not, why wasn't that paperwork started the previous day by that nurse who gave you a hard time?

This has some similarities to change of shift admits. A patient is sitting in the ER or in PACU with an RN assigned to him... Why does that patient have to come up at 6:45? That is great for the ER or PACU nurse but it really screws the receiving nurse, who now has 2-8 complete unknowns to walk into, one of them being brand new and with a whole set of admit stuff to do. (Unstable/crashing patients being a different story of course, and I've been an ICU and PACU nurse- and I never dumped change of shift admits on other units unless I had just no other choice.)

You got dumped on, my dear. And your manager showed very poor judgement in using the meeting you asked for to intimidate you. You said you're new-ish. If you are a new nurse, have hope- there are better places to work out there. Good luck.

[ratchit]

.

[h2ogoddess]

May I ask here, what do your Unit Clerks wear to work?

I must dess like the Nursing Staff, which makes me look like Nursing Staff. As soon as a pt. or family see me, they need me answer questions or help mother to do whatever she needs to do. I refer all most all questions to the RN's as I should, but dressing like Nursing only makes for confusion for pts./visitors.

What are your thoughts?

[AIS52]

I usually wore scrubs but once in a while I would wear regular clothes (maybe kahkis and a sweater, etc). Once for Halloween I dressed up really scary- that's right, I wore a tie to work. My costume? A 9-5 person!

Actually, I found it really doesn't matter what you wear, the families will still be confused.

Never was I bossy or rude. Sure its really annoying when a nurse would use my phone to take report with 3 open ones or lean over my shoulder to check labs with two other computers open but I generally took it all in stride- unless it was early July and found a new intern in my seat. Look out!

I definately appreciate the Unit Coordinators and everything they do. I also think EVERY nurse should spend a week as a U.C. to see what they have to deal with on a daily basis. Sure the job isn't physically demanding (usually) but it definately is mentally!

[NancyRN]

Nobody ever said Unit Coordinators don't work hard, but a unit clerk should not add to the stress on an already stressful unit. Nobody should, but the unit clerk has no license to lose if a patient is neglected and something goes wrong.

I can't understand why my venting about a bossy unit clerk would bring out superfluous comments about what a hard job THAT is.

I don't need to spend a week in any other job to know how hard it is. I don't know anyone who has an easy job in health care these days. Having a hard job does not justify bullying coworkers. Ever.

[mattsmom81]

I was a very quiet, nice girl when I started nursing school...but life has a way of toughening us up fast or we become victims.

Trouble is, people start sniping at each other and the workplace gets even worse....so many units today do not have strong leadership to curtail the bullies, and young nurses may not have good role models. The sniping gets turned on one another in our frustrations.

Just another symptom of the dysfunctional health care system we love.

[MollyJ]

Unit Clerks: In their defense: they do work that is mighty accountable and their knowledge and time management skills can really change a unit (for better or worse). Usually rotten pay and lots of accountability.

UC Humor: Especially if they've been their along time, they can be powers to be reckoned with. We had a great UC who could get pretty salty now and then. Everyone was busy; we were getting hammered with admits that had lots of "routine coronary care orders" which in the day of manual req's could really eat up a UC. Finally, one of us made one request too many and she snapped, "If you give me a broom, I'll put it up my butt and I can sweep the floor, too."

Yes, ma'am.

nancy,

are you new to this unit? It seems like your getting some, "your not doing it our way" messages from your NM, other staff nurses and UC's. Now this doesn't mean you should drop it all and do it their way, but my rule of thumb is that it can take up to a year for new colleagues to notice you have a brain. I've had some really difficult people learn to put up with me after a year and then they even became my friends. The fact is you learn more about each other in that year and you learn to flex to what is important to them and vice versa.

Let yourself get a little distance from this "ouch" situation. Sometimes, in these "we gotta move" situations, you have to deviate from your usual norm. Do head to toe assessment on your highest priority patients, vitals and a superficial assessment on lesser priorty patients, get your transfer gone, go back and do the rest. I know, I know. It takes you out of your routine, you risk forgetting things, you feel out of sync for a time. Sometimes it's what you have to do.

I am sorry that your NM didn't say, Ah but Nancy, you arranged this discussion. What did you want to say to me? She missed a chance to do some relationship building with you. She dropped the ball.

Sounds like a busy unit. I like Heather's reply about when one is busy, that usually means we are all busy. Rarely is there one right way to do a situation and so I would not venture to say you were right or wrong. Step back from the situation and in the future play with ways to do it. I'm a former ED nurse and we relentless rag on a unit when we're holding a patient. Guess who fields those calls? Your UC.

Good luck Nancy. Time can be a great friend.

[NancyRN]

LOL about the broom! Thanks for the input, Molly.