Didn't know I'd have to do additional jobs besides mine!

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So, I'm at a unit that is always understaffed on the tech and secretary side. I'm told repeatedly, "get this experience, because you won't always have a tech, and make sure you also know how to put orders in and do this and that because we don't always have a secretary." Just can't seem to find anyone to do these jobs, they say and staff us adequately.

Well, that obviously means the hospital has the money to pay these folks, but can't hire any in.

So, since I'm being asked to do THEIR jobs, as well as MY job, shouldn't I perhaps receive that extra pay for those responsibilities -- at least a differential of some kind on those nights where we're having to do this triple duty type of work?

I'm sorry, but I'm finding myself doing the job of not only a nurse, but also that of a tech and a secretary -- I should get paid extra for that.

And how can we say that everyone should be "cross-trained?" Are the techs cross trained to do my paperwork? My assessments? Give meds? Are they "crossed trained" to deal with docs and be the end of the line person in terms of responsibility for the patient? No, they are not.

This is NOT cross training - this is asking nurses to do three jobs at once.

How are other units with this?

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It is really nice to have a unit secretary and techs but, no, you can't always depend on them being there, and, in that case, it's still the RN's responsibility to make sure that everything (all the necessary stuff, anyway) gets done. Lots of places routinely only have unit secretaries on 1st shift, and, if you work 2nd or 3rd, you never have a unit secretary and you are responsible for entering all your own orders and doing all the other necessary secretarial work ... (Same with techs -- it's great to have them to help, but if, for whatever reason, you don't have one, most of the stuff they would ordinarily do still has to be done, by someone.)

It's not that you're being asked to do other people's jobs on top of your own -- it's a matter of sometimes having more help to get all the stuff done that is, ultimately, your responsibility as the RN. I'm certainly not saying that that is justification for a facility understaffing units or not filling open positions, but, IMHO, it's not just appropriate but necessary to "cross-train" RNs to be able to pick up the typical tech and secretary tasks -- because it's not really cross-training, it's all your (the RN's) job in the larger sense.

That's how I see it, anyway. :) I'm sure you'll get other responses with other views.

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Specializes in ICU/ER.

I like the concept of getting paid more when you dont have a secretary and or tech. But odds are that will never ever happen.

On my unit we have no secretary we enter in all our orders and have no techs. We also take out the trash and wash out the BSC and wipe down the towers behind the beds as housekeeping does not do that.

On the Med Surg floor they dont always have a ward clerk, and many times they dont have CNAs. In mgmts eyes it is not doing 3 jobs at once, it is doing complete care. Be happy when you do have the extra staffing and help, but for sure learn how to do it yourself as you cant count on always having the help.

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Specializes in Utilization Management.

I like your point--if you're routinely expected to do three jobs, higher wages might be in order.

However, I have to agree with Elkpark too. It is our job to make sure all these things are done.

I look at it this way -- being cross-trained will only help me do my job faster in the long run than if I had to ask someone to show me how every time.

If the unit secretary is busy with admissions and I get a stat lab or test, I can enter it myself without waiting for her to find it or having to interrupt her to do it.

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Specializes in SICU.

I have to agree with Elkpark. The duties of an RN include all patient care. Bathing, feeding etc are part of pt care. Getting orders done, including writing them on the MAR and placing them into the computer is part of nursing.

The fact that some of our lesser duties can be delegated to others (techs and sectaries) does not make them not ours. We still need to supervise our techs and make sure they have done their job correctly. We are still the one responsible to look over the MAR and do the chart check and make sure that orders have been subscribed correctly.

Nursing schools need to do a better job of explaining just what a nurse is and does. Too many new grads and quite a few older nurses seem to think that these basic functions of nursing (that have been given to others) are now beneath them. I am NOT saying this is the OP's view.

I hope that the OP hospital provides extra staff (nurses) for those times that you do not have the assistant help. However, I know most hospitals don't and you get to work even more short with increased work load.

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No, don't feel those jobs are beneath me at all. But I don't see how that AMOUNT of work can be completed sometimes on one shift by one individual. I'm not just putting in STAT orders -- I'm putting in ALL my orders, all night long. I'm not doing total care here and there -- I'm doing total care on all my patients, all night long, turning, emptying foleys, doing things that techs should do, and then trying to fit in my own job of managing my pt's care from A to Z and complete a mound of paperwork.

It's just TOO MUCH, and NO, they do not prepare you for this in nursng school. Or maybe then did and I wasn't paying attention -- entirely possible because you really can't understand it until you experience it and see the totality of what they expect of you as the nurse.

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Specializes in NICU, PICU, PCVICU and peds oncology.

On our unit the nurse is also the nursing assistant, unit secretary, physiotherapist, pharmacist, porter, social worker and chaplain. Even when we have any of those people on duty, they're usually too busy or unavailable when you need them to actually be of help. The bad thing is, the only nurses who are taught how to process those nasty computerized orders are the elite selected to be in charge. If s/he's off the unit, covering a break in an isolation room or not around for whatever reason, it has to wait. I needed a stat portable chest xray (and our radiology department won't send up a tech until the order's in the computer) on a patient who later died of a suspected PE, and it had to wait half an hour until I could find someone who knew how to do computer order entry and another 20 minutes for the tech to get there. Then there's the fact that we only have two computers on the whole unit that have the software to do order entry anyway. Are we ever given extra nursing staff when we don't have auxillary staff on? HAAAHAAAAHAAAAA!

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Specializes in Tele.

I agree with you, we should get paid more for fixing our own charts, putting in orders, doing our own "tech" stuff..........

but in the end.... we are left to do that.

I've had to clean rooms too, and take out garbage like the cleaning people!!!!

not all the time, but sometimes I have to do extra jobs just because I am the RN and i have to make sure my room is ready when my patient comes in. I know it's alot, and it's unfair for me.

but things will never change.

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Specializes in Tele.
No, don't feel those jobs are beneath me at all. But I don't see how that AMOUNT of work can be completed sometimes on one shift by one individual. I'm not just putting in STAT orders -- I'm putting in ALL my orders, all night long. I'm not doing total care here and there -- I'm doing total care on all my patients, all night long, turning, emptying foleys, doing things that techs should do, and then trying to fit in my own job of managing my pt's care from A to Z and complete a mound of paperwork.

It's just TOO MUCH, and NO, they do not prepare you for this in nursng school. Or maybe then did and I wasn't paying attention -- entirely possible because you really can't understand it until you experience it and see the totality of what they expect of you as the nurse.

you said it sister!!!!!

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Specializes in Rodeo Nursing (Neuro).
It is really nice to have a unit secretary and techs but, no, you can't always depend on them being there, and, in that case, it's still the RN's responsibility to make sure that everything (all the necessary stuff, anyway) gets done. Lots of places routinely only have unit secretaries on 1st shift, and, if you work 2nd or 3rd, you never have a unit secretary and you are responsible for entering all your own orders and doing all the other necessary secretarial work ... (Same with techs -- it's great to have them to help, but if, for whatever reason, you don't have one, most of the stuff they would ordinarily do still has to be done, by someone.)

It's not that you're being asked to do other people's jobs on top of your own -- it's a matter of sometimes having more help to get all the stuff done that is, ultimately, your responsibility as the RN. I'm certainly not saying that that is justification for a facility understaffing units or not filling open positions, but, IMHO, it's not just appropriate but necessary to "cross-train" RNs to be able to pick up the typical tech and secretary tasks -- because it's not really cross-training, it's all your (the RN's) job in the larger sense.

That's how I see it, anyway. :) I'm sure you'll get other responses with other views.

I certainly agree that the RN is responsible and accountable for all aspects of the patients' nursing care, and it's worthwhile to be able to do all of the aspects, yourself, if necessary. At my facility, we're occassionally short of aides and have to pick up some of the slack, at times. It's typical for two nurses to share an aide, so even when we aren't short, the aide may not always be readily available when a patient needs to toilet or needs a bath, and I don't think many of us would make them wait for an aide to get them water or an extra blanket. I really like my facility, but if I were having to do total care on 5-6 patients on more than a once-in-a-blue-moon basis, I'd be gone in a heartbeat.

Our orders are computerized, so we enter them ourselves into the computer, if the doctor doesn't. Our clerks aren't even permitted to take and enter doctor's orders. Usually, the night clerk does get a printout of all current orders to file in the permanent chart, but if that doesn't get done on nights, it's just more work for the day clerk. Running without a clerk, even on nights, is a bummer, and also an exception.

It's true, aides and clerks are "nice" to have. Running water and electricity are also handy. If you have to run without them for awhile, you can't just close the hospital, so you make do as best you can, but they aren't "extras," they're necessities.

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Specializes in Rodeo Nursing (Neuro).
On our unit the nurse is also the nursing assistant, unit secretary, physiotherapist, pharmacist, porter, social worker and chaplain. Even when we have any of those people on duty, they're usually too busy or unavailable when you need them to actually be of help. The bad thing is, the only nurses who are taught how to process those nasty computerized orders are the elite selected to be in charge. If s/he's off the unit, covering a break in an isolation room or not around for whatever reason, it has to wait. I needed a stat portable chest xray (and our radiology department won't send up a tech until the order's in the computer) on a patient who later died of a suspected PE, and it had to wait half an hour until I could find someone who knew how to do computer order entry and another 20 minutes for the tech to get there. Then there's the fact that we only have two computers on the whole unit that have the software to do order entry anyway. Are we ever given extra nursing staff when we don't have auxillary staff on? HAAAHAAAAHAAAAA!

And when a patient someday dies for lack of adequate support staff, it's the nurse's fault.

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I am so tired of having to do all the other jobs! Either we are short techs or if not I can't find them half the time. Yes it's true that know how to do all of the pt. care, but it's physically impossible. Let's see should I bathe, sit up in chair, change linen, and feed the pt. OR give them this BP med to lower the BP from 190/90, and not to mention my other pts. I'm going to protect my license and worry about what is going to get my pt dead. Plus I have to chase MD's around all day to get orders for this or that to protect their job. I am a new grad so I may be slower at this, but I talk to seasoned nurses who share my opinion. No wonder nurses get burnt out. Pt have crazy acuity, at least where I work. It isn't safe for them or me. Plus I am in debt from student loans and I just spent the last 5 yrs in school making no money-I ask myself is it all worth it? Does it get better the longer I do this or will I just come to be desensitized to it.

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