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Discussion

Double Checking Unit Secretary's Computer Order Entries?

I work a combination of nights and evenings at a small community hospital. My FTE is 0.6. A few months ago, I was filling in on days and noticed that the unit secretary does not print out the labs and no one goes into the computer to check them before signing off orders. I brought this up to our QA gal, and to my manager, who sent everyone a memo. It lasted about a week, and now no one is checking them again.

One of the evening unit secretaries came back from an extended maternity leave since I added evenings to my night schedule to bring up my FTE. She also doesn't print them out, and everyone is trusting her. I told her that I wanted mine printed out and she definately copped an attitude, although she did it. On nights we don't have a unit secretary so it's not a problem. We do chart checks and do find orders not entered.

These unit secretaries are both in their thirties with strong personalities. There is a lot of visiting and chumminess that goes on at the desk. They are constantly attending to their personal life on the phone, and act like they are in charge at times. The day secretary is otherwise excellent at her job, and knows the hospital like the back of her hand.

I've brought this up more than once to my manager. I think it goes against basic nursing good practise to not doublecheck order entries, right?

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It is always, always, ALWAYS the RN's responsibility to check all orders for accuracy. The buck stops with us......and the one time we don't check them, it'll come back to bite us in the butt. :stone It doesn't usually take more than once for the average nurse to 'get it'........sounds like you've either got some slow learners at your workplace, or management isn't consistently enforcing standard practice.

My advice to you is to continue doing what you're doing, and check those orders each and every time.......it's a PITA sometimes, with all the million and one other tasks we have to do in a given shift, but like everyone else, even the best unit secretaries are human, and they make mistakes. It's our job to catch them before they reach the patient........IMO your co-workers' laissez-faire attitude is just a lawsuit waiting to happen. :stone

My philosophy -- if I've signed off the orders, I'm saying I know they are either done or ordered. If orders are being missed by the unit clerk, then they are not doing their job and management needs to be aware.

This is a little peeve of mine. Our unit secs sign off on the orders they enter, but there is no proof that they are entered, or entered correctly. I very often do not have time to double check the computer, and honestly - I feel like I shouldn't have to shoulder everybody's mistakes. Not only that, but a day shift nurse notes that order - if anybody double checks the computer, it should be her. At my old hospital, the clerks noted the order number next to each order - that way you didn't have to go back into the computer to check if it had been entered. If it was something you wanted to make sure was in correctly - you could just search by the order number to do it instead of wading through everything looking for it.

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