Nurses as secretaries

[SoundofMusic]

This is an idea that I feel is very unsound in nursing, and that is to place a nurse in the role of secretary for the day. Because our hospital has frozen hiring now, and because we can't keep a secretary to save our lives, now we as nurses are starting to be assigned as secretaries for the shift.

I feel this is just outright stupidity and a human resource management issue. You take a degreed person w/ nursing skills and make them work in an administrative role? Why? I mean -- you're basically paying a person almost $30 per hour to enter orders.

In this job market, there would be plenty of folks who would be willing to do the job temporarily, or as part of a pool, perhaps w/o benefits, or part time, or whatever. I don't get it. Isn't this a waste of money/human resources?

And then we have nurses on the flloor who can do it, and are very good at it -- and management loves them. Meanwhile, I can't do the job, because I feel it's sort of complicated. I mean -- you've got to know what your'e doing, especially on day shift -- so now I feel inadquate that I can't do the job! If I ask for a training day, they look at me like I'm nuts -- oh, you just jump in and do it -- and get trained on the way.

But I still feel it's an improper use of clinical personnel.

[SharonH, RN]

You do understand that the work you're downplaying as "administrative" (which is erroneous, by the way, as it is supportive and not administrative in any respect) is what we were taught to do in nursing school, don't you? Accurate order transcription and maintaining complete documentation was stressed from Day 1, and in the days before unit clerks and unit secretaries, nurses did it and patient care too. And since maintaining charts and orders is also part of patient care, it's not out of line to expect us to be able to do it.

Further, during my time as an RN I've worked more often without secretaries and clerks than with them. They would be hired for busy shift, then cut back or phased out secondary to budget concerns. They didn't work off shifts, and they didn't work weekends. That left it for us, and until the severe cuts in nursing staff numbers came it wasn't really a huge issue to have to do our own paperwork, write our own MARS, do our own computer data entry, etc.

From your post, I gather that you're concerned about this perceived misassignment of clinical personnel because you are personally uncomfortable about taking the "secretarial" role. You have little basis for complaint. You've already had more training than unit secretaries and clerks get, so you can't claim that as a reason to not take on the responsibility. You just have to get over yourself and jump into it, perception be damned. You'll learn it, quickly. It's in your interest to do so because in case you hadn't noticed, the more adaptability you have on the job, the more likely it is that you'll keep it.

You were taught clerical work in nursing school? Really???! I know I wasn't. Did they really teach that at your school? I know how to put in orders, break down charts, etc but that was learned strictly OTJ.

No one is downplaying the importance of the unit secretary. God knows I'm not but as the OP stated this is a human resource management issue. Using nurses as secretaries is stupid and a waste of skilled manpower. I would hate to be out on the floor humping with a load of patients while a nurse was sitting at a desk answering phones and putting in orders.....a vital function to be sure but we already have people who do that job: secretaries.

In my experience, there was a tendency to devalue the role of secretary when a good secretary has to basically keep the floor on an even keel in addition to the work they have to do. If you put the wrong person in that chair, things can fall apart on the floor very quickly. On many busy med-surg floors where I've worked, we had two secretaries, that is how fast and furious things were flying.

It's possible that there are several issues influencing the inability to keep a secretary: workload, pay, work environment, who knows? But the OP is absolutely right that it is inefficient and a waste of fiscal and human resources to put a nurse in a secretary's chair. I see no evidence that she looks down on that role. Do you also advocate that nurses fill in for housekeeping, maintenance, dietary, etc?

[Ellekat]

We also are our own secretaries....try admitting a patient, taking phone orders on a procedure you're not familiiar with, getting the orders in the computer, the patient's tests done, IV & IVFs going and the pt prepped and ready for surgery in less than one hour...plus a computerized admission that takes approx an hour on its own. It took three of us to get that done while pretty much ignoring the rest of our patients. Then there was the time that the ED sent a patient to the floor with no doctor, no orders. Just getting an order to start a saline lock and diet orders took over 30 minutes...had to find a doctor that would take the patient.

[RosesrReder, BSN, MSN, RN]

I guess I am a little confused, so my apologies in advance. So just because you've been running a ward for decades and it's what you are accustomed to, it SHOULD be like that. Or because you did your fair share of dirty work, everyone after you should? So, it is okay for a nurse to fill in clerical duties, housekeeping, etc WHILE maintaing a heafty load, go about a long shift without a break or meal because that is the way YOU did it centuries ago and/or still do?

No wonder this profession can't advance or be respected. We don't even respect or wish well for our own kind.

I can understand a shift here and there without a clerk but I personally think it is WRONG to abuse it when you are expected to fill every freaken roll. I rather pay for a clerk any time than the average 70K for a hip because I am not an octopus and cannot possible be putting orders and taking care of 9 confused pt's at night. I don't mind putting in orders at all but let my pt assignment REFLECT that!

Also, what is wrong with a non-nurse putting in orders? I have to note them, sign for them and make sure they are correct (Just like CNA's who work under MY license and I am responsible for). If anything is incorrect, I can have it corrected or do it myself. The clerks I have worked with are tremendous at their work and very appreciated. Many are in nursing school as well. Yes, they can put orders in 3 times faster than me and sometimes 10 times faster because I have to get up and answer call lights and care for my pt's in between orders............so I agree with the OP and Sharon........waste of resources.

Gosh, I really live in a cave!

[chevyv, BSN, RN]

We have no secretary on pm shift where I work. Try running down the hall to answer the phone every 5 minutes, get your 30 residents their meds/treatments/bs done and insulin given while talking with families, docs, and paging other staff members who are desperately trying to do the same things as you are. Oh, don't forget the admits and orders that need to go in. New med for your resident and pharmacy won't deliver until the next day? Just find another nurse and go into the special boxes, after using 3 keys to get to them, breaking the seal, finally finding the med, counting every last one of the remaining 150+meds, sealing and signing, and finally getting it to the resident. I have one question to ask.....and why can't management figure out why pms can't get out on time? Don't even get me started on working short staffed and resident falls

[belgarion]

In our small hospital we don't know what a secretary is. We do all the computer entries for admissions, orders, and discharges in addition to making copies of charts for transfers. We also answer the phone calls from people suffering from everything from chest pain to toenail fungus. We are also expected to have fresh coffee ready at all times for the doc covering the ER or the doc who decides to pop in at 0430 to do rounds because it's the first day of dove season and he wants to be in the field at sunrise.

[pennyaline]

I guess I am a little confused, so my apologies in advance. So just because you've been running a ward for decades and it's what you are accustomed to, it SHOULD be like that. Or because you did your fair share of dirty work, everyone after you should? So, it is okay for a nurse to fill in clerical duties, housekeeping, etc WHILE maintaing a heafty load, go about a long shift without a break or meal because that is the way YOU did it centuries ago and/or still do?

No, it's not because it should be like that. It's because it IS like that and under current economic conditions it's going to stay like that for the duration.

No wonder this profession can't advance or be respected. We don't even respect or wish well for our own kind.

Reinforcing that this is how things are and that tasks need to be completed regardless of what license you hold is not a sign of disrespect... well, at least not to those of us who have been working for centuries, nor to those of us who recognize the snarkiness in your "I guess I'm a little confused..." preamble.

I can understand a shift here and there without a clerk but I personally think it is WRONG to abuse it when you are expected to fill every freaken roll. I rather pay for a clerk any time than the average 70K for a hip because I am not an octopus and cannot possible be putting orders and taking care of 9 confused pt's at night. I don't mind putting in orders at all but let my pt assignment REFLECT that!

You don't seem to understand that we don't disagree with that.

Also, what is wrong with a non-nurse putting in orders? I have to note them, sign for them and make sure they are correct (Just like CNA's who work under MY license and I am responsible for). If anything is incorrect, I can have it corrected or do it myself. The clerks I have worked with are tremendous at their work and very appreciated. Many are in nursing school as well. Yes, they can put orders in 3 times faster than me and sometimes 10 times faster because I have to get up and answer call lights and care for my pt's in between orders............so I agree with the OP and Sharon........waste of resources.

There is nothing wrong with having clerks and secretaries taking off orders and all of that, and I didn't see where anyone said that there WAS something wrong with it. What's being said is that reality requires and always has required that nurses do these jobs as part of nursing care. Your concern about patient load was addressed in a previous post. It was not a big deal when staffing more often meets demand. That's been said already. And perhaps the clerks you worked with were ten times better than you at entering orders and keeping charts in shape, but they are also a financial drain. To understand what is happening, you have to look at it from the other side. It doesn't make business sense to have two people doing the same job. To the business mind, THAT is the waste of resources.

Gosh, I really live in a cave!

I guess you do. This is not about lack of respect for nurses. This is economic reality. Health care is a huge business, and rightly or wrongly this is how business gets done.

Also, the OP wasn't concerned that she had too many other duties to carry out the demands of unit secretary at the same time. As she stated it, she was concerned that she wasn't up to the job and hadn't been trained for it, and then she tried to disguise it as a complaint about institutional misuse of licensed talent. My take on it is that she just doesn't want to do it.

[Ivanna_Nurse, BSN, RN]

Fwiw, I came from a smaller ICU, and there was a staffing grid. Depending on the season, and how busy we were, there were lots of nights that our secretary/monitor tech was called off. That meant running and reading strips Q 4, watching the teles, doing all the clerical work, the charges, QCing all the equipment, and doing all the admission orders and paperwork should a patient come in. Mind you, this was on top of my 2 ICU patients. I would love to just be the secretary! As far as the budget goes, I get paid the same whether I have a ton of extra to do or not. Ivanna

[Phlavyah]

the OP wasn't concerned that she had too many other duties to carry out the demands of unit secretary at the same time. As she stated it, she was concerned that she wasn't up to the job and hadn't been trained for it, and then she tried to disguise it as a complaint about institutional misuse of licensed talent. My take on it is that she just doesn't want to do it.

Thank you!!

[SharonH, RN]

It doesn't make business sense to have two people doing the same job. To the business mind, THAT is the waste of resources.

To the business mind, it is a waste of resources to have someone who gets a higher rate of pay doing a job when you can get someone cheaper to do it.

My take on it is that she just doesn't want to do it.

And so what if she doesn't? There is nothing wrong with not wanting to work as a secretary if you're a nurse. Having worked in nursing for many years now, this attitude has frustrated me so many times I can't tell you. We complain when we are unable to get our work done and provide proper care to our patients but the minute someone does not to take on additional work that could be reasonably done by someone else (thus freeing us to do the thing we were hired to do), then other nurses try to make you feel guilty and pull out the old "you think you're too good" bit. It's tiresome and old.

[SaraO'Hara]

We have a nurse as unit (well, facility really, we're tiny) secretary. I love it because she understands what she's transcribing, knows if an order may be fishy and lets me know so I can get it clarified, and can take my keys for lunch breaks.

[morte, LPN, LVN]

the physical act of doing order entry is going to take longer than simply verifying that the orders are correct; the first half is the secretarial, the second half nursing.....so YES, it is NOT business like to have the nurse do it all.

and as one other poster has said the extra 70k dollars for ONE fx hip should make it abundantly clear!

[RosesrReder, BSN, MSN, RN]

From a patient aspect, I would much rather have the nurse assigned to me taking care of myself through hands on care than her taking more of the already limited time away from my bedside and that of those who share the same nurse that I do. If it wasn't bad enough that the insane amount of documentation that requires her time, now she has to be at the computer inputting orders, taking charts down, answering phones and greeting folks at the nurse's station. Nonesense.

I admit to laugh inside when I hear of facilities paying out the nose because the nurse was away from the bedside-all in order to save a buck or two.

Anyhow, I too, don't care much for clerical work. I would much rather getting dirty with my patients. If you chose to be accept that role and enjoy it.......knock yourself out but don't judge or shove it down the throat of those that are not willing.