Putting in your own orders

SoundofMusic · Dec 15, 2009

Well, the way it has been since I've been there is that if there is a secretary there, he/she puts in orders. I've been TOLD to delegate -- to give it to the secretary. All of the other secretaries do it with no problem. I feel this particular person just thinks that nurses should be helping her because she just can't take the stress when it's all piling up.

And I think it's absolutely ridiculous to do to nurses on a busy floor as we're admitting patients, especially telemetry. So, what if someone codes because I'm busy entering orders?? And yes, SHE and all the techs just skate right on out on time and we're always, always left finishing up charts past quitting time. I feel it's yet another impossible demand on nurses. There is also the rule that we get to patients within 5 minutes of arrival!

Why employ these people if they're not going to do the job? We of course, double check the orders and check them off ourselves -- always, always.

I personally cannot wait for physician order entry. Perhaps some of these folks will wish they had their jobs back once it's all computerized and there is no need for them anymore.

MedSurgeMess · Dec 15, 2009

How often do you do this?
We have a few nurses on our unit who seem to put in a LOT of their own orders, just to either lighten the load on the secretary, or coddle her, one of the two. I know the secretaries work hard, but we have one who hassles ME because I don't put in a lot of my own orders.
I'm sorry, but I feel this is ludicrous on the part of the secretary AND these nurses who are just inviting adminstrative staff to push back work onto the nurse. We nurses are chained to our charts and computers ENOUGH, without now having the expectation of putting in our own orders. I can see if the secretary gets sick, or pulled to another floor or whatever, but if he/she is THERE -- I feel I have every right to expect that they DO put in my orders!
I got a really nasty poke from one of our secretaries the other day to "take a hint" and put in my orders myself like the "like nurse so-and-so does." This while I'm getting a new admit who had just received meds in the ER and was on the BSC every five minutes as soon as she arrived to the floor. What am I supposed to do? Leave the patient in need and sit at a desk putting in orders so this secretary can reduce her stress level?? We have another secretary who has NEVER expected this of me and puts in every order that's put in front of her, and quickly.
I do put in labs here in there, or the simple routine orders if I get a second -- but I'm NOT going to get roped into putting in 3 pages of new admit orders while I'm busy helping a patient, admitting them, assessing them, and helping a patient in need who is new onto the floor!
Are they units nuts or what?? Should I mention this to my manager or just let it go? I was SO mad at being digged for this, I almost wanted to cry.

If it goes on long enough, the Unit Secretaries may find themselves out of a job......they are eliminating some slots where I work d/t this behavior as is. The secretaries were monitored via computer, and those found not to be doing the job were discretely let go, and not replaced............

WeS-RN · Dec 15, 2009

If you have a secretary, that is their job, let them do it. If you don't, well, obviously you have to do it then. If she wants to give you a problem about not putting in your own orders when she is there, hint around that if she doesn't do her job, before long she probably will not have a job to "not do". ;P

JamieLynn RN · Dec 15, 2009

I agree with Zofran....just tell them flat out that you cannot do it. I would scan the order to see if there is anything STAT and then give the orders to her....sometimes being a RN means delegating and ******* people off...we are not there to make friends...we are there for patient care...and advocating for them. If it means the secretary is going to get in digs at you....oh well. YOU will always be needed....the US job is going to be outdated in the future....just double check and scan when they come up for the STATS.....that is all you can do. At my last job I had to put in a lot of orders and I know it is frustrating and makes the job a million times harder....hang in there girl :)

rollyp80 · Dec 15, 2009

I work at a small community hospital in Chicago that is slowly moving toward full computer documentation.....but the secretary should be the one doing so....and ofcourse the nurses can do it as well to help out......but I finished clinicals at one hospital who has everything on computer....and the nurses walk around with these handheld scan gun thingys....all I can say is wow and how much easier it is on everyone.....your job is totally laid out for you....and all the orders fall under each patients name throughout the day.....and it turns red if you need it to be done and forgot....it's truly amazing....really....ok...I'lll shut up now....lol

belgarion · Dec 15, 2009

Working in a small facility we have no unit clerk. When a patient is admitted we put in all of the orders from meds to dietary, x-ray to lab. The CNA makes out all the sticker labels and the ID bracelets. It really gets to be a time consuming monster when we get a patient with 5 or 6 pages worth of home meds to be reconciled.

Some of the docs help out by putting orders in on the computer but we still have a couple of dinosaurs who don't even know how to turn the thing on. We even have to print out our nurses notes, med sheets, assessments, etc. at the end of each shift because neither one of them is willing to learn how to look up this information for themselves.

doubleplay · Dec 15, 2009

We do not have a UC at night so we put the orders in, but the question is what to do about your UC? You need to hand her the orders and have her do the job she is paid to do. If she doesn't get things done then you need to go to your boss and let them know what is going on. They are paid to do a job and that is that. How mad do you need to get before you stop letting them push you around? I hope the time is near when the doctors put their own orders in. The handwriting that we are expected to read is a joke and is the dirty little secret that no one will address.

vivacious1healer · Dec 15, 2009

Since the docs have to place all orders in the computer (because all we have is computer charts)...the HUCs answer call lights, phones,page us or order a meal tray or supplies. It has certainly lightened their load and ours!

KeechieSan · Dec 15, 2009

My unit has a secretary for my entire shift, but I do sometimes put in my own orders. I don't usually put in admit orders because they take up too much time, but if its a simple lab or diet order, then sure I do. It would take me longer to walk the chart, kardex, and med list down the hall than it would to just put it in myself.

Up2nogood RN, RN · Dec 15, 2009

We have computerized physcian order entry except for post ops which is the bulk of our orders, some glitch in the order sets or so they say. We don't have a HUC at night so occasionally we will have to enter a phone order even though the MD can enter it from home pc. But hospitalists do enter all their own orders if we have an ED admit during the night, I love it! No more 24 hour checks since we are continually checking and responsible for following through on new orders during our shift and no med sheets to check.

SoundofMusic · Dec 15, 2009

The physician order entry system sounds like a dream! We are getting it -- it's just taking our dinosaur hospital time to get it up and running. Now I can't wait to see the tasks flushed out and secretaries fighting us over all the other nit noidy tasks that they very well could be doing to help -- answering lights, calling for volunteers, arranging diet trays, etc. If they didn't have to put orders in? My gosh -- they could stock supplies, get water, bring coffee, whatever.

What I don't like is the attitude that they seem to look at it as if I'm asking them to do something for ME -- it's not like that. It's for the patient! For patient safety, patient satisfaction -- all the things we're supposed to be working on. To fight me on it is to fight the patient on it -- but I don't think some admin types get that when they never leave the nursing station to be with the patients.

But the post about MY job never going away, and theirs possibly going away -- yeah. That really puts it into perspective for me. I may have to remind her of that at another time. :cool:

Thanks all. I'm over it. There is one secretary on our unit that I worship --she is efficient, gets it all done, anticipates things before I even ask for them, never complains, is a fantastic person to work with. I adore and WORSHIP her -- and I tell her so as often as I can. She is worth her weight twice in gold!! :redpinkhe

Meriwhen, ASN, BSN, MSN, RN · Dec 15, 2009

I don't have a unit secretary, so I do my own orders or I'll enlist the help of one of the techs. It's not so bad.