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Discussion

RNs entering all their own orders - no unit clerks?

Hi,

I got floated to a different unit and the RNs there entered their own orders.

After "X o'clock", there was no unit clerk - but they still took admissions.

Is this at all common?

Or did I get sent to the Twilight Zone? :rolleyes:

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Heh, where have you been working? Happens all the time.

The nine years I worked med/surg/telemetry I only worked 1.5 years on a unit that had a night shift secretary/unit clerk. Everywhere else I worked until then I was an expert at order entry. I actually missed the control of knowing for sure those orders were ordered instead of trusting some number written by the secretary (I didn't even have a computer access code there). At the other places there would occasionally be a "float" secretary for the whole hospital that could come help if your unit got hit with several admits. Now that I work NICU the nurses have nothing to do with order entry other than what needs to be changed on the KARDEX.

It is fairly common. I worked for a while at a place that had no charge or unit secretary at night. We entered our own orders.

Now where I work the charge enters orders on new admits at night. If a doctor calls, however, and orders some tests or something on a patient, I will put the orders in, why bother the charge for that?

I think whether you have a unit secretary or not, it's a good skill to have entering orders.

Where I am now, there is never a unit secretary anywhere, the nurses do it. I agree it is a good skill to have, and it often saves mistakes and extra steps. However, I will be glad when this contract ends...but for different reasons.

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Our ward clerks leave at 7 p.m. so night shift does their own orders.

steph

  • Author

Okay.

I'd just never worked where there wasn't a Unit Secretary who floated at night.

Guess it's not all that uncommon.

Common practice. We lose our unit clerk after 11PM unless census is low then we may lose her at 7PM or 3PM depending. Ive even worked when there was low enough census for us to not have one during the day and the ONE in house was being floated as needed between floors. I hate when that happens.

20-bed Intensive Care Unit. We have a secretary until 6:30 p.m. Many of us enter our own orders anyway; it's a huge unit (physically) and the unit secretary is just too far away and your chart is out of your reach for too long. Plus, by entering my own orders, I have a much better grip on what's going on! If I get an admission, I do give it to the secretary to assemble the chart and enter the admission orders (if we have a secretary at that time); otherwise, I do it myself.

I am on a Cardiac Surgery PCU, but we also get general cardiac patients. All on telemetry. I am dayshift.

It's quite busy-if we had to enter our own orders, they'd never get done. NO way. WE have a secretary and a monitor tech to watch the telemetry.

On nights, there is occasionally a monitor tech and secretary. Sometimes one peson does both jobs. (they are crosstrained)

We'd have to have a census of like, 5 patients to have no secretary!

I do know how to enter most orders for myself, though.

Our docs usually generate the orders on the computer, as soon as they are entered, they can be read in the Order Processing Center and the Pharmacy. After they have been entered, an ancillary will print up for us. Any handwritten ones must be faxed to both those places. We frequently enter our own Stat orders, as we don't have a Unit Secretary.

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Where I worked, if you DIDN'T put the orders in yourself, they didn't get done for hours.:o Our poor unit secretary would get bombarded with fifteen or 20 charts all at once---new admissions, post-ops and discharges, and there was no way on earth she could do all of that, PLUS deal with a constantly ringing phone, answer peoples' questions, get coffee for guests, stuff charts, do rounds on other units, find paperwork for the MDs, page nurses and other staff, arrange transportation..........

So whenever I got a fresh post-op or new admit, I'd just quietly sit there and do the order entry myself, unless I was running at full speed with my hair on fire........the US always appreciated it, and I felt better not only knowing I'd helped her out but also that the orders were done in a timely fashion. Too bad nobody else appreciated it........as a result of assisting other employees with their work, I was labeled as lacking organizational skills and given several verbal 'counselings' during my tenure.:angryfire

I know it sounds awful, but I'm telling you, if I ever were to work in a hospital again, I would come in, do my own freaking job, and go home on time EVERY NIGHT. I've learned my lesson about being 'helpful'.:o

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