Unit secretaries assigning patients to nurses??

[gratefultobeanurse16, BSN, RN]

First let me start by saying I absolutely love having unit secretaries. Our unit secretaries have many responsibilities such as ordering supplies, keeping up with inventory, answering and diverting calls, placing consults to physicians.  Our days are so much more stressful when we do not have a unit secretary. 

My only issue I have with my current unit is that the  secretaries are allowed to assign patients to nurses. When I work as relief charge I always make the assignments because I want to make sure acuity of patients are divided or a nurse doesn't get stuck with multiple blood transfusion, heparin gtts, or multiple admissions.  However, I notice that the unit manager is perfectly OK with unit secretaries assigning nurses to patients.  

I just think that nurses should be the one to make the assignments due to the above reasons. The few places I have worked as a nurse, the nurses were responsible for assigning patients to oncoming shift. Am I being too harsh? or unrealistic? Is this the norm on your unit? 

 

[Sour Lemon]

11 minutes ago, gratefultobeanurse16 said:

First let me start by saying I absolutely love having unit secretaries. Our unit secretaries have many responsibilities such as ordering supplies, keeping up with inventory, answering and diverting calls, placing consults to physicians.  Our days are so much more stressful when we do not have a unit secretary. 

My only issue I have with my current unit is that the  secretaries are allowed to assign patients to nurses. When I work as relief charge I always make the assignments because I want to make sure acuity of patients are divided or a nurse doesn't get stuck with multiple blood transfusion, heparin gtts, or multiple admissions.  However, I notice that the unit manager is perfectly OK with unit secretaries assigning nurses to patients.  

I just think that nurses should be the one to make the assignments due to the above reasons. The few places I have worked as a nurse, the nurses were responsible for assigning patients to oncoming shift. Am I being too harsh? or unrealistic? Is this the norm on your unit? 

 

Our unit "secretary" is an RN, so it's not a problem.

Have you experienced specific issues, or are you just anticipating the worst case scenario? What happens when someone does have an objection to the assignment?

[gratefultobeanurse16, BSN, RN]

7 minutes ago, Sour Lemon said:

Our unit "secretary" is an RN, so it's not a problem.

Have you experienced specific issues, or are you just anticipating the worst case scenario? What happens when someone does have an objection to the assignment?

Our unit secretary are care partners (patient care technicians) and are not nurses. Yes there have been issues with staffing assignments in that many instances 1 nurse will receive higher acuity, most of isolations, or all confused patients,  while others receive "walkie talkie" patients. When there is a conflict, the nurses sometimes speak up to charge nurses but are usually met with resistance. 

[Davey Do]

Typically the charge nurse makes patient assignments.

Unit secretaries are merely ancillary staff.

This situation, pardon me, sucks like a Kenmore.

[Sour Lemon]

13 minutes ago, gratefultobeanurse16 said:

Our unit secretary are care partners (patient care technicians) and are not nurses. Yes there have been issues with staffing assignments in that many instances 1 nurse will receive higher acuity, most of isolations, or all confused patients,  while others receive "walkie talkie" patients. When there is a conflict, the nurses sometimes speak up to charge nurses but are usually met with resistance. 

Yeah, then that would be a problem. There are nurses who make assignments the same way, but it's not accidental, they're just showing favor to their friends.

[Emergent, RN]

Charge nurses should definitely be the ones making inpatient assignments. That is a traditional duty based on commonsense and scope of practice. 

[Davey Do]

Too often managers put personalities before acceptable procedures. "If you shoot pool with some employee here", as Mr. Potter said, "you can come and borrow money from the Bailey Building and Loan!"

Case in point was when I was pulled to the women's psych unit and the RN allowed her pet tech to make room assignments with patients that were to be admitted. No way! If I was going to be responsible for them, I get to make the decision on placement based on available admitting information.

It was a real ******* contest between me and this tech, for he and I butted heads other times in other situations, but I stood my ground.

The tech was eventually fired.

But, then again, so was I.

[SmilingBluEyes]

Unless that person is a licensed nurse, this is inappropriate.

[LovingLife123]

Charge should be making assignments, period.

[JBMmom, MSN, NP]

Agree that our charge nurses are responsible for making the assignments. If this is happening, it must be because the charge nurse delegated it to the UC? If the charge nurse gets too busy, I've had floor nurses collaborate to complete the next shift's assignment, but never a UC. 

[MunoRN, RN]

I've worked places where the NTL makes the assignments by room number, rooms 1-5 go to nurse A, 6-10 go to nurse B, etc, and where UC's make assignments that are well made, so I'm not sure I'd say it's always better to have the NTL make the assignments.  I've also worked at a place where the staffing clerk made the assignments, although this was based on acuity scoring.

[NRSKarenRN, BSN, RN]

What is your facility's policy of assigning patients to staff?  

No policy, time to develop one.  Understand your concerns, have seen units where unit secretary  followed staffing pattern outline and worked well, while another unit with assignments just based on room numbers was a disaster.  Final assignment should be approved by RN Charge nurse who understands nuances of patients acuity and care needs.