Unit Secretaries

[blondy2061h, MSN, RN]

Have any of your units eliminated secretaries since the introduction of EMR? When I first started as a nurse we were still largely using paper charting and just introducing computers. Unit secretaries were busy entering orders, faxing orders to pharmacy, making sure charts were complete and in order, thinning charts and taking trips to medical records. Now this is all done on computer. The providers enter their own orders and pharmacy automatically sees them on their end. Notes are typed on the computer and there are no charts to thin. All records are scanned into the computer, so no reason to go to medical records. The secretaries come in handy when we have an admit or discharge. Our length of stay is several weeks, so discharges are rare and admits happen maybe 4-5x per week. They also order supplies as needed- as far as I can tell this takes about an hour per week. We have a unit secretary 7am-11pm Monday-Friday. This just seems way excessive for what they do. We handle admissions without a secretary just fine at night and on weekends.

I am not one to complain about extra help, but in an age where they're cutting costs right and left, I feel like the money is better spent elsewhere. Some of the secretaries who have been there forever make more money than new grad nurses. They all make more money than our aids, who are busy all day everyday. Further, the constant member of our staff not doing any work is distracting. The secretaries often want to sit back and talk and we just don't have time for it. The last time I worked I watched our secretary have an hour personal phone call, take three breaks, and have a friend come visit for over an hour. My manager said something about the friend visit, and she just said she was still doing her job by answering the phones when try rang.

There was talk a few years back about cross training the secretaries as aids so they could do aid duties when not busy. That never happened.

So, do you still have secretaries? How often? What do they do?

[s0ad]

We have secretaries about the same amount of time, and we need them! About half the doctors are computer, half are not. Some of the secretaries will occasionally help the aides. They also take the patients out sometimes, make coffee. They enter orders, enter all the orders needed for admissions, and orders needed upon discharge. Nursing home discharges (usually one or two a day) need the charts copied. They make phone calls for consults, and call in consults. And of course they answer the phone, and the call bells. LOTS of phone calls and call bells. If our secretary is sick, we definitely feel and notice it!!!

[OCRN3]

We are computerized but the secretaries still enter orders and answer phone. They are still needed.

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[blondy2061h, MSN, RN]

Our secretaries don't answer call bells. We rarely have discharges because they go to a less acute unit first.

[s0ad]

I think your reasons are why the ICU cut some of the secretary hours there. The staff were very upset, but they are still getting along with a secretary a limited amount of time. When I went over there to give report and send a patient, staff were annoyed with the constant ringing of the phone and no secretary to answer it. I assume they had the same issue there... a secretary and few discharges, rare call bell (since most patients there do not use a call bell), and a they also have a limited patient number, less than what half of our floor has.

[BrandonLPN, LPN]

Before I was a LPN I worked as what our hospital called a ICA (inpatient care associate). Basically, I was a unit secretary who was also an aide. I wasn't given a pt care assignment like the regular aides. But whenever I wasn't busy with secretary duties I would answer call lights, help get vitals, stuff like that.

Since the doctors put in their own ordeders in the computer there's really no need for a unit secretary to sit at the desk looking pretty. There's always a nurse or two or three sitting at the desk charting. They can answer the phone. It's usually for them anyways. Not like a secretary can take a telephone order or update a family.

No reason not to train clerical staff to perform aide duties. A traditional unit secretary would just be dead weight on the floors I worked on.

[Hygiene Queen]

Our unit secretary kicks butt!

We were worried about her losing her job, but she didn't.

There is still plenty for her to do with setting up appointments, paging doctors, answering the never-ending phone calls, escorting visitors, fetching supplies and utilizing her excellent basic secretarial skills.

If a bit of a load was taken off of her, that's okay by me.

She has always been an excellent worker and we really value her!

[AMR21, BSN, RN]

We have been on full computer charting for a long time. Since before I began. Perhaps the Unit Coordinator's role has evolved in that time, but out PICU couldn't run without one.

They do all our welcome info packets, door signs, check to ensure the correct isolation signs are up, answer the endlessly ringing phone, are able to take some critical lab results that are called, order special items/beds from central supply, get callers to give care code before transferring to RN (I always verify a second time). They also distribute and sort daily goal sheets, print charge report sheets, keep up on the 'travel' sign in/out book, screen visitors as our unit is locked and has strict visitation rules, update the hard copy book of all admits/ transfers/ expirations.

In addition, the have the ability to page speciality services, parents, or security quicker then lightening in emergencies.

I love love love our UCs. We have 2 on the unit 24/7 and they keep busy.

[applewhitern, BSN, RN]

We do "everything" on computer, but we still have unit clerks. They do whatever we ask them to do. Mostly they answer the phone, answer call bells, and help the nursing assistants if needed.

[anotherone, BSN, RN]

I work in acute care with emr. Days/evenings still has unit clerks and they are needed! The phone rings non stop. On night shift it also rings and no one is there to answer it sometimes. They will place calls to different departments. They are kept busy too. Most of them are also trained as aides to help out if needed.

[guest2210]

A lot of it depends on what the hospital policy is once EMR is implemented. I have been on units where the secretaries did lose their jobs due to computer charting. Those were the cases where they were not permitted to enter any orders at all. I've also seen where some can enter non-medication orders.

[canoehead, BSN, RN]

If you have secretaries sitting around they aren't looking for things to do. Restocking, general tidying, checking expiry dates, and lots of things you can dream up are available, plus answering the phone. Of course if they aren't looking to make themselves useful, frig them.