Unit Secretaries

[blondy2061h]

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?

[CodeteamB]

Our unit secretaries are not responsible for any order entry, and they are still super busy. They answer the multiple phone lines, direct calls, page physicians and allied health, order supplies, obtain old charts from other facilities, fax referrals, arrange some out patient appointments and process charts post discharge. They work their tails off and make my job a whole lot easier. I'm sure it depends on the unit, but ours aren't going anywhere.

[OCNRN63, RN]

Just because your secretaries may be problematic doesn't mean that's true for all of them elsewhere. If they have been there for many years, then they most likely deserve what they're being paid. I wouldn't want to have to deal with answering phone calls when I'm trying to do patient care.

It may seem inconsequential to just get rid of all the secretaries, like you say. What happens when someone in administration thinks there are too many nurses for your unit and you could function without some of them? When the shoe is on the other foot, it doesn't feel so good, does it?

[Morainey, BSN, RN]

Our secretaries are awesome. At first with EMR and physician order entry we were nervous that our secretaries would get canned, however, they are invaluable just for answering the phone during the day. They do lots of other clerical things to, and only later on in the evening do things slow down desk-wise, so they usually get put to work on the floor - vitals, bells, all that stuff.

[calivianya, BSN, RN]

It would be nice to work on a floor where EMR meant secretaries aren't needed... the phone rings nonstop and so do the call bells. There aren't always people at the nurse's station to answer these. On the units that have telemetry, the secretaries are also ECG trained and can notify the nurse of a change in patients' rhythms. I can't imagine working without them. How would you ever know if your patients needed anything if no one could answer the call bells?

[grandpaj]

Our unit would be LOST without our evening secretary. She checks expiration dates on everything, temperatures on required refrigerated items, orders supplies, keeps our charts in line since half of the docs are still paper charting, doubles as a PCA when necessary, handles admissions/bed tracking, answers the phone, verifies all the fall precautions are in place for every patient, fills out our daily paperwork so the charge doesn't have to, double checks order sets to make sure vitals, weights, baths, etc. are ordered and probably a thousand more tasks I haven't listed.

One of my clinical instructors once said "as a charge nurse, I would rather give up a nurse than a good unit secretary."

[flyersfan88]

I'm a student, so I have no experience with the UC's, but my friend is one and she manages to sit on fb or twitter talking about the MDs and nurses all day....doesn't seem like she does very much.

[Hygiene Queen]

I'm a student, so I have no experience with the UC's, but my friend is one and she manages to sit on fb or twitter talking about the MDs and nurses all day....doesn't seem like she does very much.

That would be because your friend probably has the work ethic of a hobo.

[blondy2061h, MSN, RN]

Just because your secretaries may be problematic doesn't mean that's true for all of them elsewhere. If they have been there for many years, then they most likely deserve what they're being paid. I wouldn't want to have to deal with answering phone calls when I'm trying to do patient care.

It may seem inconsequential to just get rid of all the secretaries, like you say. What happens when someone in administration thinks there are too many nurses for your unit and you could function without some of them? When the shoe is on the other foot, it doesn't feel so good, does it?

I'm actually busy. Our secretary is spending hours each day on breaks, visiting with friends, and on the phone with personal calls. Hours. I'm not suggesting firing them, I'm suggesting cross training them to do some aide duties since they are forever in short supply and overwhelmingly busy. As a nurse, more tasks are constantly thrown on my plate, so I'm well familiar with that shoe. Many of the posters who are praising their secretaries seem to be in facilities that have already done this.

[blondy2061h, MSN, RN]

It would be nice to work on a floor where EMR meant secretaries aren't needed... the phone rings nonstop and so do the call bells. There aren't always people at the nurse's station to answer these. On the units that have telemetry, the secretaries are also ECG trained and can notify the nurse of a change in patients' rhythms. I can't imagine working without them. How would you ever know if your patients needed anything if no one could answer the call bells?

Our secretaries do not answer call lights and they're certainly not ECG trained. Nurses or aides answer the call lights.

[DoGoodThenGo]

Saw a listing recently for a NYC hospital where the functions of a unit secretary were combined with that of a nursing assistant.

As hospitals look to decrease costs in the face of tighter reimbursements look for more merging of ward clerks/unit secretaries functions, and or just eliminating the former all together.

Old school or just older physicians whom either will not or can not learn computers are slowly either retiring/dying off. As the younger generation more comfortable with EMR and other technology take over there probably is going to be a full move away from paper, that could mean allot less need for unit secretaries.

[Munch]

Our unit clerks definitely earn their paychecks! Like s0ad, some of our doctors will not touch the computer. Our clerks also answer the phones, call bells, order/stock supplies, keep the supply/linen closets organized, admit and discharge patients, call for consults, call transporters(if a patient needs to go to radiology or another department for testing/procedures), show visitors to patients rooms, keep the coffee overflowing and they'll even relieve a staff member that is on one to one duty if they need a break. Like I said they really earn their paychecks and they are really valued members of our unit! Also if it's a rare slow night for them you can find them doing light maintenance work like sweeping the floor, wiping the desks down and emptying the trash.

[Munch]

That would be because you friend probably has the work ethic of a hobo.

That really made me laugh. It's not funny that someone is loafing on the job..but your wording was just..funny