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?
I used to be a Unit Secretary! I loved the job! And my girls loved me :-) It is because of them that I decided to go to nursing school. We did have 2 newer girls on our unit that got laid off when everything went electronic. Talk about chaos at the nurses station! It was a step down telemetry unit so we were always busy. I think the nurse manager regretted the decision, especially since it was purely budget related.
I am a CNA but I also work as a SEC. Used to do it full time, and my unit needs me. The nurses don't always (or usually) know how to enter complicated orders they may have received by telephone, and DOC's aren't all compliant with CPOE. On top of that I answer the call lights and call the appropriate person, watch any of the patients who sit up at the nurses station due to being fall risks, Put all the new admit packs together, enter the orders that non CPOE docs wrote, and it goes on and on. I also get up and help the CNA's or nurses even depending on who needs what. I will enter specimens that have been collected for them, send them to the lab. I also have to write every CPOE order that comes through onto the kardex so that the next shift sees everything thats been ordered. I'm also known as the computer fixer and i fix all the COWs as they need it. Its usually a couple a shift at least.
The FT day sec has begun making d/c appointments for patients and a ton of other social worker stuff.....its crazy.
I am a CNA but I also work as a SEC. Used to do it full time, and my unit needs me. The nurses don't always (or usually) know how to enter complicated orders they may have received by telephone, and DOC's aren't all compliant with CPOE. On top of that I answer the call lights and call the appropriate person, watch any of the patients who sit up at the nurses station due to being fall risks, Put all the new admit packs together, enter the orders that non CPOE docs wrote, and it goes on and on. I also get up and help the CNA's or nurses even depending on who needs what. I will enter specimens that have been collected for them, send them to the lab. I also have to write every CPOE order that comes through onto the kardex so that the next shift sees everything thats been ordered. I'm also known as the computer fixer and i fix all the COWs as they need it. Its usually a couple a shift at least.
The FT day sec has begun making d/c appointments for patients and a ton of other social worker stuff.....its crazy.
I do believe they'd be lost without us. :-)
I know we'd be lost without ours! I just don't get how secretaries are able to enter orders with CPOE. Only the providers and those able to take phone/verbal orders can access order entry where I work.
I know we'd be lost without ours! I just don't get how secretaries are able to enter orders with CPOE. Only the providers and those able to take phone/verbal orders can access order entry where I work.
We enter them as telephone or written orders like we did before CPOE existed. I don't understand what you mean. The only thing that changed with us, is that the Docs can enter orders themselves from wherever they may be. I still have access to everything I used to. No one can cancel or edit a CPOE order but the doc, though.
Looking back at your first post it sounds like you all are still using paper charts, I missed that part and it's where I got confused. :) We are paperless and orders are no longer written. They are all put into the computer by doctors or nurses.
Hi everyone! I was researching something an stumbled upon this forum. Unit Secretary here, for 6 years now in IMCU. I have witnessed my share of lazy secretaries but let me tell you what I do in the course of a 12 hour shift. Every morning upon arrival, I clean up my station and get things orderly. My area is so neat, I could find anything (supplies, patient education, etc) while blindfolded. I make copies of the nursing assignment and patient doctor list for each of the 8 stations on my floor. I check oxygen tanks, order food for the nourishment room and make sure all consults for patients are called in and handled. I check all 39 charts on the floor and make sure they are orderly and have patient labels. I attend discharge rounds and enter expected DC date for each patient. I sometimes arrange transport. I make sure the hallways are clear of empty beds. If housekeeping is busy, I love them myself. I place service requests and maintenance for any needed work. If a copier or computer isn't working right, I usually can fix it myself. I answer call bells. I'm limited on what I can do but I will help as much as I am allowed to. I answer phone calls and always relay messages immediately and accurately. I run for coffee and snacks for the nurses too busy to get a break. My unit knows they can count on me to help them anytime. Do I have down time some days, sure. I will sit at my desk and read but if the tube system goes off, a phone rings, a bed alarm screeches or a nurse or aide asks a favor, I am up and doing what needs to be done. I keep forms up to date at each station as well. Please do not judge us as a whole by a few rotten apples.
Specializes in M/S, Pulmonary, Travel, Homecare, Psych..
From the original topic post:
"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."
Even if you were "one to complain" it wouldn't make much difference. Healthcare facilities do what they want, when they want. Not often does input from an employee sway their (finances are the priority driven) decisions.
While I was in college many moons ago, I worked a "work study" position for my school. Do they even exist still? Anyway, my specific job was with the department that handled things for students with special needs. One of my many tasks was to take things to the main office for copying. Sometimes, they'd need hundreds of copies of whatever flier I was working on at the time (the dept office had no copier of their own, their fax machine doubled as their copier and was not sufficient for jobs of that size).
Whenever I went to the main office, the two secretaries would be there doing their own thing. And let me tell you, these girls shot daggers through my back while I was working, with their eyes. Those girls were bitter, bitter bitter. Twice I turned around to ask if they had been planning to use the copier and if I was perhaps in their way. Even offered to come back later if I was in the way. That wasn't the problem though.
The problem was: Their dept head (as with every dept in the school) was giving only minimal annual raises. Not sure what that was for the facility but, long story short, it's the raise they give to people on discipline or part timers. These were (over) full time workers who always received high score performance evaluations and had good attendance records.
You see, to justify the toilet worthy annual pay increases and instead give the disciplinary raises, their bosses had to justify things on paper. So, behind the scenes, their bosses were telling these girls the school was "unable to afford anything more" because of rising overhead. I bet you guessed it already but yes, the department head of this specific office I was sent to in order to use the copier, specifically sited the rising cost of toner for said copiers as "a big part of the rising costs for the school". So on, so forth.
So these secretaries were bitter with anyone using the copier, gave more than a few instructors lectures about not giving "hard copy" hand outs in to classes and everything else. You see.........they had drank the kool aid. They honestly were under the belief that, if less toner were needed for the copiers, they'd get a more fair raise (yes, this stuff still makes me roll my eyes).
Same thing is happening with the secretaries on your unit. Your facility is likely cutting costs and doing whatever it can get away with and claiming their overhead is out of control and "things will get better soon. Once the toner prices stabilize."
Whatever cuts and underfunding your facility is doing, they're doing it because that's what they want to do. And your manager will support it because, they don't want to end up being the one who has to absorb it. End of story. They could have Fort Knox worth profits and trust me, they will still claim to be broke and give you that substandard raise.
Summary: Don't worry whether your secretaries are completely necessary or not. It's not as if their being let go will lead to any improvements in how they fund the facility. Just be glad for whatever help they give. I mean, unless you're on the facility's board of directors and balancing their budget is a concern to you.........Seriously, if those secretaries were told "there isn't enough work to justify your wages" and they are gone, they'll still underfund your unit in other ways despite their wages being off the books.
Specializes in M/S, Pulmonary, Travel, Homecare, Psych..
Just as a side note, something I witnessed while everyone was rushing to "go computer".
From what I saw, secretaries became more necessary. You say "Doctors put orders in themselves." You're the exception then. Many doctors resisted putting in their own orders. It took being able to give verbal orders away from them and said privilege being highly abused, they didn't like "going computer". More than a few were absolutely violent about it.
As many have stated, most facilities became "hybrid" with their electronic charting. On one hand, you're have the people (us) doing everything in the computer. Then you've still have paper charts for doctors to see print outs of all the patient info and to write reports/orders in. So they still have to keep the chart going, just as they always had been. On the other hand, everything had to be put in the computer as well so that the facility appeared to be in compliance with the mandate to become electronic. So, in essence, the work was doubled. There was a constant coexistence of the two worlds taking place, the old way and the electronic way. And both had to be kept up as if it was the only way.
Many facilities still are stuck in hybrid mode. The electronic charting is just another side task to be done. And in hybrid facilities, secretaries are a must.
mostdesired3
43 Posts
I used to be a Unit Secretary! I loved the job! And my girls loved me :-) It is because of them that I decided to go to nursing school. We did have 2 newer girls on our unit that got laid off when everything went electronic. Talk about chaos at the nurses station! It was a step down telemetry unit so we were always busy. I think the nurse manager regretted the decision, especially since it was purely budget related.