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What are some reasons you either like or dislike your Unit Clerk/Unit Secretary?

I am working towards becoming a Unit Clerk/ unit Secretary. I am unsure of what Unit I would like to work on, but I do have some universal questions!

1) What is a task that your favorite Unit clerk does for you that makes your day go smoother? On the contrary, what are some habits of a Unit Clerk that doesn't help make a Unit run smoothly?

2) Can you tell me about a time a Unit Clerk went above and beyond? What was the outcome of their actions? Did staff think of them differently afterwards and did it improve the working relationship?

3) Tell me about a time that a Unit Clerk was able to successfully use crisis intervention skills. What skills did they use to gain control of the situation? Did the Unit as a whole benefit from the intervention of the Unit Clerk?

Ruby Vee specializes in CCU, SICU, CVSICU, Precepting & Teaching.

A good unit clerk has her fingers on the pulse of the unit and makes everyone's day run smoothly. A bad one makes everyone's day worse and can endanger patient safety.

A good unit clerk does her job cheerfully and knows how to get things done. You don't have to know everything, but you should know who does know. Answer the phone promptly, take accurate messages and make sure the appropriate person actually gets the message. More than once, I've been "set up" by a unit clerk who never told me the family had called (more than once) and I was faced with enraged family members when they came to the unit. A unit clerk who told me that the cardiac cath lab had called and was ready for my patient endangered that patient when a team of staff transported the patient to the cath lab for his intervention only to find out that it was really interventional radiology that had called for THEIR procedure with that patient. A critically ill patient was off the floor for an hour, and missed his slot in interventional radiology, and because we were traveling back to the unit when cath lab was ready for him, he missed that slot as well.

A good unit clerk can use her customer service skills to soothe the family who is ready to explode, keep them updated while the team is working on their critically ill family member (no, not about what we're doing, but that we're "doing everything we can" and "the doctor will be here to talk to you as soon as possible" and "can we get you a cup of coffee/glass of water/blanket/private area to wait?"). A great unit clerk does all that while keeping track of four lines of phone calls, 12 nurses and which patients they have and which family members currently on the unit need to be watched because they steal stuff, peek into other patients' rooms, or are prone to tantrums.

Davey Do specializes in Psych, CD, HH, Admin, LTC, OR, ER, Med Surge.

Unit Clerks at the facility where I work have gone the way of the Dodo. They are no more.

However, some did transmigrate into Techs and Nurses.

Hygiene Queen specializes in ......

We have one unit secretary who is amazing. She can do anything, does it quickly and is the resource person for all the other secretaries. She is a secretary only and absolutely does not double as a tech in any way shape or form, so she's always right where she's needed. She's day shift so they're luck lucky lucky.

On PM's we have the nicest woman I have ever had the pleasure to meet. She is excellent. If she hears me repeating back an order for x-ray, she already has the screen up looking for an open slot. She knows her resources. Unfortunately, she sometimes gets pulled to do transports or work the floor in a pinch, leaving us without a secretary. She's a good well-rounded worker.

Only knew one bad one. We had a tech that filled in as one and she was useless, but she did it eagerly because it was "cushy" and got her off the floor. Tossed things she didn't understand or know how to do back at the nurses. Didn't try. Didn't want to learn so that she didn't have to do anything. Only answered phones and barely listened before she immediately said, "I'll get the nurse" when a nurse wasn't necessary, pulling us into calls (that she could have handled) that interrupted our work. If there was a urine to go to lab, I learned to take it myself because she'd forget about it "because she didn't have time". She clipped coupons on weekends. Absolutely worthless. Thank goodness she didn't fill in often and I'm not missing her now that she's gone. She was a lazy tech too, by the way.

What makes the good ones good is that they: anticipate needs, take accurate messages, know when to direct calls to the nurses, get things done quickly and keep us up to date with any glitches they run into and work hard to get those glitches resolved. They don't complain, they are professional and go with the flow.

I LOVE our secretaries:inlove:

Edited by Hygiene Queen
screen not scene :p

I really liked your "finger on the pulse" analogy!

Thank you so much for your detailed response!

Oh wow! Can you give me a little insight as to why your facility no longer has them? what has the facility done to compensate for their absence? Do you find that things run smoother a Unit Clerk? :)

it sounds like if the unit clerk is showing that they are trying their best and pulling their weight, nurses will be more forgiving! This is comforting to me!

canoehead specializes in ER.

Unit secretaries seem to be able to stand above the fray. So when the place is falling apart, they can be a calm in the storm. Or the person with the answer (they'll call around and get the answer), and if you need something, but you don't know how or where to find it they say "leave it with me," and thirty minutes later, they come to you with what you needed. I'm sure they don't feel calm, but having the calm face while we're having a crisis is very much appreciated. I'm in the ER, and we need someone to hold us together!

Ruby Vee specializes in CCU, SICU, CVSICU, Precepting & Teaching.

it sounds like if the unit clerk is showing that they are trying their best and pulling their weight, nurses will be more forgiving! This is comforting to me!

As long as you're trying, we'll be reasonably forgiving. If you're on the computer all night looking at You-Tube videos with the CNAS while the phones are ringing off the hook and the call bells haven't stopped since 7, we'll be completely UNforgiving. I've worked with several like that.

As long as we're talking about desirable and undesirable traits in a USC, here's a few of the less positive traits.

When my mother developed Alzheimer's and started calling me at work several times a day, I explained the situation to the USCs. I promised them that when I went back to the midwest to visit in a few weeks time, I'd give her a "new work number" and make sure she had it recorded in all her usual hiding places. I apologized for them having to answer the calls and told them I'd do my best to discourage her from calling. I gave them a lot of private information in confidence because I knew that my mother was overwhelming them and I wanted them to understand the issue. Most were great. But one gossiped about it with her many friends around the hospital and I found myself constantly being asked "Your name is Ruby. Are you the one with the bat-sh** crazy mother?" When my Dad started actively trying to die in the middle of my shift and I had to get a flight back, talk to his doctors, coordinate with my husband and try to care for my patient, one USC was terrific. She put through calls from Dad's doctors as if they were our own physicians. The other would shout across the unit "Hey Ruby, you have another PERSONAL call."

Nor will I ever forget the USC who announced over the intercom "Ruby, the funeral home is on line 3."

There was the USC who knew all of the gossip about everyone in the hospital. (Small hospital.). Gossip is fun, sometimes. Who doesn't love hearing that her co-workers were discussing what a nice man her husband is and how lucky she is to be married to him or how she really, really deserved that Employee of the Month award? The USC who announced over the intercom "Hey Donald, your mistress is on line #3" when Donald's wife, an RT was on the unit and close to an extension was just plain wrong in SO many ways!

My personal favorite was the USC who flunked out of nursing school, but was convinced that she would be a better nurse than any of our actual nursing staff. She used to call into patient rooms to "give us doctor's orders." Some of the orders made absolutely no sense, and when we checked, we found out that there was no actual doctor involved. She'd just write an "order" in the patient's chart for something she thought the patient needed and then tell the nurse that the patient's doctor had ordered it. Strangely enough, she stopped coming to work right about the time the nurse manager was informed of this development.

Buyer beware specializes in GENERAL.

Unit Clerks at the facility where I work have gone the way of the Dodo. They are no more.

However, some did transmigrate into Techs and Nurses.

This is a very interesing, far reaching phenomenon.

Maybe our dear leader can find a way to bring these jobs back too.

kalycat specializes in CVICU CCRN.

Ruby: liking your post as a show of support. You're tougher than I. I may have caused a major scene after just *one* of those incidents... let alone the funeral home thing.

We we don't have HUCs with any regularity at my primary job. Sometimes day shift has a person who fills that role I guess. I don't know much about the two who I have seen... other than that one of them refuses to transfer calls to the nurses phone (Spectralink/Vocera type) and will only use a cumbersome "call park" type function. This regularly results in dropped calls from MDs trying to return your page.

I work with one lady at my part time ICU job who feels that she runs the unit (to the detriment of all parties involved); the two others are amazing.

la_chica_suerte85 specializes in Pediatric Hematology/Oncology.

I like the unit assistants who anticipate needs. This takes a little bit of getting used to the flow of things and what is needed but your charge nurse can give you a heads up on what that will entail. Every UAs job is different according to the hospital they work at. I'm not super-familiar with what they should do or know as they were in the middle of changing the position when I started working as a nursing assistant (with the occasional unit assistant assignment). But, I like when they can anticipate needs the way I did my best to for my nurses before I started working alongside them. For example, when I go to ask the UA to order X, Y or Z for a patient that usually requires X, Y or Z for each inpatient stay and that thing is already sitting at the counter because they ordered it as soon as the patient walked onto the unit? That's an amazing thing.

Generally, as long as you don't just announce to your charge nurse that you're going on break without checking to see if you have proper coverage and then be gone for an hour and a half, I'm good with that. Teamwork is important but when you hate your job and you aren't shy about telegraphing it to the whole unit, everyone feels it and that's no way to be.

I think it is extraordinarily unfair to our unit clerks when they get some cryptic, unclear, obscure order wrong and people over react. I have seen the illegible written doctor's orders and tell the clerk she should work for the FBI if she can decipher a swirly line with two humps as actual orders.

We just got the best new unit secretary I have ever worked with, (we'll call her Mary.) Mary is amazing, and outperforms all of the other US I have worked with because:

1. Mary comes to work looking for ways to help the unit. The second that she gets to work (always early) she starts going through the computer looking for consults the night nurses may have missed. She looks through overnight discharges and makes sure the charts were broken down. She scans the tube station counter, sends labs that were waiting to be sent, alerts the nurses of pharmacy meds or blood that has arrived, straightens up the chaos from a busy night shift...just generally comes in like a very well organized hurricane.

2. Mary anticipates needs. If she hears a doc say a pt is going to be discharged, she checks the chart for paper scripts and clips them in front. If she hears that we are getting an admission, she coordinates with central monitors and makes sure the monitor is set up and ready to go. If I mutter that my pt needs a bedside commode, she chirps "I'll run and get it! Anyone else need anything from central while I'm down there?"

3. Mary keeps track of all of the things that I can't keep track of while I am charge with a full assignment. Admission times, discharge times, census, ratios, she knows that it's Sunday and the residents reported off to the other group of residents at 1:42 today instead of 3pm. She stops us from paging Dr. X who has been home in his jammies for 2 hours and won't answer. And she writes Every. Single. One. Of. These. Things. Down...as they happen...bless her heart.

4. Mary NEVER forwards me phone calls during initial assessment or med pass. She tells family members, "this is a very busy time for the nurses, and they are providing patient care right now. I'd be happy to transfer you to your mom's room so you can ask her what the plan is, though! If you really need to speak to the nurse, I can take a message, and she will probably be free to call you back LATER THIS AFTERNOON." I love Mary.

5. When she answers call bells (she answers call bells!!) she doesn't automatically say, "I'll tell your nurse." (PLEASE DON'T DO THIS.) She says, "what do you need?" If the answer is, I need my nurse, she asks, "what can the nurse bring you?" If the patient still won't answer, she says, "Sir, the nurse needs to know what you need so that she can help you as quickly as possible." 90% of the time, the request can be handled by Mary herself (did I mention how much I love her?) or by the nursing assistant. Thank you, Mary, for letting me finish hanging blood, talking to the neurosurgery attending, dealing with a chemo reaction....

6. She is never, ever, ever bored. What does this mean? I have never seen her on her phone. I have never seen her on Amazon Prime or Facebook. She is checking on patients if the phone is not ringing. She literally walks around to every nurse multiple times in a shift and asks, "what can I do to help you right now? Are you sure? If that pt in 15 needs cleaned up, I can help with that."

Mary has what I like to call work ethic. She takes pride in her role, and she is indispensable. She has a really demanding job, and I wish they would call her what she is: the Health Unit Coordinator, rather than unit secretary. She coordinates the whole unit. Without her, things fall apart.

Be like Mary!

Julius Seizure specializes in Pediatric Critical Care.

because they are unattractive and low functioning



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