Unit Secretary - Med/Surg - FT - Nights in Harlingen, TX at Harlingen Medical Center

Date Posted: 2/15/2021

Job Snapshot

Job Description

Overview JOB SUMMARY:

The Unit Secretary is directly accountable to the Director of Med/Surg, and indirectly to the Charge Nurse, and / or House Supervisor. The Unit Secretary is an unlicensed person who performs indirect care in the department setting.  Facilitates the communication needs of the department. Transcribes physician orders from records (in the absence of CPOE and EMR clinical documentation system) with notation and signature by nursing staff. Prepares and complies records on the Emergency Room. Orders supplies for the unit, prepares and completes each patients chart for necessary forms needed on a daily basis. Able to assist nursing staff for duties involving indirect patient care.

Responsibilities KNOWLEDGE OF WORK

 

1.Transcribes physician’s orders accurately under the supervision of the RN in absence of CPOE. Monitors authentication and validation of telephone orders of physicians within 24 hours. Enters orders correctly in the computer.
 
2.Posts lab results, x-rays and other reports accurately after being reviewed by the RN. Alerts nursing staff to abnormal lab results.
 
3.Checks for accuracy, completeness and correctness of patient records. Assembles charts on new admissions and prepares charts for patient transfers.

 
4.Maintains an organized nursing station, monitors for noise levels, ensures good work flow at the desk area.
 
5.Possesses excellent communication skills thus ensuring cooperation from patients, co-workers and other organizations with whom he/she is in contact.
 
6.Possesses the ability to interact with other departments in order to resolve any conflicting issues.
 
7.Demonstrates proper use of job related equipment and supplies.
 
8.Accomplishes assigned duties accurately, completely, efficiently and within specified time frames according to established policies and procedures.
 
9.Demonstrates knowledge of National Patient Safety Goals (NPSG).
 
 

DUTIES AND RESPONSIBILITIES

 


1.Uses two patient identifiers when re-banding a patient or posting lab results on a chart to ensure correct information. Demonstrates awareness of importance of accurate patient identification at all times.
 
2.Does not use unacceptable abbreviations; alerts physicians and staff when transcribing orders.
 
3.Notifies the Bio-Med department for nonfunctioning equipment in a timely manner.
 
4.Orders supplies in cost effective manner as needed and assists with restocking. Keeps accurate inventory of unit supplies.
 
5.Checks for completeness and accuracy of patient record and correct order of documents within the record.
 
6.Maintains completeness of the patient chart for admission, transfer and discharge, medication reconciliation form as needed.
 
7.Monitors patient charts to insure hospital requirements and regulatory are met.
 
8.Maintains admission, discharge and transfer log book and Medical Surg/Tele Department staff daily patient assignments.
 
9.Practices telephone etiquette when placing and answering calls for physicians, patient/families and other departments and communicates messages timely to the appropriate person/department.
 
10.Avoids and prevents injury to self and patients by applying the principle of body mechanics. Maintains a safe environment, functioning with an awareness and application of safety issues identified within the unit facility.
 
11.Ensures crash cart is immediately restocked with the appropriate items after each code; Notifies Charge RN of any issue with timely restocking by appropriate personnel.
 
12.Notifies nursing personnel in a timely manner for call lights, clinical alarms, telephone calls, or as needed.
 
13.Consistently ensures that all clinical alarms i.e., vital sign monitors are set with the appropriate parameters for the patients and are audible at all times.
 
14.Prepares SBAR communication tool for change of shift report.
 
15.Assists with all admission, discharges, transfers and physician orders, as needed.
 
16.Utilizes the National Patient Safety Goals in the work place as related to job performance. Demonstrates awareness of a safe environment for staff, patients, visitors, or any other persons on the unit.
 
17.Participates in data collection for PI specific to the unit.
 
18.Consistently performs special projects and assignments in an accurate, efficient and thorough manner.
 
19.Assists discharge planner with faxing and acquiring authorization for release of information as needed.
 
20.Completes additional duties as assigned by the staff; seeks clarification from Charge Nurse when necessary.
 
21.Performs other essential duties as assigned or required.
 
 

INITIATIVE AND JUDGMENT/ATTENDANCE AND RELIABILITY


1.Independently recognizes and performs duties which need to be done without being directly assigned.  Establishes priorities; organizes work and time to meet them.
 
2.Recognizes and responds to priorities, accepts changes and new ideas.  Has insight into problems and the ability to develop workable alternatives.
 
3.Accepts constructive criticism in a positive manner.
 
4.Adheres to attendance and punctuality requirements per hospital policy.  Provides proper notification for absences and tardiness. Takes corrective action to prevent recurring absences or tardiness.
 
5.Uses time effectively and constructively. Does not abuse supplies, equipment, and service.
 
6.Observes all hospital and departmental policies governing conduct while at work (e.g., telephone and computer use, electronic messaging, smoking regulations, parking, breaks and other related policies).
 

EDUCATION, EXPERIENCE, TRAINING

 

  1. High School Diploma or Equivalent or relevant experience required for all new hires, effective April 2014.
    Medical terminology preferred.
  2. Current BLS (AHA) certificate within 6 months of hire and maintain current.
  3. Experience using computers for word processing, database management preferred
 

 

We are an Equal Opportunity/Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  EEO is the Law: https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf