Unit Secretary - Stepdown Unit

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• High school diploma or equivalent.

• Graduate of a Medical Assistant program or secretarial school.
• CPR certification.

• One (1) year of administrative or clerical experience.

• Performs clerical duties related to patient care, including:
• Enters pending final discharge into SMS (INVISION) system
• Identifies patient records accurately with patient label
• Reduces bulky charts as necessary; maintains storage of partial medical record until patient is discharged
• Assembles packets for diagnostic studies, admissions and surgical procedures
• Retrieves old medical records when directed
• Maintains housekeeping list of discharges and transfers
• Prepares alert band for patient allergies
• Prepare all medical records on discharge
• Organizes and fills medical record as needed
• Fax discharge instructions to the patient’s primary care physician after discharge
• Prepare IDT document
• Notify monitor tech when a patient leaves the unit for a test/ procedure
• Assists the physician including:
• Provide appropriate medical record to physicians
• Notifies nurses of physician’s presence on department
• Complete the necessary requisitions and forms.
• Forwards requisition forms to appropriate departments
• Schedules diagnostic studies as ordered
• Schedules surgery as ordered
• Signs orders with full name and time when completed.
• Provides charge nurse with orders to approve and sign.
• Accepts written orders only from physician; does not accept verbal orders.
• Notify physician’s offices regarding consults
• Provide assistance and providing resources regarding EMS (electronic medical record)
• Prepares the medical record by the following:
• Transcribes physician's orders from medical record to Kardex and/or medicine sheets (Skilled unit)
• Schedules diagnostic studies
• Schedules surgery
• Signs orders with full name and time when completed
• Provides charge nurse with orders to approve and sign
• Accepts written orders only from physician; does not accept verbal orders
• Completes ordered daily lab work (Skilled Unit)
• Notifies appropriate staff of STAT orders
• Prepares all reports, records, and permits as directed by the registered nurse, including:
• Places lab, X-Ray and other reports on patient’s medical record after the reports are checked by the registered nurse
• Completes specific unit forms
• Prepares permits for nurse to complete
• Performs SMS (INVISION) functions: i.e. order entry, cancel, discontinues, discharge, consults, work requests, etc.
• Acts as receptionist for the nursing unit including:
• Greet visitors, make eye contact and walk them to the patient’s room
• Records and relays messages accurately to unit personnel
• Answers telephone and responds to the intercom; keeps telephone lines open for incoming calls.
• Answer telephone within 3 rings, state your name, location and ask how may I help you. Do not leave caller on hold longer than 1 minute- check with them if they would like to leave a message or continue to hold
• Places calls as directed by nurses and physicians
• Answers physician's pages when required
• Answers general inquiries from visitors, patients, volunteers and hospital personnel
• Answer call lights and notify appropriate staff
• Checks incoming mail and distributes
• Update white boards in patient’s rooms
• Attends in-services and other educational programs as required.
• Attends and participates in staff meetings.
• Determines areas of self-improvement; writes developmental goals on performance appraisal.
• Performs clerical duties related to departmental operations including:
• Maintains stock of clerical supplies
• Enters CPD and Pharmacy charges, (ED only- completes charging in ED apps)
• Enters maintenance work orders
• Maintains departmental inventory; enters orders for needed items from storeroom
• Assign beepers, complete assignments in the call system, assign/ update attributes as well as preparing the daily assignment sheet for the…