Success: Clerical staff are cross-trained as ED techs

An ED in Lebanon, NJ, has been cross-training clerical staff to work as technicians for the past 10 years and reports that the system is a major help in reducing the workload for nurses and other staff.

"It improves efficiency and makes things work more smoothly overall in the ED," says Kathy Cook, LNA, unit services coordinator for emergency services at Dartmouth-Hitchcock Medical Center.

Cook started out in a clerical role in the ED and was cross-trained for patient care. "When we’re not there, the nurses really miss us," she says.

Cook then became coordinator for the program. Before the program, the ED employed staff in purely clerical roles but had a need for more clinical help. The decision was made to cross-train the clerical staff for patient care. "It was not so much that we were short staffed, but we had a need for specific types of help," she says. "We needed to make the nurse’s job better but also to make the secretary’s job more exciting, more satisfying than just spending the day at a desk."

Training was necessary, so all of the clerical staff were asked to attend courses for a certification as licensed nursing assistants (LNAs). The hospital provided the courses on-site and free of charge. Hospital educators taught the courses at a negligible cost, Cook says.

The ED ended up with 10 clerical staff who were cross-trained for patient care duties and has maintained that staffing. The ED typically has three support techs on duty from 7 a.m. to 3 a.m., and two the rest of the time. Once they are LNA-certified, they are capable of tasks such as taking vital signs and cleaning wounds. Each year, the ED tries to improve the support staff’s skills so they can do a little more. Most recently, they were trained in phlebotomy.

"The clerical work is still done by the same people. The job now has two components: clerical and floor tech," she says. "It’s been very successful for the ED, and we don’t have much turnover in our support staff."

Cook describes the support staff position as a challenging role, but she says the employees enjoy it more than purely clerical work. And the ED staff are very appreciative, she says.

"It’s not just that you’re asking them to do more work. It’s more fulfilling," she says.


For more information, contact:

• Kathy Cook , LNA, Unit Services Coordinator for Emergency Services, Emergency Department, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756. Phone: (603) 650-5000.