The History of
Health Unit Coordinating and NAHUC
Prior to World War II, hospitals were
staffed by physicians, nurses, specialists such as laboratory technicians, and
a few support personnel such as cooks and janitors. World War II brought about
massive changes in the staffing of health facilities. These changes were first
felt in England in the late 1930s as the immense number of casualties put an
intolerable strain on physicians and nurses. First, the nurses took over some
of the physicians' "duties," such as taking blood pressures and
starting intravenous therapy. This meant that the nurse needed someone to take
over some of her duties. (The vast majority of nurses at that time were women.)
It had always been noted by nurses that
"desk" duties such as answering the telephone or going on errands
frequently interrupted the giving of nursing care. So an individual was added
to the staff to do these duties. This person was designated a "floor
clerk." As the war went on, more and more responsibilities, such as
copying diet lists and condition reports, were assigned to the "floor
clerk" position description.
The first recorded unit coordinating history
was found in an article, "In Favor of Floor Secretaries," published
in 1940 in a journal, The Modern Hospital, written by a hospital
administrator. In the article, the author, Abraham Oseroff, outlined the
implementation of unit coordinating at Montifiore Hospital in Pittsburgh,
Pennsylvania. He described how "a new helper was introduced to the nursing
unit to take care of the many details of a secretarial nature that formerly
made demands on the limited time of the nurse." The new helper was called
a "floor secretary." Mr. Oseroff further said," that the idea of
a floor secretary was first met with skepticism, but it proved to be worthwhile
from the beginning."
Following World War II, new hospitals were being built and old ones were being
enlarged. The shortage of nurses continued and more responsibilities were being
placed on the "ward clerk", the name of the 1950s. These new duties,
usually head nurse tasks, were ordering supplies, keeping up with time sheets
and preparing certain reports. During the 1950s, hospitals began to train their
ward clerks to transcribe physicians' orders. About this time, some hospital
administrators recognized that these individuals were performing tasks which
were not strictly clerical, so more name changing took place and ward clerks
also became know as unit clerks or unit secretaries.
By the 1960s, recognition of the need for educational programs took place. An
article in Nursing Outlook, August 1966, by Ruth Stryker described the
findings from a small hospital study on the functions of the head nurse, ward
secretary, and ward manager. The findings resulted in the implementation of a
hospital station secretary program in the Minnesota vocational education
system. Miss Stryker had suggested the name "station coordinator,"
because the ward secretary did a great deal of managing in the form of
coordination of activities.
In 1977 a national survey was done by Myrna LaFleur (NAHUC founding president
and instructor from Phoenix) to determine the number and kind of unit
coordinating programs in existence in the United States. Fifty-two programs
were located in adult educational centers, community colleges and
vocation-technical schools. Not every state had a program. A part of the survey
asked if the recipient was interested in the formation of a national association
for unit coordinators.
In the spring of 1980, Myrna was asked to speak at the Upper Midwest Hospital
Conference in Minneapolis, Minnesota to a group of unit coordinators and unit
managers. A state association for unit coordinators had just been formed in
Arizona, and realizing the need for a national association, Myrna included the
possibility of forming such an association in her talk. Upon Myrna's return
home, feeling highly motivated by her trip she dug out the responses from the
1977 survey. She contacted those respondents who said they were highly
interested in forming an association and invited them to meet in Phoenix in
August 1980. Those people who came and became the founding members of NAHUC
included Velma Kerschner from Texas, Kay Cox from California, Jane Pedersen
from Wisconsin, Carolyn Hinken from New Mexico, and Helga Hegge from Minnesota.
They were joined by Winnie Starr and the officers from AMSCA (Arizona
association for unit coordinators). They spent a weekend hammering out the
constitution, selecting a title, and declaring NAHUC the National Association
of Health Unit Clerks/Coordinators, Inc.
In June of 1982, the first NAHUC annual national convention was held in San
Antonio, Texas. At this convention, the Code
of Ethics and Standards of Practice
for unit coordinating were adopted. Education and recognition as a health
profession were two of the main concerns of the founders of NAHUC. Accordingly,
a subsidiary Certification Board was established and the first National
Certification Examination was given in May 1983. By the end of 1991,
approximately 15,000 health unit coordinators had become certified. Two other
subsidiary boards, the Education Board and the Accreditation Board, were formed
to work toward accreditation of programs and to establish an official listing
of unit coordinator competencies.
Today Health Unit Coordinating is a health profession. According to Wilson and
Neuhauser in their book, Health Services in the U.S., for a group to
become a profession, they must meet the following criteria:
1. Have a national association.
2. Have a formal education.
3. Have certification.
4. Have a code of ethics.
5. Have an identified body of systematic knowledge and technical skill.
6. Have members that function with a degree of autonomy and authority under the
assumption that they alone have the expertise to make decisions in their area
of competence.
