History of the Health Unit Coordinator

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.”