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Medical Scribes

There is nothing to writing. All you do is sit down at a typewriter and bleed - Ernest Hemingway

Medical Scribes

image by: mpclemens


“You’re a scribe? So you just write stuff for doctors?”

If I had a dollar for every time someone used the words “only” and “just” while describing the role of a scribe, I could pay for nursing school. (Okay, maybe that’s an exaggeration.)

At the heart of it, our main task is to chart for providers. What I’ve learned in the last 7 months, though, is that the job of a scribe can be much more than that. It all depends on how much you want to put in, how much you want to learn, and how much increasing the productivity of the ED means to you.

When your ED sees over 300 patients in a day, increasing productivity of the ED should mean a lot—and a scribe can help. Daily, a scribe is tracking down EKGs; following up on radiology and lab tests; rounding on patients and offering comfort items; taking messages from nurses; offering to help busier scribes with dictations; helping scribe-less providers with their charts; looking for providers when a consulting doctor calls back; offering cute stuffed animals to pediatric patients, and much more.

Along with assuming scribes don’t do much, I’ve also encountered many people who assume that scribes don’t learn much. Last month at a nursing school information session, I was told that scribing was good experience in terms of “learning how to chart,” but that I should get more experience by volunteering in a hospital to “learn how to deal with patients.”

I volunteered in a hospital for two years and was not allowed to do much besides stocking rooms with supplies, making beds, and retrieving warm blankets. My role as a scribe has introduced me to a world with new opportunities. While, we are legally restricted from touching patients, that doesn’t mean we don’t learn about provider-patient interactions. By shadowing some of the best and brightest doctors and PAs on the job, I have seen what it takes to increase patient satisfaction, to make a patient feel heard and treated. I have seen providers assuage the angriest of patients with quality care and attention.

I will never forget the time I walked into a room with my doctor and a grumpy, 80-something year old Spanish-speaking lady began berating us for making her wait in the waiting room. In his broken Spanish, my doctor patiently explained that it was a very busy day and we were unfortunately holding patients in the ED that were already admitted. As he pleasantly interviewed and assessed her, her deep frown and furrowed brows slowly began to soften. Right before he stepped out of the room, he even earned a big smile and a “muy simpatico, muy simpatico!”

Scribes also learn about the medical decision-making process. By doing MDM dictations for doctors, you quickly begin to recognize the pattern between specific symptoms and certain tests and imaging that are ordered. You learn which symptoms to look for given certain chief complaints. You pick up on which differential diagnoses need to be ruled out.

Even as an aspiring nurse who won’t need to make the same decisions that doctors do, I am learning about my future job through scribing. I spend the majority of my shifts walking alongside or sitting beside providers and they are frequently approached by nurses regarding patient updates, medications, and orders. I am constantly observing what a nurse can and cannot do, when they need to seek advice from a provider, and how they work with providers to deliver the best healthcare possible.

I am grateful for the exposure and knowledge I’ve gained through working as a scribe. Helping out with pelvic exams, sitting in on I&Ds of 25 cm abscesses, and observing a central line placement are a few of the multitude of experiences that are invaluable to me.

Yes, I am “just a scribe,” and I am proud of it. And, my fellow scribes, you should be proud too."

Source: Anonymous, Just a Scribe, the Inside Track, CEP America, May 16, 2016.