ER Scribe Level I vs II experiences?

[cornerless]

I'm currently employed at a Level I trauma center but have the ability to transfer to a Level II trauma center that is closer. I'm mostly concerned with the quality of the experience and I'm not sure how it'll differ across the two different hospitals. Can anyone with experience in either trauma levels as an ER Scribe provide some insight?

Thank you!

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[Tappinfool66]

I work as a scribe at a children's hospital level I trauma center. They see their fair share of traumas there but most of the charts I do are for non traumas, whether I'm in the more acute zone where kids come in with asthma exacerbations or fall injuries or in the "fast track" zone where most of the patients have colds, GI viruses or minor ankle/knee/arm injuries. You've probably had a similar experience. Who knows though, it might be very different at your hospital.

My opinion is that if I worked in a level II trauma center, I think I'd still see most of the same stuff, just obviously not the occasional very severe trauma. If it's closer to you and you wouldn't mind not seeing the occasional severe trauma, you'd probably be fine with switching and still having a similar work experience at the new hospital.

 

[beethousand]

I'm currently employed at a Level I trauma center but have the ability to transfer to a Level II trauma center that is closer. I'm mostly concerned with the quality of the experience and I'm not sure how it'll differ across the two different hospitals. Can anyone with experience in either trauma levels as an ER Scribe provide some insight?

Thank you!

I work in both a Level I and Level II and there is not a significant difference in terms of the quality of the experience in my opinion. It is interesting to occasionally see the wild traumas come through, but our role is pretty limited. During my shifts at the level I tend to see no more or less acuity because the ED physicians that I scribe for don't see level I patients - that is taken by the Trauma team. In the level II we do everything and I've found we tend to be busier and take on more, but I think it's totally location specific. In terms of trauma as an ED scribe if the level of trauma is very high they're usually shipped out to the trauma service immediately so we don't really manage them. While trauma is interesting I think that the better stuff to learn as a scribe is the core medicine in the septic patients, CHF exacerbations, etc... from an ED perspective (at least where I work) trauma means we might intubate, do a FAST exam, start stabilization and start labs and CXR, etc., but beyond that the rest of the work is done by ortho or the trauma surgeon. All of this is highly dependent on the individual hospital and providers you work for. If you're doing it just for the title though I don't think it's worth it.

 

[OregonDuck02]

I pretty much agree with everything that has been said so far. I work as an emergency room scribe at 5 hospitals in my area (Portland, OR), only one of which being a Level I trauma center (Emanuel Hospital). The trauma notes we do are usually really limited as the ER docs there are only charged with the task of examining the head / neck / airway. The care of the patient is then signed out to the trauma team. The much more interesting and complex cases are ones that don't necessarily need to be seen at a Level I trauma center. After doing this for almost 2 years now, I would be glad to sacrifice working at a Level I trauma center for a shorter commute! You still see a ton of cool stuff at other hospitals and may even have a greater chance at becoming a more integral part of the treatment team, beyond being the weird guy in the corner who types quickly. Best pre-med job you can have though, by far.

 

[Pacna]

I pretty much agree with everything that has been said so far. I work as an emergency room scribe at 5 hospitals in my area (Portland, OR), only one of which being a Level I trauma center (Emanuel Hospital). The trauma notes we do are usually really limited as the ER docs there are only charged with the task of examining the head / neck / airway. The care of the patient is then signed out to the trauma team. The much more interesting and complex cases are ones that don't necessarily need to be seen at a Level I trauma center. After doing this for almost 2 years now, I would be glad to sacrifice working at a Level I trauma center for a shorter commute! You still see a ton of cool stuff at other hospitals and may even have a greater chance at becoming a more integral part of the treatment team, beyond being the weird guy in the corner who types quickly. Best pre-med job you can have though, by far.

Hmm... that's not how we do it, but I'm in Minnesota. We call trauma codes and justify them similar to you I'm sure, but so long as the patient is stable, we address their injuries in a basic fashion downstairs then admit to the hospitalist service for continued management.

 

[Laurenxxxx]

I scribe at a level II. Whenever a trauma comes in, the trauma team handles the chart because there is a lot going on.

I've only ever seen two traumas, and they were elderly people who had fallen and didn't end up having any injuries. But I have heard of scribes seeing patients from nasty car accidents.

I don't think there would be much of a difference. If you're very interested in serious trauma and want to pursue it, then you may miss the occasional wild case coming through the door. But even at my hospital, I still see something new that excites me each time I'm there. Never a dull moment in any ER

 

[Pacna]

Never a dull moment in any ER

Ahhh what?

 

[Laurenxxxx]

Ahhh what?

What are you questioning?

 

[Pacna]

What are you questioning?

There are totally dull moments. In fact, most peds shifts (we have a peds ED) are boring as snot because they all have ear infections or strep. Borrrinnngggg.

 

[TXhopeful]

I work in both a Level I and Level II and there is not a significant difference in terms of the quality of the experience in my opinion. It is interesting to occasionally see the wild traumas come through, but our role is pretty limited. During my shifts at the level I tend to see no more or less acuity because the ED physicians that I scribe for don't see level I patients - that is taken by the Trauma team. In the level II we do everything and I've found we tend to be busier and take on more, but I think it's totally location specific. In terms of trauma as an ED scribe if the level of trauma is very high they're usually shipped out to the trauma service immediately so we don't really manage them. While trauma is interesting I think that the better stuff to learn as a scribe is the core medicine in the septic patients, CHF exacerbations, etc... from an ED perspective (at least where I work) trauma means we might intubate, do a FAST exam, start stabilization and start labs and CXR, etc., but beyond that the rest of the work is done by ortho or the trauma surgeon. All of this is highly dependent on the individual hospital and providers you work for. If you're doing it just for the title though I don't think it's worth it.

Level 2 for me as a scribe, and I agree with this post. Looking back, it was always cool to see gory and unfortunate gun-shot wounds or open fractures, but the things that matter and stick with you is the medicine and patient care that you're witnessing. I mean, unless you want and can somehow clearly predict that you will be a trauma surgeon, your experience as a scribe in either hospital will be extremely valuable. I might add that we had the chance to shadow docs and their scribes at a Level 1 trauma center in Dallas before we switched to EMR and I highly preferred my work conditions at my current hospital. At our hospital the docs had a better relationship with the scribes, more time and willingness to teach us, along with generally less chaotic conditions. Our Level 2 functioned very much like a Level 1, only difference is we weren't doing current research and didn't have live-in trauma surgeons. It all is good experience that allows you to see the reality of the profession you're pursuing, and is a win/win in this case.

 

[Laurenxxxx]

There are totally dull moments. In fact, most peds shifts (we have a peds ED) are boring as snot because they all have ear infections or strep. Borrrinnngggg.

I don't work in the peds ED. I work in acute. Maybe I'm just not there enough to be bored but my shifts are pretty exciting and diverse. Sorry you don't have as much fun as I do!

 

[Pacna]

I don't work in the peds ED. I work in acute. Maybe I'm just not there enough to be bored but my shifts are pretty exciting and diverse. Sorry you don't have as much fun as I do!

Fair enough! I actually had an overnight once where we didn't see a single patient. Dull moments galore.

 

[Mad Jack]

Hmm... that's not how we do it, but I'm in Minnesota. We call trauma codes and justify them similar to you I'm sure, but so long as the patient is stable, we address their injuries in a basic fashion downstairs then admit to the hospitalist service for continued management.

In my Level 1, the ED team does the initial assessment and airway management, but trauma surg shows up and takes over on anything really interesting.

I'm currently employed at a Level I trauma center but have the ability to transfer to a Level II trauma center that is closer. I'm mostly concerned with the quality of the experience and I'm not sure how it'll differ across the two different hospitals. Can anyone with experience in either trauma levels as an ER Scribe provide some insight?
Thank you!

Scribes around here are not allowed to be present in the trauma room. A nurse does all of the recording, because trauma assessments are way too complicated and fast paced for a scribe to handle, in addition to the make medical-legal issues that would result from an error. So you probably won't have much different of an experience, really. Another thing to consider is that not all L1s and L2s are created equal. You might see more "interesting" stuff in an inner city L2 than a boondocks regional L1. No matter what you decide, it won't really affect your med school application, so choose what works best for you.