Emergency Medical Scribe-What it's actually like

[DrFizition]

Hello all. So I haven't seen too many threads on this website about ED scribing, so I thought I would add my two cents to give future premeds an idea of what the job actually is. Please note that everything I describe below is based on my experiences and may vary for you depending on the ED you are working in or the company you are working for.

The Job:
As most of you know, medicine is a form of science, and with any science comes documentation. Documentation is essential in medicine not only because it helps providers keep track of patients (their histories, previous visits, etc), but it also allows insurance companies to bill and code so doctors actually get paid. Unfortunately, with the electronic medical records being so time consuming, physician productivity has also been affected by the documentation. This is where scribes come in: As a medical scribe my job is to complete most, if not all, of the charts for each patient that was seen by a provider.

And that's pretty much it for the job, you walk around with the physician that you are assigned to, go into patient rooms and type away on a mobile computer. In general, you are responsible for taking note of the history provided by the patient, review of their systems (what symptoms they have, what they don't have), physical exam findings, lab/x-ray/CT scan findings, and sometimes the differential diagnoses and medical decision making. Shifts are 8-10 hours, and I generally see anywhere from 12-18 patients in my ED (max I had was 25).

Scribes generally do not get paid well (minimum wage-$11/hr), most are part time (few days a month), others are full time (few days a week), but in the end it is not a high paying occupation. If money is an issue for you due to loans or other matters, you may want to find a second job.

The experience:
The experience is great for pre-meds as individuals get to experience both the clinical and clerical aspects of medicine. Although there's no "hands on" interaction involved, you do get to see EVERYTHING your doctor sees. A lot of medical schools talk about shadowing experiences. I must say that scribing is the best shadowing experience out there (and you get paid a little). You get to watch how doctors interact with patients, procedures performed, lab results (and what they mean), sometimes get to see x-rays/CT scans/bedside ultrasounds, and my favorite, watching patients get intubated. Additionally, you get to experience the art of medical decision making and how documentation is done. This, of course, is just as important as patient-healer interaction itself.

I believe it's a misconception that the emergency department is filled with super sick patients who may die at any second of a heart attack, gun shot wound to the lung, or other crazy conditions. While you do have patient who are super sick like that, it is not as common as you would think (or as shown on TV). Most of the patients I have seen are there because they are old and fell (falls are SOOOO common), because they are seeking drugs/narcotics, because they were found intoxicated, or some other non-life threatening conditions. Of course, this may be different for you guys as the ED I worked in was small and didn't have a trauma center.

The value of a scribe:
Something that has been bothering me since I began working as a scribe almost six months ago: Is my job even beneficial to the ED? And I assume that many other scribes feel the same way, that they aren't really contributing much in any way. This feeling varies between the doctors I work with too; some doctors require us to complete the ENTIRE chart just so they can skim through it and sign off on it immediately. They make you feel productive and good about your job. Other doctors have us do everything but the differential diagnoses/MDM, and then they read and correct through what you typed up as if they don't really trust your work. With these doctors you'll often ask yourself: alright, so what's the point of my job? Sometimes I wonder why some doctors even volunteer to work with scribes, as they would probably be equally as efficient without them.

Then again I may be totally wrong, and doctors truly do enjoy scribes. I'd love some physician feedback here about this topic.

But the message here is that as a scribe you will often feel like you are not a crucial component of the ED. In fact, you are on the very bottom of the ED totem pole, and this may bother you as it had bothered me.

Is it worth it?
Yes. Even with all of its ups and downs, scribing is a great opportunity for premeds who are in college or recently graduated to get a glimpse of what the emergency department is really like. You will begin to speak and think like doctors, which I believe will help me a lot when I begin medical school. Some scribes I worked with turned away from medicine after being part of the job because they simply didn't like it. Others, like me, were drawn closer to medicine. At the end of the day, it is a great way for you to know if being a health care provider is really for you. Even though you are only seeing through the eyes of an emergency physician, these doctors are trained to understand and interact with a VAST amount of situations that can be encountered in the field of medicine. It's good experience, no matter where you want to take your medical career.

Bests,
Dr. Fiz

Again, I'd love some honest physician feed back on the scribe program. Thank you.

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[ZPakEffect]

I am also a scribe, but I work at a very busy downtown ED in a major urban area. Seeing 40-50 patients in one 9-hour shift is common, and the average is about 30 patients over 7 hours. The scribes on my team do EVERYTHING. We not only document the entire chart, but we also discharge and admit patients, as well as pend orders for labs, imaging, and meds into the computer for the doctors to sign. Some doctors even have us hold their Voceras and answer calls from secretaries, nurses, and techs. Our physicians would not be able to function without scribes. We make it possible for them to see patients at rates up to 10-15 patients per hour. It is quite possibly the toughest scribe job in the country but the learning opportunity is also tremendous.

 

[DrFizition]

I am also a scribe, but I work at a very busy downtown ED in a major urban area. Seeing 40-50 patients in one 9-hour shift is common, and the average is about 30 patients over 7 hours. The scribes on my team do EVERYTHING. We not only document the entire chart, but we also discharge and admit patients, as well as pend orders for labs, imaging, and meds into the computer for the doctors to sign. Some doctors even have us hold their Voceras and answer calls from secretaries, nurses, and techs. It is quite possibly the toughest scribe job in the country but the learning opportunity is also tremendous.

Hey ZPakEffect. Thank you for responding. I am actually pretty jealous that my ED is small and that we don't experience such a high volume of patients. Additionally, the scribe program in my hospital is new so there's a lot of limitations as to what we can do (we can't answer calls, for example). But it must honestly be so exciting seeing so many patients. Keeps you busy and keeps you learning.

 

[ZPakEffect]

Hey ZPakEffect. Thank you for responding. I am actually pretty jealous that my ED is small and that we don't experience such a high volume of patients. Additionally, the scribe program in my hospital is new so there's a lot of limitations as to what we can do (we can't answer calls, for example). But it must honestly be so exciting seeing so many patients. Keeps you busy and keeps you learning.

Yes, the learning you can do as a scribe is enormous. Just the other day, I was able to correctly call an abdominal pain as a kidney stone just by hearing the history. After we took the history, I told the doctor I thought it was a kidney stone. He said it might be but he was leaning more towards ovarian cyst. The CT proved me right in the end.

 

[wasteofspace323]

Thanks for the evaluation! It's good to know how others experiences are panning out! Just curious, how long have you been working at your ER?

 

[DrFizition]

Thanks for the evaluation! It's good to know how others experiences are panning out! Just curious, how long have you been working at your ER?

Approximately 6 months. I forgot to mention that I didn't really feel that I was "good" at my job during the first few months. It's really a lot of practice as well as learning what each provider likes in the chart. Everyone likes things documented differently and its important to understand those little differences. It's somewhat of a learning curve and I don't like how my company tends to throw me into the job after only a few days of training.

 

[bumpy]

So the pros of scribing are well-documented by the OP. You do get a first hand look at what ER docs (and sort of what some other specialties) do on a regular basis. Also, most of what you see is not as aggressively exciting (gunshots, stab wounds, ODs, etc.) as one may think, but the sheer variety of conditions and personalities that come in make the job interesting.

I think the most disappointing aspect of my scribe experience has been...well, with the nature of many of the providers and some of the nursing staff. I've discovered that you don't have to be extraordinary, interesting, curious or even a good person to be a healthcare provider. Out of the 12 physicians I work with, only about 3 or 4 seem to be inspired by their work or feel like what they do is for the better good. I've dealt with a lot of abusive/materialistic personalities...docs who spend as much time as possible complaining about patients or other staff instead of trying to treat those who walk through the door. Some of them are incredibly sloppy with their charting (would rather be doing something else), some only seem happy when talking about stuff they want to buy, some talk to patients like they are on an assembly line (with zero inflection or empathy in their voices). I think I just had higher expectations...but then again, there are a few who really do seem to be good, interesting people....they are just not the majority, at least in my ER. Anyway, I guess the silver lining is that I've witnessed a lot of behavior that shows me what I don't want to be like...I can only hope that if I ever become a provider, I will try to emulate the few goods docs I've worked with and not the majority.

 

[XxThaDoggxX]

I scribe in multiple ER's across my area....Love the job and really like being able to cycle through different hospitals...sometimes I am in a level 1 trauma hospital with people being flown in from all over the place, other times I am in free-standing much slower ER's listening to physician's talk shop for hours..Every day is different and the learning opportunities--IF YOU ACTIVELY ENGAGE YOURSELF--are tremendous.

And yes it is true...Some attendings will basically refuse to start working until their precious scribe arrives

 

[Petrichor1]

Some doctors even have us hold their Voceras and answer calls from secretaries, nurses, and techs.

I don't know if you should be doing that. A lot of policy in healthcare mandates calls to be received by certified nurses and physicians especially when results are concerned and those are usually of immediate importance.

 

[catie_jane]

I work in an ED just south of Boston so we get to see a variety of stuff (gun shots, STEMI's, stab victims, ETOH withdrawals, section 12's, section 35's, chronic conditions, codes, etc.) I was lucky enough to be the student intern the summer before they started our scribe program so I was familiar with the EMR, docs, hospital, staff, etc. before I was hired.

I agree with @XxThaDoggxX in the sense that you can learn a lot from this job, but that is solely dependent on how engaged you are. Most of the docs I work with love to teach while I am there (do not work in a teaching hospital) and I will get called in on other cases by docs I am not working with if they think it is something interesting. I always ask questions, look at radiology reports with the docs, and they will sometimes even quiz me on some basic stuff.

To @DrFizition comment, I feel like a helpful part of the team at my hospital, but that is because most of the docs I work with make it a point to tell us how helpful we are and will complain (jokingly) to our supervising doc if they aren't scheduled with scribes. I also make it a point to help out the nurses or techs when I can by calling the lab for results, getting urine specimens, cleaning rooms, getting water, etc.

Almost every doc that I have spoken with have said how much of an advantage I will be at when I (hopefully) enter medical school because of how much I have been exposed to. I've learned how to read EKG's (at a basic level) just because of how many I see and input into the computer a day. In addition, because of all the repetition I see when it comes to patients, I could probably do an HPI, exam, and order labs on someone coming in with a chief complaint of headache, abdominal pain, back pain, etc.

Lastly, being a scribe not only showed how AWESOME medicine is, but more importantly it has shown me the true challenges you face having a career in medicine. There have been days where I am beyond frustrated with drug-seeking patients, patients who don't manage chronic conditions, mounds of psychiatric paperwork, politics between hospitals or even within hospitals, etc. Working in this particular hospital has shown me some of the worst parts of a career in medicine, but even after that I still want to become a physician. I feel that seeing these challenges and dealing with them first hand has prepared me even more for a career in medicine.

 

[DrFizition]

I've discovered that you don't have to be extraordinary, interesting, curious or even a good person to be a healthcare provider. Out of the 12 physicians I work with, only about 3 or 4 seem to be inspired by their work or feel like what they do is for the better good. I've dealt with a lot of abusive/materialistic personalities...docs who spend as much time as possible complaining about patients or other staff instead of trying to treat those who walk through the door. Some of them are incredibly sloppy with their charting (would rather be doing something else), some only seem happy when talking about stuff they want to buy, some talk to patients like they are on an assembly line (with zero inflection or empathy in their voices). I think I just had higher expectations...but then again, there are a few who really do seem to be good, interesting people....they are just not the majority, at least in my ER.

I've seen this with a few doctors that I've work with as well. I think that comes with time and is part of the whole "high emergency medicine burnout rate" idea. After seeing thousands and thousands of drug seeking, ETOH, poorly managed acute on chronics, psychiatrics, and simply unhappy/rude patients it really starts to get old. A lot of the physicians I work with love complaining about the flaws in our health care system because of this. Everyone steps into med school with a big smile and passion saving lives. But after 10 or so years of doing that with the same repetitive patients, anyone would get sick of it. At that point it becomes just a job. Additionally, the hours these docs work really messes with their sleep, leaving them cranky most of the time.

But it is true that most of these doctors love teaching, or at the very least don't mind it. It's so exciting to pull up radiographic scans in front of the doctor and share ideas about what the "lump" below the kidney might actually indicate.

 

[Hospitalized]

Ahhh, I remember when I had been scribing for 6 months. Good ol' days. Blissful ignorance.

 

[Lost in Translation]

Yes, the learning you can do as a scribe is enormous. Just the other day, I was able to correctly call an abdominal pain as a kidney stone just by hearing the history. After we took the history, I told the doctor I thought it was a kidney stone. He said it might be but he was leaning more towards ovarian cyst. The CT proved me right in the end.

Doing any sort of work that gives you adequate patient contact or physician shadowing in an ED is definitely the best way to learn about medicine. In my time at my ED, I've learned but never performed since that's a legal liability (though I have been asked if I would want to) IV insertion, basic suture removal including techniques for deeper cuts–I'm a big fan of the horizontal mattress, what symptoms are common to meningitis, who's having a real heart attack and who's faking it just to get a bed to stay in for the night (this ED serves a lot of homeless; to add, I know what sort of symptoms you should say you have if you want to stay in a hospital overnight for whatever reason), how to reduce simple orthopedic emergencies (just pull ), Narcan withdrawal, and other small things. It really is the best pre-med experience one can get in terms of exposure.

In the words of an EM resident I've met: do EM if you want to know something in many fields, but nothing in one. Not sure if that was a dig or not

 

[Lost in Translation]

I work in an ED just south of Boston so we get to see a variety of stuff (gun shots, STEMI's, stab victims, ETOH withdrawals, section 12's, section 35's, chronic conditions, codes, etc.) I was lucky enough to be the student intern the summer before they started our scribe program so I was familiar with the EMR, docs, hospital, staff, etc. before I was hired.

I agree with @XxThaDoggxX in the sense that you can learn a lot from this job, but that is solely dependent on how engaged you are. Most of the docs I work with love to teach while I am there (do not work in a teaching hospital) and I will get called in on other cases by docs I am not working with if they think it is something interesting. I always ask questions, look at radiology reports with the docs, and they will sometimes even quiz me on some basic stuff.

To @DrFizition comment, I feel like a helpful part of the team at my hospital, but that is because most of the docs I work with make it a point to tell us how helpful we are and will complain (jokingly) to our supervising doc if they aren't scheduled with scribes. I also make it a point to help out the nurses or techs when I can by calling the lab for results, getting urine specimens, cleaning rooms, getting water, etc.

Almost every doc that I have spoken with have said how much of an advantage I will be at when I (hopefully) enter medical school because of how much I have been exposed to. I've learned how to read EKG's (at a basic level) just because of how many I see and input into the computer a day. In addition, because of all the repetition I see when it comes to patients, I could probably do an HPI, exam, and order labs on someone coming in with a chief complaint of headache, abdominal pain, back pain, etc.

Lastly, being a scribe not only showed how AWESOME medicine is, but more importantly it has shown me the true challenges you face having a career in medicine. There have been days where I am beyond frustrated with drug-seeking patients, patients who don't manage chronic conditions, mounds of psychiatric paperwork, politics between hospitals or even within hospitals, etc. Working in this particular hospital has shown me some of the worst parts of a career in medicine, but even after that I still want to become a physician. I feel that seeing these challenges and dealing with them first hand has prepared me even more for a career in medicine.

This post 100%. I feel many on here, and many more elsewhere, don't understand that being a doctor is often boring. For every 1 bilateral amputation you see, you'll have 10 drunk-and-fell-but-we-need-to-call-it-a-level-2-trauma-because-head-injury cases. For every 1 tumor removal, you'll do 20 appies (appendicitis). Residents tell me you might think those would never get boring, but do you ever get bored of playing the same video game over and over? You're lying if you say no. Many pre-meds have a romanticized view of medicine, and it's why experiences like yours and mine and many others ITT are so important to the application: if you are ready to deal with the bull**** on a daily basis while waiting for that one critical level 1 trauma (not that you should ever wish that upon anyone, but I'm talking about the opportunity to run such a case) then you might be cut out for medicine. No one who doesn't hold an M.D. or D.O. knows what it's like to be a doctor, but the pre-med with hundreds of hours shadowing in an ED knows much better than someone without such an experience.

 

[NotYou20]

It is quite possibly the toughest scribe job in the country

Jesus Christ please tell me this is a joke

 

[ZPakEffect]

Jesus Christ please tell me this is a joke

If you know of any scribe job that requires you to do even more than document the entire chart, including HPI, ROS, PEx, MDM, DDx, labs, rads, EKG interpretations, procedures, rechecks and consults; input all orders, including labs, rads, meds, fluid, consults, admits; discharging all patients including putting in diagnoses, follow up, instructions, and prescriptions; keep track of up to 30 active patients at once and all of their outstanding consult calls, labs, and rads; answer constant calls from secretaries about consult calls, from nurses with questions about anything and everything, from techs asking where the doctor is so they can bring yet another EKG or ABG or bedside lactate, or from other doctors asking your doctor to do a procedure for them; all while seeing up to 10-15 patients per hour, let me know.

 

[Hospitalized]

If you know of any scribe job that requires you to do even more than document the entire chart, including HPI, ROS, PEx, MDM, DDx, labs, rads, EKG interpretations, procedures, rechecks and consults; input all orders, including labs, rads, meds, fluid, consults, admits; discharging all patients including putting in diagnoses, follow up, instructions, and prescriptions; keep track of up to 30 active patients at once and all of their outstanding consult calls, labs, and rads; answer constant calls from secretaries about consult calls, from nurses with questions about anything and everything, from techs asking where the doctor is so they can bring yet another EKG or ABG or bedside lactate, or from other doctors asking your doctor to do a procedure for them; all while seeing up to 10-15 patients per hour, let me know.

You forgot to mention that you are able to identify choledocholithiasis on CT scans, identify Wellen's syndrome on an EKG, diagnose a occult distal phalanx fracture, and properly assess if a renal anemia patient needs Epoetin injections.

Not serious, but that's what you're making it sound like.

Your job sounds not only dangerous, but poor medical practice. It sounds like a living hell of inefficient grunt work. But nonetheless, "congratulations." You have "the best experience in the country."

 

[ZPakEffect]

You forgot to mention that you are able to identify choledocholithiasis on CT scans, identify Wellen's syndrome on an EKG, diagnose a occult distal phalanx fracture, and properly assess if a renal anemia patient needs Epoetin injections.

Not serious, but that's what you're making it sound like.

Your job sounds not only dangerous, but poor medical practice. It sounds like a living hell of inefficient grunt work. But nonetheless, "congratulations." You have "the best experience in the country."

Wow, who pissed on your Cheerios?

 

[Hospitalized]

Wow, who pissed on your Cheerios?

No one. I just think you are over-exaggerating what you do, so I felt the need to call you out.

 

[sovereign0]

If you know of any scribe job that requires you to do even more than document the entire chart, including HPI, ROS, PEx, MDM, DDx, labs, rads, EKG interpretations, procedures, rechecks and consults; input all orders, including labs, rads, meds, fluid, consults, admits; discharging all patients including putting in diagnoses, follow up, instructions, and prescriptions; keep track of up to 30 active patients at once and all of their outstanding consult calls, labs, and rads; answer constant calls from secretaries about consult calls, from nurses with questions about anything and everything, from techs asking where the doctor is so they can bring yet another EKG or ABG or bedside lactate, or from other doctors asking your doctor to do a procedure for them; all while seeing up to 10-15 patients per hour, let me know.

I am an ED scribe at a regional trauma hub, and my experience is more or less the same. We're pretty high volume but not quite that high (we see 35-40 patients in a 9 hour shift, depending on what unit/time), my job description is the same. We document the entire chart, call out for and document consults, call and document for radiology reports, observe and document procedures, discharge patients, manage the physician's patients and relay information between the staff and physician, etc. My responsibilities vary a bit depending on who I am working with - some docs will ask that I go obtain a "brief" HPI for new patients while they manage a trauma or do a procedure. Docs will edit and review charts to varying degrees (one I work with doesn't care about the "meat" - just wants a diagnosis in there, another will meticulously point-check my charts before signing) before they are signed and submitted.

With that said, I agree with Hospitalized. My job is the same as yours - minus a little volume, add a little more autonomy - and I wouldn't describe my job the way you did. I'm not essential, nor do I feel essential, to the physician at all. We help the doctors focus on the MDM and allow them to do more doctoring and less bull****, because we do the bull**** for them. My job is highly educational, high-voilume bull****.. Can the job be hard or stressful? Sometimes. I haven't felt overwhelmed since my first three months. I'm fortunate in that the doctors know I'm not working there for the money (we make $10/hr, paid directly by the physician partnership and subsidized by the hospital), so they really do their best to teach. Despite all of this, I recognize that I know absolutely nothing. I've met quite a few scribes who think otherwise, but they get straightened out pretty quickly. I definitely agree with OP that scribes are at the bottom of the totem pole. We get an invaluable glimpse into the medical decision making process, and how to interpret the information, but the fact remains that we (often) have little-to-no formal medical education.

 

[MrCow]

So how does this work exactly? You mentioned it as clinical experience, which you obviously would out down on your apps, but you mentioned it as shadowing experience as well. Would you put it down as such? Or maybe I don't have a clear understanding of how the apps work (i am not even premed yet). Thanks. Just curious.

 

[ZPakEffect]

No one. I just think you are over-exaggerating what you do, so I felt the need to call you out.

So, just because you haven't seen it, then it must be false? Believe me, I am not over-exaggerating one bit. If anything, the numbers I state in my previous post do not include abnormally busy nights. For example, I just got off a shift tonight where i saw a doctor see 20 patients within exactly 1 hour of arriving at the hospital.

 

[ZPakEffect]

I am an ED scribe at a regional trauma hub, and my experience is more or less the same. We're pretty high volume but not quite that high (we see 35-40 patients in a 9 hour shift, depending on what unit/time), my job description is the same. We document the entire chart, call out for and document consults, call and document for radiology reports, observe and document procedures, discharge patients, manage the physician's patients and relay information between the staff and physician, etc. My responsibilities vary a bit depending on who I am working with - some docs will ask that I go obtain a "brief" HPI for new patients while they manage a trauma or do a procedure. Docs will edit and review charts to varying degrees (one I work with doesn't care about the "meat" - just wants a diagnosis in there, another will meticulously point-check my charts before signing) before they are signed and submitted.

With that said, I agree with Hospitalized. My job is the same as yours - minus a little volume, add a little more autonomy - and I wouldn't describe my job the way you did. I'm not essential, nor do I feel essential, to the physician at all. We help the doctors focus on the MDM and allow them to do more doctoring and less bull****, because we do the bull**** for them. My job is highly educational, high-voilume bull****.. Can the job be hard or stressful? Sometimes. I haven't felt overwhelmed since my first three months. I'm fortunate in that the doctors know I'm not working there for the money (we make $10/hr, paid directly by the physician partnership and subsidized by the hospital), so they really do their best to teach. Despite all of this, I recognize that I know absolutely nothing. I've met quite a few scribes who think otherwise, but they get straightened out pretty quickly. I definitely agree with OP that scribes are at the bottom of the totem pole. We get an invaluable glimpse into the medical decision making process, and how to interpret the information, but the fact remains that we (often) have little-to-no formal medical education.

If you don't feel like you are essential, that is, if the doctor can see just as many patients if you never show up, then you're not really doing a whole lot. It is physically impossible for doctors to see 10-15 Level 1-3 patients in one hour and input all the orders without scribes. From your job description, it sounds like you don't input orders, which is pretty time consuming.

 

[futuredoc70]

I am a scribe as well. I've been told by interviewers that they view this as better than most other clinical experiences and plain old shadowing. I feel like I've learned a good amount and would definitely recommend it to others looking to get into medicine.

I would absolutely not do it in an environment described above though. Where I work we do the entire chart. That's not really all that hard. The doctor tells you everything to put in. You just type and click buttons. You need to type quickly and be able to spell. That's not to downplay the importance of a scribe. Studies have shown we increase the physician's efficiency by upwards of 20%. They are also very pleased to have us, as we make their lives a lot easier.

With that said, there is no way I'd be doing this if we had to act as secretaries and take phone calls for nurses. That's actually against the policy in our hospital and can absolutely be dangerous.

A scribe is a scribe. We are not medical professionals. Make the most out of the experience, learn all you can, but don't get a big head. You'll just be laughed at and everyone will secretly (or not so secretly) hate you.

 

[yeshymae]

I was recently hired as a medical scribe for an ED in my area that has never had scribes before. After going through the training and having two full shifts, I am a bit disappointed by it. I have really enjoyed the experience, but the physicians/nurses are so uninterested in the patients and they are so hateful and rude towards psych patients.
Since it's a new program in the hospital, the physicians are not used to us being there so they often leave without us. Or they say they will go and see a pt themselves (w/o us) and end up going to reexamine/reevaluate a pt we were working on or another new pt. I feel like they don't really care for us being there. Which it makes our job a little harder than it should.
The ED is also very small, we have 12 beds and a tiny nurse station. Not much room to be there.
I have been reading and it turns out the company I am working for is the least desirable one, which i am starting to notice, but as all of you, the experience is unmatchable anywhere else so I think I am going to stick it out for a few more months.

 

[rajp98]

is it good to scribe during your premed or after you have graduated college? I am contemplating about doing it while i'm still a premed but am worrying that this may cause me to place less focus on coursework

 

[Germanicus89]

is it good to scribe during your premed or after you have graduated college? I am contemplating about doing it while i'm still a premed but am worrying that this may cause me to place less focus on coursework

I personally know one scribe that tried to be a full time scribe/full time student. He crashed and burned. His gpa is in the gutter and now he's doing an SMP. He's a great guy, but his heroic effort or hubris ended up costing him lots of time and money. Add ECs slowly until you know what you can handle.

 

[xerei]

is it good to scribe during your premed or after you have graduated college? I am contemplating about doing it while i'm still a premed but am worrying that this may cause me to place less focus on coursework

I worked part-time while being a full-time student. The nice thing about the hectic ED schedule is that working nights (after 5pm) is possible, which fit my college schedule nicely. Training to become a scribe is the hardest part, they throw a lot of stuff at you (powerpoints, videos, hospital credentialing, etc), but once you're hired and trained, it's pretty smooth sailing.

 

[DrFizition]

I was recently hired as a medical scribe for an ED in my area that has never had scribes before. After going through the training and having two full shifts, I am a bit disappointed by it. I have really enjoyed the experience, but the physicians/nurses are so uninterested in the patients and they are so hateful and rude towards psych patients.
Since it's a new program in the hospital, the physicians are not used to us being there so they often leave without us. Or they say they will go and see a pt themselves (w/o us) and end up going to reexamine/reevaluate a pt we were working on or another new pt. I feel like they don't really care for us being there. Which it makes our job a little harder than it should.
The ED is also very small, we have 12 beds and a tiny nurse station. Not much room to be there.
I have been reading and it turns out the company I am working for is the least desirable one, which i am starting to notice, but as all of you, the experience is unmatchable anywhere else so I think I am going to stick it out for a few more months.

Hang in there buddy. 2 shifts is not a long time. In fact, I didn't think I was a "good" scribe until months after I started. Also, I started when the program started in my hospital so I understand how you feel. Scribes are on the bottom of the ED totem pole. We got many shifts cut out this month because our hospital has widespread cuts and, obviously, we are the least important. But we do help and a lot of doctors do enjoy us after they are use to us. I'd say scribes help more in larger EDs where doctors see a LOT of patients.

 

[ahc336]

Anyone here ER scribed and gone to school full-time?

 

[Planes2Doc]

I personally know one scribe that tried to be a full time scribe/full time student. He crashed and burned. His gpa is in the gutter and now he's doing an SMP. He's a great guy, but his heroic effort or hubris ended up costing him lots of time and money. Add ECs slowly until you know what you can handle.

This is terrific advice. I appreciate the things people are saying in this thread and the work that scribes do, but people on SDN often tend to bite off more than they can chew . I know some people personally that got too involved in their entry-level clinical jobs. They had too long of shifts and too many hours, and therefore ended up destroying their GPAs and or MCAT. Some of them now are long done with college, and still working these jobs that don't even require a college degree.

As a pre-med, I volunteered in an ED and shadowed. When I started medical school, there were a few former scribes, EMTs, and other entry-level clinical workers in my class. Since medical school started us as step ONE with our clinical education, I have never once felt behind or inferior to these people.

Before you pick up a job that requires a significant commitment like scribing, you need to realistically assess whether this will negatively impact your stats. You're going yo be undertaking a significany commitment which is common among pre-meds, and therefore won't set you apart. While you get paid, it is pocket change compared to future earnings, and also won't come anywhere close to covering one year's worth of an SMP tuition if you blew your GPA or MCAT. I have seem too many people go down this path and then fail because they took on too much. I doubt these people would keep posting on SDN, so they will likely simply never log into their accounts again.

If you want a great experience, try ED volunteering. The shifts are very short, where you do 3-4 hours once weekly. You can also make the experience into ehat you want. You can be heavily involved and be an honorary member of the team, or you can sit in the background, studying for school or the MCAT, and only do things when asked. You can also shadow during these shifts and double dip these hours. It's nice that ED volunteering is what you make of it. Don't forget that scribing isn't enough, on top of a busy scribing schedule you will also need volunteering on top of it! So take that ino consideration.

Finally, schools only want you to get a sense of what the clinical environment is. There is no need to learn specific skills. Medical schools start you from the beginning in terms of clinical education. You won't be at a disadvantage if you don't scribe.

So please evaluate the decision to undertake a serious commitment like scribing very carefully before you do so. I know people on this board make it sound very attractive. Don't get me wrong, you lesrn and get to see a bunch of things. But your ultimate goal is to become a medical student ans then physician, not a professional scribe. So if scribing ends up causing you to fail, then it wasn't worth pursuing. This is just my opinion on the other end of the spectrum, and please keep it in mind.

 

[hopefulERdoc251]

Anyone here ER scribed and gone to school full-time?

I have. I worked anywhere from 21-30 hours/wk while a full-time student (anywhere from 2-4 9 hour shifts, more often than not, 3 shifts a week) and I was able to maintain my GPA both semesters while taking upper level sciences + internship + research. It is absolutely possible but you need know how to prioritize your time efficiently. I would have class in the AM, work efficiently during the day, and then work 3-12 or 6-2. Repeat. The first semester, the only problem was that I would work 6-2 often, and then have class at 930AM so sleep wasn't really there.

 

[yeshymae]

How much do you need to know beforehand if the position does not train? Can I learn the necessary terminology by completing a workbook?

i don't think there are companies that don't train you. it is very important to know the terminology so they should train. anyway, there are apps that give you the medical terminology. I am sure that can help.

 

[yeshymae]

Hang in there buddy. 2 shifts is not a long time. In fact, I didn't think I was a "good" scribe until months after I started. Also, I started when the program started in my hospital so I understand how you feel. Scribes are on the bottom of the ED totem pole. We got many shifts cut out this month because our hospital has widespread cuts and, obviously, we are the least important. But we do help and a lot of doctors do enjoy us after they are use to us. I'd say scribes help more in larger EDs where doctors see a LOT of patients.

Thank you, I am scheduled for a few shifts for the rest of the month so I will at least get through that month and reassess at the end. I am sure I will be fine. The most frustrating thing is the fact that the EMR itself is so small, I am super blind (not literally, just really bad sight), not even my glasses help to see the chart too well. The errors I make because of it are very frustrating,

 

[Planes2Doc]

I am a full time student, work full time, and volunteer as well. I have been able to get As in all of my classes thus far. I wanted to focus on school, but I think working full time while fulfilling other requirements is even more impressive if you can maintain a high level of academic performance. Everyone is different so you should tread carefully if youre taking difficult classes or a full course load.

So much work will end up risking burn-out. I'm not sure how impressed ADCOMs will be about this, and it may only end up causing detrimental psychological effects that will haunt you in your future. Rest assured that you will have far more work and more pressure once you're in medical school than what you're doing now. Spend the time you have now at least enjoying things.

 

[BeachBaby]

My first and second year of college I volunteered 4 hours/week every Friday night. From my third year on I worked 8-12 shifts a month as a scribe (instead of volunteering). Even working part-time like that was a challenge because the scribe shifts are usually 8-10 hours after a day of classes. But if there is a will there is a way.

I still scribe full time now. I think the best part about the job is that once you get comfortable writing the note you can start looking up the conditions, asking the MD questions, be more helpful, etc. I've learned so much from the job. But do not sacrifice your GPA and do not start scribing when you are taking ochem/physics haha

 

[rocklobstr]

So how does this work exactly? You mentioned it as clinical experience, which you obviously would out down on your apps, but you mentioned it as shadowing experience as well. Would you put it down as such? Or maybe I don't have a clear understanding of how the apps work (i am not even premed yet). Thanks. Just curious.

It goes under paid clinical experience, and in the title type something along with lines of "ED Scribe with embedded shadowing"

 

[petyr_baelish]

is it good to scribe during your premed or after you have graduated college? I am contemplating about doing it while i'm still a premed but am worrying that this may cause me to place less focus on coursework

After college, hands down. The first three months of scribing is like taking 6-8 additional credits in terms of time spent, the learning curve and fatigue that would come from juggling the job with school.

 

[Doxorubicin]

is it good to scribe during your premed or after you have graduated college? I am contemplating about doing it while i'm still a premed but am worrying that this may cause me to place less focus on coursework

I worked 20 hours/week scribing while taking 19 hours of coursework. Unfortunately, my class schedule meant working only night shifts, so I routinely stayed up for 36-40 hours at a time going to school, eating dinner, going to work, then going to school all day the next day. Oddly, I was rarely scheduled for the weekend, so this scenario was the norm. I saw the writing on the wall when most people working there had to reapply -- or never made it. I knew I'd rather be a doctor than a professional scribe, so I left after several months. I used my new-found free time to improve my application in other ways. The experience has been viewed positively by all adcom members I've talked to, but I don't feel like it would've made a huge difference in my application cycle.

I have friends who work 10 hours/week scribing in a family medicine/urgent care clinic, and their lives seem so much more manageable. The shifts are much shorter and exclusively daytime.

If you can find a less intense scribe job, I'd recommend that, unless your course load is pretty light. Otherwise, do it after you graduate. You'll get rejected much faster for a low GPA than you will for not having scribed.

 

[DetectiveAlonzo]

Scribing was coo. Did it for like 3-4 weeks before I found out I was accepted and quit right then and there to enjoy my last months of freedom.

Dickish on my part? Yup. I agree it sure was.

Would I do it for a longer term before being accepted if the app cycle wasn't underway and I really needed the money and the experience? Definitely.

Shout out to all the scribes outchea.

 

[neuromaria9]

I have a question!! How do you go about getting to work as a scribe? I volunteer at the ER and it's something I'm definitely interested in.

 

[DetectiveAlonzo]

I have a question!! How do you go about getting to work as a scribe? I volunteer at the ER and it's something I'm definitely interested in.

Apply for it... If your hospital as an ER scribe program that is..

And if they are even accepting applications.

 

[aymar]

I have a question!! How do you go about getting to work as a scribe? I volunteer at the ER and it's something I'm definitely interested in.

If your university hospital is like mine, they only hire once or twice a year. Talk to scribes you meet in the ER, and get their supervisors contact. That way you can indicate your interest and hopefully get a notification when the hiring cycle starts.


Sent from my iPhone using SDN mobile app

 

[YoungDoc25]

I think scribing is an awesome opportunity. I have a friend currently employed as a scribe and he loves it. On the other hand, I work as an ER tech and would push any premed student to go for it if they want a more hands on learning experience. I run EKGs, insert and remove all types of Foley catheters, CBG checks, and are the one everyone looks at when the trauma patient codes and CPR is needed (among a number of other jobs). I'm a much more hands on person, so this position fit me better personally. I also get to experience what being the low man on the totem pole feels like before (hopefully) becoming the person everyone looks at to make the decisions. I think it will serve me well as a physician because I will never look at these members of my staff as insignificant or useless as some of the physicians in the ED.

You can't go wrong with either route though as they are great experiences! Just throwing in my 2 cents.

Edit: We also do all phlebotomy work for the nurses and physicians.

 

[Doctor-S]

.Then again I may be totally wrong, and doctors truly do enjoy scribes. I'd love some physician feedback here about this topic.

I have worked with scribes and enjoy their contributions to the efficient operation of a medical care team.

Scribes Attend/Focus on Data Entry Work ... and Clinicians Focus/Attend to Patient Care. I dislike the data entry skills required for EHRs. I am not (and have never been) a fast typist. I don't mind navigating through EHRs to review a patient's hx. However, I don't want to spend too much time thinking about navigational matters when I am actually consulting with a patient. At that clinical moment, I want to be *thinking* about the patient (and not thinking about a data entry matter).

Plus, I sincerely dislike pecking away at an electronic display screen - especially since I prefer to be using my eyes, ears and mind to focus my clinical attention on the patient. Patients prefer my mind and eyes to be on them, too. So, if I say something out loud, it gets typed into the chart. If I don't say it, it doesn't get entered in the chart. I maintain control over the patient's chart; the scribe is my data entry specialist. Like many other clinicians, it is my professional policy to review the scribe's notes and make adjustments, as needed, before I sign (co-sign) anything.

Fortunately, I am comfortable"speaking" at a reasonable pace/tempo to concisely articulate/explain my clinical findings, data, etc. So, "dictating out loud" (as needed ... or not needed, depending on the patient's case) - is straightforward for me, and probably makes the scribe's work easier, too.

Patient Confidentiality. Not surprisingly, some patients are uncomfortable if a third-party is present (e.g., a scribe) who is not providing them with some type of hands-on clinical care and treatment, such as a licensed MD, RN, PA, NP, PhD, lab tech, etc.

For instance, a patient who has sustained injuries, secondary to suspected elder abuse or sexual assault, might be reluctant to volunteer certain information to me if a scribe is present. Understandably, many patients value personal privacy, among other things. Although some patients might not verbalize their objections to the physical presence of a non-licensed individual such as a scribe (e.g., due to anxiety, embarrassment, cultural issues, etc.), I am acutely aware of their strong need (and expectation) for clinician-patient confidentiality. In those instances, I have calmly "invited" the scribe to attend to another matter, out of sight, elsewhere. Fortunately, the scribe has always been "in tune" with these types of privacy situations and quietly moves somewhere else.

Thank you.