For current/past SCRIBES

[MexicanDr]

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I currently started scribing for an EM and so far love it! The experience and learning that you get from the ER Physicians is simply a dream come true.

The way this program trains is that they set you with a senior scribe, get you the computer and start playing with the system and learning it.

I am good with the HPI but I am having a bit of issues with the ROS and Physical Examination. I have been there for two days, so I know I am putting extra pressure on me, but is there any information, programs online that I can read and be better prepare for my next shift in 4-5 days?

Any input you can reply/PM me and I will really appreciate it.

Thanks in Advance..

 

[noshie]

I currently started scribing for an EM and so far love it! The experience and learning that you get from the ER Physicians is simply a dream come true.

The way this program trains is that they set you with a senior scribe, get you the computer and start playing with the system and learning it.

I am good with the HPI but I am having a bit of issues with the ROS and Physical Examination. I have been there for two days, so I know I am putting extra pressure on me, but is there any information, programs online that I can read and be better prepare for my next shift in 4-5 days?

Any input you can reply/PM me and I will really appreciate it.

Thanks in Advance..

It takes a while to get medical writing down, it is a little different than anything you have probably ever done. I would say that it will take you a few months actually... Also, you have to remember that you are writing for the doctor, so you need to use the terms that they would use. What you have written is pretty much read by others as what the doctor has written. You can’t really look up a certain way to write these things on the internet, mainly because each doctor is different, and the way they like their notes written will be different from doc to doc. Just pay close attention to the details. What helped me the most was reading the notes after the doctor had edited what I wrote and accepted it. They don’t usually have time to tell you the little things they changed, and sometimes they would just rather fix it themselves because it is easier that way. But if you go back behind them and look for those subtle things they added and removed, that will give you a good idea of how to better your notes.

As for ROS and phys exams, the doc is not going to yell things out for you in front of the patient. You need to watch them closely and pick up the little things they do. If you don’t catch it just mention it to them when you leave the room quickly and they will tell you what the positives were, which means you make everything else negative…

Being a scribe is a big responsibility. At first it seems really fun and exciting, but you need to understand that the notes you write are serious business… Others read them, and when the patient comes back years from now, every person at the hospital will be looking to these notes for information. Make sure they are as detailed and accurate as possible. As a former full time scribe myself, and the head trainer to may scribes that came after me, I felt that many undergrads that were hired as scribes lacked a bit of life experience, which made them a little naïve and unable to do a very good job as a scribe. They thought of it as more of an experience to get them into med school, but it’s really a trade off… You get some shadowing experience, and they get someone to do the paper work that they hate doing. Still, the best advice I can give you is to be enthusiastic and humble. Don’t think that just because you are with the doctor every day, you are now better than everyone else that works hard in the ED. And by the same token, go above and beyond your job description for the docs. This will ensure a good LOR in the future. I scribed back in 2006 and 2007, but this year I knew that I was able to call up any doc that I worked with and get a really good LOR because when I was a scribe I worked from the bottom and moved up. I wasn’t above getting them coffee or whatever… I wasn’t just a scribe, I was their assistant, and I did everything I could to make their job easier…

Good luck with your new job! I am sure you will love it every bit as much as I did!

 

[CZDreaMD]

I currently work as a scribe in California too. It took me at least 4 months before I started to feel comfortable at work. There is a ridiculous amount of vocabulary to learn and every MD is slightly different. You'll figure out what works best for you!

The ROS varies from doc to doc. Some like the ros to just be the pertinent positives and negatives related to the chief complaint of the day, but others want you to include things like headaches, joint pains, etc from chronic conditions. Ask the doctor. Usually i just take the ros from the history, but again, it depends on the doc.

And, for the physical exam, i think knowing anatomy was the key. you have to be able to pick up on stuff and spell it really well otherwise you'll go nuts. just listen and ask for clarification for the things you don't know. Google is also fantastic.

Over time, you'll start to see that much of emergency medicine is pattern recognition. For example, a person coming in with right lower quadrant pain as a chief complaint will have a differential diagnosis of appendicitis, pregnancy, diverticulitis, ovarian cyst, constipation, small bowel obstruction, etc... You'll see them poking around trying to see if Murphy's sign is positive or negative, etc.. Over time, the physical exam will be second nature to you and you will be able to tell them your exam and ask, is there anything else?

Being a scribe is truly a blessing and is the best job a pre-medical student could hope for. You will see amazing things and learn a ton. It is hard in the beginning but it gets easier and your speed will improve.

If you want to know anything else feel free to PM me!!

 

[dancingdoctor13]

I sent you a pm 🙂 I wanna learn more about this!

I currently work as a scribe in California too. It took me at least 4 months before I started to feel comfortable at work. There is a ridiculous amount of vocabulary to learn and every MD is slightly different. You'll figure out what works best for you!

The ROS varies from doc to doc. Some like the ros to just be the pertinent positives and negatives related to the chief complaint of the day, but others want you to include things like headaches, joint pains, etc from chronic conditions. Ask the doctor. Usually i just take the ros from the history, but again, it depends on the doc.

And, for the physical exam, i think knowing anatomy was the key. you have to be able to pick up on stuff and spell it really well otherwise you'll go nuts. just listen and ask for clarification for the things you don't know. Google is also fantastic.

Over time, you'll start to see that much of emergency medicine is pattern recognition. For example, a person coming in with right lower quadrant pain as a chief complaint will have a differential diagnosis of appendicitis, pregnancy, diverticulitis, ovarian cyst, constipation, small bowel obstruction, etc... You'll see them poking around trying to see if Murphy's sign is positive or negative, etc.. Over time, the physical exam will be second nature to you and you will be able to tell them your exam and ask, is there anything else?

Being a scribe is truly a blessing and is the best job a pre-medical student could hope for. You will see amazing things and learn a ton. It is hard in the beginning but it gets easier and your speed will improve.

If you want to know anything else feel free to PM me!!

 

[juliedi]

Roughly how much money do medical scribes make? I just applied to a company (EMSS), but I couldn't find any information about pay rate.

 

[blueblueblue]

Hey guys.

I've been a scribe for 3 months now and all I can tell you is to not stress out. Believe me, my first 4-5 shifts were crazy; I had absolutely no idea what the doctors were telling me half the time and was totally unaccustomed to the new work environment. But if you're very respectful and ASK QUESTIONS, almost any doctor will be happy to help (unless he has like 20 different patients to see at once). From my experience, most doctors love to pass on knowledge.

TIPS:

1. KNOW YOUR TEMPLATES! I don't know what documenting program you're using (our hospital uses T-System), but know it intimately. Start off memorizing specific templates that are common for the ER (i.e. abdominal pain, chest pain, etc.). When you know how each template is laid out, you'll be able to do your job more efficiently.

2. GOOGLE IS YOUR FRIEND! Don't know how to spell a certain word? Spell it out to the best of your ability in google. Google has a sort of spell check in their system, so it'll tell you what you're looking for. It's also great for figuring out medication names. If you don't get a correct search result, just change the spelling of your words (i.e. use a 'k' instead of a 'c', etc.). You'll get good at your google-fu sooner or later 🙂.

3. WATCH THE DOCS CAREFULLY! Most of the time you can pick up certain positive findings just from where the doctor is minding his attention. For example, say he pushes on the patient's abdomen with ease and the patient exhibits no signs of pain. If that's the case, it's fair to assume that the patient's abdomen is non-tender. Ask your doctor at the end of the exam just in case.

4. ASK YOUR DOC! When you are completely lost, ask your doc. Also, it's good to get caught up on the physical exam findings right as you and your doc exit the patient's room. Very quickly, just ask "Hey doc, what were the positive findings from the exam?" and then he'll spit out everything you need while you're walking back to your stations.

5. RELAX! Eventually, you'll get the daily motions down. You just need to hone your ability. All that foreign medical jargon you're not used to? Don't worry about that! You'll even eventually use it in your daily vocab.

You've only done two shifts, dude or dudette. You'll be fine. 👍

 

[blueblueblue]

Roughly how much money do medical scribes make? I just applied to a company (EMSS), but I couldn't find any information about pay rate.

Hey juliedi,

I work for EMSS as well. From my understanding, this is how it goes:

-For the first month or so, you'll be busy with classroom, computer lab, and bed-side training. During that period, I believe they paid us $8/hr. Might be less, but not sure.

-After your three day bed-side training, you'll be paid $8/hr for the next three months or so.

-After the three months, you'll be evaluated by the chief scribe. He/She'll basically ask all the docs you've worked with their opinions of you and take a look at your past charts. If you're satisfactory, you'll get bumped up to $10/hr.

-You also have the potential to get a raise up to $15/hr (I think) depending on how well you do and how much responsibility they think you can handle.

Yeah, the pay isn't that great. But hey, at least you're getting awesome experience. I've learned a lot about the medical field just by asking and watching the docs. If you are really in need of money (thankfully I wasn't), I suggest looking at other better paying jobs. My hospital is saturated with scribes at the moment, so I'm only getting 3-4 shifts a week. Full-time is not available yet :/. Good luck!

 

[Harassing]

Going to PM you... in a nutshell, don't stress! 😉

 

[juliedi]

Hey juliedi,

I work for EMSS as well. From my understanding, this is how it goes:

-For the first month or so, you'll be busy with classroom, computer lab, and bed-side training. During that period, I believe they paid us $8/hr. Might be less, but not sure.

-After your three day bed-side training, you'll be paid $8/hr for the next three months or so.

-After the three months, you'll be evaluated by the chief scribe. He/She'll basically ask all the docs you've worked with their opinions of you and take a look at your past charts. If you're satisfactory, you'll get bumped up to $10/hr.

-You also have the potential to get a raise up to $15/hr (I think) depending on how well you do and how much responsibility they think you can handle.

Yeah, the pay isn't that great. But hey, at least you're getting awesome experience. I've learned a lot about the medical field just by asking and watching the docs. If you are really in need of money (thankfully I wasn't), I suggest looking at other better paying jobs. My hospital is saturated with scribes at the moment, so I'm only getting 3-4 shifts a week. Full-time is not available yet :/. Good luck!

Great, thanks for the info!

 

[LiveLaughLove15]

Hey juliedi,

I work for EMSS as well. From my understanding, this is how it goes:

-For the first month or so, you'll be busy with classroom, computer lab, and bed-side training. During that period, I believe they paid us $8/hr. Might be less, but not sure.

-After your three day bed-side training, you'll be paid $8/hr for the next three months or so.

-After the three months, you'll be evaluated by the chief scribe. He/She'll basically ask all the docs you've worked with their opinions of you and take a look at your past charts. If you're satisfactory, you'll get bumped up to $10/hr.

-You also have the potential to get a raise up to $15/hr (I think) depending on how well you do and how much responsibility they think you can handle.

Yeah, the pay isn't that great. But hey, at least you're getting awesome experience. I've learned a lot about the medical field just by asking and watching the docs. If you are really in need of money (thankfully I wasn't), I suggest looking at other better paying jobs. My hospital is saturated with scribes at the moment, so I'm only getting 3-4 shifts a week. Full-time is not available yet :/. Good luck!

I've worked for EMSS for about a year now. What you said is essentially correct, but you only go up to $11/hour after the first year. After that, the next highest pay is for trainers, but I'm not sure exactly how much they make. I'm going to guess $13-15/hour.