I hate dictating

[ZincFingers]

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Some people are great at it, but not me. That's just not how my mind operates. And of course, our crap EMR system doesn't let us type in discharge summaries directly. So you know what I do? I write out my discharge, recite that into the dictation system, so that someone in India can rewrite it back into text.

Your healthcare dollars at work! Honestly. 😕

 

[PeepshowJohnny]

Although I feel I've gotten a lot better at dictation with practice, I still find myself not happy with how the overall style of them come out. I get all the information in there, but it seems to flow poorly and abruptly.

My pet theory is because my whole life I've been composing stuff in a word processor where it's easy to rearrange a list, replace a word with a better one, or move a sentence earlier or later for better emphasis. In dictation I feel hampered without the ability to personally do this.

 

[edmadison]

I can assure you, once you do it for a little you won't mind dictating. We don't have that capability to dictate anymore and are required to type. I can type pretty fast, but I can certainly dictate much faster. It probably takes me half the time to dictate a clinic note that I use when typing. Multiple this by thirty patients and you're talking about some real time!

Ed

 

[dragonfly99]

ergh
I don't think making med students dictate a bunch of stuff is a very good use of their time. In my residency we hardly ever dictated stuff just b/c the place was highly computerized...we just typed everything. We weren't allowed to dictate our medicine clinic notes, just type them, because it cost the hospital less money.

 

[45408]

Do things in the same way, every time, and it should help. Have an outline for a discharge summary, and then read off of different papers when you dictate it. I've only done two, but I would just grab my H&P, different radiology reports, lab results, make a few bullet points of the hospital course, and start talking. I'm on an intermediate ICU month, and every note by every resident and attending is dictated every day - they often just read what they wrote yesterday and make a few changes as necessary.

 

[ZincFingers]

I do hope it gets better. If I try to do it on the fly right now, I fumble and stumble more than a freshman asking a junior cheeleader to the prom.

I'll try to move beyond the crutch of writing it out first, but it's hard. At the VA, we enter everything in directly via keyboard... whatever the faults of the VA are, at least they have a kickass EMR.

 

[nightowl]

zinc fingers-

I'm in the same boat. It's about the equivalent of doing an FOBT in terms of dislikes. There's no doubt that I sound like a stammering idiot Here's to hoping it gets better!

 

[oompaloompa]

I used to be painfully detailed in all of my dictated discharge summaries, but it's really not necessary. If anyone reads your note at all (unlikely), then it's just to get a general gist of the issues and the outcome. Towards the end of my intern year I had a better idea of the big picture and was able to dictate not only shorter but more relevant summaries.

I sure don't miss it. One the best things about no longer being an intern is no dictations.

 

[marie337]

My base hospital doesn't let students dictate for billing purposes. So, on the rare occasion that I am asked to do a dictation, it takes me forever. I also write most everything out and then use it as a guide. I'm afraid that I'm going to waste a lot of time as an intern figuring out how to dictate efficiently!

 

[Anka]

My base hospital doesn't let students dictate for billing purposes. So, on the rare occasion that I am asked to do a dictation, it takes me forever. I also write most everything out and then use it as a guide. I'm afraid that I'm going to waste a lot of time as an intern figuring out how to dictate efficiently!

Nope -- trust me, when you're an intern, you'll do it efficiently. Guess why? Because ain't no one grading you on it. You'll try to do a good job, of course, because that's the sort of person you are -- but ain't no way you're gonna be sittin there writing it out and then dictating. You'll kinda flip through the chart as you go.

Anka

 

[Substance]

Clinic dictations are fine because they're short.

Inpatient discharge dictations are the devil. They're boring and lengthy. I hate them - one of the many reasons I'm not touching inpatient medicine.

 

[deleted109597]

I can type pretty fast, but I can certainly dictate much faster.

Plus, I can dictate while walking down the hall, out the door, through the parking lot, and on the way home.