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insaiyan-premed

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I'm about to have my 3rd day in training for scribing, I find it hard to record most of the notes needed. HPI is hard to put together and the ROS/PE are hard to catch because the doc doesn't mention them. I heard OP was more laid back. However, in this clinic, it's quick to move on to the next patient right away and the doctor closes the note quickly. Another thing is parking isn't free, the day I work I have to move my vehicle for street sweeping. I parked in one of the garages and it was $22. I was also finished ER VCRT so should I ask to switch from OP to ER or change doctors? I haven't been able to finish a full note w/o my trainer editing it.

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I've been a scribe in the ED for over a year and a half. What are you struggling with specifically with HPI? ROS you shouldn't need the doc's input at all, it's all based off what the pt says. I know it can be intimidating but most docs are nice people that are okay with you asking questions, and would prefer you asking questions to there being mistakes in the note or the note being unfinished.

See if there's someone you can talk to about getting a parking pass or a different spot to park, because paying $22 to park while making $10 an hour is ridiculous.

As for switching to ED, I really like the ED because of the variety and a clinic setting sounds kinda boring to me, but YMMV.

Also, keep in mind you're still only on your 3rd day of training. I didn't really hit my stride until day 4 or 5 of floor training.
 
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To add on to the previous comment. It's okay to feel overwhelmed at first. It takes about a month before you truly feel like you have the hang of everything.

If it helps, list things in bullet form during the initial encounter, and then reorganize your thoughts. This helped me when I was starting out.

Also a scribe in the ED for over a year and a half.
 
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@NYCking It's hard to point out what is limiting you, however I would suggest reviewing common admit diag workups for the patients that you are seeing in the outpatient clinic. For instance, if you have a patient presenting on day X, with fever of Y temp, then what does your brain jump to when you think about likely symptoms that would present itself on the ROS?

Vital Signs - SIRS criteria
- hypotension?
- new onset tachycardia?
- respirations per minute? - tachypneic?
- temperature too high? temperature too low?

What would you be asking yourself that you would expect to see on ROS?
- Neuro - Altered mental status? Neck stiffness? New sensitivity to light?
- Integumentary - are they diaphoretic?
- Respiratory - are they SOB? Expiratory wheezing? SOB? CTAB?
- Musculoskeletal - generalized weakness or specific pain to a site?
- Gastrointestinal - tenderness to palpation around bladder area?
- Genitourinary - diminished urine production? UTI?

What are the usual treatments that you see for patients with infections?
- Pain management/Antipyretics - Tylenol
- Antibiotics - Rocephin, Zosyn, Levaquin, Bactrim, Zithromax-
- Antivirals - Zovirax

What are the usual tests that you see for an infection workup?
- CBC: White blood cell count?
- Venous lactate?
- Urinalysis, urine cultures
- Blood cultures (suspect bacteremia/sepsis)
 
I've been a scribe in the ED for over a year and a half. What are you struggling with specifically with HPI? ROS you shouldn't need the doc's input at all, it's all based off what the pt says. I know it can be intimidating but most docs are nice people that are okay with you asking questions, and would prefer you asking questions to there being mistakes in the note or the note being unfinished.

See if there's someone you can talk to about getting a parking pass or a different spot to park, because paying $22 to park while making $10 an hour is ridiculous.

As for switching to ED, I really like the ED because of the variety and a clinic setting sounds kinda boring to me, but YMMV.

Also, keep in mind you're still only on your 3rd day of training. I didn't really hit my stride until day 4 or 5 of floor training.

This is a very urbanized area. I asked my trainer who I believe asked my manager if they can reimburse me but they already denied it. Street parking is tough since it's already packed. I'm most likely going to switch to ER training to see how that goes. Otherwise, my trainer said I'm catching on.
 
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