Working as an ED Medical Scribe
For any pre-health student, obtaining clinical experience is so critically important. Not only does it give you a glimpse into your future career, but it also builds unique skills that will benefit you in the long run. Although still fairly new, medical scribing has become quite popular amongst pre-health students. A medical scribe is a person who documents physician-patient encounters in real time, such as documenting the patient’s history and physical exam findings. I personally found my scribing opportunity through Handshake, but a lot of other job platforms may be offering scribe positions as well (Google Search is our best friend)!
Without scribing, I never would have had an “up-close and personal” experience in the medical field. My job as a medical scribe in the ED is a whirlpool of experiences, with each day holding a new case. Below is an example of how a typical scribe shift would go:
8:45am – Arrive in the ED and log-into a laptop device
9:00am – Meet the physicians
9:15am – Open the charting program and start a brief template
“Patient is a __ year old _______ with a history of ______ who presents to the ED with a chief complaint of _____ that started at ___.”
9:30am – Patient X shows up on the waiting room list. Copy down the basic information
“Patient is a 39 year old male with a history of hypertension and diabetes who presents to the ED with a chief complaint of chest pain that started at 5:00am today.”
9:50am – Follow the Physician into the patient’s room and chart everything about what led up to the patient being in the ED today
10:30am – Compile the information from the patient’s room and sort it into an HPI and ROS
10:40am – Ask the Physician for his exam findings on Patient X
11:00am – *CODE BLUE* EMS is on the way with a 79 year old male who has been unresponsive for the past 30 minutes
11:15am – The ED becomes flooded with hospital staff and you get ready with the Physician to go into the room
11:30am – EMS arrives and gives you all the necessary information about the patient
EMS states: “This is ~patient Y~ who has a history of Asthma, COPD, and dementia and lives at ___ nursing home. His caregiver says that he was watching television when he suddenly became unresponsive. When we picked him up, his BP was 60/40 mmHg with severe bradycardia, and his oxygen saturation at 62%. His caregiver mentioned that he refused to take his COPD mediation this morning.”
11:40am – The physician gives you the exam findings from the code blue patient
12:00pm - You continue with the rest of the patients who come into the ED…
5:00pm- Pass on any information to the next scribe and clock out
Before even stepping foot into the hospital, you will be tested on various medical terms, medications, and exam findings that you otherwise would not have known without prior knowledge. I was enrolled in a “scribe academy” where I had to score 80% or higher on various exams in order to move on to my in-person clinical training phase. Some typical terms/findings may include:
Dysuria, melena, postictal, vertigo, atelectasis, epistaxis, papilledema, 2+ pitting edema in the BLE, abdomen soft, non-tender, nontympanic, alert and oriented x3, etc
There will be days where you will witness cases involving children where CPS becomes involved or watching the family of a car crash victim rush in one-by-one to the ED. And, as a scribe, you have to make sure that your charting comes first so that the physician can take better care of these patients in the long run. You will merely be a “shadow” in the room, with your role as being the sole note-taker for the Physician.
In the span of one scribe shift, you will most likely encounter more than 30+ patients in the ED and may find yourself to be lost in charts at times. But, other nights you will find yourself to only encounter 15+ patients and find more down time to study in the break room. The ED is always unpredictable which is what I find to love about it!
By,
Kaylee
