How Working as an ER Scribe Prepared Me for Medical School

Note: this is the draft I submitted to KevinMD, you can see that post here.

After undergrad and before starting medical school I worked for two years as an ER Scribe. I followed emergency room physicians and completed theirThis looks familiar... charts as they saw patients. I would also remind the physicians of various tasks to complete, alert them of abnormal lab values and pull up x-rays to be interpreted.

One of the reasons I wanted the job was to gain experience in medicine, first as a litmus test to determine if medicine was right for me and then as sort of an early training grounds to help me succeed in medical school and beyond.

Now, as a second year medical student I see my experience as an ER Scribe as invaluable. Working as a scribe gave me a jump start into the world of medicine.

Here are a few specific areas where I have noticed an advantage:

Terminology

Medicine is a whole new language. The most difficult part of starting out as a scribe was learning how to spell and recognize the variety of foreign terms. Not to mentioning having a vague idea of their meaning. After a steep learning curve, I started to become comfortable with the language of the hospital. Now that language is used in my education and I don’t have to expend any more energy looking up definitions.

Taking a History

While taking a history in an ER is often a rushed affair, the basic structure still holds. I observed and recorded countless patient interviews, learning not just the structure of a history but how to alter and refine questions based on previous answers. When I work in clinic now taking a history usually flows quite naturally.

Clinical Knowledge

Working as a scribe I looked at hundreds of x-rays and recorded each interpretation by the physician into the chart. I am grateful for this little head start I have in interpreting x-rays.

I have even found benefits during exams and quizzes. On several occasions during exams I have come across a question I was not sure about but was able to think back to experiences as an ER Scribe and remember the treatment or disease.

While working as a Scribe was a great experience nothing can completely prepare you for the rigors of medical school. But any little edge helps!

Pre med students, if you are interested in becoming a scribe, search for jobs in your area. A pre med advisor at your college should be aware of any scribe programs nearby.

ER Physicians, please remember that your ER Scribe may be a future colleague. They may model how they practice medicine after you and if you take the time to teach them something, that knowledge will stay with them.

How Not to Talk with a Doctor

While I’m Scribing, it is key for me to understand exactly why the patient is in the ER and provide an accurate history describing their illness. This is often difficult as patients are often terrible providing a coherent history.

Thus leading to this post by Ten out of Ten, outlining many different types of patients and how they mess up such a simple task. Ten states, “Maybe 1 patient in 10 manages to concisely describe their issue and stick to yes/no answers.”

The post is incredibly entertaining and it’s worth taking the time to read the whole thing. Beware though, you may find a bit of yourself in some of these descriptions. Here are a couple of my favorites:

Me: “Do you take insulin or pills for your diabetes?”
Patient: “Well, at first they put me on a diet, and told me to exercise, and I did for a few days anyway and at first it seemed like maybe it helped a little bit, but then I guess it got worse, so they put me on a pill…what was it called…metop-o-nin…metamucil…formethorin…no…metlife?”
Me: “Metformin.”
Patient: “Yes! Metformin! So anyway they put me on that at first and I was getting it filled and then there was a problem with my insurance so I had to switch to a different pharmacy and that one was way farther away and the people there were not nearly as nice, except for Lula although now that I think about it she didn’t even work there, she worked at the Marshall’s across the street — I think it was a Marshall’s, either Marshall’s or Ross I can’t remember, which reminds me I need to take those shoes back, um, so…uh…where was I now?”
Me: “Um, insulin or pills?”

Wanderers are the worst. I usually end up afraid to ask any more questions and cut the conversation short.

Me: “Have you had fever?”
Patient: “No, but chills.”
Me: “Vomiting?”
Patient: “No, but I feel like I need to.”
Me: “Surgery on your belly?”
Patient: “No, but I’ve had my tonsils out.”
Me: “Heart problems?”
Patient: “No, but my mom’s a diabetic.”

The no/buts cannot bring themselves to stop at no. Do I need these extraneous details? No, but my knee is a little achy today.

Have I ever read a post so entertaining? No, but my memory is a little hazy today.

A Great Compliment

A few days ago we received evaluations from doctors we have worked with. Most of the ER Scribes on our team are new this year and have worked for about 6-7 months, and this was the first time we received any feedback since training.

Here is what one of the doctors wrote on my eval:

“One of my favorite scribes! Reminds me of myself 12-15 years ago.”

What a nice thing to read. It helps that it was from a doctor that I like and respect.

Anyway, it was great to get some feedback. I feel lucky to have this job.

What is Life in the ER Really Like?

I’ve worked as an ER scribe for a little over two months. I’m often asked, “How’s the job going?” or “What’s it like in the ER?” I usually rattle off an interesting story, or talk about how difficult and stressful the job can be at times (it is getting easier though).

But no matter what I say, it’s difficult to truly capture what working in the ER is like. It’s a completely different world. It’s a world I’ve never been exposed to. I’m only just beginning to understand how things work, and why things are the way they are.

A post over at ER Stories has helped me understand much of what I’ve been seeing. The author describes life from the perspective of an ER doctor, and it is an amazing description. It’s long but worth reading. Here’s a quote:

Continue reading What is Life in the ER Really Like?

What is an ER Scribe?

As I mention in the about page, I have the privilege of being an ER Scribe. However, many people are unfamiliar with what an ER Scribe does. Here is a brief overview:

An ER Scribe is a specialized transcriptionist that works in the Emergency Room (ER) of hospitals. Scribes follow ER doctors as they see patients and record all the charting notes for that patient’s visit. Some Scribes write notes by hand, but it is becoming more and more common for hospitals to use electronic charts, so most of the scribing involves typing and clicking. ER Scribes are in the unique position to not only work in the hospital environment, but also observe and work directly with physicians as they practice medicine.
Continue reading What is an ER Scribe?