Graduate nurse: difficulty finding job.. Emergency Medical Scribe Experience - page 2

I've been reading and hearing about many graduate nurses both new and old who face a difficult time finding a job and experience for a while. I'm not sure if this may help or not, but if you feel as if you've applied to the jobs... Read More

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    I used to be able to enter orders, but the higher ups stopped allowing it this year. So now I take care of the rest of the paperwork, such as discharge instructions and calling back patients. I also do my best to help the nurses out. The docs I work with for the most part are pretty chill. A lot of them like to teach, and I have learnt a lot. It was this job that made me decide that I want to work as an ER nurse.

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    Like Yes, order entry by those who do not have prescriptive authority crosses over to the realm of quality assurance and liability. At my hospital, the docs entered the orders and we just copied it on the paper chart or mentioned it in the medical management piece on the computer along with the rationale for the orders.
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    That's fine thank you again for the info
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    Aniva your reply and comment was very professional and by going on and beyond to describe an example helps clarify the actual job description . I also believe that you can learn a lot , it will help you imo to be present to listen , clarify and most importantly document. This is vital in the nursing profession. I am going to look into it knowledge is power ,but more importantly it helps you the rationales will support and enhance your knowledge in pharmacology , as stated before you also become a better listener.
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    Aniva I am looking into it but my hospital doesn't seen to offer it . When I google Medical Scribe I get hiring agencies . how should I go about it should I ask the nurse manager . I would love to do medical scribe part time . Please pm me if you have time so we can chat . Thanks
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    Yes, having emergency medical scribes is a relatively new addition to the emergency team. A lot of people have never heard of a scribe, until they've been to hospitals that have them and figure out the person tailing the attending is the scribe haha. The hospital I was in never posted the position on their "jobs available" list online. They contract with a third party, which was EMSS. I had to apply to the website and tell them where I was interested in applying to. This particular company was based in California (and there are more hospitals they contract with down there). There was one in Ohio/Michigan - where I was at, and some on the east coast. Since you live in the NY area, I think they contract with some hospitals there, but you may have to contact them to make sure.

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    I saw a posting at a Johnson City, NY:
    https://www.healthcaresource.com/uni...&cJobId=315611

    If you can get a hold of these third party companies, I would contact them to see if there are any opportunities in the area. OR you can directly contact someone from the hospital (maybe someone in the administrative offices of the ER). They can tell you if they have scribes and who to contact (In house program director, or company manager). Play around with the search item as well. Try all the different titles: "Scribe" "Medical Scribe" "Emergency Medical Scribe" "ED scribe", etc...

    Here's an article about scribes from the Los Angeles Times:
    Medical Scribe | Scribes are doctors' tech support - Los Angeles Times

    I hope you find a position If you land a scribe job, I hope you see and learn a lot. It can also help you network for future nursing job! Good luck!
    __________________________________________________ _____________________________

    I also realized that what I previously mentioned could be an avenue for knowledge as well. The HIT/HIMS profession is exploding right now and one operational area within the department is medical transcription. You get get similar experience by "transcribing" or writing down the providers dictation/recording via phone. So in a way, you hear a good basic summary of what went on during that patient encounter. I feel this is an alternative, but not as strong as the scribing position because 1)you're not seeing the patient (VERY important in nursing/medicine), 2) the charting details may not be available (e.g. strong history taking), 3) you're stuck in an office... (although if you like this option, then that's awesome- - you may also be able to work at home if the hospital allows it..).
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    Also, if they don't have a position open at the time, keep checking. the turn over can be quick if not annually. All scribes on my team were students. Moving around for various reason goes along with that life, so a training round may start when you least expect it...
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    Thank you so much .
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    Quote from Anivia
    Here's an example of a scenario working with a provider during a patient encounter: Enjoy!

    Dr. John: Hello. How are you today? What brings you to the ER today?
    Patient (pt.): I've had this horrible cough, fever, nasal congestion, pain in my face, and runny nose. I'm miserable.
    Scribe writes: 36 y/o F c/o cough, fever, nasal congestion, facial pain, and rhinorrhea. (age and sex on the triage note)

    Dr. John: How long has this been happening?
    Pt.: About a week or so
    Scribe writes: pt. c/o cough, fever, nasal congestion, facial pain, and rhinorrhea x 1 week.

    Dr. John: Any bad headaches, vomiting, nausea, chest pain, abdominal pain, difficulty breathing?
    Pt.: No (to each)
    Scribe writes: Denies HA, V/N, Chest pain, and. pain, dyspnea.

    Dr. John: Anything make it better or worse?
    Pt.: Oh Doc, I've tried everything... Nothing works.
    Scribe writes: No modifying factors leading to improvement of sx.

    Dr. John: Have you taken anything recently?
    Pt.: Just some Motrin before coming.
    Scribe writes: Pt. took Motrin prior to arrival.

    Dr. John: Are you allergic to any medication?
    Pt.: No
    Scribe writes: NKDA

    Dr. John: Any prior medical history (e.g. asthma, COPD), surgical history, or family history?
    Pt.: I had my tonsils removed when I was young.
    Scribe writes: [under surgical hx] tonsillectomy

    Dr. John: O.k. now I'm just going to look you over and you make hear me babbling about what I find, but that's for [your name] to help me document. ...this is where you'd write down the physical exam (exactly what they tell you-usually the positives and significant negatives), an end medical management piece (which they also tell you):

    Scribe writes:
    Pt. has mild tenderness to the frontal sinuses upon palpation, nasal congestion, mildly erythematous turbinates, and clear discharge from bilateral nares. Oropharynx exam has post nasal drainage, no uvular deviation or oral petechiae. Bilateral TM clear and normal. Anterior lymphadenopathy. Lungs clear to auscultation, no wheezing, or consolidation. All vitals stable.

    No indication for XR/CT scan, labs.

    Final dx: Acute Sinusitis
    Discharge: home


    Pt. to be discharged with script for antibiotic (Dr. will do this himself).

    If sx. worsen or does not improve, return to E.R. or see PCP. Follow up with PCP in 2-3 days.
    __________________________________________________ ____
    Scribe signs and makes sure the Dr. Signs. IF the provider doesn't sign the chart or is missing something, it will be checked by someone in the HIM dept. and sent back to the provider. Sometimes when a resident is charting and they forget to sign or forget the entire physical exam/medical management, the chart is sent to the attending and they have to redo the entire chart (whether they remember the patient or not. they probably didn't take care of him/her either..). Any order are separately done by the provider (depending on the policy, you can note that or not). Consults can be charted with the medical management (e.g. at 1405, Spoke with Dr. Name in Ortho services. Dr. Name reviewed the XR and saw pt. in the ER at 1420. Dr. Name comfortable with discharging pt. and following up with him on an outpatient basis".
    I totally understand what a scribe is and I meant no offense but since when does the MD not write their own H&P. I have been a nurse for 33 years all critical care, emergency medicine, trauma flight, cath lab.....I began nursing when we gave our Chairs to the MD and "fetched" their charts for them and carried the charts for the MD on "rounds" and took notes for every patient for the busy doctor........to being a part of the "team" in the patients care and able to make independent decisions for the patient's care and the thought of walking behind them AGAIN and writing down everything they say.....doesn't sit well with me. I am still cautious about the legality of having a license when the MD is sued for malpractice and you are his "scribe", secretary or personal assistant and being held legally liable as well..

    Power to whomever has this position.....I will however remain skeptical. I see how it provides you with some experience and it is a job. I am just unsure how this will play out.
    BuckyBadgerRN likes this.


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