Physician scribes- Can this be a nurse? Anyone using them?

  1. 1
    Hello. We currently use CPOE on our inpatient side in the hospital I am employed at. We have moved towards using it in the ED also, but several of the physicians are claiming it is slowing them down too much for an ED setting. They are now requesting to have a "scribe" for them in the ED, which they say is to be a nurse that will put in all their orders for them.
    Just wondering if anyone else out there is using this method. If so, do you put them all in as verbal orders and let the physician sign them later? If not, how do the orders get put in electronically?

    Any insight would be very much appreciated.

    thank you.
    rninformatics likes this.
  2. 4 Comments so far...

  3. 1
    I would ask the health information management department about physician scribes. Usually there is someone in that department that keeps up with hospital, state, and Medicare or commercial insurance guidelines. If scribing is allowed by an RN, the physician has to sign off on the note to make it valid. Even if scribing is done by an APRN or PA for the physician, the physician has to sign off to my knowledge.
    rninformatics likes this.
  4. 1
    We are using physician scribes in our pediatric ER, however our ER is not on CPOE , they are fully on paper. They use Medical students for scribes. The medical students essentially walk with the ER physician as they are seeing patients. The scribes are writing orders and patient documentation. Some ER physicians use the scribes - some prefer to continue writing their own orders / documentation.

    We are beginning to pilot CPOE in the ER - oddly enough there have not been any discussion of having the scribes enter orders - YET.
    rninformatics likes this.
  5. 2
    Physician "scribes" defeat the whole purpose of doing CPOE(Computerized PHYSICIAN Order Entry). I am currently heading the implementation of CPOE at our critical access hospital and the physicians, for the most part, are doing OK. They're those who are wanting to use a scribe because they think of it as clerical work and not as a tool like a laser that gives more precise results. They have actually stated that they are the "most educated and highest paid personnel and you have us doing clerical work. The real key to success is the hospital administration taking a stand to persuade the physicians that it is in the best interest of the patient and the physician to do CPOE right. Physicians will say they are going to review the orders before they electronically sign them but I suspect most will take the lazy way out as usual.
    Rickbos and rninformatics like this.
  6. 0
    IMHO, a critical access hospital is far different than a level one trauma center. I can see scribes as a necessity at the level one but maybe not so much at the CAC.


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