Scribes in the ED

[whichone'spink]

Do any of you work in an ED where the doctors use scribes to interface with the computer on their behalf? If so, what are your thoughts.

Disclosure: I am a scribe myself and I'm just interested in what the nurses think of them.

[GOMERNATOR]

DEPENDS ON THE SCRIBE. SOME ARE GREAT. SOME, ON THE OTHER HAND, THINK THEY CAN GIVE ME VERBAL ORDERS AND DO NOT LIKE IT NONE TO WELL WHEN I TELL THEM I DO NOT TAKE ORDERS FROM ANY ONE BUT A DOCTOR. ANOTHER PROBLEM THAT I HAVE RUN INTO BUT MUCH LESS FREQUENTLY IS WHEN THEY WRITE AN ORDER WITH AN ERROR IN IT. SOME ARE OBVIOUS AND SOME NOT SO MUCH. I THEN HAVE TO TRACK DOWN THE DOC AND GET CLARIFICATION WHICH WASTES EVERYONE'S TIME.:angryfire

GOMERNATOR:smokin:

(YES I TYPE IN ALL CAPS. NO I AM NOT YELLING. IT JUST SUITS MY HUNT AND PECK METHOD OF TYPING)

[murphyle, BSN, RN]

We've got them in our EC as private contractors (they're supplied by a company called PhysAssist) and, I'm sorry to say, by and large they are a horrifying pain in the neck. All of them are some flavor of pre-med, and any time savings we might have gained from improved physician efficiency is lost in that our ECPs spend all that time talking with the scribes - sometimes teaching about the day's cases, more often BSing about life as a physician. End result, our patients get their initial exam faster, but spend longer waiting for orders, which in turn backs us up - and there's only so much we can do under advance treatment guidelines. About the best thing I can say about them is that they tend to congregate in the physician charting areas and stay out of the nurses' stations.

Some of them also seem to have issues scribing, either not knowing the proper use of medical terminology or not paying attention to spelling/grammar check, which makes us wonder exactly what they're here for if they can't even take dictation properly. The following gem came from one of my patient charts a week ago:

"The impression has of an etiology related to gasto intestinal disease, with symptoms of esophagal spam..."

...Really?

[whichone'spink, BSN, RN]

Wow, that sucks that your scribes are just wasting time. I always put in orders fast and retrieve them as soon as they are done. And sometimes, I have to call the lab if something is taking longer than it should. I try to avoid doing that, especially on a high-volume day, but it has to be done. I also try to avoid being a pain in the ass to the nurses about whether blood or urine was sent, but that has to be done too. Too bad the scribes at your ED get paid to have them sit on their butts. Do the doctors even care that they're getting backed up because their paid assistants are not doing anything? The doctors I work for do care that their scribes are doing their job.

[RosesRN]

Usually the wage for the scribe comes out of the physicians pocket. no cost to the hospital.

[SaraStrong]

This was a helpful thread, thanks! Just interviewed for an ED scribe position yesterday.

[al7139, ASN, RN]

I am new to ED, and the one I work at has scribes. I don't really know what their responsibilities are, and what kind of medical background is required, but I have noticed that some seem to do more than others. As I said I don't know what the scope is, but I know one got into trouble for going to a patient and answering their medical questions (I don't know the whole story here, not sure what really happened).

I do know that most of them are pre-med or going for PA, NP, etc.

[whichone'spink, BSN, RN]

I am new to ED, and the one I work at has scribes. I don't really know what their responsibilities are, and what kind of medical background is required, but I have noticed that some seem to do more than others. As I said I don't know what the scope is, but I know one got into trouble for going to a patient and answering their medical questions (I don't know the whole story here, not sure what really happened).

I do know that most of them are pre-med or going for PA, NP, etc.

Well basically, scribes are hired by the ER doctors to enter orders in, make sure orders are processed timely, retrieve results, and enter discharge instructions. Some may even write dictation notes, but it depends on what the physicians expect from their scribes. They are paid either by a contracting company or by the physicians themselves, not by the hospital. Scribes really should not answer patient questions, especially if it's related to their ER visit. That one was definitely out of line.

[hillaryedrn]

We have some scribes and the MD's pay them out of their own pocket. So far, they haven't been a hinderance. I'm not sure if they really help tons, but they don't hurt so far!