Scribes for nurses. Yeah I like that!

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Specializes in Med Surg, ICU, Infection, Home Health, and LTC.

I just read a super article about the need for more scribes in healthcare and how they are essential for doctors so they can focus on the patient and not on the EHR. (electronic health record). I wanted to nut up! Doctors "have to have" scribes in order to practice medicine safely. In our ER the physicians refuse to cover any shift if they do not have scribes. They can't be bogged down with all the new time consuming computer work and documentation. Really?! I could spit!

What a luscious fantasy it would be if nurses had scribes to allow them to take care of their patients. O happy Day!!

Nurses would not have to live in fear they will forget to chart something that will show up in court one day to haunt them. We could help could make beds, spend real quality time with patients and their families, change IV sites because they are due and not wait until they are infiltrated and have to be done.

We could actually take our time to teach about med side effects or diabetes, and at long last there would be true documentation to reflect the in-depth assessments we do at the start of our shifts. We could even do some of the chart checks and reviews that Quality asks us to do for the latest PI project.

I will hush now. Slowly backing off my soap box with my eyes down and cheeks still flushed with righteous indignation.

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Charting is a thorn in my side, but it really doesn't take too long since a lot of it is just clicking through options. I just need someone to do all my other work so that I have 20 minutes to chart.

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Specializes in Med-Surg, Emergency, CEN.

There are scribes where I work. They are usually incredibly nice people. However, during pt care, my main thought is "GET. OUT. OF. MY. WAY!!!"

Some of our MDs feel the same way and refuse to use them. On the other hand, some of them LOVE having them follow around and write down their every move.

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Specializes in ICU Stepdown.

I just think it's super beneficial for doctors because they have a lot more to actually write than to just "chart." And in the ER, it would just make the slow doctors even slower if they didn't have the scribes.

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Specializes in Med Surg, ICU, Infection, Home Health, and LTC.
I just think it's super beneficial for doctors because they have a lot more to actually write than to just "chart." And in the ER, it would just make the slow doctors even slower if they didn't have the scribes.

Docs do have detailed notes on their assessments, but I guess I am thinking about the days when nurses wrote long notes out by hand and not the point and click options now built into the EHR. Even with the newer systems I never felt they gave an accurate enough picture of the Pt and I would always open the note section and free text my heart out in it.

I wonder if they teach charting because there are so many computer classes required. Its really hard when I review charts and see the Pt is out on the general medical floor one minute and then in ICU on the vent 30 minutes later and there is nothing in the chart to tell me what happened. Clicking boxes doesn't really tell much and a great many of the staff use the F12 (?) key and hit recall and just copy whatever the person before them had in the space.

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Specializes in Medsurg/ICU, Mental Health, Home Health.

I didn't even know this existed.

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Specializes in ER.

Theres a profit in it for the hospital of they free up the docs to see more patients. If nurses got scribes, we'd get a heavier patient load, with no time to think and reflect while charting. Myself, I need that time. Maybe critical care nurses could use scribes?

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Specializes in Reproductive & Public Health.

I would love to have a scribe chart my check box HPI/ROS/PE and procedure notes for me- that would be incredibly amazing. I'd still want to do the narrative components myself, though. Dictating is not realistic because I am rereading, adding, editing and rewriting it as I go, and I don't want a scribe making those changes for me because i don't want the note to lose my "voice." If that makes sense.

More importantly, especially in my line of work (CNM at Planned Parenthood), a scribe would be a significant bigger barrier to open communication- much more so than my laptop, which I have never found more disruptive than a paper chart.

The real solution is to make EMRs that are designed with the primary goal of helping us do our jobs better. We have the technological ability to make programs that are user-oriented and still effective at capturing data for billing, meaningful use, benchmarking, and all the ridiculous requirements imposed upon us by all the interested regulatory bodies.

Good charting is important, and I want to do it well. I've never worked with a system that didn't actively make it difficult to write a comprehensive note on a visit (although we switched to Athena last year and it is my favorite system by far). Between all the flipping back and forth between tabs, redundant (and required) checkmarks, popup warnings about SUPER DANGEROUS drug interactions (CAUTION! misoprostol is contraindicated in patients with the diagnosis of "positive pregnancy test." Are you sure you want to proceed?), and prepopulated "discussion templates," filled with things I did not discuss and hardly anything that I actually did... no matter how well you chart, the final "visit note" is full of irrelevant information and so long and disjointed that you have to hunt for the information you want.

EMR can be so great when it works well, and we could make it so, so, so much better! All of you health care people who moonlight as software engineers, get to work!

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Specializes in SICU, trauma, neuro.
Theres a profit in it for the hospital of they free up the docs to see more patients. If nurses got scribes, we'd get a heavier patient load, with no time to think and reflect while charting. Myself, I need that time. Maybe critical care nurses could use scribes?

Excellent point about pt loads! This CC nurse doesn't want more hands in the kitchen, though. ;)

I'm wondering how this works (I've never seen medical scribes either). Wouldn't we have to dictate to them? If so, how much time would that save us? I usually think as I type, exactly what to say in my narrative notes, and I type pretty quickly.

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Specializes in Psychiatry, Oncology.

Even if we had a device to convert voice to chart, so we could mumble assessment/i&o/etc while we do it or otherwise on the go and it would populate the chart, that would be great. And in today's day and age not out of the realm of possible.

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Specializes in Med Surg, ICU, Infection, Home Health, and LTC.
Even if we had a device to convert voice to chart, so we could mumble assessment/i&o/etc while we do it or otherwise on the go and it would populate the chart, that would be great. And in today's day and age not out of the realm of possible.

I like the idea of an ability to dictate notes. I noted some are not familiar with scribes so I found this to help explain what they do. I am still not sure how they fit in but they are certainly working in our ED.

Using Medical Scribes in a Physician Practice

The Joint Commission defines a medical scribe as an unlicensed individual hired to enter information into the electronic health record (EHR) or chart at the direction of a physician or licensed independent practitioner. A scribe can be found in multiple settings including physician practices, hospitals, emergency departments, long-term care facilities, long-term acute care hospitals, public health clinics, and ambulatory care centers. They can be employed by a healthcare organization, physician, licensed independent practitioner, or work as a contracted service.

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Specializes in ICU Stepdown.
I wonder if they teach charting because there are so many computer classes required. Its really hard when I review charts and see the Pt is out on the general medical floor one minute and then in ICU on the vent 30 minutes later and there is nothing in the chart to tell me what happened. Clicking boxes doesn't really tell much and a great many of the staff use the F12 (?) key and hit recall and just copy whatever the person before them had in the space.

I know what you mean! I'm a tech and I try to find out what happens without searching for the nurse and physically asking and the right details just never seem to be noted/charted. So I understand where you're coming from. But also, at least in the ER, nurses can't get to charting until later because they have so many other things to do. So I do see where the benefits of having a scribe would come from but the hassle and cost would make them counterproductive.

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