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.
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.
When I see scribes follow doctors and PA's into patient rooms, the doctors and PAs just ask questions to the patient (history, what's going on, etc) and sometimes they'll tell the scribe something to note or whatever. The scribe always seems to know what they're doing and they type pretty much nonstop while in the patient's room and then finish up typing once they're out. I was .87 seconds away from being a scribe so I know that it's repetitive, a lot of typing and a job where you have to stay aware so you don't miss anything the doctor says. Sometimes, the doctor or PA tells them something to add or remit once leaving the room.
They pretty much type the whole chief complaint, doctor assessment , patient and family history, etc.
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.
I work private duty home care, three separate agencies, and have to chart longhand in all three!
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.
I work private duty home care, three separate agencies, and have to chart longhand in all three!
Scribes may be great for the efficiency of doctors and nurses but how about the patient? If there is something of a personal nature that I would discuss with a doctor or an RN I will not do it in front of some kid fresh out of high school or who is a college undergrad. It might be my health that suffers for withholding info but I'm not sharing personal stuff with a non-professional listening to every word. I will change doctors or hospitals if you insist the scribe be present when I ask them to leave.
I have had LOTS of intimate care in medical settings by female professionals, more than most people ever have. That's OK with me. However there is no way I am taking my clothes off or letting anyone lift my gown in front of a female scribe. They are often still teenagers and they are not even remotely medical professionals. It will be either she leaves or I do if it is an outpatient setting, or I'll just refuse treatment if an inpatient.
So, in your internal discussion about scribes, please do not forget to think about this from the patient's perspective. They are a non-medical person intruding in what should be a very private situation. It is just as bad as doctors bringing in the receptionist as a chaperone, something else I will not allow under any circumstances. Please also do not think you can disguise what they really are by inferring they are medical students or residents. You will totally destroy any trust you have with the patient when they realize they've been had.
My hospital is doing it now, and I feel like it is a terrible waste of money. This person gets $14/hr to do part of my job that I enjoy and can do competently and timely. A lot of what I do is automatic and it's harder to have to think out loud. Plus it's confusing to the patients. I have to edit and sign off on their charting which is harder than doing my own. I wish I knew why they thought it was a good idea and how it could possibly be cost effective.
Hi there, I have many years of experience as a patient and as a retired IT person, am watching my son's RN career with a bit of jealousy. He is encouraging me to at least train as a CNA but prolly to go to my local community college to get my RN training... and then start a 2nd career. I'm on this site to see if I can learn a little bit about what you experienced nurses deal with daily. Can I hack it as a nurse? Dunno. We'll see. Meanwhile, what Biker53 said rings true. As a patient, I've almost always had an opportunity to ask personal questions of the doctor after the "chaperone" leaves the room. Occasionally, the doctor can't/won't excuse the scribe. In those cases, I refrain from asking my question. Usually this isn't a problem because I will have a chance later for privacy with the doctor. One time, my failure to ask the question turned out to be a really bad thing for me. It would be great if nurses and/or doctors made time to have 1:1 with patients at every visit so the patient is free to talk. Just my 2cents :-)
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?
As an ICU nurse, I can say that I am way too OCD about my care to let anybody else chart for me. The stuff we do is so technical, too, that I feel like I'd have to spend way too much time explaining what I'm trying to say, and it would be faster to just type it myself. Having a scribe would drive me nuts.
Also, I definitely agree that it would be an opportunity for management to squeeze staffing even tighter.
mindofmidwifery, ADN
1,419 Posts
When I see scribes follow doctors and PA's into patient rooms, the doctors and PAs just ask questions to the patient (history, what's going on, etc) and sometimes they'll tell the scribe something to note or whatever. The scribe always seems to know what they're doing and they type pretty much nonstop while in the patient's room and then finish up typing once they're out. I was .87 seconds away from being a scribe so I know that it's repetitive, a lot of typing and a job where you have to stay aware so you don't miss anything the doctor says. Sometimes, the doctor or PA tells them something to add or remit once leaving the room.
They pretty much type the whole chief complaint, doctor assessment , patient and family history, etc.