Do your scribes suck? Do just mine suck? Do I suck? Am I doing it wrong? You tell me.

[RustedFox]

Yeah the only one I played after FFX was FFXIII, but wasn't that into it (I much prefer turn-based). They were called Aeons in FFX I think!

I remember going back to EB games to return FFX because it sucked; it was my first year of college. That was back when you could return games if you just didn't like them.

Turn-based FTW; its where all the strategy comes from, which is what makes the genre, the genre. Running around with 2-3 AI-controlled "party members" that you can't control and are off-camera most of the time is just silly. Don't get me started on "social" RPGs. I don't want to be social; I want to solve the puzzle. No, I don't want help.

---

Members don't see this ad.

 

[b-real]

I think he meant at one time. Like for a single 8 hour shift the scribe is charting for 1 provider.

God I hate that ****ing word.

Then stop using it! I cringe when I hear it too, and I also correct people. It's a phony term meant to dilute our role.

 

[jw3600]

Then stop using it! I cringe when I hear it too, and I also correct people. It's a phony term meant to dilute our role.

The person I responded to mentioned PAs and NPs so that's why I made the reference. But yeah I hear ya.

 

[TeamZissou]

A++++++++++

This.

This actually happened to me three days ago.

Patient sent to ER by PCP (who is some dip**** NP that I know from other dealings) for STAT ultrasound of the abdomen to r/out "intraabdominal hemorrhage" from MVC 5 days ago. Repeat: FIVE days ago.

Reason being? The patient noticed that the bruise on her left anterior abdomen (seat-belt/lap-bet line) had gotten bigger and coalesced together in some parts. - And she is scheduled for exploratory lap in 2 days time for nonspecific pelvic pain. She's worried about.... *dun-dun-DUNNNNN* ... INTERNAL BLEEDING!

RustedFox: "Who is your family care doctor?"
*******: "I don't see the doctor. I see the NP; "Jenny McJennyson" she knows me. I've never even seen the doctor."

My physical exam:

GENERAL: Patient is a fat, bloated late 40-something who has clearly given up on life 15+ years ago. She loves saying things like "this is how a REAL woman SHOULD look." + 5/5 Fibromyalgia self-pity. Forget about conditioning and general fitness. HR = 72 and regular. BP = 155/75. Social history: Single and smokey. (Surprise!!!)
HEENT: NC/AT. EOMs are fat. + Taco bell sauce to left cheek. PERRL.
CHEST: Breath sounds are fat, but symmetric. Generally sweaty and gross. + Chalupa breath. Heart sounds = regular rate, fat rhythm. No murmurs. The heart actually whispered to me thru the stethoscope: "Please, help me."
ABDOMEN: Seat belt bruises are present in the expected pattern on an obese abdomen with loose adiposity. I can fully grab the small (2-3 cm) hematoma in question in the LLQ between my fingers, which is well-demarcated and defined. To assume that it would extend to even the superficial surface of the abdominal wall would require 8-10 cm of depth thru adipose tissue, which is clearly not present. THEN, it would have to somehow magically penetrate the fascia and the abdominal wall musculature... five days after the accident.
NEURO: CN 2-12 = Fat. Focally and globally neurologically intact.
EXTREMITIES: 3+ baking bread edema to the bilateral feet. Feet crammed in shoes two sizes too small for vanity purposes. Shoes clearly too expensive than should be practical for this person. Nicotine stains are somehow present.


It gets better. Patient is pissed that I can't order ultrasound because I don't have them in-house (patient decided to show up at 11:45 PM... after her typical 10 PM fast food pig-out), even though midlevel-******* sent her to the ER at 6pm from the urgent care ("quittin' time! yabba dabba doo!"). Patent says: "The DOCTOR sent me HERE to get the ULTRASOUND !!" Forget trying to explain that my physical exam findings and general common sense obviate the need for this unnecessary exam. This one is just not having it.

Your Command:

[FIGHT]
[RUN]
[MAGIC]
[ITEM]
[DEFEND]


Moral of the story, to properly reply to Psai's post: These MLPs out in the community.... there are more and more of them every year, and none of them have a whit of sense about them.

 

[CliveStaples]

They're called Aeons now ?

I quit playing after FFX. Its no longer Final Fantasy, its "Final Science Fiction Teen Romance"

You chose a good one to end on at least.

 

[cbrons]

The term "provider" levels distinctions and implies a uniformity of expertise and knowledge among health care professionals. The term diminishes those distinctions worthy of differentiation such as education, scope and range of ability. Generic terminology implies an interchangeability of skills that is inappropriate and erroneous, as well as conferring legitimacy on the provision of health services by non-physician providers that are best performed by, or under the supervision of, physicians.

The term "provider" is one of bureaucratic origin and has no significance or relevance beyond that created by regulators and insurers. The effect of the term is to create confusion among individuals seeking care, especially those seeking care within a managed care environment. The implication is that "providers" are interchangeable and patients can expect to receive the same level of care from any "provider." Use of the term is especiallyb inappropriate if it is employed as a tactic to confuse and thereby encourage use of health care professionals of less cost to the insurer.

http://www.aafp.org/about/policies/all/provider-term-position.html

Sent from my SM-N910P using SDN mobile

 

[gutonc]

Your Command:

[FIGHT]
[RUN]
[MAGIC]
[ITEM]
[DEFEND]


Moral of the story, to properly reply to Psai's post: These MLPs out in the community.... there are more and more of them every year, and none of them have a whit of sense about them.

DEFEND...
Admit to whatever dumba** surgeon/Gyn agreed to plow through that mess for further evaluation.

 

[slatermd]

GENERAL: Patient is a fat, bloated late 40-something who has clearly given up on life 15+ years ago. She loves saying things like "this is how a REAL woman SHOULD look." + 5/5 Fibromyalgia self-pity. Forget about conditioning and general fitness. HR = 72 and regular. BP = 155/75. Social history: Single and smokey. (Surprise!!!)
HEENT: NC/AT. EOMs are fat. + Taco bell sauce to left cheek. PERRL.
CHEST: Breath sounds are fat, but symmetric. Generally sweaty and gross. + Chalupa breath. Heart sounds = regular rate, fat rhythm. No murmurs. The heart actually whispered to me thru the stethoscope: "Please, help me."
ABDOMEN: Seat belt bruises are present in the expected pattern on an obese abdomen
NEURO: CN 2-12 = Fat.
EXTREMITIES: Shoes clearly too expensive than should be practical for this person. Nicotine stains are somehow present.

..,and that her allergy to toradol makes her head explode and she dies every time. She has a surgical history significant for broken toes. She denies any other complaints, but says that her hair hurts."

Dude, this is hands-down some of the funniest stuff I've ever read in my life. I laughed so hard I woke my wife up. Then continued laughing for another 5 minutes so she couldn't fall back asleep and got pissed

 

[RustedFox]

Dude, this is hands-down some of the funniest stuff I've ever read in my life. I laughed so hard I woke my wife up. Then continued laughing for another 5 minutes so she couldn't fall back asleep and got pissed

Lol. Thanks.

There's a small element of truth in every good joke. Don't get me started on the senior citizen population down here (Florida). Funny how much I thought geriatrics was interesting as a resident, and how much the snowbirds aggravate me now.

 

[Deuce Doc]

This.

This actually happened to me three days ago....

I am trying to be a kinder, more compassionate doctor, so I will be unable to tell you how groin-grabbingly hilarious this was. Bwahahahaha....

 

[Old_Mil]

This.

This actually happened to me three days ago.

Patient sent to ER by PCP (who is some dip**** NP that I know from other dealings) for STAT ultrasound of the abdomen to r/out "intraabdominal hemorrhage" from MVC 5 days ago. Repeat: FIVE days ago.

Reason being? The patient noticed that the bruise on her left anterior abdomen (seat-belt/lap-bet line) had gotten bigger and coalesced together in some parts. - And she is scheduled for exploratory lap in 2 days time for nonspecific pelvic pain. She's worried about.... *dun-dun-DUNNNNN* ... INTERNAL BLEEDING!

RustedFox: "Who is your family care doctor?"
*******: "I don't see the doctor. I see the NP; "Jenny McJennyson" she knows me. I've never even seen the doctor."

My physical exam:

GENERAL: Patient is a fat, bloated late 40-something who has clearly given up on life 15+ years ago. She loves saying things like "this is how a REAL woman SHOULD look." + 5/5 Fibromyalgia self-pity. Forget about conditioning and general fitness. HR = 72 and regular. BP = 155/75. Social history: Single and smokey. (Surprise!!!)
HEENT: NC/AT. EOMs are fat. + Taco bell sauce to left cheek. PERRL.
CHEST: Breath sounds are fat, but symmetric. Generally sweaty and gross. + Chalupa breath. Heart sounds = regular rate, fat rhythm. No murmurs. The heart actually whispered to me thru the stethoscope: "Please, help me."
ABDOMEN: Seat belt bruises are present in the expected pattern on an obese abdomen with loose adiposity. I can fully grab the small (2-3 cm) hematoma in question in the LLQ between my fingers, which is well-demarcated and defined. To assume that it would extend to even the superficial surface of the abdominal wall would require 8-10 cm of depth thru adipose tissue, which is clearly not present. THEN, it would have to somehow magically penetrate the fascia and the abdominal wall musculature... five days after the accident.
NEURO: CN 2-12 = Fat. Focally and globally neurologically intact.
EXTREMITIES: 3+ baking bread edema to the bilateral feet. Feet crammed in shoes two sizes too small for vanity purposes. Shoes clearly too expensive than should be practical for this person. Nicotine stains are somehow present.


It gets better. Patient is pissed that I can't order ultrasound because I don't have them in-house (patient decided to show up at 11:45 PM... after her typical 10 PM fast food pig-out), even though midlevel-******* sent her to the ER at 6pm from the urgent care ("quittin' time! yabba dabba doo!"). Patent says: "The DOCTOR sent me HERE to get the ULTRASOUND !!" Forget trying to explain that my physical exam findings and general common sense obviate the need for this unnecessary exam. This one is just not having it.

Your Command:

[FIGHT]
[RUN]
[MAGIC]
[ITEM]
[DEFEND]


Moral of the story, to properly reply to Psai's post: These MLPs out in the community.... there are more and more of them every year, and none of them have a whit of sense about them.

That's easy...grab the sonosite, position it so the patient can see the screen, do a quick fast and point out what you see and what you don't see +/- a half mg of Ativan so she can better tolerate the probe on her belly.

She has her ultrasound.

You have your press ganey.

Discharge.

Next chart.

 

[RustedFox]

1. I don't have a sonosite.
2. 4 others waiting. *Obi wan waves hand*... "This one's not worth your effort."

 

[RustedFox]

UPDATE:

I worked at another job site that I only so-often work at laset week. Two shifts. Guess what? They got scribes now!

The scribes there are light-years ahead of the scribes at my present primary job site. LIGHT YEARS. Its not even close.

I am told that the difference is in the company that you use. I'm investigating further.

 

[GeneralVeers]

They're called Aeons now ?

I quit playing after FFX. Its no longer Final Fantasy, its "Final Science Fiction Teen Romance"

The company should train the scribes to hit all the CMS requirements. Mine put stuff in ALL patient's charts without me having to ask:

- MIPS crap (yes they do this!)
- Hypertension screening (they just document existing hypertension, or referral to PMD)
- Level 5 ROS
- Sepsis re-eval

In addition they prompt me for NIH, Critical Care, re-evaluation, and consultant recommendations. Definitely invaluable, and saves me from having to chart a lot of medically worthless BS.

 

[RustedFox]

The company should train the scribes to hit all the CMS requirements. Mine put stuff in ALL patient's charts without me having to ask:

- MIPS crap (yes they do this!)
- Hypertension screening (they just document existing hypertension, or referral to PMD)
- Level 5 ROS
- Sepsis re-eval

In addition they prompt me for NIH, Critical Care, re-evaluation, and consultant recommendations. Definitely invaluable, and saves me from having to chart a lot of medically worthless BS.

My existing scribes do absolutely none of this beyond putting the tag of "Elevated BP reading" on every patient's chart, regardless of whether or not the BP is elevated.

We also have two attestations for the MLP charts... one that states that I saw the patient and agree, and one that states that I did not see the patient and based on the medical record that the care appears appropriate.
Out of the 8 MLP charts that I just signed from yesterday's shift, 5 had BOTH attestations in them.
2 had no diagnosis even listed.
I actually said this to the scribes today - "Guys, there's only room for ONE attestation in the chart... the RIGHT ONE. Anything else is wrong."
The excuse I got was that they are trained to put one attestation in each chart based on the triage level.
"Then how are there TWO attestations... one of each... in these charts?!" - I asked.
No answer.

If I did that nonsense as a resident... maaaan.

 

[deleted859535]

My existing scribes do absolutely none of this beyond putting the tag of "Elevated BP reading" on every patient's chart, regardless of whether or not the BP is elevated.

We also have two attestations for the MLP charts... one that states that I saw the patient and agree, and one that states that I did not see the patient and based on the medical record that the care appears appropriate.
Out of the 8 MLP charts that I just signed from yesterday's shift, 5 had BOTH attestations in them.
2 had no diagnosis even listed.
I actually said this to the scribes today - "Guys, there's only room for ONE attestation in the chart... the RIGHT ONE. Anything else is wrong."
The excuse I got was that they are trained to put one attestation in each chart based on the triage level.
"Then how are there TWO attestations... one of each... in these charts?!" - I asked.
No answer.

If I did that nonsense as a resident... maaaan.

Screw it. Email the lead scribe person or whoever and name names of the people who don't know what they're doing. Don't have time for that, and it needs to be fixed.

 

[MareNostrummm]

UPDATE:

I worked at another job site that I only so-often work at laset week. Two shifts. Guess what? They got scribes now!

The scribes there are light-years ahead of the scribes at my present primary job site. LIGHT YEARS. Its not even close.

I am told that the difference is in the company that you use. I'm investigating further.

Some companies have much higher expectations than others and will quickly punish lazy or incompetent scribes. I would advise you to complain to the scribe company, then maybe they will try to only assign the more experienced scribes to work with you. If a physician complains about a scribe in my company, the scribe will be contacted within the next day and told to clean up their act, or they will see their shifts decreased and or become assigned to the unwanted shifts. However, in my experience usually the physician will not even bother complaining to management, unless you seriously mess up.

 

[GeneralVeers]

If there are specific scribes you don't want to work with, just request they not be assigned to you.

 

[BAM!]

[MAGIC] --> [SONOSITE] --> [PLACEBO MEDICINE] --> It's super effective! ******* fainted!

I summoned this spell earlier today!! Dealt 100 points of damage and worked like a charm.

 

[MareNostrummm]

If there are specific scribes you don't want to work with, just request they not be assigned to you.

That's the best option. Although if the site has difficulty with finding coverage, it may come down to either having a bad scribe or no scribe at all!

 

[GeneralVeers]

That's the best option. Although if the site has difficulty with finding coverage, it may come down to either having a bad scribe or no scribe at all!

If you are a reasonably fast typist, and efficient at charting it is often better to have no scribe than any scribe at all.

 

[CajunMedic]

This.

This actually happened to me three days ago.

Patient sent to ER by PCP (who is some dip**** NP that I know from other dealings) for STAT ultrasound of the abdomen to r/out "intraabdominal hemorrhage" from MVC 5 days ago. Repeat: FIVE days ago.

Reason being? The patient noticed that the bruise on her left anterior abdomen (seat-belt/lap-bet line) had gotten bigger and coalesced together in some parts. - And she is scheduled for exploratory lap in 2 days time for nonspecific pelvic pain. She's worried about.... *dun-dun-DUNNNNN* ... INTERNAL BLEEDING!

RustedFox: "Who is your family care doctor?"
*******: "I don't see the doctor. I see the NP; "Jenny McJennyson" she knows me. I've never even seen the doctor."

My physical exam:

GENERAL: Patient is a fat, bloated late 40-something who has clearly given up on life 15+ years ago. She loves saying things like "this is how a REAL woman SHOULD look." + 5/5 Fibromyalgia self-pity. Forget about conditioning and general fitness. HR = 72 and regular. BP = 155/75. Social history: Single and smokey. (Surprise!!!)
HEENT: NC/AT. EOMs are fat. + Taco bell sauce to left cheek. PERRL.
CHEST: Breath sounds are fat, but symmetric. Generally sweaty and gross. + Chalupa breath. Heart sounds = regular rate, fat rhythm. No murmurs. The heart actually whispered to me thru the stethoscope: "Please, help me."
ABDOMEN: Seat belt bruises are present in the expected pattern on an obese abdomen with loose adiposity. I can fully grab the small (2-3 cm) hematoma in question in the LLQ between my fingers, which is well-demarcated and defined. To assume that it would extend to even the superficial surface of the abdominal wall would require 8-10 cm of depth thru adipose tissue, which is clearly not present. THEN, it would have to somehow magically penetrate the fascia and the abdominal wall musculature... five days after the accident.
NEURO: CN 2-12 = Fat. Focally and globally neurologically intact.
EXTREMITIES: 3+ baking bread edema to the bilateral feet. Feet crammed in shoes two sizes too small for vanity purposes. Shoes clearly too expensive than should be practical for this person. Nicotine stains are somehow present.


It gets better. Patient is pissed that I can't order ultrasound because I don't have them in-house (patient decided to show up at 11:45 PM... after her typical 10 PM fast food pig-out), even though midlevel-******* sent her to the ER at 6pm from the urgent care ("quittin' time! yabba dabba doo!"). Patent says: "The DOCTOR sent me HERE to get the ULTRASOUND !!" Forget trying to explain that my physical exam findings and general common sense obviate the need for this unnecessary exam. This one is just not having it.

Your Command:

[FIGHT]
[RUN]
[MAGIC]
[ITEM]
[DEFEND]


Moral of the story, to properly reply to Psai's post: These MLPs out in the community.... there are more and more of them every year, and none of them have a whit of sense about them.

I needed that laugh! The only thing that would have made that better is if they had come by ambulance!

 

[Cath Up]

My existing scribes do absolutely none of this beyond putting the tag of "Elevated BP reading" on every patient's chart, regardless of whether or not the BP is elevated.

We also have two attestations for the MLP charts... one that states that I saw the patient and agree, and one that states that I did not see the patient and based on the medical record that the care appears appropriate.
Out of the 8 MLP charts that I just signed from yesterday's shift, 5 had BOTH attestations in them.
2 had no diagnosis even listed.
I actually said this to the scribes today - "Guys, there's only room for ONE attestation in the chart... the RIGHT ONE. Anything else is wrong."
The excuse I got was that they are trained to put one attestation in each chart based on the triage level.
"Then how are there TWO attestations... one of each... in these charts?!" - I asked.
No answer.

If I did that nonsense as a resident... maaaan.

Sounds like they did not want to own up to their own mistakes.

I scribed. Sucked at first, was driven, and improved. I improved mainly because a physician invested time in me.

As lots of people have said:
Find 1-2 scribes that work best with you, or have the potential to work best for you, and request them for every shift.

I made the most progress as a scribe when:
a) I spent more time outside of work studying relevant material (i.e., go after scribes that seem motivated)
b) The physician that I worked with made it clear that I could stay as long as I wanted off the clock to observe him making changes to the notes. I did this for 3-4 hours a shift for many shifts. he didn't even have to say much; I just watched the changes he made.

Obviously, your scribe has to have the motivation to improve. But you need to make clear exactly what you want from your scribe, especially if they are working with other docs that WILL want contradictory content and style. If they work with other docs, you will need to repeat your preferences over and over.

Overall, sounds like scribes aren't for you, or at least not the ones in your area. I don't think I would personally use one.

 

[Dr Mantis Toboggan]

I kind of want to start scutting mine out for non-patient care errands (getting my oil changed, etc) when it's not busy. Anybody ever try anything like this?

 

[MSmentor018]

I kind of want to start scutting mine out for non-patient care errands (getting my oil changed, etc) when it's not busy. Anybody ever try anything like this?

well actually yes. they each have their own side business doing babysitting, wim lessons, cleaning, errands...etc. but that's off duty, not during a shift. some are nice enough to bring coffee for you before starting. but i do the same if I know who's on with me

 

[GeneralVeers]

I kind of want to start scutting mine out for non-patient care errands (getting my oil changed, etc) when it's not busy. Anybody ever try anything like this?

I send them out to get food/coffee sometimes if it is slow. Of course I buy them food/coffee too.

 

[RustedFox]

I send them out to get food/coffee sometimes if it is slow. Of course I buy them food/coffee too.

This is what my scribes have been relegated to.

I worked with the lead scribe trainer the other night. Had to ask her to just close the chart and let me finish it myself, because despite me saying clearly: "Just type exactly what I say: capital letters and periods and all"... she just couldn't do it without going into the shorthand nonsense that never turns out close to right.

I said to her: "Listen. I just had three shifts at (other job site). The worst of those scribes are better than the best of our scribes here. Period. Your workflow... is not working. It HAS to change; or we're going to drown come tourist/snowbird season."

I was told later that she cried and called me a "meanie". My department assistant director "counseled me on constructive criticism".

I had no choice but to reply with a firm but polite rebuttal:

"Listen; this is millennial snowflake nonsense. If what you're doing isn't working, and you don't know it... then you'll never change and get better."

I was interrupted with "but education and guidance is..... whatever"

"Yep. You know where that approach has gotten us? Right here; with scribes that are barely functional and act like *we're* the problem because we're not sensitive to their needs. What's better yet is that our scribe trainer wants to go to medical/PA school. Really? Well... buckle-up, buttercup. You're going to get your arse chewed out plenty in clinicals/residency. There's no "time-outs" and "safe spaces" there."

Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week.

Stop the world. I want to get off.

 

[jw3600]

This is what my scribes have been relegated to.

I worked with the lead scribe trainer the other night. Had to ask her to just close the chart and let me finish it myself, because despite me saying clearly: "Just type exactly what I say: capital letters and periods and all"... she just couldn't do it without going into the shorthand nonsense that never turns out close to right.

I said to her: "Listen. I just had three shifts at (other job site). The worst of those scribes are better than the best of our scribes here. Period. Your workflow... is not working. It HAS to change; or we're going to drown come tourist/snowbird season."

I was told later that she cried and called me a "meanie". My department assistant director "counseled me on constructive criticism".

I had no choice but to reply with a firm but polite rebuttal:

"Listen; this is millennial snowflake nonsense. If what you're doing isn't working, and you don't know it... then you'll never change and get better."

I was interrupted with "but education and guidance is..... whatever"

"Yep. You know where that approach has gotten us? Right here; with scribes that are barely functional and act like *we're* the problem because we're not sensitive to their needs. What's better yet is that our scribe trainer wants to go to medical/PA school. Really? Well... buckle-up, buttercup. You're going to get your arse chewed out plenty in clinicals/residency. There's no "time-outs" and "safe spaces" there."

Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week.

Stop the world. I want to get off.

I think you would be surprised who comes off looking worse in the encounter you just described. Speaking as a third party...

 

[Cath Up]

This is what my scribes have been relegated to.

I worked with the lead scribe trainer the other night. Had to ask her to just close the chart and let me finish it myself, because despite me saying clearly: "Just type exactly what I say: capital letters and periods and all"... she just couldn't do it without going into the shorthand nonsense that never turns out close to right.

I said to her: "Listen. I just had three shifts at (other job site). The worst of those scribes are better than the best of our scribes here. Period. Your workflow... is not working. It HAS to change; or we're going to drown come tourist/snowbird season."

I was told later that she cried and called me a "meanie". My department assistant director "counseled me on constructive criticism".

I had no choice but to reply with a firm but polite rebuttal:

"Listen; this is millennial snowflake nonsense. If what you're doing isn't working, and you don't know it... then you'll never change and get better."

I was interrupted with "but education and guidance is..... whatever"

"Yep. You know where that approach has gotten us? Right here; with scribes that are barely functional and act like *we're* the problem because we're not sensitive to their needs. What's better yet is that our scribe trainer wants to go to medical/PA school. Really? Well... buckle-up, buttercup. You're going to get your arse chewed out plenty in clinicals/residency. There's no "time-outs" and "safe spaces" there."

Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week.

Stop the world. I want to get off.

Sounds reasonable that you were frustrated with the scribe's poor performance. I hope you did actually suggest ways in which she could improve her workflow, instead of just tell her she was wrong- at this point, sounds like that is all you did.

 

[RustedFox]

I think you would be surprised who comes off looking worse in the encounter you just described. Speaking as a third party...

Sounds reasonable that you were frustrated with the scribe's poor performance. I hope you did actually suggest ways in which she could improve her workflow, instead of just tell her she was wrong- at this point, sounds like that is all you did.

I thought I was clear in that a large amount of time was spent in "education" with the scribes, which has only resulted in "fail". Perhaps this is more clear if you read the thread from the top.

The fact that you guys give "suggest ways in which she could improve her workflow" as an option makes it clear that you don't understand that this has already been exhausted.

If it were up to me and my director (not assistant director, mentioned above), we would have fired FizzAssist awhile ago, but we can't. Why? Because there's a handshake deal between FizzAssist and CMG.

Yep. CMG wants the docs to run the ER, but everyone else's feelings are more important than concrete results.

 

[jw3600]

I thought I was clear in that a large amount of time was spent in "education" with the scribes, which has only resulted in "fail". Perhaps this is more clear if you read the thread from the top.

The fact that you guys give "suggest ways in which she could improve her workflow" as an option makes it clear that you don't understand that this has already been exhausted.

If it were up to me and my director (not assistant director, mentioned above), we would have fired FizzAssist awhile ago, but we can't. Why? Because there's a handshake deal between FizzAssist and CMG.

Yep. CMG wants the docs to run the ER, but everyone else's feelings are more important than concrete results.

That's possible. I don't claim to be privy to the entire account of your working relationship. Maybe you're just coming off as an ass because you're stereotyping an entire generation as snowflakes because of one girl, when by your own account you have competent scribes in the same age group. That kind if back assward thinking should be reserved for cretins on Facebook.

 

[RustedFox]

That's possible. I don't claim to be privy to the entire account of your working relationship. Maybe you're just coming off as an ass because you're stereotyping an entire generation as snowflakes because of one girl, when by your own account you have competent scribes in the same age group. That kind if back assward thinking should be reserved for cretins on Facebook.

Its actually an excellent example of why anyone born before 1984-85 says things like: "Millennials are unprepared for the world because they all think that they're special."

In this particular case; the exalted "scribe trainer" is woefully outclassed by other scribes at other sites. When confronted with this knowledge... she cries and screams: "Meanie! Don't you know how many participation ribbons I have?!"

Respect is earned, not given.

 

[jw3600]

Its actually an excellent example of why anyone born before 1984-85 says things like: "Millennials are unprepared for the world because they all think that they're special."

Wow this post is legitimately scary.

 

[KGflyboy]

Wow this post is legitimately scary.

Not really. If that post scares you, you just proved his point.

 

[RustedFox]

Wow this post is legitimately scary.

Have you seen your post history?

What's scary is what awaits you in residency and beyond.

 

[evilbooyaa]

This is what my scribes have been relegated to.

I worked with the lead scribe trainer the other night. Had to ask her to just close the chart and let me finish it myself, because despite me saying clearly: "Just type exactly what I say: capital letters and periods and all"... she just couldn't do it without going into the shorthand nonsense that never turns out close to right.

I said to her: "Listen. I just had three shifts at (other job site). The worst of those scribes are better than the best of our scribes here. Period. Your workflow... is not working. It HAS to change; or we're going to drown come tourist/snowbird season."

I was told later that she cried and called me a "meanie". My department assistant director "counseled me on constructive criticism".

I had no choice but to reply with a firm but polite rebuttal:

"Listen; this is millennial snowflake nonsense. If what you're doing isn't working, and you don't know it... then you'll never change and get better."

I was interrupted with "but education and guidance is..... whatever"

"Yep. You know where that approach has gotten us? Right here; with scribes that are barely functional and act like *we're* the problem because we're not sensitive to their needs. What's better yet is that our scribe trainer wants to go to medical/PA school. Really? Well... buckle-up, buttercup. You're going to get your arse chewed out plenty in clinicals/residency. There's no "time-outs" and "safe spaces" there."

Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week.

Stop the world. I want to get off.

I think if you're in a clinical setting, and you get berated, you don't get to call other people 'meanie', like it's kindergarten or elementary school.

If you can't call an attending a dick, dingus, or whatever (behind his back obviously) then you probably aren't cut out to handle it working in nearly any capacity in an ED.

Millenial is someone born from a certain time-frame and is stereotypical and quite frequently wrong.

I'm more OK with calling someone a "snowflake" if they can't handle criticism properly, regardless of the generation they are from.

However, the bolded is clearly just old crotchety man syndrome. Carry on RF, carry on.

 

[RustedFox]

I think if you're in a clinical setting, and you get berated, you don't get to call other people 'meanie', like it's kindergarten or elementary school.

If you can't call an attending a dick, dingus, or whatever (behind his back obviously) then you probably aren't cut out to handle it working in nearly any capacity in an ED.

Millenial is someone born from a certain time-frame and is stereotypical and quite frequently wrong.

I'm more OK with calling someone a "snowflake" if they can't handle criticism properly, regardless of the generation they are from.

However, the bolded is clearly just old crotchety man syndrome. Carry on RF, carry on.

 

[jw3600]

I think if you're in a clinical setting, and you get berated, you don't get to call other people 'meanie', like it's kindergarten or elementary school.

If you can't call an attending a dick, dingus, or whatever (behind his back obviously) then you probably aren't cut out to handle it working in nearly any capacity in an ED.

Millenial is someone born from a certain time-frame and is stereotypical and quite frequently wrong.

I'm more OK with calling someone a "snowflake" if they can't handle criticism properly, regardless of the generation they are from.

However, the bolded is clearly just old crotchety man syndrome. Carry on RF, carry on.

Take your logic and go elsewhere. It's not welcome here.

 

[jw3600]

Not really. If that post scares you, you just proved his point.

Lol deep bro.

 

[deleted109597]

He's got a fairly legitimate point. I've often sent scribes home for woeful incompetence and failure to follow basic instructions.
Sadly, I cannot do the same for techs, nurses, laboratory personnel, midlevel practictioners, or even the registration people. So the scribes might get the brunt of some of it, but truthfully, like every position including doctors, some suck. And they should have insight, and also accept external instruction.

 

[lucid_leprechaun]

Your criticisms of an entire generation are obviously idiotic, more a reflection of yourself than the people you criticize. Every older generation says the same things about newer generations, back to the ancient Greeks. That being said, there are always incompetent people worthy of criticism, that is absolutely fair. Scribes are highly variable, as are all health care workers. Be careful using terms like "millenials" as a perjorative when many of this generation are extremely competent and coming to fill ED jobs across the country. Don't get stuck in the "kids these days" mentality.

 

[Venko]

To me, I have seen a greater incidence of people who are younger than me who struggle to accept negative appraisals of their performance. Also, again just my experience, a greater number of these people with performance that is lacking tend to desire that I find solutions for their problems without spending time trying to solve the problems on their own.

This could be sampling bias, my misperceptions, a result of different cultural and educational standards, I don't know. Certainly it's not universal, but I tend to perceive a trend.

I have been trying to retool as an educator to keep up with this perceived trend. At the end of the day, i want great graduates and colleagues etc and so will find a way to connect that gets the outcome desired.


Sent from my iPhone using SDN mobile

 

[Tip4]

Lol deep bro.

As someone within the millennial timeline, I take no offense at what Rusted Fox said.

We are where we are today because of the many sacrifices of our older generation, and the disregard and irreverence of a spoiled generation shows. The value systems of what it once meant to be hardworking American citizen--owning responsibility of both self and others--has clearly shifted, and unfortunately not for the better. It would behoove you not to continue providing that self-verification.

If you disagree with a sentiment, try temperance. The world of EM is a very small ecosystem, and i'd tread carefully with your words around people who have decades more experience saving lives over you. A little respect pays dividends in a field where everyone knows each other.

 

[GeneralVeers]

47% of all U.S. high school kids are getting an "A" average. This is proof of the snowflake/special mentality. They are not set up to handle real-world failure or criticism.

 

[jw3600]

As someone within the millennial timeline, I take no offense at what Rusted Fox said.

We are where we are today because of the many sacrifices of our older generation, and the disregard and irreverence of a spoiled generation shows. The value systems of what it once meant to be hardworking American citizen--owning responsibility of both self and others--has clearly shifted, and unfortunately not for the better. It would behoove you not to continue providing that self-verification.

If you disagree with a sentiment, try temperance. The world of EM is a very small ecosystem, and i'd tread carefully with your words around people who have decades more experience saving lives over you. A little respect pays dividends in a field where everyone knows each other.

Are you implying that I'm offended by what he said because I'm technically a milennial? I'm stating that making broad sweeping generalizations is a bad idea regardless of the targeted group. And we're not talking about emergency medicine. His attending status and experience is irrelevant in this discussion. This thread lacks reading comprehension.

 

[RustedFox]

Your criticisms of an entire generation are obviously idiotic, more a reflection of yourself than the people you criticize. Every older generation says the same things about newer generations, back to the ancient Greeks. That being said, there are always incompetent people worthy of criticism, that is absolutely fair. Scribes are highly variable, as are all health care workers.

I know, right ?! My criticism is so idiotic and a "reflection of myself" that .... oh, nevermind. Here you go.

[EDIT]: The image didn't come thru! Its a nice big green "PARTICIPATION RIBBON" for you!

NEWS FLASH: I am well-aware of the criticism of the "old guard". I had to endure it, too. You want self-reflection? You got it.

HERE'S THE BEST PART:

They were right!

I was a medical student. I was told that I sucked. I did. I sucked. Hard.
I was a resident. I was told that I sucked. I did. I sucked. I got my ass chewed out a lot. It did nothing but made me better.

It. Was. The. Truth.

HERE'S THE DIFFERENCE:

When I was told that I sucked, and I was laughed at by a cohort of people above my skill level....

I got better.

I went back to my little room. I read. I studied. I acted out scenarios with my roommate (a semi-pro football player turned grad-student.... guess what? he was told that he sucked, too!!!)

It wasn't easy. It wasn't pleasant.

There was no "YouTube". There wasn't "FOAMed". There wasn't a wealth of "easy resources" like there is today. I didn't scream "meanie!" and blame the whole educational system for my inadequacy.

I simply went "to the shed" and got better.

And when I was better... I heard things like: "Hey - strong work, Fox."

"Come round with us sometime."

"Nice central line. I'd let you put one in me if I needed it."

"Nice effing tube, dude. Glad it was you on this one."

One. More. Time.

Respect is earned, not given.

The millennials would do rather well to think about this.

 

[shoal007]

I know, right ?! My criticism is so idiotic and a "reflection of myself" that .... oh, nevermind. Here you go.

[EDIT]: The image didn't come thru! Its a nice big green "PARTICIPATION RIBBON" for you!

NEWS FLASH: I am well-aware of the criticism of the "old guard". I had to endure it, too. You want self-reflection? You got it.

HERE'S THE BEST PART:

They were right!

I was a medical student. I was told that I sucked. I did. I sucked. Hard.
I was a resident. I was told that I sucked. I did. I sucked. I got my ass chewed out a lot. It did nothing but made me better.

It. Was. The. Truth.

HERE'S THE DIFFERENCE:

When I was told that I sucked, and I was laughed at by a cohort of people above my skill level....

I got better.

I went back to my little room. I read. I studied. I acted out scenarios with my roommate (a semi-pro football player turned grad-student.... guess what? he was told that he sucked, too!!!)

It wasn't easy. It wasn't pleasant.

There was no "YouTube". There wasn't "FOAMed". There wasn't a wealth of "easy resources" like there is today. I didn't scream "meanie!" and blame the whole educational system for my inadequacy.

I simply went "to the shed" and got better.

And when I was better... I heard things like: "Hey - strong work, Fox."

"Come round with us sometime."

"Nice central line. I'd let you put one in me if I needed it."

"Nice effing tube, dude. Glad it was you on this one."

One. More. Time.

Respect is earned, not given.

The millennials would do rather well to think about this.

technically i am a millennial depending on the criteria. I guarantee you that I did not do the "meanie" attitude and didnt get catered to.

I worked hard for where I am now. I am burdened with large student loans with high interest rates.

I am looked upon by elder generations like you who think I am a snowflake. public undergrad 20k/yr, state med school 45k/yr. no help from parents financially. RF, please be careful with your generalizations. I feel that the term millineal is only used as an insult.

Sent from my Pixel using Tapatalk

 

[deleted859535]

I think you would be surprised who comes off looking worse in the encounter you just described. Speaking as a third party...

That's possible. I don't claim to be privy to the entire account of your working relationship. Maybe you're just coming off as an ass because you're stereotyping an entire generation as snowflakes because of one girl, when by your own account you have competent scribes in the same age group. That kind if back assward thinking should be reserved for cretins on Facebook.

These silly comments aside, I'm on the edge of millennial generation and similarly hate the trend.

"The greatest generation" ... was.

 

[Apollyon]

Take your logic and go elsewhere. It's not welcome here.

You don't get to speak for everyone.

 

[jw3600]

You don't get to speak for everyone.

You take issue with me advocating for trying not to use broad steroypes?