ER Scribe adbice

[Classof2021!]

I am at the end of my training but I feel so unprepared so I was wondering if someone could give me advice. I'm having trouble with the speed. My trainers keep telling me to finish most of the chart before leaving the pt's room but I don't even get past the HPI. For the HPI, I tend to miss descriptive details and make it a "Story". I have such a hard time understanding the medical terminology, specifically for the physical exam, so I have to either keep asking the physician or google it. I barely get the first chart done and the physician has already seen 4 other pts. Lastly and probably the biggest challenge is that I am a very shy and conscious person. I have come a LONG way in terms of being more talkative and holding engaging conversations but I have a really difficult time talking to the physicians. I hate asking them to repeat themselves or confirm something, it makes me feel incompetent.
So, basically I need to improve on everything.
I really want to be good at this job. It's very important to me so I'd appreciate any advice you guys offer!

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[QowsEatDumlogic]

Not in ER, but I've heard from other scribes that it takes around 3 months to actually be good. Just make sure to look up terms you don't know and maybe write them down and ask physicians for clarification. They should understand you're new and they shouldn't care if you have to ask them things. You'll be fine!

 

[P0ke]

I am at the end of my training but I feel so unprepared so I was wondering if someone could give me advice. I'm having trouble with the speed. My trainers keep telling me to finish most of the chart before leaving the pt's room but I don't even get past the HPI. For the HPI, I tend to miss descriptive details and make it a "Story". I have such a hard time understanding the medical terminology, specifically for the physical exam, so I have to either keep asking the physician or google it. I barely get the first chart done and the physician has already seen 4 other pts. Lastly and probably the biggest challenge is that I am a very shy and conscious person. I have come a LONG way in terms of being more talkative and holding engaging conversations but I have a really difficult time talking to the physicians. I hate asking them to repeat themselves or confirm something, it makes me feel incompetent.
So, basically I need to improve on everything.
I really want to be good at this job. It's very important to me so I'd appreciate any advice you guys offer!

20 y/o female reports to ED w/ c/o intermittent chest pain and palpitations onset 1 month ago s/p becoming a scribe.

There's definitely a steep learning curve, and I didn't know what the heck a lot of the medical terminology was when I was a scribe, I guess it just takes time. It's probably the best learning experience a pre-med can have.

 

[rewind100.24]

Most everyone feels this way at first! I cried after my last few training shifts because I wasn't fast enough and didn't understand the terminology. Now most things I hear are repetitive and things go SO much faster after that steep initial climb.

You WILL get better, you just have to keep at it!

Do not worry-coming from a scribe coming up on one year and feeling way more comfortable at work/chatting with the physicians

 

[RemyMD]

Every scribe goes through this. The more you work with the providers the more comfortable you'll be asking them for things. Keep studying, do practice HPI's, you'll be fine.

 

[Killjoycrazy]

I can offer several recommendations as a fellow ER scribe

1. open up charts early without saving, get your clicks out of the way earlier importing meds, hx and what not, validations in so you don't have to worry about clicking and can focus on your HPI
2. I have a notepad open at all times, I copy and paste the HPI and remnants into the HPI notes section and clean it up in between patients and downtime, the information is there but unorganized and only takes a few minutes to clean up.

for you, it is WAY more important to get the details than to be finishing charts in the room, your timing will improve over time

As for communicating with your doctors, let them know you're new and learning, and eager to help them. After that, you can let them know if that ever become irritated after being asked to repeat themselves that you are only trying to make sure their charts are as close to perfect as they can get. They understand you are not a doctor and that terminology can be difficult. Break the barrier and be redundant. You will eventually catch on to the swag of most providers in your ER and will be fine before you know it! Goodluck

 

[timephone]

Just know that your doctors probably can't type as fast as you and would likely have more trouble writing up a chart than you. That's why you're there! I've been around docs 50+ y.o. who peck like chickens at the keyboard with their index fingers. The 30-something docs on the other hand will sit there charting while talking with the patient. It's an invaluable skills for you to develop now before you even start med school!

 

[Classof2021!]

Thank you everyone!!! I got through the training but I'm told they'll be monitoring my progress. I appreciate everyone's advice!

 

[MareNostrummm]

Don't worry its common to feel this way. Usually you want to knock out all the major elements in 1 long sentence and then flesh out the rest of the HPI afterward: Ex: "This is a __ year-old Male/Female with no past medical history who was brought to the ED by EMS/family/themselves complaining of acute, intermittent, mild to moderate, non-radiating substernal chest pain associated with diaphoresis and mild shortness of breath that began __ hours prior to arrival tonight. Per EMS, patient was given Aspirin ___mg en route etc. Patient denies any (pertinent negatives): history of hypertension, family history of cardiac disease, smoking cigarettes, fever, chills, nausea, vomiting, etc...

Writing HPI's takes some flexibility as well. Don't become attached to one easy formula. I've had a few 2 paragraph HPIs because the patient was very complicated and the physician wanted everything to be very thorough.

 

[Spr1ngrolls]

I've been a scribe trainer for a while now, my #1 advice that I always share with anyone I train at the beginning of the shift (if you're someone I trained personally... you know who I am now...) is to always work to trick whoever is training/floating/monitoring you that you're utilizing every moment you have to push out a chart. Even if you're simply trying to think of how to word something in the HPI or waiting for a dictation, flip to the ROS and start doing clicks. You can always come back. It's a good habit to develop the speed and multitasking capabilities.

If you're able to trick me during your training shift, I will give you a good eval. That's literally what I tell them to encourage them to work hard and be aware of things they can be doing at all times.

 

[MareNostrummm]

I've been a scribe trainer for a while now, my #1 advice that I always share with anyone I train at the beginning of the shift (if you're someone I trained personally... you know who I am now...) is to always work to trick whoever is training/floating/monitoring you that you're utilizing every moment you have to push out a chart. Even if you're simply trying to think of how to word something in the HPI or waiting for a dictation, flip to the ROS and start doing clicks. You can always come back. It's a good habit to develop the speed and multitasking capabilities.

If you're able to trick me during your training shift, I will give you a good eval. That's literally what I tell them to encourage them to work hard and be aware of things they can be doing at all times.

Good tip, you can be filling out the mindless stuff while thinking about how to word things.

 

[Papa Oso]

As far as medical terminology, you need to set some time aside to learn it on your own. I am a big fan of flash cards. You should have already been given a list but if you haven't, write down every single word you had trouble with in some word document, make a flash card of each word, and quiz yourself when you have some free time (like 10 minutes everyday). It's a gradual process but it'll get to a point that you can do charts with one eye closed. It seems daunting, but the big thing to keep in mind is that it's ok to not be amazing at the start, just make an honest effort and unless your doc/scribe staff are jerks, they won't mind you struggling or being a bit slow. Personally as a scribe, I don't mind if someone is lagging a bit as far as development, what triggers me is when they freak out instead of just putting in the effort. Think of this challenge as a good precursor of what you'll have to go through in medical school, rotations, residency, and so on. Good luck, PM me if you have any other specific questions.

 

[agingscientist]

I am going on an interview today for an ED scribe! I'm really nervous about how fast paced it'll be, but everyone's advice has been really helpful.

@Classof2021! Did you have in-class training to learn terminology or are you having to learn it while on-the-job?

 

[Classof2021!]

I am going on an interview today for an ED scribe! I'm really nervous about how fast paced it'll be, but everyone's advice has been really helpful.

@Classof2021! Did you have in-class training to learn terminology or are you having to learn it while on-the-job?

My training portion was online and the medical terminology module was optional. I did go through it several times after I started on-site training. I also used Quizlet, which was really helpful.