Scribing at INOVA Fairfax Emergency Department
Q: How did you become a scribe?
A: Scribing is an opportunity that I would recommend to anyone considering a career in health sciences as it offers invaluable experience. The first part of the process of being a scribe is to apply to a program, after which there is an interview, which is basically used by the head scribes to determine if they could see you being a valuable contributing member of the team. They also assess whether applicants are mature enough to handle working in an emergency department. Assuming that the interview goes well and the program has a spot available, you will be hired and the training portion begins. This involves approximately ten hours of technical training after which clinical training begins. The clinical part is eight full ten hours shifts where you shadow a senior scribe (someone who has been a scribe for over a year). Over the eight shifts, you slowly take on more responsibilities until the final shift where you do all the work, and the senior scribe merely observes.
I began scribing because I needed a job during summers and wanted experience in the medical field. I had heard of scribing through a family friend and the more I looked into it, the more I was interested. I was initially very nervous to begin scribing as I was only 18 and had just graduated from high school. I felt very young and unequipped to do the job, but I was lucky that the people training me were both knowledgeable and helpful. I learned so much from them over my eight training shifts, and after five years, I still remember lessons that they taught me. One of my favorite parts of working in the ER is that everyone is very willing to help, and that all you have to do is ask. I think that potentially the most important skill I have learned through my time of being a scribe is to admit when I do not know something and seek out the appropriate person to ask for help.
Q: What is the role of a scribe?
A: The primary job of a medical scribe is to accompany an ER doctor for the course of their shift and to complete the electronic medical record of each patient that you see. What this means is that you take down the history of the patients, record the physical exams that are done, and document any other important information on the patient, such as an important consult. These are the official duties of the scribe, but as you become more experienced, you are able to take on more responsibilities, such as prepping a room with the ultrasound machine and isolation gear or calling the pharmacist to help process an order. The only skill that is truly needed to be a scribe is the ability to type on a computer. Everything else just requires that you be able to adapt and be flexible.
Q: What did you learn from your scribing experience?
A: I find this job so valuable and rewarding because it gives you such an in depth view into what it is like to be a physician. You work the same hours and see everything that they do. This is a benefit, but it also means that the job requires a certain level of maturity and ability to handle difficult or stressful situations. I still vividly remember the first hour of my first training shift where three unstable trauma patients came in after a multi-car accident. I had never seen a real patient before and the first one I was introduced to was a middle-aged man with multiple lower leg fractures and a collapsed lung. These things are commonplace in the ER and take some getting used to, but it helps you quickly determine whether you want to choose a career where you could potentially see things like that every day.
I have taken so much away from this job. First of all, you acquire a wealth of medical knowledge, such as the tests to diagnose appendicitis. You learn a lot of the common language spoken amongst health care workers, such as what frequent flyer or road test mean. And what I think has been most important is that you learn how a complex team of doctors, nurses, techs, NPs, PAs, etc. is able to function in a cohesive manner to provide the best care to the patients.
Q: Additional thoughts on being a scribe?
A: It is a draining job at times; I can remember days where in the course of 45 minutes, I help welcome a healthy baby boy into the world and then walk into another room and witness a family tell the physician that they are finally ready to take their grandfather off of all treatments and let him die peacefully. There are patients that I still think about today and that have helped shaped the person that I have become. I would not trade these experiences for anything and would highly recommend this job to any pre-med student.