The Day Begins
Sometimes, I wake up tired. I have two sons – both toddlers, and I work three jobs. Working a ten-hour shift kicks my butt sometimes, but I keep going back to the hospital because I love it. After putting my scrubs on and double-checking my schedule, I place the lanyard holding my badge around my neck. The picture of me on it looks old, and I think back to those days when I had first started my position as a scribe here. Things have changed so much since then…
Driving to my shift is easy now since I moved ten minutes away. I turn my music up loud every time that I drive as I mentally prepare myself for my shift. I scan my badge a few times before entering the hospital. The halls always smell clean, and my nursing clogs always squeak against these floors. The ER looks so different now than it did when I first started. Back then, it used to be more confined. Now, it’s been expanded with additional rooms and a larger trauma area, and it spans across an entire tower – hence, the need for good shoes.
After gathering the doctor’s Vocera (a communication device used by hospital personnel), pulling up their preferences on my computer, and grabbing a few tidbits of needed paperwork, I wait for the doctor within the main area. Looking within the waiting list, I can tell that several patients are in the waiting room, meaning an extremely busy, high-speed shift for us. Looking up from my laptop, I see the doctor walking in and greet her. At the beginning of every shift, I genuinely enjoy getting to know how the doctor is doing and helping them prepare for a busy ten hours. I find this is important because ten hours is a long time to stand at someone’s side without getting to know them first.
Every doctor that I have worked with has taught me something new about the medical world. The first doctor that I ever worked with was extremely kind and taught me the importance of asking about important details in the patient room (no matter how minor) and taking the time to treat every patient and their family with kindness and respect. Another kind doctor that comes to mind was a young doctor who was very meticulous, detailed, and held quite a sense of humor. I loved the nine months that I worked with him on overnight shifts.
The doctor that I’m working with today has taught me the most out of anyone. She is tenacious, hard-working, and she reminds me of my mother. Her compliments towards me are extremely appreciated each time. I work the hardest when I am with her because she pushes me harder than any person ever has. I guess I’m one of those individuals who works best under pressure.
As I look at my patient tracker to mark down the many patients that she has picked up, my heart starts racing. My typing is not normal. I type one-handed with my right hand, holding my laptop with my left hand. I find this faster when I am in a small room and need to pace quickly with several patients. For the first few hours of the shift, I can’t stop typing. I ask for physical exam dictations, input lab results, and prepare discharge instructions for each patient. I focus on her differentials and the ending diagnoses for each patient, matching them up with the patient’s lab results.
A trauma alert is voiced overhead. In that moment, I drop everything I am doing and get ready to walk to the trauma bay. I listen closely to the charge nurse’s report for the incoming patient, begin prepping the trauma patient’s chart, and get as far back in the trauma room as I can so I can stay out of the way. Within these trauma rooms, I’ve witnessed dying children, a teen who recently overdosed, abuse victims, motor vehicle collision victims, burn victims, and so much more. It takes strength to be a scribe at a pediatric emergency room, and it takes the proper mindset to keep listening to the physician’s dictation of the physical exam as you are witnessing the chaos surrounding you. However, I see hundreds of nurses and doctors keep their heads level as they work to save lives. I just hope I’m half as good as them after I gain my degree.
As we head back to the main area of the ED, I note that the time is 02:00. Normally, I would be in bed asleep or getting milk for my little one at home. However, tonight I am sitting with a doctor as she and I drink coffee, taking a quick break from seeing patients. This doctor doesn’t take many breaks, so I have one chance to check emails and perform a few other scribe responsibilities prior to us seeing more patients. As Assistant Chief Scribe, formerly Chief Scribe, it is my responsibility to oversee scheduling and manage the 30 – 40 scribes in our ED alongside our current Chief Scribe, who is a great friend of mine. Being a Chief Scribe isn’t easy. It’s full of tough decisions and immense responsibilities. You have to be capable of handling criticism of yourself and your scribes from all of the doctors. You have to be willing to train new scribes while supporting them emotionally in their new role as they witness tough patient scenarios. For some things, no amount of online training or written training can prepare you. I’ve witnessed new scribes back out because the expectations of our ED are so high, and I don’t blame them in the least because this job is not for the faint of heart.
After our coffee break, it’s time to reassess our patients. At the very least, several physicians expect to see at least twenty patients. So far, we have seen twenty-seven this evening. There are times when this job is tough, and I don’t just mean the harsh criticism that must be taken gracefully. In fact, I’m talking about the constant reminders I see in patients, physicians, and just by walking through these halls – reminders of my daughter, Lily Belle. She was born five years ago with congenital Cytomegalovirus, the number one cause of birth defects in the U.S. We basically lived five stories up from where I am today for her treatments. She was followed by eighteen specialists at this hospital, and we were seen right in this very ER a few times due to her illness. Sadly, she passed away in my arms when she was four months old due to liver failure. The reminders of her are everywhere here. Sometimes, we see patients born with the same virus, and I silently curse it under my breath. However, I keep my cool by fulfilling my promise to her – to save lives, help others, and create a better life for her brothers. You see, my passion runs deep for this job because there was a time when I desperately needed these doctors’ help. Now, it’s my turn to help them, even if it is just by grabbing their coffee or through charting. Make no mistake – the reminders are in no way a cause for me to suddenly feel grief during my shift. I enjoy the reminders of her – the reminders of why I am doing this.
Before I know it, 07:00 is here and it’s time to end my shift. As always, this doctor gives me a “thank you,” which is all that I could ever ask for as it is a pleasure to work for her. After putting my laptop away, I walk towards the exit of the ER. My knees are popping and I have lines under my eyes. A ten-hour shift really takes a toll on you, especially when you have two chronic illnesses – endometriosis and interstitial cystitis, both of which are incredibly painful. It’s all worth it though. I’ll keep scribing until the day that I have my nursing degree, and then I’ll pay my dues by helping to save lives until I gain my Doctorate in Nursing Practice. Outside, I can see the sunrise as I drive home, and you can bet that I feel great about the last ten hours.
Crawling into my bed, I take off my nursing shoes and attempt to rest as I remember the faces of the patients we saw throughout the night. However, the job of a Chief Scribe is never over. There is proof in that as my phone chimes with a scribe who needs help regarding scheduling. This is a day in the life of a scribe…
Briar Arissa Gorrell
Chief Medical Scribe at Cook Children’s Pediatric Emergency Department
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