The relationship that a medical scribe creates with their doctor at our hospital can either make or break their entire scribe career. Too quiet? You should be prompting and asking more questions. Too loud? You shouldn’t talk so much. Too fast? You’re jumping ahead of the provider’s decision-making. Too slow? You work in an ER and need to keep up. Too sensitive? You need to grow a back-bone. Too stoic? You need to learn to accept that you make mistakes. However, this is all just the medical world.
When I first started my scribe career two years ago, I was the first new trainee at Cook Children’s Emergency Department. I was nervous and scared to make mistakes. I tend to be the type who is reserved at first glance – careful as to who I open myself up to and always studying the person in question. Then, I open up and allow myself to be a bit more extroverted.
My first day was with a doctor who was quite interesting and entertaining. She was all over the place, skipping from patient to patient. However, in the patient’s room, she was the most compassionate I had ever seen a provider be. The way that she encouraged conversation from the family and asked for even the smallest of details all while providing emotional support astounded me – it made me want to be like her. She showed the same compassion to me that day and still, to this day, is one of the kindest providers that I have ever had the opportunity to work with.
My second shift as a trainee was quite different. This doctor had very specific preferences, with several clicks being necessary on each chart in the EMR. It was tough for me to keep up, but he was very understanding. This doctor has a characteristic “dark humor” that still entertains me when I work with him. His clinical decision-making skills are right on target and he is quick in seeing them through. He is thorough and tenacious in his efforts to ensure that quick care is provided. I recently had the opportunity to work with him again and watched him identify a stroke off just one physical exam finding that was still lingering.
During one of my first shifts alone, I was switched to work with a different provider. He, by far, had some of the most complex preferences I had seen. He was fast-paced and dictated quickly with several medical terms that I had never seen nor heard of – nevertheless even spelled. That night, my entire scribe career changed. I had looked at this doctor as very determined and precise. I saw little emotion from him…that was…until we had a patient die. Soon after walking out of that room, he walked down the hall straight past me. As he turned the corner, his hand was in a fist. When he returned, he acted composed again and sent me home. After leaving the hospital that night, I sat in my car for 20 minutes, bawling my eyes out.
That night, I thought about everything I had gone through as a mother. I remembered my youngest son who I had just given birth to 2 weeks before starting my job as a scribe. I remembered my oldest son who was fast asleep in his crib at that moment. I remembered my only daughter who I had lost at 4 months and 2 days old due to stage IV cirrhosis secondary to congenital Cytomegalovirus. I remembered signing the DNR for her in the very same hospital I was working in this evening. Finally, I remembered looking at the mother of the child we had just lost that very evening – seeing in her eyes the very same grief I still feel. That night, I saw what every doctor and nurse saw in me as I was in that mother’s shoes
That night, I knew that this job was no “walk in the park.”
That night, I knew that I was capable of still holding the job as a scribe and the long term goal of becoming a nurse. I didn’t care what it would take. I would graduate nursing school and be there for future patients in those same circumstances -supporting them from the beginning to end. However, until I graduate nursing school, supporting the very same doctors that worked so hard to keep my daughter alive for just a little while longer would do just fine.
So, I studied. I studied all the medical terminology I could get my hands on. I listened to every doctor who was willing to set me aside and offer teaching. I learned to type – fast…and with one hand. I learned how to multi-task like a CEO managing three companies. I learned to juggle two sons plus three jobs plus nursing school. Then, I took it one step further and learned how to become a Chief Scribe – AND I LOVED IT.
From there, establishing a relationship with these providers proved extremely important. They came to me with concerns about any of our 30 – 40 scribes – which I would work quickly to address. They came to me with any scheduling concerns – which I worked quickly to alleviate.
To this day, I can’t think of a single provider in our ER that I have not learned some piece of valuable knowledge from:
The doctor that I worked overnight shifts with for 9 months straight – he has a great sense of humor, a willingness to teach, a kind heart, is talented, and taught me what it meant to hold several high acuity patients on your shoulders without letting your decision-making skills or accuracy fall through.
The doctor who taught me what real work is – she sees over forty patients in a ten-hour shift without missing a beat. She gave me one heck of a reference. She reminds me of my own mother. She can multi-task like no one I have ever seen and has one heck of a backbone. As soon as she walks in the room, you know it’s time to get to work.
The doctors who I have worked 4 AM shifts with – all three of which have taught me just how important that time in the morning is. The 4 AM shift relieves the 9 PM doctor and…also sees some of the more acute patients during some shifts. Sadly, this is the shift where families arrive with their babies who, God bless them, did not awake from their sleep that morning.
The doctor who taught me to “learn something new every day.” He is one of the most knowledgeable people I have ever met in my life. His intelligence is admirable. His sense of humor and willingness to teach? Even more impressive.
I could keep going on, but at the end of the day, what matters most is that the relationship between a scribe and their doctor(s) is one that can become invaluable. I’m appreciative beyond words of the relationships I have with these doctors and the amount of knowledge they have given me. I am grateful for this opportunity, so much so, that I have committed myself to working at their side until the very end of nursing school. After all, they have taught me so much about how to be a great nurse – it’s only fair that they get to see me finish what I started.
-Briar A. Gorrell, Assistant Chief Scribe at Cook Children’s ED
Special “thank you” to the doctors at Cook’s for making all of this possible and for teaching me so much!