My Scribing Experience

Post-graduation was a difficult time for me, especially the first few weeks. My senior year of college was extremely stressful because I took on 21 credits while working two part-time jobs. I was also volunteering in the pediatric outpatient unit at the hospital once a week. Unsurprisingly, my schedule was so full that I did not have the time to apply to jobs prior to graduating, which increased my post-graduation stress level.

As soon as I completed my last final, I got online to begin my job search. I asked everyone around me if they knew of opportunities. There were so many options, but I was looking for something clinical that had a lot of patient contact. Luckily, I was able to land a full-time scribe position at a geriatric primary care clinic and started 3 months after I graduated. I was thrilled. However, the excitement did not last long.

Scribing was terrifying at first. I was expected to complete a clinical note accurately, which was initially overwhelming with my very limited clinical experience. I’d only had very narrow patient contact during my CNA training (about 4 weeks). I was very nervous because my documentation would affect patient safety as well as provider liability. Of course, the provider reviews the completed note and verifies it meets their standard before signing it, but still, it is a huge responsibility. Looking back now, I am glad to say it was worth every minute of stress and pressure.

It took me about 3 months to feel comfortable and confident with the workflow and charting responsibilities.  I began developing my own workflow based on what worked best for the provider and myself. We had developed into a remarkable team and even the patients noticed how in sync we had become. One of my favorite patients always remarked how we seemed to “read each other’s minds”. I was very proud of our teamwork and coordination. We were able to accomplish this by having very open communication. We would also meet weekly to address any questions or concerns either one of us had regarding a patient encounter or chart documentation. I was even given extra responsibilities in addition to scribing, which included processing prior authorization with insurance companies and ordering medical equipment. I was very excited to have the contact with these other organizations in healthcare as well as having the extra patient communication.

Once I was comfortable, it was satisfying to understand the clinical workflow and decision making of the providers I was working with. It is very rewarding to work with multiple providers and see the difference in clinical decision-making and personal interactions. It was so much better than my shadowing experience because providers came to see me as part of the team and encouraged my contributions and ideas.

I had the opportunity to advocate for patients on multiple occasions and I often think about one specific instance. The entire team was very upset because for the last couple weeks we were unable to locate a homeless patient, who frequently came in for checkups. The only news we had of him were his frequent ED visits for chronic obstructive pulmonary disease (COPD) exacerbations. Finally, he returned to the clinic. During our care team meeting, we discussed ways to prevent him from disappearing and going to the ED frequently for something that could be managed if only he had a place to store and use his nebulizer. I suggested that the nebulizer be stored at our clinic and the patient come in three times a week to use it. That way, we would always keep track of his health and make sure he was doing well. The NP agreed to suggest this to the patient, and fortunately, he agreed. Over 6 months had passed, and the patient had remained compliant with his treatment at the clinic and his ER visits were almost nonexistent. I am so happy that I was able to contribute to this patient’s better health and it made my day to see him come in the clinic with a smile.

Scribing has been one of the best clinical experiences I’ve had so far. It has reinforced my desire to become a physician and has taught me invaluable skills like attention to detail, problem solving, working in a fast paced environment, as well as exploring other processes involved in patient care. I feel very fortunate to have had this experience. I recommend that others considering entering the medical field try scribing to enhance their skill set, gain invaluable experience to reinforce their desire to work in medicine while also earning income to help pay down debt or save for medical school.