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A Day in my Shoes as a Pediatric Emergency Scribe

By Briar Gorrell

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 needing 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, so I may learn.

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 chart, and get as far back in the trauma room that I can so I can stay out of the way. Within these trauma rooms, I’ve witnessed dying children, a child ran over, a teen who recently overdosed, abuse victims, motor vehicle collision victims, burn victims, and so much more. It takes strength to be a scribe for pediatric emergency 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 chief scribe responsibilities prior to us seeing further patients. As Chief Scribe, it is my responsibility to oversee scheduling and manage the 30 – 40 scribes in our ED. Being a Chief Scribe isn’t easy. It’s full of tough decisions and an immense responsibility. You have to be capable of handling criticism for, not only yourself, but also for all of your scribes from all of the doctors. You have to be willing to train new scribes while supporting them emotionally in their new job 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 where the 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. You see, my daughter was born to me five years ago with congenital Cytomegalovirus, the number one cause of birth defects in the U.S. We basically lived five stories up 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 at 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 keeping 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 leave 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 painful in nature. 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 ending. 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…