First Impressions

As I reflect on my first few weeks as a medical scribe, I’m reminded of the classic phrase most medical students use to describe their early training: “It’s like drinking from a fire hose.” Now, I’m not here to compare scribing to med school, as this life will probably seem like paradise to me in a few years, but I will say that those first few shifts felt like being body-slammed, albeit less by information and more by real-world experience.

Despite coming in with some solid credentials—being a medical assistant in a private practice, EMT training and certification, hospital volunteering (even in the very ED I now work in)—I still felt wildly unprepared for the dynamic and pace of the Emergency Department (ED). And quick side note: the ED isn’t just one place. Oh no. It’s more like three departments in a trench coat. You’ve got the acute side, the “really sick acute” side, and the “probably-not-an-emergency-but-we’re-here-anyway” side. I hope most EDs are structured similarly, so someone can relate to this. The point is, I quickly learned: there's a LOT to learn in this place.

A Mini Rant (With Love)

One of the biggest shocks? How many people treat the ED like it’s their primary care office… or worse, a drive-thru urgent care with Wi-Fi. And before I sound too salty, let me clarify: I get it. Access to healthcare is hard, and sometimes the ED feels like the only option. But when you’re juggling 30 charts and someone rolls in because they noticed their blood pressure was high after they stopped taking their blood pressure meds because a doctor told them to, AND they have a follow-up with their PCP (primary care provider) in three days… yeah, the eye twitch starts.

It’s a strange emotional tightrope; on one hand, I want to be endlessly compassionate (I swear, I do). On the other hand, I see how this behavior overwhelms EDs that just aren’t designed for routine care. It’s frustrating, for sure, but that frustration has actually helped guide my future interests. I find myself leaning toward primary care or preventative medicine, where health education plays a huge role in patient visits. If I can help someone understand their health before they end up in the ED unnecessarily, that feels like a win for everyone.

Life with a COW

Back to those early days: nothing makes you feel more like a newborn giraffe than trying to maneuver a COW (Computer on Wheels) behind a provider who's basically power walking the Boston Marathon route through the ED. Rounding corners with a huge machine on wheels becomes a game of spatial awareness meets Mario Kart.

There’s definitely an art to scribing: juggling speed, accuracy, timing, and, let’s be honest, social courage. This brings me to my next food-for-thought.  It takes guts to interrupt a provider who’s deep in thought just to clarify whether they said “diverticulitis” or “diverticulosis.” And as a young, smiley, overly enthusiastic blonde, I sometimes feel like I have to work a little harder to be taken seriously. (You know... No, I didn’t get lost on my way to Starbucks. Yes, I do know what troponin means.) 

But over time, it gets better. You stop feeling like a human roadblock. You start to find your voice, your rhythm, your place on the team. And despite the chaos, the frustrations, the occasionally questionable patient complaints, I love it here. The ED has become one of my best classrooms. No textbooks, just fast-paced, unscripted, real-life medicine.

So, to all new scribes out there: hang in there. Stay curious. Be brave enough to ask questions. And for the love of all things holy, watch out for those sharp corners with your COW.