My Usually Unusual 6 AM Shift.
04: 30: alarm goes off. (snooze)
04:40 (snooze, yet again).
04:50 only 20 minutes until I have be out the door... (snooze).
05:00 okay, I'm up...I'm up. I get out of bed and head for the shower. I get my green scrubs on and gather my things as I run down the stairs, grab a banana and my backpack and I'm out the door. As I arrive to work, I try to think about what kind of shift I'm going to have: will it be busy? Will someone, unfortunately, pass away? What will I learn? And so on. I use this time to get my mind set for a day that will be totally new from yesterday... or last week... or last month.
I log in to the electronic health record and look at the board. The 6am shift can go one of two ways: busy or not busy. Usually it's not too bad early in the morning and I'll run to get some coffee (there's always coffee somewhere). My provider arrives and we exchange pleasantries and talk about the latest thing the weather is doing (Spring in February?!). Once the clock hits 0600, we are on the move.
The first few patients (for some reason) always sort of determine what kind of shift you are going to have. The lucky thing about working in the Emergency department is that you get a whole lot of everything - from acute to chronic illnesses as well as young and elderly, high and low acuity, and so on. Sometimes, you'll have a day filled with people who have chest pain and other days it's an abdominal pain day. Whatever the soup of the day, it will always somehow surprise you in ways you wouldn't expect. For example, I once had a patient come in on a regular chest pain sort of day. He was in his late twenties, healthy, with classic symptoms of acute chest pain (intermittent, 5-10 seconds of sharp pain in the left side of his chest). Surprisingly, he had elevated cardiac enzymes and ended up with a diagnosis of pericarditis (inflammation of the pericardium). Wow! I never would have guessed someone so young could have pericarditis. I was able to ask the physician I was working with a lot of follow up questions and learn about a disease I thought I’d had a pretty good understanding of.
I’ve only been a scribe for a few months and I’m just beginning to have time to relax a bit more and focus on learning (your first few months as a scribe are pretty intense and you need to work hard just to keep up.) Now that I have more time to relax, I like to google medications, medical problems or surgeries I come across on a patient's charts. I get a basic understanding and then ask follow up questions to my provider such as; "how does this (insert medication, medical problem, past surgery) affect the patient today? Sometimes they are not related and other times they are. When I have a little extra time and we’re about to see a patient with a dislocation, I'll look up what the bones look like and the proper alignment and, sometimes, I'll walk through the steps required to reduce or fix the dislocation. This way, when I watch the doctor perform the procedure, I can follow along and see what this looks like in real-time.
Overall, being a scribe is more than just typing behind a computer. It's up to you to make it a great experience. If you start early, like when you are driving into your shift, you can get yourself in the right mindset to learn something new. Now, as for overnight shifts, well that's a whole other routine...
-Current EPPA Scribe