Span of One Day

At 4 AM yesterday, I went off to babysit a child who was about to become a big brother. At 7 AM, his father sent me pictures of the latest addition to our population. Although the delivery itself had some complications requiring a C-section, the outcome was a healthy baby boy. My charge and I spent the rest of the day looking at pictures of his new sibling and celebrating the day of his birth.

At 6 PM the same day, I headed to the ED to start another 8 hour shift. Not even thirty minutes into the shift, we had two full arrests come in by paramedics. The physician whom I was scribing for took the 97 year old who was in respiratory distress. The other ER physician took the 4 year old pediatric cardiac arrest. As far as I know, our 97 year old is still thriving, albeit in critical condition in the ICU. The 4 year old, who was running in the park just an hour before, was pronounced dead shortly after her arrival. There are a lot of terrible sounds in the world. But the sound of a mother screaming out her daughter’s name is bone-chilling. It is a wonder how anyone – physician, nurse, respiratory technician, EMT – can continue on with their jobs after losing such a battle.

January 29th marks a witnessed birth and death. Life works in strange ways, doesn’t it?

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Scribing

I may or may not have mentioned this already, but I have been working as an ER Scribe for the past few months now at a nearby hospital. I was actually hired on by the company back in October, but I had to go through an arduous training period until I was finally “recommended” to begin solo shifts. The length of training was understandable given that scribes work directly with physicians and ensure that these physicians are billed adequately for their time. One mistake could cost the ER doctor a lot of money, or worse, a lawsuit. But some of the delay was partly due to administration and miscommunication, so I couldn’t become a “full-fledged scribe” until earlier this year.

Before I go on, for those of you who do not know what the job entails, which is totally okay because up until a year ago, I knew very little myself, as a scribe, I help write up charts for patients who come into the ER, allowing the physician to spend more 1-on-1 time with the patient.

23 year old female presents to the ED with complaint of insomnia onset three days ago. Patient complains of back pain and weakness, but denies vomiting, nausea, or any other symptoms.

Scribing is becoming increasingly popular as hospitals shift from paper to electronic medical records. And why pay extra for an educated individual, when you have boatloads of pre-meds who would jump at the chance of working with physicians directly! Thus, I am the physician’s shadow, listening in when a patient explains their symptoms and medical history and typing away furiously when the physician dictates to me findings from a physical exam. Is it overwhelming? Most definitely. But is it interesting? Hell yes! I have seen so many exquisite cases in just my few months at the hospital so far. And if there is one thing I have taken away from my experience it’s that during a shift, a physician may be presented with 100 patients with abdominal pain as their chief complaint. However, it takes a keen observer to distinguish that one patient who might have a unique and possibly life-threatening diagnosis. No matter the time or how tired you may be, you cannot afford to careless when it comes to a person’s life.

It is astonishing how invested I am in this job, when initially, I had only applied to silence my mother who was badgering me about finding a “real job” for my résumé. I’m sure there is a crafty way to present ‘babysitting’ on your résumé, but it just didn’t seem like something that would impress future schools or employers. Don’t get me wrong, babysitting has been, and still is, a great way to make cash. I still babysit on the side now because I do make 2x, sometimes even 3x, the amount I make as a scribe. But the experience that I have gained as a scribe, is just unparalleled. I have learned more field-related information in the past few months than I did in the last 23 years of my life!

There is definitely a steep learning curve associated to this job. During my first few weeks of training, I had over 600 abbreviations and terms thrown at me, some so foreign-sounding that I questioned what I was getting myself into.

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when I found out that HA stood for headache -.-

To be honest, I am still learning, and will probably continue to learn until my last day as a scribe, but that’s something I should be used to if I want to become a physician. Just the other day, I was working with an older physician who was unsure if a patient’s diagnosis should be paraphimosis or phimosis. She had me do a Google search (which revealed some interesting images in the ER that I’m sure would be labeled NSFW) and then proceeded to devise a mnemonic to remember the difference between the two terms.

As I mentioned above, I work 8+ hour shifts, most of those shifts are devoid of breaks, and 95% of the time, I am on my feet. I come home mentally and physically exhausted. But, I have worked many jobs in the past and I can honestly say that this is the first job that I am so involved in what I am doing, that time simply flies by. There are the occasional glances at the clock – I’m only human after all – but for the most part, I am constantly entertained with charts or looking up bits of information online, or engaging with the physicians, that before I know it, my shift is over and I leave with a sense of fulfillment. It just validates the sentiment that when you are doing what you love, you’re never really “working”.

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<3 A.