Are scribes necessary healthcare staff?

[datboi_58]

My friends are shocked that I’m still required to come in and think I should be at home because I’m not essential healthcare staff. I’m by no means part of a team dealing with COVID-19 patients but I’m still part of healthcare team that sees Ortho patients. I feel like me working makes sense as long as we have a normal patient load because the notes still have to be done and without me, the physician’s hours might see a 1-2 hour increase per day. That’s not a lot but it is a lot when you’re already working 11-12 hour days. Of course, we are just now seeing less patients so it makes sense I might no longer be required. Just wanted to get your guys’ opinion: are scribes essential / necessary healthcare staff?

---

Members don't see this ad.

 

[sgw97]

According to my ED site we are. Our doctors are really used to having scribes and lean on us heavily. Yes, our census is down right now and we're comparatively not that busy, but we're anticipating a large increase in ED numbers in the next few weeks. When **** hits the fan and the EDs in our area get really busy, and with how long it takes to gown up to go see pts safely, I think scribes will be essential for my site to function.

 

[StudentDoGter]

Maybe it’s up to the discretion of the place where you work and the physicians you work with. At my location, all of the physicians throughout the various departments agreed to temporarily suspend the scribe program to eliminate the number of employees present and reduce as much risk as possible if anyone becoming infected.

I also think it’s probably easier for outpatient clinics to go without scribes, as EDs may have a higher caseload and no ability to cancel non essential appointments.

 

[sgw97]

Also, at my site, when my docs go to see any pt with possible COVID symptoms (fever, cough, SOB, or URI symptoms) scribes stay at the nurse's station and the doc dictates the HPI to us later so we're not going into these rooms and potentially getting exposed.

 

[caterwaiter]

Also, at my site, when my docs go to see any pt with possible COVID symptoms (fever, cough, SOB, or URI symptoms) scribes stay at the nurse's station and the doc dictates the HPI to us later so we're not going into these rooms and potentially getting exposed.

+1. My site is an ED in a very heavily affected area and the providers made the decision to keep us on, but only for dictations.

 

[kenykj49]

I’m the Chief Scribe (Scribe America) at a medium-volume ED. We have had a few confirmed cases of COVID so far - the doctors are anticipating this to increase, to what degree they are unsure. We’re on the outskirts of the Bay Area in Northern California, population density is nowhere near the main metropolitan areas.

Anyways, we are still scribing as we usually would for the most part, with a few exceptions. We are not seeing patients presenting with classic COVID symptoms and obviously positive cases. Personally, I believe this is semi-futile at this point.

I talked with our medical director yesterday - he doesn’t seem to have a strong opinion on us being there or not, I’m sure he has more important things on his mind. However, he did request that I coordinate with my manager and develop a plan to have in place in the case that we experience the full force of the virus.

After speaking with my manager, apparently, other sites are using Zoom audio to document patient encounters. For example: scribes would sit in a designated room in the hospital or from home (this would be harder to implement) and the doctor would bring some Zoom capable device into the the patient room and have the audio turned on.

I have some immediate initial reservations/questions to this.

1. Is Zoom HIPPA compliant? (a quick search says yes) I’m ignorant to the nuances of how that would work.
2. What devices are doctors going to use? We don’t have iPads or anything techy. I think they would have to use their phones.

This “solution” feels like slapping a piece of duct tape on the problem. It begs the question - is the cost of implementing this worth the benefits that scribes provide?

Myself and my team rely on this job for financial support. Most of us are comfortable working at the moment.

I’m curious to hear if other sites are implementing some quasi-telescribe solutions? What’s working and what’s not? Should I have more serious reservations about continuing to work in this environment?

 

[SleazySalesMed]

Not 100% sure what the purpose of this thread is, besides maybe venting? I'm sure they thought about the situation and how it impacts their workflow and your own personal well-being, assuming they care as direct supervising health-professionals.

Here's how I see it: If they require you to show up to work, then you go to work. If they don't require you to work, then you don't work. If they require you to show up to work and you genuinely feel concerned for your well-being or health, then you speak up. Depending on how that conversation goes, you 1. Go back to work (With extra-precautions???) 2. They release you from your responsibilities temporarily 3. You quit because both parties disagree. I went through a similar conversation and I fall into #2. Pretty cut and dry

My old roommate, that I still keep in contact with, is a scribe and is still going to work. You're not alone. However, none of this gets solved here. You need to have a conversation with your supervisors @ OP

 

[A_Knowbody]

Also CS at large multispecialty OP facility that suspended scribe services per discussions with CMO - expected decrease in OP volumes and WHO recommendations for endemic areas to limit non-essential services were sited. However, many of the physicians voiced disagreement with our non-essential designation. Staff were mixed - some wanted to work for financial situations (even to the point where they wanted to work sick, yikes!), some were indifferent, some thought staying home was best use of resources and for patient and staff safety. Regarding those that wanted to stay home, it was a consistent message that you were expected to be at work, both from my leadership, our company administration, and clinical partner until the switch to non-essential was deemed necessary. However, I believe patient volumes and costs drove this decision more so that safety.

I’m curious to hear if other sites are implementing some quasi-telescribe solutions? What’s working and what’s not? Should I have more serious reservations about continuing to work in this environment?

Our company is working on establishing tele scribe solutions, but it is not possible for my specific locations. Tele-scribing would need to occur from home, as risk of COVID exposure was deemed equivalent in the workplace as being anywhere else in public. This does not mesh with the clinics commitment to shelter in place per government action. Scribes do not have authority to access or record patient data remotely - we do not have the technology or the security clearance. We have been offered tele-scribing for other clients or cross-training to other open locations, but I don't think this is working well. I believe many of my staff applied for unemployment benefits. I personally got another job.

I went back and forward on work continuation. At the end of the day, it isn't really your decision, but you could certainly advocate one way or the other.

 

[caterwaiter]

To answer OP's original question, are scribes "necessary"? Certainly not. The experience, IMO, has been invaluable, but providers could absolutely do their own charts. I'm grateful for the fact that our leadership took no-patient-contact precautions early and none of our staff is sick. I'm also grateful that our providers have been more than willing to advocate to keep us.

It has also been communicated by our leadership that we have the ability to call out of shifts penalty-free if we feel ill, or even remotely unsafe coming to work. I know this is generous, and I imagine it's not the same everywhere.

If I were a scribe elsewhere, I would carefully weigh whether or not the clinical experience was worth it in my particular department.

 

[datboi_58]

Not 100% sure what the purpose of this thread is, besides maybe venting? I'm sure they thought about the situation and how it impacts their workflow and your own personal well-being, assuming they care as direct supervising health-professionals.

Here's how I see it: If they require you to show up to work, then you go to work. If they don't require you to work, then you don't work. If they require you to show up to work and you genuinely feel concerned for your well-being or health, then you speak up. Depending on how that conversation goes, you 1. Go back to work (With extra-precautions???) 2. They release you from your responsibilities temporarily 3. You quit because both parties disagree. I went through a similar conversation and I fall into #2. Pretty cut and dry

My old roommate, that I still keep in contact with, is a scribe and is still going to work. You're not alone. However, none of this gets solved here. You need to have a conversation with your supervisors @ OP

Purpose of the thread is genuine curiosity about what policies have been implemented and why and what people think about said implemented policies (or in some cases about a lack of implemented policies) as well as about what people find valuable. I have no reason to vent. I’m fine with going to work or not going to work and my team / doc are both great and the company I work for has offered to compensate us whether we go to work or not because of government money they received.

 

[cheese puff]

Also, at my site, when my docs go to see any pt with possible COVID symptoms (fever, cough, SOB, or URI symptoms) scribes stay at the nurse's station and the doc dictates the HPI to us later so we're not going into these rooms and potentially getting exposed.

Same!

 

[datboi_58]

I’m curious to hear if other sites are implementing some quasi-telescribe solutions? What’s working and what’s not? Should I have more serious reservations about continuing to work in this environment?

We’re implementing TeleMedicine for patients that we don’t think need to come in to clinic so I as a scribe still have to go in and be in the same space as my physician but some of our patients are having TeleMedicine visits. As far as serious reservations about continuing to work, I think you’re fine unless you yourself are sick or if you or someone else you come into contact with is part of an at risk group.