I spent Christmas Eve in the emergency room with my father, which is stressful enough when you think about it. I should mention that my father was 88 years old and suffering from dementia, so just the trip to the emergency room was difficult.
We went through the normal check-in process and finally found ourselves in a room in the very back of the ER. Our doctor walked in followed by an individual who was pushing a computer on a rolling cart. The doctor immediately started asking questions and making sure the person who was typing on the computer was getting the answers. All of this may sound like good practice, and I’m sure that in theory it is, but let’s take a step back and look at the situation from the patient’s perspective.
I am sitting in the emergency room on Christmas Eve with my 88 year old father who has dementia. He is confused and not understanding everything that is going on. Two strangers walk into the room. At no time did the physician tell us that the person with him was a scribe or inform us of his role. A simple “I’m Dr. Smith, and this is John Doe. He will be here to make sure we get all the information about your father correctly documented,” would have been wonderful.
The doctor and the scribe were also not near each other, so the doctor had to keep repeating things from across the room. Each time this happened, my father would ask “What?” or “Now what?” and become more agitated with the fact that he couldn’t hear everything, and he wasn’t sure what was going on.
I understood the situation, so I was able to try to reduce his stress level, but how many people actually know what a scribe is? How many people, during a stressful time, really want an extra person standing at a computer while their personal information is being shouted or spoken loudly across the room?
I am all for the advancement of technology and change meant to increase efficiency and accuracy. I firmly believe that there is a place for the many different ways of gathering the information needed for proper documentation. But I also feel that we need to take a step back and think about the patient, his or her family and what they are going through.
If you are going to use scribes, I really beg of you to please make sure the doctors have been given ways to introduce the scribe and use their services in the least intrusive way for patients and their families. Put a plan in place to educate your doctors and staff members on ways to integrate scribes into the patient care process so that all parties involved feel comfortable. Preserve the human element in healthcare.
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