With social isolation and COVID-19 on everyone's minds, let's read about John Eyring's experience in a quick-paced emergency room at Timpanogos Regional Hospital. This is not a job for the faint of heart!
What did you do for your internship?
My internship has been quite the experience – I have been working as an emergency room scribe at Timpanogos Regional Hospital for the doctors there. I chart and record physician dictations into an electronic medical record, including the history of present illness, risk factors, review of organ systems, past medical history, physical exams, lab and imaging results, emergency procedures, and the patient course and diagnosis. My purpose as a scribe is to provide the physicians with more time to spend with patients and medical decision making, rather than time spent charting on the computer.
This experience provided me the opportunity of being constantly around patients and see the entire process from checking in to being sent home. I was able to see what it’s like as an ER physician, including all the stress, decision-making, and team-leading that goes on. It was eye-opening, to say the least. Getting to see the wheels turning in the mind of the ER doctor – interpreting data; reading labs, scans, and EKGs; consulting with other physicians; interacting with the nursing staff, respiratory team, and radiology department – all of it, was everything I could ever have hoped for. I had a front-row seat to learning about the work/life balance of an ER doctor and what that would look like in my life.
What was a highlight?
There have been few moments in my life as energizing as when the ER physician turned to me and said, “Now this is emergency medicine!”. With a grin on his face and a kick in his step, he ran from patient to patient, with me on his tail trying to keep up. During the 20 minutes prior to the doctor making that comment, several patients checked-in to the emergency department – three trauma patients from a high-speed freeway crash, two patients with possible strokes, one patient with a possible heart attack, and three psychiatric patients, two of whom reported suicidal ideation, along with the inevitable and constant cases of nose bleeds and suture removals. It was quite the scene. Once codes began being called over the hospital intercom, respiratory teams, radiography teams, and a whole slew of on-call physicians, nurses, and other healthcare professionals popped up in the ER. Bodies swarmed in and out of rooms and piled into where they were needed most. Thankfully for the doctor, he had a mid-level and a mid-level student and they could all see patients, simultaneously. I was a little less thankful because it essentially means I have to scribe for three people at the same time. Difficult, to say the least, but it was invigorating to be right in the middle of so much action.
I was impressed. Not really with the capacity of the ER, nor the medical knowledge and prowess of the staff, nor the severity of the cases were dealing with (though they were indeed severe), and not the volume of patients walking through the door. What impressed me was the doctor’s stoic demeanor while interacting with patients, amidst the (what appeared to me to be) chaos. It seemed that he made every patient with whom he spoke to feel like they were the only thing that mattered to him, that they were the only patient that he was going to see all day. That’s what impressed me: his level of sincerity and charisma in such stressful and time-sensitive circumstances.
In such situations, being the scribe can be very difficult. When there is so much going on, it’s hard to keep track of each patient while keeping the charts complete, appropriately billable, and legally accurate. The physicians have to deal with a lot more information and critical thinking than I do, which is probably why their level-headedness stood out to me. I often feel stressed when the ER is busy, but it doesn’t seem to phase them. They focus on the patient and what their needs are – how they are feeling and what they can do to best serve them.
The patients’ experience with that physician was pleasant, it caused their anxiety to dissipate and gave the feeling that they were in good hands. I truly believe that it greatly affected their perception of the quality of care they received. This had a huge impact on me. Before being in the emergency room, I imagined that the physicians would be intense and what some may call “hard-core”. What I’ve found is essentially the opposite – the doctors in the ER are some of the most loving, caring people I have ever known, even in critical situations. They treat patients with respect and great care. The feeling grows inside me every day; I want to be like that as a physician. I want patients to have pleasant experiences when they see me; times that they look back upon with fondness and gratitude. I want to emulate these attributes in order to provide the very best experience for the patient. Of the many things that I have learned (and will learn!) from working in the ER, this may very well be the most important takeaway I have. This insight will allow me to be a better physician and a better person in general. I’ll forever be grateful for the experiences I’ve had with the physicians that I’m blessed to work with.