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Serving Over 20,000 US Medical Transcriptionists

Not just lazy...DANGEROUS

Posted By: MTPockets on 2007-10-22
In Reply to: To all the dictators out there - CB

This is how patient care errors are made. I know they hate dictating, but it is very disrespectful to their patients when the doctors won't even attempt to dictate clearly so that their patient's lives are not in jeopardy. They should be chastized by their hospitals and not allowed to dictate like that!


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Or she'd be doing QA because she's not lazy
Talk about pot calling the kettle...
the lazy way out
It takes more time and effort to train without pain... Shock collars, shock fences etc., are the lazy way out - and not a kind way to treat a beloved animal.
No, I don't think you are lazy sm
I have a dozen yrs in, I am an acute care MT, OP note specialist. I have been shopping for a job a lot here lately and I have had my pick, so I have been very choosy and I have not found quite what I think I would like best...yet.

In this search recently, about half the places that say they require testing have deferred testing me. I have a short written multiple choice test to do this afternoon, which I don't mind because the MTSO said that of the 100 resumes she got, mine was the only one that popped out at her as the ONE MT to talk to about this position. Okay, so I am a sucker and with an ego!

BUT, if someone thinks I am going to do more than 4 notes or use my keyboard to start and stop the dictation, they are can take a hike. I have to use my pedal and it needs to be 4 or less, period, and they need to be short.

My current IC position they required a test. The recruiter said I'll send you the test to do because I have to, but I'll call you tomorrow and hire you regardless. She said she felt she had found the right MT for the position when she read the first OP note I had transcribed, and this is as it should be.

All of you are right about this issue. I also think that anyone who hires MTs regularly can tell by talking to you whether or not you have lied on your resume, whether your English skills are adequate or whether you sound like a total buffoon or whatever else. Besides which, once you are a well-experienced, well-seasoned and high-caliber MT I think you have already proven yourself and a test is worthless.
lazy
You're not lazy. I'm old school, 53, 30+ years of transcribing, learned on the job in a hospital, took a few terminology courses and that was it. Best way to learn transcription but this is no more, alas. I believe it's the times we live in, the attitudes about actually having to work daily for a living, management in charge (younger generation?), our love in this country for excess nonsense "education" instead of common sense and experience, etc. I have coworkers who don't even bother calling in sick, they just don't show up and don't even get written up. That in itself blows me away. Nobody trusts anybody's word, of course. Okay, I'm done. I'm just glad I'm where I am and hope they don't change too much more before I can retire, ha-ha.
lazy men
why do you stay with someone like that, I would never stay with a man that didn`t bring home the money and put so many demands on me and gave nothing in return, what good is that.  
because that is the lazy way out and sm
newbies are doing this. You learn nothing if you don't know how to research and find things out. Besides there are too many questions answered about stuff that folks should know...the basics....when they get out of school and start. I am not talking about bad dictators etc, I am talking about plain every-day medical terms that go with physical examinations, etc. etc. Its obvious people don't want to research, which I AM SORRY is part of the job. Shouldn't be working production if you are not expert at the profession yet.
Here are a couple lazy MTs now...

Its attitudes like this that give our line of work absolutely NO respect.  Take pride in your work girls, you'd get treated a LOT better. 


We're just lazy, really.
Easier to say *Oh, but you do that so much BETTER than I EVER could* - reminds me of an episode of Everybody Loves Raymond when his wife found out he was purposely feigning ignorance and helplessless regarding various household chores when really he just didn't wanna do 'em. I'm afraid once she was *on* to him the gig was up!
That I support his lazy ass (nm)
x
That sounds beyond lazy to me...
I neglected to mention in my post above that my wonderful husband helps me out all the time and on weekends, he does all the cooking...over and above working 60-70 hours a week... (My post is the one re: 3 kids, DD works PT, DS college, etc.). I am more blessed that I ever imagined...
Yes, but sometimes they are just plain lazy sm
I have a couple of MT friends. I make about twice what they do, but I "work" roughly the same hours they do. They do a lot of whining about wishing they made what I made. When the work is there to be done, they tell me about the work piled up, but how they don't feel motivated. By the time they get motivated, the work is gone. Then it is whining about finding a new job, but when contacted, they can't get motivated to test and one is always wanting me to look over her tests to see if I think she will pass (I saw that her work was very poor indeed) and I have only done it once, which was enough.

Working at home is not for everyone. It takes a lot to park your buns in front of the computer when the dishes are in the sink and the laundry is piled up, or the kids, DH or whomever wants your time. It is SO EASY to not work. I get distracted by the housework, especially today because my daughter was home from college this weekend and every single coffee cup and bowl are dirty! I did her laundry, not mine over the weekend...so I feel distracted.

The OP is right. Use the answering machine or voicemail, don't answer the door (I never do) and get down to it. If you are like me and the housework drives you nuts, you can do what I do. I type 3 reports and go do a short, under 5-minute task, and sit back down. I find I can get the kitchen 90% clean in a day by doing this and I catch up my laundry this way too. Then I can focus because I like a really clean house to support me when I am working. It is a support because I don't think about it when it is clean.

My last rant is about those $tupid TV ads about working at home as an MT. Gimme a break! It is NOT like that.
Dangerous as far as what? NM
x
Not sure. I just know enough to be dangerous.
x
Is it dangerous to buy used?
Used may be cheaper . . . but is it safe?  I hadn't really thought of getting used because I'd hate to get a "problem" computer.  However, if it were just as good as new . . . maybe . . .
Lazy (spoiled) dictators
They're so used to somebody (like us and/or nurses, etc) picking up after them and waiting on them hand and foot, that they just don't think they need to bother.  When I worked on-site in a hospital, it was easier just to get the chart and write their dis summaries for them, but of course we can't do that from out here so I guess we have to use our mind reading skills. 
Anyone else to lazy to take tests..LOL. I applied for a job
but I swear when I opened up the testing and it was 6 reports including discharge summaries, right then and there, I just thought to my "NO way." I guess I just don't have the drive or energy to do testing for a job that takes a hour or more.  Part of me realizes that they need this information, but the other part, just thinks it's ridiculous to expect people to spend so much time on a test. Trust me, most of the time, when you see one report, it's quite apparent if the person has any skills or not. Sooooo, I guess I'm lazy because I'm NOT doing this test. Anyone else get these feelings...Maybe I'll regret it and maybe not. Time will test because a lot of other people were sent the same test so I'll wait for their report LOL
dangerous abbreviations
It really depends on the account. Some facilities/doctors really don't care for the new set of guidelines and want their work verbatim precisely. But employers want it practiced just in case for some of the more confusing abbreviations.
dangerous abbrevs

Pharmacies make plenty of mistakes on prescriptions and I have never heard of one being shut down.  They aren't any better or more careful at their job than anyone else in health care these days - which is to say, the consumer/patient needs to be on their toes at all times because you simply cannot trust anyone to do their job properly. 


Yes, sloppy writing is responsible for some of these mistakes, which is one of the reasons why many elements of  the AMA, the pharmacist associations, and the pharmaceutical industry are pushing for all drugs to have an individual number assigned, so that medication errors can be eliminated or at least greatly reduced.   Thousands of people are injured, make sick or even die from prescription errors every year.


I have been doing MT since the 1970s and I have seen huge changes in health care.  Most obvious change is that it has become a BUSINESS rather than a human service.  Most if not all involved in health care delivery care foremost about the bottom line and their own "bottoms."   Like one of the posters below, I too have noted how long the disclaimers are at the bottom of the H&P and Consults, particularly by the surgeons and interventionalists. 


When I started MT, almost no report was more than 1 page long.  Now, I sometimes transcribe reports where the "disclaimer" section with risks, benefits, alternatives, possible outcomes explanation is half a page long.   This information is already contained in the consent forms that are signed by the patient, so it is redundant to include it on the dictated report, but more and more MDs are doing it.   I have also noticed, or perhaps it is just my perception, that all dictators are including more information about patient attitude, knowledge and compliance regarding their (the patient's) regarding their medical condition.   Personally, I think that is a good thing - people need to take more responsibility for themselves and stop expecting the doctor to solve all their problems. 


 


 


Dangerous Abbv. below
I want to know how come a hospital says they are compliant with the list and AAMT guidelines but tell you transcribe ver batim even if incorrect? Can't have it both ways seems to me. I got caught by QA between a rock and a hard place about this but stood my ground. I did ver batim because that was the hospital's wish even though I knew it was wrong dictation. At least I flagged it for QA but it caused a problem. No one seems to have the answer. Next time, I'm not flagging it.
Dangerous Abbreviations

Q.D., QD, q.d., qd (daily) = Mistaken for each other = Write "daily".


I woud say this should over ride anything BOS has to say, but we aim to please the client.  As transcriptionists though we should be aware of these dangerous abbreviations since it can affect a patient's medical record and how it is interpreted.


cc is not correct, mL is. cc is a dangerous
x
PO is not a dangerous abbreviation (see msg)

Go to this website: 


http://www.ismp.org/tools/errorproneabbreviations.pdf 


 


IV is not a dangerous abbreviation.
For Pitocin it is WAS given.
Dangerous Abbreviations
"IV" isn't on the Joint Commission list of dangerous abbreviations. Don't take this as an indication that you're getting old--the confusion surrounding those darned abbreviations can be aggravating.

Here are some reasons for the aggravation. You might have seen it on a facility's list in the past or you might have encountered it as a recommendation from a consultant or in a journal article. Before The Joint Commission solidified its list of dangerous abbreviations, there was a lot of confusion about this--some groups banned any and all abbreviations.

There is an abbreviation that is banned because it can be CONFUSED WITH "IV." It's "IU," the abbreviation for "international unit." While it's OK to use IV, some facilities do not want you to use it, reasoning that if IU can be confused with IV, then IV can be confused with IU. And then some would want you to avoid using IV, until they discover that they have to pay extra for you to transcribe "intravenously."

Here is a link to the whole list. The document on The Joint Commission website was broken, so this link is to another website, but it is the same thing. http://www.aapmr.org/hpl/pracguide/jcahosymbols.htm




q is a dangerous abbreviation.
x
If you suspect something dangerous, then
for heaven's sake go and visit a doctor.

Why do you suspect a pulmonary embolism? I dounbt tht you wiklk be able to cough it up. Are you producing some blood when coughing?

It might just be some mucus or phlegm that you cannot lodged in you lungs.

Does your cough produce blood?

Here are the symptoms tht indicate a pulmonary embolism
(blood clot in the lungs):

Google:

'Pulmonary embolism symptoms can vary greatly, depending on how much of your lung is involved, the size of the clot and your overall health — especially the presence or absence of underlying lung disease or heart disease.

Common signs and symptoms include:

Sudden shortness of breath, either when you're active or at rest.
Chest pain that often mimics a heart attack. The pain can occur anywhere in your chest and may radiate to your shoulder, arm, neck or jaw. It may be sharp and stabbing or aching and dull and may become worse when you breathe deeply (pleurisy), cough, eat, bend or stoop. The pain will get worse with exertion but won't go away when you rest.
A cough that produces bloody or blood-streaked sputum.
Rapid heartbeat (tachycardia).
Other signs and symptoms that can occur with pulmonary embolism include:

Wheezing
Leg swelling
Clammy or bluish-colored skin
Excessive sweating
Anxiety
Weak pulse
Lightheadedness or fainting (syncope)
Fever'

If you do not have these symptoms, take an aspirin, drink hot tea with lemon juice and honey, you might just have a cold.
Hamburger helper-stroganoff, I'm lazy..
nm
Thoughts on dangerous abbreviations

You're partly right.  Joint Commission has no jurisdiction over a private office setting; however, this was adopted by Joint after it was first given to the national pharmacy assocition.  When a doctor has his/her nurse phone in a prescription or writes one himself regardless of private office or inpatient setting, s/he better follow these guidelines. 


Having worked in a pharmacy, I understand how critical it is to be able to know EXACTLY what the doctor wants the patient to have presribed.  Pharmacy is going down the same path as MT work.  Notice how many insurers allow for your prescriptions to go to a mail order company who will fill up to three months of your prescriptions at a time.  The first line of defense these companies have (well, really just one anymore as they are becoming the MQ of pharmacies), is to scan the prescription.  If it is not written clearly, a body must contact that physician.  Addtionally these mail order companies allow MDs to relay prescriptions online.  These guidelines better be followed or they will be contacted.


Depending on which division within the mail order pharmacy you work, a tech may fill more than 100 prescriptions an hour.  If ONE of those prescriptions is filled incorrectly, it is reported to the State Board of Pharmacy who requires a monetary penalty be forwarded by the company depending on the error classification.  If there are too many errors in a given month, the pharmacy is shut down, the supervising PHARMACIST receives (typically) a $5000 fine and a one month to five year suspension of practice, all actions of which are published and distributed to all 50 states in a monthly newsletter.


To say this is all AAMT's fault is ludicrous.  To say the doctors are not going to change their ways because they have god complexes is ludicrous.  This happened because too many mistakes were being made through haste, bad handwriting, lack of time to thoughtfully write prescriptions, etc.  This is today's reality.  If you do not adapt, you do not survive.  Just ask a Cro-Magnon.


d~


This is extremely dangerous reasoning. SM
It isn't what the "suits" are saying, it is what they are doing.  These are two totally different and separate entities.  My God, are you so complacent that you cannot even take a look around and see the face of the future?  No one is telling anyone to not just "be happy."  A little foresight and present thinking is imperative, not only in the MT world but in many other areas of business, especially IT.  It's all going over to Asia and it's all same-same there. 
JCAHO dangerous abbreviations
Do physician offices/clinic notes need to comply with this list?  I thought JCAHO was joint commission for hospital compliance. 
Is p.o. considered dangerous abbreviation?
nm
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Thanks! I have the dangerous abbreviation list
I was just afraid I was missing something buried in the book somewhere. I just didn't want to be making a mistake. Thanks again.
Lazy is what they are. I just turned down a request to type for one at the clinic.
dd
What success...she is a lazy, rich HOUSEWIFE..sounds like the
successful one is her husband.
Nope. We are all lazy bums living off welfare.
n
cc is on the dangerous abbreviation list and should be converted to ml.
x
Not to mention extremely dangerous for your pets - sm
especially the flea collars, shampoos, etc. Totally agree. Awful products. Should be banned completely.
Here's a link to that dangerous abbreviation list

This is the site the BOS recommends visiting, so I did.  It is a long list of stuff fer sure!  Here's the link...just copy and paste it into browser.


http://www.ismp.org/Tools/errorproneabbreviations.pdf


Hope it helps!


would you like a copy of the DAL(dangerous abbrv. list).
Just so happen my supervisor sent it to me today thinking that a report was mine with a dangerous abbr. listed in it.  Let me know if you would like for me to email you a copy.
I feel kinda lazy reading your post as i'm content just

Where I feel crazy, I set a goal of around 300 lines an hour (ha! not with these dictators but 250 is still good), every two hours make a snack to get me moving.  I love juicing veggies and making fruit smoothies in the blender, coffee makes me nuts.  I also do calisthenics (sp?) every couple of hours for about three minutes to keep my blood flowing and keep toned.  I walk the dog two times a day for about 10 minutes to get energized from the sun and keep a good color.  I take an hour break to watch good ol Judge Judy, and fix myself something nice n yummy, and after Judy I crank out my last hour called the 'power hour' where I take no prisoners and smoke comes off my keyboard!  Like a race to the finish line.


I can't see how you could do the 20 and the 10 minute clean break, that would slow me down!  Maybe I should take cleaning breaks, because I never want to clean when I have a block of time off and the dirt just collects.


There's nothing lazy about 'fixing.' Same thing as 'preparing' or 'getting ready.&
f
why let him call you lazy more than once? also, sit him down and make him transcribe a generic note.
nm
Only a person who consistently leaves blanks because they are lazy should be docked.
Or maybe they should just be fired. The first place I ever worked docked us for errors that we should not have made. I was only docked a couple of times, and it was only a small amount, but it made me pay attention and be more careful, and I think it made be a better MT.
Lord, preserve me from Sam's Club! That place is dangerous!

That is THE most dangerous thing I think I've ever heard. You don't understand it?!

We have been told to use mL for all, regardless if dictated cc. Dangerous abbrev. blahblahblah nm
x
The Joint Commission's Dangerous Abbreviation List... SM

applies to written entries on a patient's chart, i.e. nurses' notes, doctor's orders, etc.  For some insane reason, someone somewhere decided to apply it to transcription as well which is just silly.  I work for a facility that has decided not to force transcription to strictly adhere to the dangerous abbreviation list and Joint Commission has not counted it against them in the last three audits.


I will say most MTs where I work do not use qhs, qac or qd.  We expand those out because WE (the transcription department) decided that we should for clarification purposes. 


My dangerous abbreviation sheet doesn't list...sm
q. as a dangerous abbreviation. It lists q.d. and q.o.d. and q.n. but not just q. by itself. ?
There are so many variables at play that it's dangerous to compare to others along these lines. s
I know that there have been occasions when I've had a run of one of my more familiar docs -- one for whom I have a lot of canned text and who tends to dictate with a great deal of regularity, and quickly -- and I've been able to break the 500 lph barrier, but only briefly. Otherwise, working a large hospital account as I do, with dozens of regular docs and a hundred or so others who just crop up now and then, I can't conceive of anyone averaging anything close to that ... I'm luckly to average above 250-275 lph on a typical day, and some days -- when it's resident and ESL heavy -- that can go down to 150-200.

But, again, it's really pretty silly to compare lph between different MTs unless the variables are the same.
One of those radio financial guys said debit cards are the MOST dangerous to use.
s