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Serving Over 20,000 US Medical Transcriptionists

Maybe not flitting but when you talk medical reasons

Posted By: Mine on 2007-11-21
In Reply to: Um, I'd guess she presumed because - sm - tnmt

for not sitting, I am sure a lot of MTs have some- I know I do as stated but I wanted the 3000 lines per day and that is what I do, do not care to work fulltime and decided if making that, would add up to what I want- the question was how many lines per day so that was what I answered. I have done this for almost 35 years now and hopefully plan to continue. Lots of people suffer from problems, does not mean it always come from their work.


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Oh, do you really want to start into medical reasons?
I have urge incontinence so bad can hardly make it to the bathroom which is about 6 steps away from me and other things also such as fibromyalgia where my ribs were hurting both back and front I could hardly sit- BUT I put my mind to making this and I do. I type in ShortHand only- cannot type without it- too many mistakes and my speed is high.
You talk about medical bloopers at a party
nm
Give professional reasons why you deserve it, not personal reasons
x
I stayed for many reasons and while those reasons have changed - sm

I loved MT because I was good at it and it came naturally to me.  Typing, language, etc.  The perks of working from home and being able to raise my family were a huge plus.  I stayed because in the hayday of MT you could make really good money really fast (2500 lpd @ $0.15 cpl). 


I stayed while my children were young and I could be available for them.  I stayed so I could return to school and have that flexible schedule to juggle everything once the kids grew  older.  I stayed full-time and cut school back to half time so I could take care of my ailing parents and inlaws when the time arose.   


I continue to stay because I still need to finish school (3 semesters to go) and unfortunately my DH is ill and needs someone to care for him now.  I stay because it is convenient, but I do not plan to stay forever. 


I sure miss the big money days, but what money I make now is sufficient enough to pay my bills.  It is a means to an end so to speak and it has been a godsend along the way.  But I in no way plan to stay at it forever.  It served and continues to serve a purpose, but it is no longer what I "love" to do. 


Eewwww... you don't talk like an MT, you talk like mangement. Ick. (n/m)
:p
I would buy new a Dorland's Medical Dictionary, Stedmans Medical and Surgical Equipment...SM

and Tessier's The Surgical Word Book, 3rd edition.  Books you could buy used I would say would be Stedman's Pathology and Lab Medicine and Cardiology/Pulmonary word book.  These are all the books I use the most during my day.  You could buy other speciality word books as you need them and could probably go used with those.


I wouldn't bother with buying a drug book, new editions come out every year and I just stick to the FDA website and RXList as my drug references.


Also FYI, not a book, but I use my Stedman's Electronic Medical Dictationary a lot.  It's easier to open the program than it is to pick up a huge 30-pound dictionary.


Medical Transcription In The Era Of Electronic Medical Records
EMR has revolutionized the healthcare industry in recent times. Many experts felt that EMR & Voice Recognition would totally replace Medical Transcription - however; the industry soon realized that transcription has certain advantages over point & click charting and many physicians preferred to dictate notes rather than document the data at the point of care themselves.
just try to help him be sure its for the right reasons
You have to let kids this age make some decisions, even wrong ones, and live with the consequences. But i would just try to get the dialog going, find out why it isn't 'fun'...personally, i feel if the desire is gone -- he won't play well anyway. Ultimately, his is one decision i'd let him have.
Many many many reasons
Too many to type...just believe me...
My 2 reasons...

I love my husband because:


1.  He's thougtful...calls or emails me several times a day.


2.  After almost 20 years together, he still gives me chills when he walks in the door after work.


There are so many more reasons why, but you said 2...


 


my reasons
1. He knows me better than anyone else on the planet after knowing me for 27 years and being married for 23 and SILL loves and accepts me! :-)

2. I always feel that "everything will work out" if he tells me so.
there are many reasons - sm
I know of two hospitals that had decided to completely outsource their transcription to a well known large national service. Their reason was that they could not find transcriptionists in their area. Two years later, both hospitals let the service go and decided to go back with in house transcription. There were many reasons behind that decision.

I have a friend that works at a hospital in the midwest and says that the outsource service is costing the hospital more than if they had kept their staff. She had said that her hospital is in the process of hiring people to come back to work either at the hospital or, hopefully, at home.

The hospital I worked at could not find transcriptionists in the area, so they decided to outsource as well. Our boss didn't make it a secret that the service was charging them $45,000 MONTH. That was more than if our whole staff was working 10 hours of overtime a week/per transcriptionist. So our boss is looking into hiring transcriptionists that live within a 2 hour driving radius to work from home after a week of training in our hospital and paying for them to stay in a hotel.

Sometimes it is not cost effective to outsource. Sometimes the service is really bad and the hospital does not want to continue to pay for the errors. There could be other reasons, but those are ones that I can think of off the top of my head.
Which, among other reasons, is why I would -
;)
My reasons...
Well, Pattie, I have been doing this for 25 years. I am 50 years old. I am good at it. I want to work at home. I am reluctant to leave my chosen field at this stage in my life.

I could not have predicted, when I obtained my MT training, that this field would take such a nosedive in pay. Obviously I would have chosen another field had I known.

As you get older, you are more reluctant to train in a new field.
My reasons...

for stick with MT and even coming back after a couple of absences:


1. I love the work. It satisfies my need to be in the medical field (quit nursing school way back when - bonehead move on my part!) without having to go back to school or actually deal with people too much.
2. My husband is disabled and my boys are teenagers. If I worked outside the home in another field, I'd be spending everything I made on paying someone to take care of things at home.
3. I really like the company I'm with. Been with 'em now for about 4 years and have loved nearly every minute of it.
4. I'm too old (44) and set in my ways to retrain in a new field and get used to dealing with office politics again.
5. The money that maybe I'm NOT making, I'm also not spending on gas, clothes, lunches, etc. that are part of working outside the home.
6. Did I already say I love the field?


Well, 2 reasons. 3 really.

1)  That seemed to be what everyone was hiring for.


2)  I hoped to make more money that way.


3)  After being an MT for 14+ years, I had a lot of confidence in my abilities as a transcriptionist.  Honestly, I didn't realize how much I didn't know.  I feel like a dang newb again


Several reasons ... sm
1) May be checking to see if you have previous employment history with them under different name.

2) May be doing some type of credit/background check.

reasons
You know I will definitely pass these along. Some people just think you are being racist because you state the obvious and because you show such bitterness towards these people. Look at what they cost our country. Do you know how much crime these people bring here? The diseases? Do some research. They don't have proper vaccines over there. I mean think about it these are poor 3rd word people from an uncililized culture apparently. How can 3rd world culture merge into 1st world culture smoothly. It can't and it won't. They will never smoothly transition to the American culture because they do not want to.
And people can say well what about all the European immigrants many years ago? Well guess what? They wanted to be American so bad that they learned the English language and worked hard. They wanted to be AMERICAN. They did not expect Americans to transition for them they were willing to transition to our culture. These uncivilized vultures basically come here and they come here for one reason only: money and all they can get for nothing. They come here to work but they also abuse our social services to the utmost degree. I have seen on news programs where they will come over here and fly their Mexican flags. And you know how they fly the American flag? Upside down. Oh yes I have seen it on TV. I have seen them trying to burn the American flag. I don't care if it cost a trillion dollars this country needs to send every one of these people back to Mexico. Our country would be a whole lot better for it. We don't need this filth and crime in our nation. We are better than that. I am sorry if this offends some poeple but it is so true and sometimes the truth just hurts. That is what is wrong with our country today. Poeple tiptoe around the truth. Lets dont offend anyone! Well hey I say state the obvious. Tell it like it is.
Reasons

I answered your question above where you posted it as well.  I must have misunderstood your post, as it seemed that you were challenging me.  But, I was just trying to say that I don't want to debate the fact as to whether or not the queue is shuffled, cause I see it happen.  I don't know their reasons, but this new shuffling maneuver only happens on one account that I work on there, and it just began about 5 weeks ago.  It is really difficult for me to get a decent line count now, as all of the reports that I get are laborious since the reports that I find to be easiest are always being shuffled to the bottom of the pool.  I understand that it is not a prison and that my only option is to get out the kitchen if I can't stand the heat.


I would think that those reasons
are given as opposed to unexplained weight loss, disease process, etc. 
Three reasons...
1. It's good for a company to provide upward pathways for their people.

2. Some accounts can be very complex and require the QA to have prior experience with different special worktypes and/or exposure to certain dictators, etc.

3. There are many things you learn about an MT over the course of their employment that you will never learn from interviewing and even testing a new applicant, however experienced they may be. Unfortunately, our litigious society has rendered reference-checking practically useless, and you will never be able to test any applicant across the full range of dictation that you see coming in from your MT's every day.
There could be several reasons.

1.  A lot of companies are hiring and do overhire to get their backlog down.  Once their backlog is caught up, they weed out. They don't have to let people go, they can manipulate their queue until they quit.   And please don't say this isn't true because one of my ex-friends who was a production manager actually told me this.


2.  Benefits are based on production.  If management can hire a lot of people, they can produce a lot for their clients, they still get the same bottom dollar.  Yet, if the queues or servers are controlled, they can avoid overhead on benefits if production quotas are not met. 


3.  Why pay domestic employees 7 or 8 cpl when they can pay offshore MTs 3 or 4 cpl?  They still have the same amount of production and still make the bottom dollar, yet they can control where the reports are going and who is getting them. 


It all comes down to bottom dollar to management and owners.  They can control whatever and whomever to achieve their goals.  Not all companies are like this, but it is becoming more and more common.


Not working out for a lot of reasons...
The platform they have me on is not user-friendly at all.

It seems simple enough. You have to enter the job # and date, and then press enter to get the template to download with the patient's name, etc.

But if the doc hasn't entered the patient ID correctly, you'll have to look it up.

This can take a minute or several minutes, depending on if the patient exists in the system, among other things.

You'll come out ok if the note is long, but they average about 30 seconds.

Also, the doc may not have entered the correct clinic note ID, or the correct dictator ID, so that's another story.

If all goes well, you'll download a template. If there's something typed in the template, you don't get paid for it...but, if the doc makes changes (which of course they do), you have to delete.

I know what I'm capable of doing, but for some reason, I just can't make any lines working for Spheris.

I gave it a shot, but I'm ready to move on...maybe even change careers.
First, be very sure of the reasons that you want to homeschool.

It is tougher beginning at such a late grade, but it can be done.  I started my son in 9th grade 9 years ago, so obviously I know a little bit about it.  I also had a great friend who homeschooled her high school kids, so she could get me started with a lot of support and encouragement.  Be sure you're ready to be with this child 24/7, because that's pretty much how it will feel.  We did have problems with the school but tried every avenue to solve them before saying, "We don't need to put up with this, we do have a choice," when the school counselor said that we didn't have a choice.  They thought they ruled my son's world;  they were WRONG.  I AM HIS PARENT, I believe I do have his best interests in mind when making choices for him.  We are a Christian family, so it was easy to start by investigating Abeka Books for materials;  bear in mind you'll have to buy all your own materials, nobody helps with that.  My son now has his degree and is IT manager at a bank, looking to make VP. 


You'll need to check out the homeschooling laws for your state, they vary.  Just do an internet search for homeschooling laws for your state.  Check around for homeschool groups, there are several out there.  But, the biggest thing is just to make sure that you and your child are committed to working together to do this.  It does take a lot of commitment and communication to do this and do it right.  BEST of luck to you whatever your choice.


So, PFFFT to the person who says kids need to be in school.  I know better and obvious hundreds or thousands of others do too.


Those are the reasons I do shop SM
at Target. I have a huge problem with the Salvation Army's practices (be our religion, go to OUR church, adhere to OUR values, or stay cold), I think our government ought to be the ones supporting the military since they sent them where they are, and as for supporting gay and lesbian rights, I think that is a good thing. I'm not sure exactly how you phrased that.
QA can be very tedious for these reasons:
1. You get all the garbage someone else either could not or did not take the time to hear and understand.
2. You often have to fix all kinds of little errors that the MT had no idea they even missed.
3. If you also have to provide feedback, then you will type your fingers to the bone.

I decided after 5 years to go back to being just an MT! :-)
I like your idea for 2 reasons
The MT knows what they need to be taught.. and it would give MTs losing jobs to outsourcing something to do!  Great idea!
2 other reasons i've seen are
using the transcription area of the hospital for other things and not having to pay benefits.
There could be any of a number of reasons.
Some physicians have a God complex and freak at the slightest mistake. I have seen that happen many times even if it was something the MT could not control. You should have been given better instructions regarding format, but the powers that be may not have realized you were not. If the physician freaked, the office staff was not going to admit that they did not do their part.
I agree it's one of the reasons
I do this work...hard to get the work done with a baby or preschooler in the house but great once they go to school...no latchkey kid problem.  Now if I only had a separate room for my own office...
What are the reasons you want to do MTing?
NM
No, for all the reasons you mentioned.
for those same reasons, i refuse to be a member, though i too was originally. AKA AAMT is like congress today, self-serving, not representing "the people."
a couple of reasons
Canada has 2.1 physicians and 8.8 nurses for 1000 people in their population. Plus they are paid by the government. Approximately 12% of the Canadian physicians practice in the US because they are compensated better.

This was taken from a publication called "Health Care News."

In recent years, patients treated by the Canadian health care system have increasingly experienced lengthy waits to see providers. Treatment waiting times are now part of the public policy debate on the quality of the Canadian health care system.

In its 16th annual installment, the report titled "Waiting Your Turn" tracks how waiting times vary across Canadian provinces depending on the type of treatment needed. The report also documents waiting times for referral to specialists and the subsequent amount of time spent waiting for actual treatment from the specialist.

"Despite all of the promises made by Canada's provincial and federal governments, and despite the fact that Canadians are spending more on health care than ever before, the total wait time in Canada continues to hover near the 18-week mark as it has since 2003," coauthor Nadeen Esmail said in an interview for this article. "Equally troubling is the reality that the total wait time in 2006 is 91 percent longer than it was in 1993."

These findings should give pause to proponents of universal coverage, who often cite Canada as an example of a country where health care costs less than care in the United States and everyone has free health care at the point of service.

"While many proclaim Canada's Medicare program to be one of the best in the world, or suggest it should be the model for reform in the United States," Esmail said, "the reality is that health spending in Canada outpaces that in most other developed nations that, like Canada, guarantee access to care regardless of ability to pay, and yet access to health care in this country lags that available in most of these other nations."

The average amount of time spent waiting to receive treatment after referral by a general practitioner averaged 17.8 weeks across Canada. At 14.9 weeks, Ontario had the shortest waits. Prince Edward Island, Saskatchewan, and New Brunswick had average waits of 25.8 weeks, 28.5 weeks, and 31.9 weeks, respectively.

Patients referred to a neurosurgeon waited an average of 21 weeks just to see a specialist. Getting treatment required an additional 10.7 weeks.

Patients waited an average of 16.2 weeks to see an orthopedic surgeon, and another 24.2 weeks for treatment to be performed after the initial visit.

The number of people routinely waiting for services is staggering, according to the report. Approximately 1.1 million people had trouble accessing care on a timely basis.
About 201,000 had problems obtaining non-emergency services. An additional 607,000 had problems getting in to see a specialist, and about 301,000 patients experienced problems obtaining diagnostic procedures.
"So much for the myth of government-run health care being compassionate and fair," said David Gratzer, a Canadian doctor and senior fellow at the Manhattan Institute. "Canadians wait and wait and wait."

In Canada, waiting lists are considered a way of rationing medical care and holding down health care spending. Because health care in Canada is largely free at the point of service, demand is likely to exceed supply. In a typical market system, the price would adjust to the point where the quantity of services provided is equal to the amount patients are willing to buy. But in a system devoid of a market mechanism, scarce resources are rationed through means other than price.

"The long waits for needed care in Canada show the danger of abandoning markets in favor of central planning," explained Sean Parnell, vice president of external relations at The Heartland Institute, an Illinois-based think tank. "Just as there were long lines for food and other basic necessities in the old Soviet Union because planners couldn't accurately match supply with demand, the politicians and bureaucrats who run health care in Canada can't provide enough health care to meet the citizens' needs."
"It's like the old Soviet system," Gratzer said. "Everything is free, but nothing is readily available. Except that we're not talking about lining up for toilet paper in Russia in 1976, but queuing for surgery in Canada in 2006."

Economists generally agree such "non-price" rationing of resources is less efficient than a system that uses prices. One reason is that productivity is lost when people are unable to work due to treatment delays. Also, the risk of death while waiting is higher for serious conditions such as cardiac care.

Waiting lists are consequences of the way the Canadian health care system is structured, not a lack of money, critics say.

"The fact that this is the 16th annual report on wait lists for needed care should be enough to prove that the problem isn't a temporary one that can be fixed with just a little more money, as defenders of Canada's government-run system have claimed for years," Parnell said. "Long waits and widespread denial of needed care are a permanent and necessary part of government-run systems," Parnell noted.

According to the study, Canadian provinces with higher spending per capita did not experience shorter wait times than provinces that spent less. In fact, increased spending was associated with longer waits, unless the increased spending was targeted to physicians and pharmaceuticals.

"The current health care model simply does not deliver to Canadians the access to care they should expect for the amount of money their governments are spending," Esmail said.

Oh please! Now its all about the $$ again. He lives in France for several reasons,
the obvious of which is his wife wants to stay in her homeland, and, secondly, he has said that the Parisians treat him like a regular guy - we all know that celebs living in the USA are stalked and their lives are chaotic trying to avoid stalkers, paparazzi, etc. He feels his children are safe there, and they are his #1 priority.  Even a lesser known actor like Gary Oldman, who has NEVER stated anything politically incorrect, had to leave the LA area in the USA because some nut case "fan" keeps threatening to kill his 2 little boys. While Gary Oldman has been quoted as saying he LOVES living in the USA compared to Britain, he's had to return to Europe because the climate for celebreties is not as crazy as it is in the USA.  Its INSANE.  They do live some of the year in the USA by his family, but he has chosen not to disclose the location or times of year. He is like one of the BIGGEST stars in the world right now - and still nuts hate him. Hmm....I saw BOTH interviews, and read the original "USA hatred" article, and he never said that. While eccentric, the man is brilliant - do you think he'd be stupid enough to say he hated the USA?  He NEVER said it, but its just the perfect example of how media manipulates things, and how some of us are naieve enough to believe it.  Boycott him all you want - its your loss, not his!
there are reasons for part timers
I have a medical condition and cannot always do a full two weeks, due to exhaustion and pain from my blood dyscrasia. That is why I am not a full time employee.  I was but had to cut back and when I did MQ canceled my insurance.  I would gladly go back to a hospital and work in-house but the two hospitals out here have outsourced all transcription.  When I did work in-house, I was able to work part time and the hospital offered insurance coverage to part timers.  I only had to pay $70/pay period for insurance.  Im astonished that most trans services will not cover part timers..I cant figure that out.  If the part timer is willing to pay the extra amount, why not?  I also have lost faith in American private insurance, as how can you trust private companies making decisions about whether you can get chemo, MRI's, etc?  Back a few years ago, whatever the doctor said you needed, you got.  Not anymore.  Now American HMOs and insurance companies pay people to check over your medical history and decide whether you can get this or that done.  How can you trust companies when their only concern is profit and making as much for the stockholders as possible.  Give me a universal health plan throughout the country any day.
I always turn mine off - for several reasons...

mainly because my computer guy told me it's better for the machine to cool off (I think of it as "resting").  Also, we have LOTS of thunder storms here, so I completely unplug it, including the DSL phone line and router, as well as the cord to the surge protector.  I've learned surge protectors don't help with near lightning strikes...fried my computer about 3-4 years ago when lightning hit a pole near our house.


As far as the cat hair (4 cats here), I blow out everything every few weeks or so with compressed air. 


Inhalers are used for a lot of reasons besides asthma.
My Dad is on one for his COPD.  My son was on one temporarily due to a severe viral lung infection.  I have to get one every summer and wear one of those white masks because of hypersensitivity to forest fire smoke with bronchitis.
Reasons for home office
I too have home office for tax purposes.  Also, with friends and family knowing I work in an office at home, they seem to take my job more seriously.  I am not just sitting at the dining room table "playing" at the computer.
Uh, probably for the same reasons YOU stayed for 10 years? nm
@@
I did it because of health reasons, mine and my
However, I don't think anyone likes being in the middle of an office argument or office politics or dealing with rude people on the job. People usually just put up with it because there is no choice or they may say "leave me out of it." I am a loner but put on a face at work and in public. I guess I like being around people but to a degree. I do love my privacy. So, I can see your point. I think psychology is an excellent choice and something I thought of too many moons ago but let someone talk me out of it. Now seriously thinking about grief counseling as a career. Good luck with that. Best wishes.

me
Thanks, it has been a rough 2005 for many reasons - sm
but Jen is doing well now. Her hair grew back quick (3 different colors currently, quite interesting), looks like a little elf now and everyone thinks she is so cute (those that don't think she is a boy, get that a lot now since her hair is so short). Almost 10 months cancer-free so far and things look very good for her. She looks so different and healthy now that she is done chemo. Her 6th birthday present will probably be being told her Port-A-Cath is coming out--Dr. appt. day before her birthday, due to come out a year or so after the initial surgery. But I am so thrilled that she was eligible for a wish. She got exactly what she wanted and it was a trip of a lifetime I don't think any of us will ever forget. I am very grateful to everyone who contributes to Make-A-Wish, it is really amazing what they do for sick kids and their families. I hope everyone here had a good 2006!
I can't believe you thing those are good reasons.
I cannot believe you think these are valid reasons to do your dog a dis-service like that.  Yes, it is your laziness that doesn't want to go have to get up and let him outside.  As far as fleas, if you cannot afford to care for a dog properly, you shouldn't have one.  The cheapest part about owning a pet, is the initial cost. Your expensive flea med excuse is like saying, "Gee, I am short on cash. Get the dog doesn't get to eat this week."  There are expenses that go with owning a pet and that should be considered before you bring one into your home.  And the digging,,, just don't leave him out for hours at a time and the digging won't be an issue.  THis poor dog.  I unfortuneatly can see this dog's future.  Either he will end up put down like the other poster's dog or he will be placed with strangers.  If he is lucky, it will be with a responsible dog ower.  If he is unlucky, it will be with some one who won't take the time and he will either end up outside all the time or be passed to yet another stranger.  Poor pooch.
Several reasons. If in an office situation

perhaps the patient is expected for follow-up a short time after the first vist. That dictation needs to be on the chart by the next visit.   Doctors are seeing more patients than ever and they don't want to have to read through the chart trying to find info an want the note there. 


If in a hospital situation and they are accredited they are only allowed a certain amount of time to have the dictation done and on the chart.  


I know there are times work isn't dictated properly.  In a hospital setting doctors can lose privileges at hospitals and not be able to see patients, yet there are always a couple of doctors who don't dictate until they get a deficiency letter.


When the agency is at fault they can overlook things, but when they're not at fault they aren't very forgiving.  If they are contacted with an issue they might be a bit understanding, if they don't know of a problem and they get the work whenever then that creates a problem. 


 


 


 


Share 2 reasons (or more) about why you love your DH?

I love him because;


1- He knows me better than I know myself sometimes.


2- After 17 years together... he still makes me believe that I'm
the most beautiful girl in the world.





 


2 reasons! That's pretty hard to do...sm

After 40+ years, what do I love most about him?


I love him because we were best friends most of AL from the start, before falling in love. Sure, he doesn't do much around the home, but we made a pact way back then...you take care of the outside, I'll take care of the inside....he  keeps his end up, I don't...too busy working, and he never says a word. I love him because mess, he only complains maybe twice a year about it and I sure wish I could wave a magic wand and have things perfect in that department.


I love him because we talk about his work, my work, things going on in the world, the kids, etc., etc.


I love him because-even though he never says it except in one of those rare moments- neither of us could do without each other. I can't imagine ever being with anyone else and neither can he. We don't have to say "I love you" every day or so, but we know we do. We're too tired at the end of the day to do much but go to sleep, but that's okay, too., because we know we're with each other.


I'm comfortable with him. I do not have to look like a princess or queen and heaven knows, I have lost my looks over the years, while he is looking better all the time, yet he still thinks I'm gorgeous.


Need more?


Well that's not true! Plenty of reasons
to check other reports! Maybe you are typing a DS and you can't understand a drug. You suspect it will be listed on the H&P, so you check there. Not there? Check the consult report. Or say you are doing an OP report and the dictator is slurring. You suspect this means he always says the same thing, so you look at some of his other OP reports for a similar report. Sure enough, you find a report with the same wording, so now you can make a normal. No HIPAA violation for doing research.
That is one of the reasons why I work at HOME!! nm
x
OK - how's that? I need to be healthy for ME (for several reasons) before I can be true to...
anything else in my life!  Thank you ALL for the words of encouragement!  It does help.  I need to do this for ME.  Once I see I can accomplish this goal I will have the encouragement, strength and faith that I can do anything!  And you know what, I really BELIEVE I will do it this time!  Thanks again!  Will keep you updated!
My main reasons for looking to enter any job are:
First the ability to care for my family, which would mean money. Second, the ability to schedule around my children’s' needs.

But...I do like caring for people. I actually thrive in environments that are stressful and that I have to be on my toes. The drawback to nursing for me is the idea that someone's life is in my hands and that I could make a potentially fatal mistake.

Reasons for late work?
What kind of reasons does she give for the work being late? I have had some weeks that were horrendous - son with an accident - had to have surgery - 2 days later - sister (who lives with me)fell and broke her hip - another surgery - then daughter with an eye injury (another ER visit) - or the week that I've had 3 funerals - that's happened more than once. Needless to stay - I did not meet my quotas those weeks - I would let her know the reason work has to be on time and find out if she is having extenuating circumstances. If she is new, she may not understand about turnaround times, etc. I would always give a new MT a chance if they were any good at all - as we are a dying breed that needs to be replenished - give her one more chance before letting her go - it may be easier to just get things straight with her than have to train someone els which always takes time.
Just Say No: Five Reasons to Turn Down a Job Offer
None of us would have a job if we went by this Yahoo article.

Employer caution has extended the hiring process by weeks, even months. You may interview for a position several times, in person and by phone. No matter how long the process is and how well you've gotten to know your potential colleagues, it's still perfectly acceptable to turn down a job offer. In fact, there may be many valid reasons that you should politely decline an opportunity, assuming, of course, that you're not in dire financial straits.

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1. The word on "The Street."

Is the company's stock price tanking? Or is there talk of a merger? Both of these things could indicate that layoffs loom large, and the position you accept today may not exist in a few months. To calculate your risks, speak with industry experts, do your due diligence on Yahoo! Finance, and consult with family and trusted friends. If you still want to accept the position, try to obtain an iron-clad employment contract.

2. A revolving "Employees Only" door.

A certain percentage of employee turnover is normal. According to the Bureau of Labor Statistics, the average voluntary employee turnover in the U.S. for 2006 was 23.4 percent. However, high employee turnover should raise a red flag for any potential worker. Research a company thoroughly before accepting an offer. Also, be sure to listen carefully during the hiring process. Do interviewers keep referring to folks who've left the company or mentioning a total lack of redundancy? These could be signs that people are leaving faster than replacements can be recruited.

3. Money isn't everything; it's the only thing.

If money is a major factor in your decision to accept a new job, think twice before you do. In fact, think three times. Even four.

Depending on your personal financial situation and how much more you'd be earning in a new job, money may not buy you on-the-job happiness or professional fulfillment. It may not even guarantee career advancement. Assess your finances. Revisit your career goals. Look at the situation with a big-picture view of your future. Making a move for a modest increase may not be worth it if there's more long-term potential with your current employer. Also, be sure to calculate your entire compensation package to make sure that you're not forfeiting a valuable retirement or insurance plan for a bigger paycheck.

4. All work, no life.

There's a time in almost everyone's career where they have to put their nose to the grindstone and work almost to the point of burnout. If you're just beginning your career or starting a second one, this may be what lies ahead for the next few years. However, if you're a mid-careerist with a family and personal obligations, it may not be wise to accept an 80-hour-a-week job. Consider the impact your new schedule will have on you and your family. Will generous vacation make up for the longer hours? Is there flex time available so you can still attend family functions? Can you work from home? Forfeiting invaluable work-life balance benefits without assessing the consequences can have a devastating impact on your personal life.

5. A bad reputation.

Going to work for a company with a reputation that's been sullied by a corporate scandal or that isn't well respected can, in turn, sully your resume. Investigate any potential employer's standing within their industry. Solicit opinions from within your network as well as that of an executive recruiter. You may learn that it's better to be a top salesperson at an admired organization rather than a VP of sales at a suspect one.