A community of 30,000 US Transcriptionist serving Medical Transcription Industry

Not on the verge of crying, tears are pouring - nola

Posted: Aug 06, 2012

I have NEVER cried with a job before. Over 20 years in this world and it has finally brought me to this. A new QA/Team lead has now informed me that the specs are wrong and to do it like she says. Next problem, report had that a patient had her bags stolen from an airline. She had her "big bottle of narcotic pain medicine" in those bags. She called her pain management doctor as soon as she landed. He told her to go to the nearest ER. I could not make out the drug with 100% certainty, so I left a blank. This Team Lead filled in NSAIDs in the blank. I questioned this, because the last time I looked they were not a narcotic pain medicine. I was put over the coals and also black listed from that account. I questioned it again, about why would her pain doctor tell her to go to the ER to get NSAIDs?????? I was told that was what the blank was and that was why she had the position at the company she had. I have to finish my shift but I just needed a virtual shoudler....

I'm very sorry about your experience. I wish it were less - commonplace.

[ In Reply To ..]
I agree that the scenario makes it quite unlikely that the lost meds were NSAIDs.

But let's say that "NSAIDs" was dictated in error. In that case it should be left blank and flagged for risk management anyway, because NSAIDs doesn't make sense in this context. It's no different than if the dictator said the patient was given antibiotics and named Lasix among them. You would leave that blank and flag it because it would be nonsensical.

When I did QA, there were three things that I always tried to remember:

1. Everyone doesn't have the same audio setup, the same earphones, etc., and what I can hear you might not be able to hear (or vice versa) - but that's no one's fault.

2. Everyone doesn't have the same hearing, either. Age and many other factors cause changes in hearing that practically guarantee that my acuity isn't the same as yours.

3. These digital files travel many hundreds of miles across not only wire but also fiber and other media. This can degrade my signal differently from your signal.

Fortunately, I was in a position to fire a QA person who was unwilling to take any of these things into account, and I believe she went on to become a professional nitpicker.

Or perhaps it was nose picker. I can't recall.

Oh, Nola -- I sympathize. - (see message)

[ In Reply To ..]
Some people just don't use the brains that the good Lord gave them!! As the second poster in this thread said, "IF" the dictator had indeed or clearly said "NSAIDs" by mistake (which we all know COULD happen), it should definitely have been left blank and flagged as "Doc: please double-check this word!"

I miss the days when we longer-term MTs, who are, by virtue of the job's difficulty, generally quite intelligent, were allowed to use our brains, common sense, and years of experience to do what we KNEW was a good job....not constantly trying to second-guess what the QA person will THINK is correct or incorrect.

One of my coworkers had QA mark an error on an op report: QA said her "Pean clamp" was incorrect--changed it to "peon clamp" and sent it to the client that way. My coworker spent WEEKS trying to get her manager to fix QA's error in her record (probably more the principle of the thing than anything), and I don't know if she ever got them to figure out that QA had it not only "wrong" but probably made the MT look "dumb" in the client's eyes.

Oh, heck...who am I kidding? I don't suppose the client even noticed. But, the point is also that any THINKING person should have realized that a clamp called a "peon" wouldn't make sense; and a patient needing to go to an ER to replace their "big bottle of narcotic NSAIDs" doesn't make any sense, either.

((Nola)) -- hugs! :-) I feel your frustration!

OMG - Here's what you need to do. - mt

[ In Reply To ..]
DOCUMENT all of the above. Print the email from her. Print out the job with the blank. Keep all of that to cover YOUR butt with the client. Now to the crying part, I've been there. I have never had such depression/anger over a job in my life. I had a meltdown 4 weeks ago. I walked away from the job for 2 weeks. No one ever contacted me, so knowing I was not eligible for UE, I logged in 2 weeks later and went to work. LOL! That's because my company has a resolving door and they need everyone they can get.

Just log in, do your job, log out. Print out everything from TL and QA people. Verify for UE. LET THEM FIRE YOU. In the meantime, if you are not happy there, start job hunting. That's what I am doing. This time, I will not take just any old job either. That's how I ended up where I am today.

I've been a MT for close to 30 years. I don't care if I find a job answering phones, ringing up customers, typing, just enough $$ to pay the bills (husband has income, thank God.)

Keep your chin up. Do NOT let these companies break you down. I found it is now worth it. WE are worth more than that. Life's too short. Like the song says - be happy !!

Resign or get fired.... - Molly

[ In Reply To ..]
Could this be Transcend/Nuance. This just happened to me. I have all kinds of printed letter saying what a great job I am doing but I can't seem to pass a QA at 98%. I was told I could have 5 probation jobs a day for x3 days and then if I did not achieve 98% I was fired. They kept with the "resign" or take the probation thing. Would not lay me off. I have been doing this 30 years, 6 years with them. I was going to push for unemployment but I seriously lucked out and got a job the very next day. So glad to be out of that stress. Either your work is no good or your to slow and not making what they wanted you to make. Finally feel like I am in a happy place.

Resign or get fired - see msg

[ In Reply To ..]
I agree with Molly on finding a new job; however, I would have stayed on for the 5 probabtion jobs a day so they could fire me. That is their way of getting out of paying unemployment - Either you quit or we starve you to death because 5 jobs a day = No pay check and whose gonna stick around for that?

I would have called their bluff, meanwhile sought out an IC job (as there are many out there these days) and continued on with the 5 jobs a day until they had no other choice but to fire me, then I would have collected UE. Totally unbelievable they did that to you!

Nola - beaten down

[ In Reply To ..]
Nola - the TL should be fired for this stupidity. I would start looking. There are a lot of MTSO companies out there and really some are not that bad, but whoever you are working for, is bad. So sorry this happened to you. Best of luck to you moving forward.

Well, the sun's up again and presumably things are - feeling better? Good girl. Pull your

[ In Reply To ..]
big girl panties up and forget about it (after documenting, of course). Your competence will be questioned again at some points in future, and it's entirely possible that you will find yourself under attack for no seeming reason, so now's the time to decide to bring your competence to those situations--by being strong and acting responsively and decisively. Often that does mean doing nothing at all. In any case, every job involves a person with coworkers who are wrong, incompetent, dishonest, and sometimes specifically vicious. Recognize that and do not allow them to hurt your feelings or your job.

So sorry, similar experience here - anon

[ In Reply To ..]
I was typing an ER report, a patient in their 20s in for abdominal pain and workup for that. In the labs was a clearly dictated hemoglobin of 4. Nowhere else in the report was ANY mention made of anemia or need to work up that value. Hematocrit value was not given. I flagged it and was also raked over the coals because it was very clear that was what the doc dictated.

I am almost done with my classes to be done with this profession!! Enough is enough!

AGREE - Document Everything (see message) - StoicMT

[ In Reply To ..]

Document everything, particularly QA related issues. I have found this is extremely important especially regarding any “questionable” issues that arise throughout my work as a MT/ME (20+ years experience) – and personally I have developed the habit of documenting everything. Some times, though, I feel that my integrity is being questioned -- but I do not want to automatically become defensive. The saying goes: The best defense is a good offense. So yes, I document everything.

For example during the early stages of my work as an MT my enthusiasm to learn terminology was matched perfectly with the QA staff checking my reports, and they were very beneficial with helping me understand what I needed to know in order to improve my skills and learn the medical terminology necessary for the job. But that is my story and of course everyone learns differently.

Also, later on during my MT career I remember situations where a report of mine was corrected by QA and I was accused of doing things that I know I did not do – such as sending a report directly to the hospital, and later the client complains, then I get blamed for something that was actually incorrectly done by the QA staff on my report. Of course, once I got “the e-mail” from management blaming me for the error, I could no longer go back and verify by re-listening to the audio file (which was no longer available). But I had already documented what I previously anticipated would become a problem down the line and I was adequately prepared to respond to management.

Bottom Line: I learned to anticipate problems that may arise. Document everything. Experience has taught me to literally “be on the lookout” for any problems that could arise down the line. Then I would have already documented what I needed to provide evidence to support myself, just in case I needed it at some point in the future.

These are some of my personal coping skills – and so that I would not have a nervous breakdown involved in any work place environment that could potentially drive me to tears (and I have also felt like crying on some days) because it does become frustrating, just like a lot of experiences from the MT's described here. My heart goes out to anyone who has to experience something so horrible that brings you to the point of tears as it relates to doing your job. The reality is that it happens – and I personally have learned the value of documenting everything to protect myself!!

Who are these companies? - CTMT

[ In Reply To ..]
This is why they lose accounts, I would look for another job, they don't deserve good people that care.

NUANCE - KK

[ In Reply To ..]
I'd bet anything!

Wow, blacklisted - for questioning

[ In Reply To ..]
the blank? That's incredibly punitive, not to mention fostering an environment that discourages critical thinking. So sorry you went through that.

why it was NSAIDs - just me-chronic pain patient

[ In Reply To ..]
Because emergency rooms hate us chronic pain patients and do not refill our lost medication at the emergency room. The doctors just say that to avoid confrontation and a scene.

As for QA, please read each email with a positive attitude. They are only trying to assist you. Everybody takes QA so personally. Yes, I too have been there when I had a QA that was a nightmare and feel for you (she would mark items incorrect and therefore I would be charged $1 each for finding something a certain way in some obscure book and not the reference material we were instructed to go by). Heads up....Good luck.

I don't understand, Chronic Pain Patient... - (see message)

[ In Reply To ..]
....do you mean that you do have to actually go to the ER to get a Rx for NSAIDs?

Do you mean for prescription strength or something? I guess I hadn't thought about that....thinking someone with chronic pain must have to have something stronger than NSAIDs. If someone takes 800-mg ibuprofen, can't they just take four 200-mg OTC tablets? or is that not the same effectiveness?

chronic pain patients in the ER - just me, chronic pain patient

[ In Reply To ..]
No, the emergency room physicians WILL NOT replace lost narcotics. The physicians just say to go to the emergency room to cover themselves. The emergency room physicians will just say too bad and tell you to take over-the-counter medications and call your doctor. I know. My medications were stolen from me (including 80-mg OxyContin). As if over-the-counter medications will even help... Jeesh...Ended up entering another clinic, as my doctor prescribed methadone to replace the lost medications (which cardiac patients cannot take and I had extreme chest pain). Emergency room physicians absolutely hate us chronic pain patients...

Boy, are you way off. NSAIDs are not "narcotics" as clearly - stated by the OP.

[ In Reply To ..]
Furthermore, I must beg to differ with you that "QA is only trying to assist you". This particular QA certainly was not in an "assisting mode", and unfortunately many QA's are not properly chosen for their "helpful" characteristics.

Not assisting at all - nola

[ In Reply To ..]
Back in the good old days, I was also a QA. This Team Lead was on a power trip and because I questioned the whole sense of the paragraph with NSAIDs, I was in the wrong. However, have interview with a new company now. Keep your fingers crossed.

NSAIDs and narcotics-losing prescriptions - just me

[ In Reply To ..]
As I stated earlier, emergency room physicians WILL NOT REPLACE NARCOTIC MEDICATIONS the patient lost. PERIOD. In fact, the emergency room physicians are very rude to us chronic pain patients. Every patient in a chronic pain clinic is given an opioid contract clearly stating this. You are responsible for your medications, and they will not be replaced whatsoever. If you are lucky and have never had issues before and are in certain situations, they MIGHT put you on another narcotic medication, such as Duragesic patch or methadone but only after being seen personally in their office and your case thoroughly reviewed. You can also face arrest and/or being discharged from the clinic and certainly being reported to the powers that be (our state has several regulatory boards for narcotics). They simply tell you too bad, take Advil or whatever, and now get out of our emergency room (this when my blood pressure was 260/140 from pain).

I am not only a chronic pain patient who had my medication stolen but transcribe for numerous pain clinics.

When that happened to me, I SHOULD have cried! - Instead, I lost my temper and -S/M

[ In Reply To ..]
hauled off and punched my PC tower. HARD. Hard enough that it started making funny noises, turned off, and then back on, and then died. The repairs cost me 2 days' work and $400.
I guess it could've been worse. I could've broken my hand.

Stupid computer. Can't even take a punch.

LOL! S/M, I feel your pain. I have wanted to do that myself! - no message

[ In Reply To ..]
s

Nola, one day it is going to be too bad, so sad.... - sm

[ In Reply To ..]
When your MTSO has black-listed too many MTs for this kind of "mistake," and they have no one else to transcribe/edit on the account except newbies, India, or QA. I am all for QA catching mistakes and bringing it to an MT's attention, but you did not make a "mistake," you left it blank because you were unsure. What if you had put NSAID and it was wrong? Your way of thinking was totally logical. At least you were thinking!!!!! And that says a lot in my book!

Agree, NSAIDs are definitely not narcotics. She could - have purchased those at Walmart.

[ In Reply To ..]
nm

NSAID narcotics - On site MT

[ In Reply To ..]
I don't know the entire story here, but actually there are NSAID narcotics; Percocet is one that comes to mind (acetaminophen and oxycodone).

Yep and another is vicoprofen. nm - just me

[ In Reply To ..]
xx

The emergency room is NOT going to prescribe narcotics - just me

[ In Reply To ..]
Read any form from a pain clinic, and it clearly states no replacement. The physicians instruct the patients to go to the emergency room only from a legal standpoint to cover their butts, knowing full well those emergency room physicians will not replace those medications. No Vicodin, vicoprofen, or anything else, just tell you to try over-the-counter NSAIDs, not even prescription strength. They do this even when the amount of narcotics prescribed is high enough to cause significant withdrawal when stopped abruptly. They will usually prescribe something to help with that, but that is it and even if they have spoken with your pain physician.

Tears are pouring - QA

[ In Reply To ..]
As a QA person I have to say we are human and make mistakes too. However, not being willing to admit your mistake is incompetance. The comment "thats why I have this position" is disrespectful. I have made errors like this and been called on it by an MT and I admitted it was my mistake. Now I am very careful when an MT leaves a blank that is clear and go looking for the why. I respect the MTs as most of them are very good. We all make mistakes sometimes (even QA), even the very experienced MT. We are all humans and deserve to be respected. This was not your mistake but the QA person. I agree with just documenting it and going on. You did the right thing, if she cannot see that then that is "her problem". It really bothers me the lack of respect given to MTs now. Hope your day gets better!

QA - just me, chronic pain patient

[ In Reply To ..]
A very nice comment from QA.

I would definitely take what they say with a grain of salt and read the QA feedback with a smile on your face regardless. Some have more tact than others. Sometimes feedback can be taken incorrectly on both sides, but think of it as a learning experience, and if you have problems, report it to her boss (something I repeatedly did at one company I worked for). Her manager saw it for what it was--a personal thing against me... Gosh, I hated that job worse than anything, so I can relate to how you feel. Thank goodness I do not have to deal with that anymore, as I have my own accounts again.

I think what you stated is what makes good QA - sue

[ In Reply To ..]
When something is clear and there's a blank, there must be a reason. I had something dictated very clearly, a med and a dose which did not fit at all. I left a blank. QA filled it in as dictated. I could have left a note as to why I left it blank, but I figured QA would have questioned it as well, but I was wrong.

Another thing that makes good QA is looking something up before changing something MT typed. I've reseached things extensively because I wasn't sure, only to see they've been changed because that's what the QA "thought" it was without checking it out.

Your post was very nice :-)

QA and such... - just me, chronic pain patient

[ In Reply To ..]
Yes, some QA definitely have more tact than others, something I do lack and call my feedback simply "notes," acknowledge when something can be transcribed either way and do not EVER charge the MT for a blank. I hate those companies that do. As for your blank, how were you to know it was NSAIDs, which with me specializing in pain management and being a chronic pain patient, I definitely would have flagged prior to my own incident.

When I QA behind MTs, I (a) know they do not have the audio-enhancing equipment I have (although I offer to provide it) as well as the experience I have with the accounts and (b) realize sometimes we just have plain brain farts for lack of a better term, and (c) do know there are several ways to transcribe the same info. I know most try,. It is when they email me stating it is not their job to look up a term or (yes, this really happened) not their job to transcribe a report that burns my britches.... Other than that, because I transcribe myself, I always say what a great job they do... even when they leave blanks... I would rather have a blank than incorrectly guessing. Trust me, I have had several reports on my desk where dictation and transcription do not even match... one even pasting part of an orthopedic sample onto a breast cancer removal report. Dah............

Thank you - nola

[ In Reply To ..]
Thank you. We all make mistakes!! When I was in QA, I always looked on it as a learning experience. I make mistakes as everyone else does. The whole problem with this situation was patient care. That is what I thought we did or tried to to with this voice rec stuff these (which is what this report was). Your comments reminded me of how things used to be and I smiled..

Awful - Lynda

[ In Reply To ..]
This is a not right at all. It is like they don't care what they put in the report. I worked in house and came across a note that had contraindications on the med list vs allergy list and no one cared. They expected me to leave it as dictated. It is as if I had to compromise my professional integrity. Needless to say I don't miss that job at all.

That's too much confidential info to share with us or anyone else - nm

[ In Reply To ..]
nm

Similar Messages:

Dec 17, 2009

Several weeks ago, received an e-mail from my CCM, stating that all reports that had gone through the offshore MTs on a particular account had to be 100% QA'd voice to text. First off, this report had gone through an offshore MT and not one but TWO offshore QA and now has to be 100% QA'd by a US MME on top of it and all changes have to be documented for an audit. This has been going on for several weeks due to complaints from the hospital on the quality ...

May 06, 2015

First job of the day. Shoot me now. Too old to be crying....especially by some jerk. What's WRONG with people? Can't even say their name. Have to bark it out and stumble over it 3 times...and it's their own frickin name. And they can only hold the mike under their chin....UNTIL that they have to cough. Oh yeah. Make sure you get that mouthpiece right up there, buddy, for the cough. And your d*mn cell phone is ringing! Aga ...

Dec 02, 2009

My entire "pool" is completely and utterly out of work. My sup emailed today saying we could plan a day off if we wanted. Before you say it, I KNOW this time of year is feast or famine, don't need to tell me (I've been an MT for 15 years), but this is ridiculous. Its been slowly dwindling since late summer where I was scrounging around for ANY SHIFT that would provide me a few lines, now its NOTHING. I have a backup job that is also empty, but for a company (MQ) that ...

Dec 04, 2014

Just so sick of the run-around by Nuance and the crappy speakers. Feel so trapped. ...

Jan 26, 2014

I hate this new job so much and yet I have to work. Can't survive on Social Security. I was so relaxed and calm on my days off and now that I'm back to work, I'm in tears again. There is way too much "computer crap" for me to learn and I am just so frustrated. MT has turned into a computerized nightmare for me and I'm sure a lot of other old MTs as well. My transcription QA has been 100% so there is definitely no problem with knowing how to do transcription ...

Feb 27, 2014

Tired of bouncing around. Been an MT for 30 years, 58 years old, last company I was with thought I would be there for at least until I retired, but kept running out of work, and there was a lot of mandatory overtime when the work did build up, and there was no flexibility when it came to vacations and off days. I started with a company and this is my last week of paid training 12 DPH. The pay is good, but they do not pay me for spaces (I knew this when I hired on) but thought I would give it a ...

Jan 25, 2011

I am level 3. I have been typing report after report for the worst doctor on the planet (not English of course). I have lashed out at my daughter, sent her a text to school apologizing, and now am in tears. I only want to work and make a decent wage. This has become so stressful and impossible I am just sitting here crying. Please no flaming today -- I look all the time for something else, have applied, interviewed, etc. When you have done this ...

Sep 21, 2011

So, decided to rip the band-aid off early and check on my paycheck in Ultipro. After deducting my pto pay and using actual hours, production pay, Now at just over $8/hr. There was a day I made average $15/hr, and I was one of the slow, meticulous ones. Really not sure why I put myself through this pain but it renews my resolve every 2 weeks to get out of here. This working 3 jobs is slowly killing me, and so tired of working until 10 o'clock at night. And like so m ...

Nov 04, 2009

After using ExText speech for a couple years, I'm now having to learn Escription. Either I haven't had the right training or I just can't get with it. It doesn't help almost all the work is regular transcribing either, then a speech document, then back to regular transcribing. I so looked forward to Escription but the keys used are quite different from ExSpeech, and so far it's been a disaster. The red cursor box: How do you make changes to a word that's wron ...

Feb 11, 2011

I really had hopes this payday after really pouring it on every shift, adding to expansions every shift, using all the "handy hints" they gave us. Still not cutting it. Please God answer my prayers and get me out of this stress factory. And God, if it's not time to get out of here, please, oh please get MQ to do the right thing and "fix" ASR. Don't make us keep changing dangerous abbreviations. Don't make us keep fixing "headings" that were not dic ...

Feb 19, 2014

the stress of having to work under these conditions for pretty much peanuts. I don't know how much more I can take. ...

Apr 14, 2015

Have you ever had a patient's report bring you to absolute tears? I've been doing this for nearly 9 years and this if the first time this has happended...wondering if this job is really starting to get the best of me? ...

May 19, 2010

nm ...