Q.O. Friday
Volume 2, No. 1, January 29, 2005
Editor In Chief
Rebekah Rankin
RebekahFabulous@yahoo.com
Rrankin@Spheris.com
Featured MT
Catherine Steele
Winner of the 2004 HynesSight Humanitarian Award
Primary Account:Health Systems Minnesota -
Methodist Hospital section
Catherine Loves Spheris Because: I love working from
home! I was able to set my schedule to where I love
it! I work 6:00-7:30 a.m. then take my kids to school
and work 8:30 a.m. - 3:00 pm. M-F. I get a decent amount of OT offered,
and my paycheck always makes it to the bank when it is supposed to!
Catherine would like to see changes in: The pay plan what else :-) I
really think they need to give you some kind of raise each year for experience or
longevity or something.
Her MT History: I have only been an MT a little over 6 years. (I know, I
got lucky and "slipped through the cracks"). I taught instrumental and vocal music
in a Catholic school for seven years, then moved to a new town and taught at a
public school on year.. I pretty much burned out after teaching music for eight
years (the average "expectancy" actually of a music teacher although I thought
"it will never happen to me"). Then I had a 4 year old and a new baby and wanted to
be a mom but couldn't afford to be a stay at home mom. I searched the
net to see what legitimate work-from-home jobs there were - saw medical transcription
-- then just happened to look through a local community college catalog and
saw medical transcription courses. They were "independent study" and since I
wasn't employed and saw my last teaching check come and go I studied hard and I
did all my classes in three months. I only needed three classes because I had
already earned a bachelor's degree. Then I got a transcription/coding job
at a local hospital but had a horrendous babysitter so started applying for at
-home jobs. (When I did get a job from home I had a college-age girl come here
and babysit). The Edix recruiter misread my application that said "three
months on site experience" as "three years" but when he realized that was while I was on
the phone interview - I said "Give me the tests and if I fail hang up, but if
I don't fail you really should give me a shot". HSM was coming online and they needed
people to fly to Minneapolis within two weeks to 'clean up" the cassette
recorded reports. He gave me the job - I went to Minneapolis twice for a week each
time and did my "training" at home the week in between. I loved the
opportunity to actually see the hospital and clinics I was working for so I'm attached to
my account now and am having trouble wanting to move up a level to a new
account!
MT Personal Information: I pretty much covered that in my history :-)
It's kind of funny that Connie asked me to be the feature MT as I had just
gotten a call from my old transcription teacher - the college is featuring me in some
big newsletter so I had to answer a lot of questions for her too! :-) I love
volunteering and still like to teach (the good parts of teaching - not the "budget",
parents, kids who didn't want to be there, having to be at school from 7:30 a.m. to 9:00
pm because I had to have a pep band at a game or have musical practice
etc.). When I was teaching music - teaching music was my life (and I really loved
it before I had children of my own I wanted to spend time with).
Transcription lets me do my "job" 8 hours a day but then I have a lot of time to volunteer -
lead girl scouts, K4J (Kids for Jesus), teach CCD, the music coordinator at my
church,and spend time with my kids! I was just asked by my old teacher of
transcription to serve on the college advisory board to revamp their transcription
program!! I told her I would if she promised me her job whe she retired :-) (I did
tell her I was kidding - but she has been teaching there 35 years so she has to retire
sometime you would think!) Teaching at college and a transcription theme all rolled
into one... but man - they'll have to move the college here because I love
working from home!
Personal MT Goals: My goals are to hit 6200 lines/week consistently
without OT. Would love to hit 7,000 - I've done that once but it was with 8 hours of
OT.
Tips From Catherine: Samples, samples, samples and macro, macro macro!
Also productivy wise I've started "power hours". I saw that there are
some MTs who challenge each other - if anybody's interested I would love to! Right
now I try to do three "power hour-and-a-halfs" a day. A "power hour" is where you
do nothing but transcribe for an hour straight - no getting up to potty,
help kids, answer the phone, or check email or anything during that time period. Then
I give myself a 15 minute break and go at again. It's really helped me
focus and challenge myself!
Featured Account
HSM (Health Systems Minnesota - Methodist Hospital).
1. Do you feel you can obtain your minimum line count easily? Minimum
yes. My "goal" is to hit between 6000-6200 a week - which I can do depending
on how many op notes or consults and discharges I get -consults and discharges
slow me down.
2. Is there a high number of ESL's? There are a few -not too many and once
you get used to them if you have samples of them it's much easier. There are
couple ESLs who are actually easier than plain English ones as they slow down and
enunciate!!
3. Do you have a good help loop which you participate in and which you
find to be helpful? I have a loop of only about 5 people and only two of us that I
know of are on the same hours. We lost two off our loop in the new pay plan and I
guess I haven't emailed my sup to see who replaced them.
4. Is the learning curve for this account; easy, average, or
difficult;short, medium, long amount of time. I've been on this account so long I
can't remember! I do remember when I went from HSM clinics to HSM Methodist Hospital
it took about 3-4 months as I really didn't have much hospital experience in the
first place, but when I was looking around for level 7's to go from
hospital account to hospital account.
5. Do you have OT opportunities? Do you run out of work often? We have OT
offered a lot - sometimes mandatory although that hasn't happened since
the new pay plan. Last weekend they did limit it to 4 hours of OT but this Monday
morning I see our account is over 2000 again anyway (our goal is like 1500 jobs or
something before they declare OT). I can probably count less than ten
times in 6 years I've run out of work. Oh -- I did run out of work on New Year's day
and actually got to take 3 hours PTO! The supervisors are great about
putting you on a secondary (HSM is a locked account). The thing I don't like is the
few times Methodist Hospital has run out of work they ask me to do a secondary
clinic because we are locked rather than a different, level 7, account. HSM
clinics are level 5, Methodist Hospital is level 6.
6. Are the sound files of good quality? Yes.
7. Are the account specs easy or difficult to learn? DIFFICULT! Which is
why we are a locked account - the specifics are like a book or something. I've
been on HSM since I started - 6 years ago - so I lived through all the changes the
customer made which were A ton of changes. ... we used to have conference calls
nearly every week discussing the changes.. what a pain. I think the account
specifics are pretty well set now so if you join HSM now I wouldn't think it would
be as hard as it was in the early days.
8. What do you like best about the account? The doctors are in Minnesota
and quite easy to understand for the most part. I get a lot of really long
(like over 800-900 seconds) so I can really get involved and interested in the
patient and I absolutely love my hours and can't find a level seven with the same
hours open - and now with quantity bonuses the risk is even higher moving
to a new level I think.
9. What is most challenging? The account specs are probably the most
challenging.
10. If you could improve one thing on this account, what would it be? I
would put an extra supervisor on. Our supervisor is swamped so you hear from her
twice a day at the most most of the time.
11. What skills do you feel would be of importance to excel on this
account? Having lots of samples and macros.
Other Comments about _HSM (Health Systems Minnesota - Methodist Hospital).
- great account -- which is why I've been there so long and now kind of
"scared" to move to another level.
Remember to utilize
www.hynessight.com for
your One-Stop Internet
Spot! If you want to join
the HynesSight Yahoo!
Group, go to
http://health.groups.yahoo.
com/group/HynesSight/,
or email Connie Vance at:
vanceck@centurytel.net
WEBSITES
Spheris Anniversaries
Melissa Smith, 2 years
Connie Vance, 5 years
Wedding Anniversaries
Ada & Gary Stollsteimer
Feb. 12, 2005, 26 years
Birthdays
Melissa Smith, age 33,
February 5th
Announcements
We are the proud "parents"
of an 8-week-old German
Shepherd puppy. His eyes
are still blue, and he is the
sweetest! He joins dog
Annie and kitten Bob to
round out my household
zoo! I'll attach a pic of little
Ozzy, who was a
retirement gift for my
husband Gary from family
and friends. :) Ada
Stollsteimer
It is six months since my
separation, and I am
proud to say I have made it
through the last six
months successfully!
Melissa Smith:
Medications and Terms
Courtesy of MT Daily's
newsletter: New Terms:
Ada Stollsteimer
PhysAssist Sports Creme,
MiraCLEAR Skin,
LeukoScan, Ultra-Screen,
Scarguard ScarCare,
Navitrack
Navigation System,
VirtuoSaph Endoscopic
Vein
Harvesting,
3F Enable Aortic Heart
Valve
Production tips
TIPS TIPS TIPS
Catherine Steele: I love PE's
because if you have a sample
or a macro you can save tons
of keystrokes! A lot of doc's
have their standard routine
and you only have to change
the pertinent stuff. I have
macros that are "Pesmith"
(Pe plus the doctor's name)
and samples so I can speed
up production that way.
TIPS TIPS TIPS:
Ada Stollsteimer:Learn the
most common things that tend
to be dictated and makes
macros for these. Example:
LUNGS: Clear to auscultation
bilaterally. Your macro for
this could be lctab.
Additionally, once I've typed
for a doctor a few times and
I'm getting a feel for what they
tend to say, I save their entire
PE, usually one for male and
one for female, and use that
as a macro for that doc. You
can refine it as needed, and
it's a real time saver!
Featured Specialty:
Physical Examinations
Below are macro's for a simple PE gathered
from HynesSight members in the hopes that
we could pick up something useful from each
other . The translated "key" is the last one.
Physical Exam Macros:
Diane Rosen:
PE
GX Tpi an ao man in nadx.
vsx: Tempx is 98.4, pu is 70, res are 16, bpx is 124/80, 02 sat is
100% on ra, weight is 190 lbs, height is 5 feet 9 inches.
heent: Head is atnc. Perrlax. Sclerae anicteric. Tmsx are clear. Nose
is clear. Orop is moist wo exus and slightly eryt.
nk: Su, nt, frm. No la. No tmeg.
lx: Causb with nr excursion. No wherura.
htx: Rrr with no muruga.
abx: Sntnd. No hsmeg.
genx: Nr ma.
extx: No cce, 2+ radial and pedal pus bill.
neux: Ao3. Cn are grin.
Pamela Cox
PE:
GEN: Tp is an aao man inad.
[in no apparent distress: inapd.]
VSS: Temp is 98.4, pls is 70, re are 16, bpx is 124/80, o2 sat is 100%
ora, wt is 190 lbs, height is 5 feet 9 inches.
heent: Head is atnc. Perrlax. Sclani. Tmx are clr. Nose is clr. Orop
is moist wo exus and slty erys.
NK: Spl, nont, from. No lyy. No thyy.
[I use f for the word "from." Good range of motion: Grom.]
LUNGS: Ctab w norm xcrn. No whzs, rubs, or rales.
HRT: Rrr w no mrgs.
[Regular sinus rhythm: Rsr. Irregularly irregular: Irir. No murmur,
rub, or gallop: No mrg. No murmurs, gallops, or rubs No mgrs...
ABD: Snn. No hsm.
GENITALIA: Norm ma.
EXS: No cce, 2+ radial and pdl plss bily.
[No clubbing, cyanosis, or edema: No clce.]
NEU: Aao x3. Cran are grsly ict.
[neurological: neul. neurologically: neuly. neurology: neuy.]
Nancy Huffman
pexx
genxx Thp is an alor mn in nad.
visixx Te is 98.4, pu is 70, ress are 16, bpx is
124/80, o2 sat is 100% on roai, wt is 190 pounds, ht
is 5 feet 9 inches.
heent: Head is atno. Perrlax. Sclerae anic. Tmsx
are clr. Nose is clr. Orph is moist wo exus and sliy
erys.
nexx Supple, nont, fromx. No lyad. No thme.
luxx Ctab wi nm excursion. No wzs, rubs, or rales.
heaxx Rrrx wi no mrgs.
abxx Soft, nont, nond. No hsm.
GETA: Nm ma.
extxx No cce, 2+ radial and pepus bily.
neuxx Alor3. Cn2 are grint.
Catherine Steele
PHYSICAL EXAMINATION:
GENERAL: /t pt is an anox man in no acdis.
VS (my acc specs have a order for those we must follow
and the format pops up with this macro, then I just
insert the values). or:
Temp, pulse is 70, resp are 16, bp is 124/80, O2sx on
rair, wt is 190 lbx, ht is 5 ftx 9 inx.
HEENT: Head is atraum, normoc. PErrlax. Sclerae
anicteric. Tmx are clear. Nose is clear. Orop is
moist wo exudates and slightly erythem.
NECK: Supple, nont, full rom. No lymphad. No tmeg.
LUNGS: Clear to ausc bly w nml excursions. No
wheezes, rubs, or rales. (I have a wrr for wheezes,
rales, or ronchi though!)
HEART: Rrrr w no mrgs.
ABD: Soft, nont, nond. No hsmeg.
GENITALIA: Nml male.
EXTREMITIES: No cce, 2+ radial and pedpul bly.
NEUROLOGIC: Anox3. Cranial nerves II-XII are grossly intact
Angela Hardin
pe:
GEN: Tp is an aao man in nad.
VTLSNS: Temp is 98.4, pulse is 70, resp are 16, bpx is 124/80, o2s
is 1005 on rmar, weight is 190 pounds, heiight is 5 feet 9 inches.
HEENT: Head is atnc. Perrlax, Sclerae anicteric. Tmx are clear.
Nose is clear. Op is moist wot exudate and slightly erys.
nesu, nont, fromx. No lympha. No thyro.
LUNGS: Ctab wot nml excursion. No wrr.
HEART: Rrr with no mrgs.
ABD: Sntnd. No hsm.
GENITALIA: Nml ma.
EXT: No cce. 2+ radial and pedal pulses bll.
NEURO: Aaox3. Cran are grossly intact.
Ada Stollsteimer
PEX:
GEN: Tp is an aao man in nadi.
VSS: Temp is 98.4, pu is 70, resps are 16, bp is 124/80, o2s is 100%
on rair, wt is 190 lb, ht is 5 ft 9 ins.
HEENT: Hd is atno. Perrlax. Scla. Tmx are clr. Nose is clr. Op is
moist w/o exus and sly erys.
NCK: Spl, ntr, fromx. No ly. No thyy.
LUNGS: Ctab ww nl excu. No wrra.
HRT: Rrr ww no mrgs.
ABD: Sft, ntr, ndt. No hsm.
GENA: Nl ma.
EXTS: No cyce, 2+ radl and pepus bilat.
NEUC: Aao3. Cngi.
Yvonne Captain:
PE:
GEN: Tp is an ao man in nad.
VS: Temp is 98.4, pulse is 70, resp are 16, bp is 124/80, o2s is
100% ora.
Wght is 190 lb, hght is 5 feet 9 inches.
heent: Head is atnc. Perrlax. Scl anic. Tmx are cl. Nose is cl. Op
is
moist wo exudates and slightly erys.
NECK: Supple, nont, full rom. No la. No thyro.
LUNGS: Ctab wi nl excursion. No wrura.
HEART: Rrr wi no mrgs.
ABD: Sntnd. No hsm.
GENITALIA: Nl male.
EXTS: No cyce, 2+ radial and pedal pulses bily.
NIC: Ao x3. Cngi.
PE Examination Translated:
PHYSICAL EXAMINATION:
GENERAL: The patient is an alert and oriented man in no acute
distress.
VITAL SIGNS: Temperature is 98.4, pulse is 70, respirations are 16,
blood pressure is 124/80, O2 sat is 100% on room air, weight is 190
pounds, height is 5 feet 9 inches.
HEENT: Head is atraumatic, normocephalic. Pupils are equal,
round, and reactive to light and accommodation. Sclerae anicteric.
Tympanic membranes are clear. Nose is clear. Oropharynx is moist
without exudates and slightly erythematous.
NECK: Supple, nontender, full range of motion. No
lymphadenopathy. No thyromegaly.
LUNGS: Clear to auscultation bilaterally with normal excursion. No
wheezes, rubs, or rales.
HEART: Regular rate and rhythm with no murmurs, rubs, or gallops.
ABDOMEN: Soft, nontender, nondistended. No hepatosplenomegaly.
GENITALIA: Normal male.
EXTREMITIES: No cyanosis, clubbing, or edema, 2+ radial and pedal
pulses bilaterally.
NEUROLOGIC: Alert and oriented x3. Cranial nerves II-XII are
grossly intact.
Grammar, Punctuation, and Style
Per AAMT Book of Style
2nd Edition
Exam is an acceptable
brief form of examination
when dictated, except as
a heading. Do not use
the brief form if the
expanded form is
dictated.
Commas and adjectives
Use commas to separate
two or more adjectives if
each modifies the noun
alone. HINT: If you can
replace the comma
between adjectives with
and, the comma is
necessary.
Classification Systems:
Apgar score: Newborn's
condition rating pulse,
breathing, color, tone, and
reflex irritability, as 0, 1, or
2 at one and five minutes
after birth. Each set of
ratings is totaled and both
totals are reported.
Names after Virginia
Apgar, M.D. Do not
confuse with APGAR
questionnaire for family
assessment. Use initial
capital only. Express
ratings with arabic
numerals. Write out the
numbers related to
minutes, so that attention
is drawn to the scores.
Apgars 7 and 9 at one and
five minutes.
Ballard scale: Assesses
gestational age of infants
based on neuromuscular
and physical maturity.
Expressed in arabic
numerals. Scores are
converted to gestational
age in weeks: Score 5
equals 26 weeks, score
10 equals 28 weeks, 15
equals 30, 20 equals 32,
25 equals 34, 30 equals
36, 35 equals 38, 40
equals 40, 45 equals 42,
and 50 equals 44.
Catterall hip score:
Rating system for
Legg-Perthes disease.
Use roman numerals I-IV.
Decubitus ulcers:
Classified using roman
numerals from stage I to IV
Glasgow coma scale:
Describes level of
consciousness by testing
ability to respond to verbal,
motor, and sensory
stimulation. Each scored
on scale of 1-5, then
totaled. Glasgow refers to
Glasgow, Scotland. Score
of 3 or less is brain death,
score of 7 or less is coma,
score of 14 or 15 is normal
Trauma score: Measures
systolic blood pressure,
respiratory rate and
expansion, capillary refill,
eye opening, verbal and
motor responses on a
scale of 2-16. Predicts
injury severity and
probability of survival. Use
arabic numerals.
GVHD grading system:
Graft-versus-host disease.
Use arabic numerals 1-4
directly after abbreviation
or can also be written as
clinical grade 1-4.
GVHD1 or GVHD clinical
grade 1.
Harvard criteria for brain
death: In addition to body
temp equal to or greater
than 32 degrees C and the
absence of CNS
depressants, criteria
below must also be met:
Unreceptivity and
unresponsiveness, no
movement or breathing, no
reflexes, flat EEG.
Hunt and Hess neuro
classification: Classifies
prognosis of patients with
hemorrhage. Write out
and lower case grade; do
not abbreviate, arabic
numerals 1-4: grade 3
New Year Resolutions
Catherine Steele: Lose
weight. I've joined the
2424milk.com challenge -
have only lost four pounds
though :-) but I'm at least
trying!
Ada Stollsteimer: I have
got to start exercising, but
so far laziness is winning!
I'd also like to learn to be
less of a nag to my very
sweet husband.
Websites
Screening Physical Exam, Loyola University,
submitted by Angela Hardin -
http://www.meddean.luc.edu/lumen/meded/medicine/pulmonar/pd/contents.htm
A comprehensive physical examination and clinical education site
http://medicine.ucsd.edu/clinicalmed/eyes.htm
"Shipwreck's Go-By" Physical Examination Guide
http://www.vnh.org/Shipwreck/Shipwreck.html
Funnies &
Bloopers:
Subject: Medical Care
A woman brought a
very limp duck into a
veterinary surgeon. As
she put the duck on
the table, the vet
pulled out his
stethoscope and
listened to the bird's
chest. After a moment
or two, the vet shook
his head sadly and
said, "I'm so sorry,
your pet has passed
away." The distressed
owner wailed, "Are
you sure? "Yes, I'm
sure. The duck is
dead," he replied.
"How can you be so
sure", she protested.
"I mean, you haven't
done any tests on
him." The vet rolled
his eyes, turned
around and left the
room. He returned a
few moments later
with a black Labrador
Retriever. As the
duck's owner looked
on in amazement, the
dog stood on his hind
legs, put his front
paws on the
examination table and
sniffed the duck from
top to bottom. He then
looked at the vet with
sad eyes and shook
his head. The vet
patted the dog and
took it out and
returned a few
moments later with a
beautiful cat. The cat
jumped up on the table
and also sniffed the
bird from its beak to
its tail and back again.
The cat sat back on its
haunches, shook its
head, meowed softly,
jumped down and
strolled out of the
room. The vet looked
at the woman and
said, "I'm sorry, but as
I said, this is most
definitely, 100%
certifiably, a dead
duck." Then the vet
turned to his computer
terminal, hit a few
keys, and produced a
bill, which he handed
to the woman. The
duck's owner, still in
shock, took the bill.
"$150!" she cried.
"$150 just to tell me
my duck is dead?!"
The vet shrugged. "I'm
sorry. If you'd taken my
word for it, the bill
would have been $20.
But what with the Lab
Report and the Cat
Scan, it all adds up."
More MT Fun
Catherine Steele: I love
the chit-chat at
today.spheris - I've met
quite a few Nebraska
spheris MTs and we are
talking about having a
get together in the spring
- I think that would be
great to actually "Meet"
the people you work with!
Darlene Fletcher:
Just skim read you can
actually figure it out quite
easily.
I cdnuolt blveiee taht I
cluod aulaclty
uesdnatnrd waht I was
rdanieg The phaonmneal
pweor of the hmuan
mnid Aoccdrnig to
rscheearch taemat
Cmabrigde Uinervtisy, it
deosn't mttaer inwaht
oredr the ltteers in a
wrod are, the olny
iprmoatnt tihng is taht
the frist and lsat ltteer be
in the rghit pclae. The
rset can be a taotl mses
and you can sitll raed it
wouthit a porbelm. Tihs
is bcuseae the huamn
mnid deos not raed
ervey lteter by istlef, but
the wrod as a wlohe.
Such a cdonition is
arppoiately cllaed
Typoglycemia :)-
Amzanig huh? Yaeh and
yuo awlyas thought
slpeling was ipmorantt.
Darlene Fletcher:
The Washington Post's
Style Mensa Invitational
asked readers to take
any word from the
dictionary, alter it by
adding, subtracting, or
changing one letter, and
supply a new definition.
Here are this year's
winners:
Intaxication: Euphoria at
getting a tax refund,
which lasts until you
realize it was your
money to start with.
Reintarnation: Coming
back to life as a hillbilly.
Bozone (n.): The
substance surrounding
stupid people that
stops bright ideas from
penetrating. The bozone
layer, unfortunately,
shows little sign of
breaking down in the
near future.
Cashtration (n.): The act
of buying a house, which
renders the subject
financially impotent for
an indefinite period.
Giraffiti: Vandalism
spray-painted very, very
high.
Sarchasm: The gulf
between the author of
sarcastic wit and the
person who doesn't get it.
Inoculatte: To take coffee
intravenously when you
are running late.
Hipatitis: Terminal
coolness.
Karmageddon: It's like,
when everybody is
sending off all these
really bad vibes, right?
And then, like, the earth
explodes and it's like, a
serious bummer.
Decafalon (n.): The
grueling event of getting
through the day
consuming only things
that are good for you.
Glibido: All talk and no
action.
Dopeler effect: The
tendency of stupid ideas
to seem smarter when
they come at you rapidly.
Arachnoleptic fit (n.): The
frantic dance performed
just after you've
accidentally walked
through a spider web.
Beelzebug (n.): Satan in
the form of a mosquito,
that gets into your
bedroom at three in the
morning and cannot be
cast out.
Caterpallor (n.): The color
you turn after finding half
a grub in the fruit you're
eating.
New Years Resolutions
MT Fun
Game Links. Play word
searches, matching
games, chronological
games, etc..have fun!
Physical exams = http://www.quia.com/jg/592328.html
Cardiac Cycle Order = http://www.quia.com/rd/29469.html
Structure and Function of the Body = http://www.quia.com/jg/390560.html
A Nurse was
teaching a group
of Boy Scouts
some basic first
aid, when one of
them interrupted,
"Are you going to
teach us the
Heimlich
remover?"