A Matter of Perspective
I love to toss off the headset and get a change of scenery, and find myself occasionally rummaging around other Advance boards to see what's up (did you even notice they've got like 243 magazines skewed toward different areas in health care?) Lately, we've also been getting crossover blogs here and as usual, I've found a way to pretty much ignore the gist of them and ponder parts the author undoubtedly never intended.
Since the dawn of time (or at least the advent of the necessity for a medical record), medical transcriptionists have apparently gotten no respect. We always hear tales from the veterans how over the years, MTs have been nudged out of the office to unobtrusive areas of the hospital--say some utility closet or next to the morgue in the basement--until finally, they have found a way to get us out of the building altogether, just a virtual cog in the documentation wheel. Bless their hearts, many practitioners do still recognize that there's a person on the other end of that phone when they're dictating a report and toss us a, "Thank you very much for transcribing this dictation," or if we're lucky, an aside to crack us up but for the most part, we're a nonentity. Out of sight, out of mind. First to suffer in a budget cut, even though we're volunteering free office space and are subject to third-world pay scales already. I can almost guarantee that even the most considerate dictators don't give us a second thought as long as the system is working properly. We are persona non grata. No one wants to give us our due, few Americans even want to be us anymore, and they certainly aren't creating fascinating characters in teevee shows based on us. The closest I've seen to a medical record on the tube are those haggard residents slaving over charts in the locker room at the end of their shift--never dictating, never by a computer, but always a mountain of paper and a pen. Hollywood doesn't have a clue where those charts come from.
On the other hand, just look at nurses. Yeah, they're the ones getting stuck with the crap work but thanks to television, we see them as kind of glamorous. They're key characters. They're in the trenches. In the TV world where the maternal figure is always the smart one and the paternal a bumbling dork much of the time (what's with that, anyway?), nurses are often the ones who save the day, keep the overworked doctor from making a colossal mistake, and advocate for the patient. Yeah, those nurses on ER were always striking and complaining about the lack of respect they got, but it was obvious who was the backbone of the hospital. And besides, they wound up with all the cute doctors and cops, to boot.
So here's Lyn McCafferty and her HIPAA article. Of course, I grok the gist of the story and share her dismay at the violations. I'm always astounded when someone tries to profit personally from things we're sworn to keep private. We can see patients' personal information, financial information--SSN, home address, phone numbers, family members--and it's never occurred to me to abuse that. I've transcribed a respectable number of celebrity reports and aside from a brief flash of sympathy (a hospital stay is a great equalizer in the scheme of things and celebrity doesn't count for much when it comes down to it) I transcribe, send it off, and a day or two later, most likely can't even remember who it was. I'm not sure if that's just me or one of those things that happens to MTs because we're already so disjointed. (MT necessitates operating at least a day in the past most of the time--add in the graveyard shift and I usually can't even tell you what day of the week it is.) Maybe I'm just not easily impressed because SW Florida is where so many celebrities choose to get away from it all and I have yet to be impressed with one. Maybe it's just that I've never been interested in celebrity gossip or fandom. I see a report of some MT trying to hold records hostage or a nurse sacrificing her career to jump on the bloated media bandwagon and claim her 15 minutes and it just makes me marvel. . . How does it even occur to someone to do this stuff? All those years I fancied myself a rebel down the tubes--I apparently lack the gene to become a legitimate bad girl or criminal.
All of this is digression, though. What really struck me about Lyn's blog has nothing to do with HIPAA. I got stuck at her very first line. Nurse Jackie is bad for Nursing's image? I love that show! One episode in and I was kicking myself for not taking advantage of the free tuition when I could have gotten my BSN because it is so obviously where I belonged. Mean and quiet--those ARE my people! As a non-nurse, I think she's a great poster child--well, aside from the Percocet and infidelity, which I chalk up to just being a well-rounded character. This is teevee, after all. As a nurse, though, she's what I expect. She's the one who makes a connection with the patient. Under the crusty exterior, she's sympathetic when it matters. I've had nurses just like her--the lady who came to massage my back and keep me company in the middle of the night, the nurse who recognized my son's life was in danger if someone waited until morning to take him to surgery, the woman who drug me into the nurses' locker room for a shower, a meal, and a nap when I'd spent days at his bedside, and the nurse who winked over the shoulder of an egotistical surgeon to let me know someone had a clue and was looking out for me.
If you ask me, MTs could stand to have such a sympathetic representative to lend us a little respect. Maybe if House had some gnarly advocate down in the basement trying to make him look good on paper, he wouldn't always have that stack of old charts dogging him--and maybe MTs wouldn't be the the red-headed stepchildren of the healthcare process.