Wednesday, April 29, 2009

Nameless and faceless.

I've touched on these topics before. but obviously no one reads my blog or cares what I say. I'm alright with that, I think. I keep reading ridiculous comments about the things that the lab does to mess with a nursing staff. I think I need to reiterate a few things.

1. Yes, we make mistakes, no we're not trying to fuck you over or do we ask you to do anything out of spite. It's just not worth it. If we get caught, we're generally not highly valued and will be replaced.

2. I can shake the ever loving crap out of a PT/PTT for a straight year, and it won't cause it to clot if the specimen was drawn correctly. Along those same lines, dropping it won't do anything either. It's not my fault you can't draw blood correctly. Reference This Post.

3. A specimen being hemolyzed isn't a bullshit excuse not to run a test. I'll remind everyone that most chemistry analyzers work on the basis of Spectrophotometry. Can we all see how a bright red color could effect results. Also, it's a good overall indicator of specimen integrity.

4. Vacutainers are made of hard plastic and don't break. We didn't break your specimen. Contrary to popular thought. It's MUCH MUCH easier for us to just run a specimen and not call and have it recollected.

5. Most chemistry analyzers run microassys that require a little more tha 100ul , Vacutainer tubes have a lip on them, if you were to somehow knock over a uncapped specimen, despite all of our automated safegaurds, they're designed to leave about 5oo ul in the tube anyway. I'd have to turn a tube upside down and shake it in order to spill all of it.

6. If something does need to be recollected because there isn't enough in it, it's probably because the first run gave us poor results, whether because of a bad stick, or because of analyzer error. that's why Sometimes you can send underfilled tubes and "cover it up with a label and we'll never know."

7. As much as I'd like to do shit to spite some of you, I can't afford to, The nursing staff is always the squeaky wheel that gets oiled. We're always the one that has to adapt to the nursing departments because you have many more employees. I've come to terms with it.

I realize that it's easy to blame the lab because we're nameless, faceless "robots idiots" and frankly I'd do the same thing if I did patient care, and I was the one that had to stick a patient again. Frankly, I'd find anyway I could to blame nameless people that make me look better, I get it, but I don't understand getting on the internet and acting like you really believe the stupid ass conspiracy theories and then spreading said theories. Oh well, maybe I should be the squeakiest wheel.

Tuesday, April 21, 2009

Off The deep end.

Yesterday was my 100th post and I didn't even realize it.... not too good considering I've been around for about 2 years now. that's almost one per week.

Anyway, I realize that I talk about how much I hate my job and my boss entirely too much, but yet again, she amazes me so I have to share my thoughts and feelings to keep from donkey punching her. I'm convinced she's not naturally mean spirited, just too dumb to know she's being a bitch.

I think the issue that she and I have is that she views my kindness as weakness. I'm a much different person today than I was just a few years ago. I've beaten a man with a baseball bat to within an inch of his life, I've pointed a rifle and fired at someone with the sole intent to end their life, I've destroyed peoples lives with malicious intent. If I were me three years ago I would have her cowering in fear, crying in a corner of our lab curled up in the fetal position. She's lucky I'm not that person anymore.

One of my personality flaws is that I can take a little thing and blow it way out of proportion, and I can take perceived slights to heart. One small issue can ruin my whole day/night. I shouldn't let it, and knowing that I can recognize that in myself, I really should do something about it. Too bad I can't seem to.

I'm sure you're wondering exactly what happened and I'll tell you. Our ER has a habit of screwing up orders, they'll cancel the wrong tests, order the wrong test, cancel things, and reorder them, then just send down the mess to us to figure it out. Just so you know, we don't have a magic box that tells us what you want regardless of what you think. So we got sent down two requisitions, one had several tests and the other had two tests that were also included on the first set. Our specimen processor decides she can discard one of the reqs because it had duplicate orders on it. The only way for me to know to look for a test or to make sure it's running, is if these tests get logged into our lab, it's impossible to look up every single patient individually in the computer and ensure things are correct. Well, the ER decided to cancel the duplicate orders on the original req, but still include it in what they sent down, and then reorder what they wanted. so basically it was a mess that didn't get dealt with to their satisfaction, the tests they originally cancelled didn't get completed because our specimen processor decided to discard what she thought was an extra label.

The patient's testing was delaying, and surely her dispo as well, you could probably logically conclude that fault could be divided equally be between the ER and our processor. That is, if you're a normal person, not my boss, She pulled me aside and tried to lecture me about ensuring I complete all tests yada yada yada.... making zero sense. All I could do is walk away. She has a tendency to "correct" me because everyone else on my shift at some point in time has blown up at her, I guess she figures since I haven't yet that I must be weak and that I won't stand up for myself. Frankly, like everyone else in this economy I need my job but I wonder how much bullshit I'll deal with before I tell her to fuck herself.

Monday, April 20, 2009

Good for miss California

I was reading a Story about miss California on Foxnews. and evidently she's being lambasted for giving a decidedly non-pagent answer to the question "Do you believe in gay marriage." Her view isn't exactly in line with what I believe but I applaud her for having the guts to say what she feels is right, and to do it on a national stage in front of an openly gay man.

Too many people forget that free speech, or any amendment for that matter doesn't just apply to the minority or the people that feel they are oppressed. Free speech is universal. Carrie Prejan thank you for giving an honest answer and not being afraid to voice your convictions.

"We live in a land where you can choose same-sex marriage or opposite. And you know what, I think in my country, in my family, I think that I believe that a marriage should be between a man and a woman. No offense to anybody out there, but that's how I was raised." These are the words she spoke and these are the words that everyone should feel alright saying if that's what they believe. Who cares if you don't agree with her, she has to listen to the crap that liberal jackasses spew everyday, and it's okay because they're "oppressed". Screw them.

My personal opinion is that the government should have no place in deciding civil unions, and that every couple should be afforded the same civil liberties/opportunities regardless of your sexual preference. However, In terms of a religious ceremony I believe that marriage was intended as as a union between a man and a woman, the only combination capable of procreating. Child birth is a miraculous thing and is afforded to a couple that is a man and a woman. Before calling me a hypocrite notice my use of the word "civil union" then marriage.

I think part of the reason I'm getting upset about this, is that for the last five years or so I can see America sliding in a direction of hypersensitivity and being overly politically correct. Remember that a democracy is majority rule. while protecting just three natural rights life, liberty and the pursuit of happiness. Pursuit of happiness is admittedly vague, but I hardly think it includes being free from hearing any criticism at all. I'm all about protecting physical definable rights of a minority group, but they shouldn't be free from opposing viewpoints simply because it's not popular in the media or in hollywood. I'd be willing to bet her view is much closer to societal norm than the other side whether you admit it or not. We were founded as a christian state, and our laws and values are all based on judeo-christian principles.

Btw, screw you keith lewis, no one cares how sad or hurt you feel because a young woman stood up and instead of giving a retarded pagent answer to a question, she had self-conviction to give a true representation of her feelings. How can he possibly try to say "religious beliefs have no politics in the Miss California family." She was obviously baited, why even ask the question? If they thought the answer was so egregious why did they ask such hotly debated question. I'll tell you why, they expected to hear this lovely young lady give the politically correct pageant answer to give further clout to the idea that gays should be allowed to be married, ya know, just in case she won. Even miss america thinks it's okay, so it must be. Shady bastards.

Where are all the boos I heard so much about????

Wednesday, April 15, 2009

Response to Nurse K

I was reading Nurse K last night and found myself leaving a comment about a post concerning a dumb lab tech that turned into a mini post so I figured I'd just write it down here, where no one will see it.

I've been an adamant supporter of my fellow lab workers online. I'm done with that shit. I'm finding out that my little corner of lab heaven doesn't exist everywhere else. I'm knowledgeable, have good social skills, and have common sense. In general, you're lucky to get an average lab worker with one of these skills. You could be a serviceable Med tech with only the ability to maintain an instrument and follow a flow sheet telling you what to do in certain situations.

The reason I'm giving up on my fellow lab workers is simple, they're pissing me the eff off and I'm running out of excuses. Some of the silly shit I hear from other places and even from transplanted coworkers is ridiculous. we have strict time limits on completion times from the ER so I've had a hard time listening to people say it takes hours to get results or that techs make up random excuses as to the whereabouts of a specimen. We have 15 min for an ER CBC, 30 min for a BMP, and 45 for a CMP. Every specimen is tracked and you can face disciplinary action for not having a plausible reason for taking longer (ie documented instrument failure). I guess in smaller rural areas things like this are real concerns, you can't exactly afford to hire the best and brightest they get a lot of bottom of the barrel employees.

The second issue I have is with older techs that are generally full of shit, back in the day a medical technologist was well respected and testing was complex. Some people can't come to the realization that a new analyzer and a relatively bright high school grad could do their job. They think too much of themselves and their skills. They try to maintain that their jobs are still complex because they lack the computer skills essential to succeeding in our job market. in Ten years a lab will be run by 1 med tech with the background knowledge to maintain QC and QI records and everyone else will be a high school grad running a computer that won't make judgment calls. They will follow a flowsheet made by someone with real experience and pass along issues to people with real knowledge.

I've already begun to prepare myself for changes. The only real way to demonstrate our usefulness will be through management or mechanical skills. As of now, you still need some basic knowledge to do your job well. in five years, maybe not. I've started taking classes in engineering, if you can start making medical technologists take engineering classes so that they have a better understanding of how the analyzers they use work, you may be able to maintain the usefulness of a med tech. Administrators will certainly see the value of not having expensive service contracts because of the new found engineering knowledge their techs will have.

I promise there are a few good med techs left that really have a good understanding of what they're doing, have the social skills, and the common sense to do our jobs well. Unfortunately the number of us are dwindling. A perfect example of this, was a conversation I had with a tech at a smaller hospital within our network concerning some FFP.

The tech called asking if we could thaw and ship some FFP to them, which is pretty strange. I asked why they wanted it thawed and was told they don't have a thawer. Alright, I'll deal with it, I start getting some info and ask what blood type he is, the tech says O plus. WTF! you don't even know blood types? It's not plus it's pos or neg. In the grand scheme of things, it's not a huge deal but it's ignorant, and I don't deal with ignorance. I form an immediate prejudice when you say something ignorant. To compound the problem, she called back later and asked the indications for use of FFP. I know it's a crazy idea but if your facility can't store or thaw FFP and your medical technologist doesn't know the indications for use, maybe you shouldn't be using it. or anything else for that matter.

I know I went off on a bit of a tangent, and I didn't do a good job organizing my thoughts but let me give you a general synopsis of what I wanted to really say. At the end of the Day med techs are in a strange place, we're in the middle of a transitional phase. We no longer need a Medical technologist with a degree to do moderately complex testing. The most important skills you need are organizational and multi-tasking skills to keep up with volume testing that every lab has to do to remain viable. Unfortunately because of this transitional phase, we have a lot of old techs that lack skills needed in high volume testing markets that use a computer for everything. The new techs are learning too much extraneous information to perform their job, then because you never use that info, you can't recall it the one time every 2 years you need it. Many schools have closed and are closing because it's quickly becoming an archaic job. The job title and skills taught need to be revamped. Hopefully schools will start to incorporate more engineering and more business skills and eliminate teaching old methodologies.

My friends, please pray for my sanity. My boss rejected three urine drug screens collected via catheter because the specific gravity was too low, indicating (in her opinion) that they must have been water. He're an idea, maybe they're pumping people in the ER full of IV fluids... I know it's crazy to think about, but it just might be possible. Why am I the only person that seems to understand that????

A hypochondriacs wet dream

This little nugget of info might be useful for those in our community that seem to get off on being sick or being in the hospital.

It's not uncommon to see elevated protein in the urine of patients from the ER. It's most commonly associated with some form of kidney impairment or severe dehydration. Usually if the protein from a dipstick on a urinalysis is elevated, it's prudent to do a few more tests. Obviously elevated urine protein isn't an indicator of acute renal failure by itself but it is a clue. that requires further investigation.

The reason I bring it up is that we had a gentleman in his early thirties come into the ER today, the only real issue he had was this elevated urine protein. His urine was a pretty cloudy considering there were no cells, things just didn't quite add up. While doing the microscopic evaluation, I found an ass-ton (that's alot) of sperm. What I don't get was that it came down to us in a tube that is generally used to collect urine from a catheter. If it had been a normal cup I would have said he just masturbated into the cup right before he peed. Since it was a cath tube I guess he had to masturbate while the catheter was in him. I can't imagine that being comfortable. Who does that?

So in conclusion, if you have the desire to stay in the ER just a little longer and get a bigger work-up because you're a piece of shit drain on our healthcare system, then just jack off in your urinalysis cup. It will elevate you're protein falsely and you'll get a few more hours with our lovely ER nurses. Especially if, as usual, our docs are overworked and have huge patient loads preventing them from immediately ordering you're follow up testing. You may even get a free hot meal! hooray for perverts abusing the system.

Tuesday, April 7, 2009

POO worms

I've pretty much given up on blogging but I may make an appearance every once in awhile. This is obviously one of those instances.

At work, I don't get to see most of the crazyees being in the lab and all, and not dealing with patient care (THANK GOD!), but tonight we got to deal with one, it made my night.

A lady in her 40's came into the ER about a week or so ago convinced she had worms. I'm not entirely sure why, but she was absolutely positive. My guess is that the Doc who saw her in the ER just decided she was bat shit cray and did an Ova and parasites work-up on her just to appease her. I'm fine with this, I'm sure I'd do the same thing. As expected we found nothing. no big deal right????

WRONG!, This bat shit crazy woman comes into the lab, just walks right in with a bag of shit in her hand demanding to speak to the micro supervisor because all of us were "obviously fucking idiots". It's 2 AM no one important is here. Oh well, I didn't get the pleasure of running into her first so I thought I was going to get to sit back and watch the show, but of course, being the only male, and a large one at that I had to tell her to back the fuck up, in some kind of authoritative tone. She was having none of it,

She was flinging around her baggie of poop and getting it perilously close to my face, Thank God those Glad zip tie things work so well. She was pointing out undigested plant matter in her poop saying that it's plain to see a worm, and asking how we could possibly be so stupid as to miss the worms, The worms that were eating her alive. The poor thing couldn't get any help if we continued to suck at our jobs and not see the obvious. She needed help alright, but not the variety I could provide.

What drives a person to be this crazy, Too much time on their hands??? who knows. I really never thought I'd ever have to call security working in the lab, but I did, and of course it took their happy asses about 70 bajillion years to get there. (70 bajillion is alot, in case you didn't know.)

Just to make my life that much better, as she was being escorted out of the lab, she took her baggie full of poop and flung it as hard as she could against the wall. Not cool, Good thing I didn't have to clean it up, I'd pick it up and fling it right back into her face, shit eating grin and all.