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????


Anonymous said...

Hi guy
I don't have blogger account but read your comment on RN K's blog. I'm a former Med Tech and have been in IT for 12 years now.
As a tech in one of our first Stat labs 25 years ago I used to teach techs how/what to deal with on ER/Surgery requests.
Like you I am saddened by the quality of judgement or lack of it that pervades our clinical labs.
I beleive until we get people of good judgement and people skills as managers this sad situation will prevail. In the two hospitals I am affiliated with, the same managers have been running the places for 25 plus years. Our CAP inspections are great but our service to our customers sucks. In our case, some of the policies about repeats and call backs are rigid and mandated by the pathologists - don't get me started.
Glad I found your blog...

rob rob the party slob said...

I'm glad you enjoyed the post, Unfortunately, those rigid policies are going to become more and more common as administrators realize that you don't need a med tech to do everything. Even with med techs, unfortunately you can't always trust their judgment. People just aren't as knowledgeable as they once were. Everyone wants things to be automated to speed up processes and to take judgement calls out of the job, and it hurts the overall skill level of the job, Frankly I spend most of my time looking for Specimen that get lost in the system or maintaining piece of crap automated systems instead of using the knowledge I acquired in school.