Lack of professionalism

I get more and more irriated by the general lack of professionalism that is displayed in hospitals. It's a bit silly really, I understand wanted to like you're coworkers and wanting to be friendly and jovial, but if I hear "Oh thanks honey/sweetie" one more freaking time I'm going to flip the eff out.

The weird part of the lack of professionalism in a hospital is the fact that it occurs on both ends of the spectrum. You'll hear someone yell and scream and cuss you out, which wouldn't be acceptable anywhere else, and you'll also see someone get waaaayyy too involved in your personal life, of touch you when they're talking to you, or call you honey or sweetie. Either way you slice it, it's not cool.

I realize that from a nursing point of view, the overly nice act comes from having to do patient/pallative care, but frankly no one will take you seriously when you're fake. Believe me, we all know you're being fake, and it pisses me off. Then again, anymore, what doesn't piss me off. I need to find a new career.

Realizations

My wife is a brand new nursing graduate and she opened my eyes to something. That I never thought about. There's a good reason Med techs think nurses are stupid. We only talk to the dumb one's that don't know there shit. They're the only one's that call down with stupid ass issues that make me want to shake my head in disgust, and hope I never become a patient.

She also said there's a reason Nurses think Med tech's are stupid. In most large labs like mine, We have people that answer our phones that are aren't certified to do anything. They're glorified secretaries that log specimen's in and then send them to the appropriate areas. When a nurse calls she get's that person, that doesn't really know anything, but tries to help regardless. So the nurse is almost always talking to the uneducated people in the lab, and assumes that person is a medical technologist as well.

How could I have been so dense as to not realize all this before. Maybe now I can take it a little easy on the nurses that I know probably do a good job, like Nurse K. I think her last post was especially poignant. Don't be a lazy slackass that assumes shit if fucked up because that's the way it has to be. I don't imagine I'm getting phone calls from nurses like her.

Who do i get to shit on?

There seems to be a natural progression in a hospital, Patients try to shit on doctors. In turn, they shit on nurses, and nurses shit on the Lab, My question to you, is; who exactly do I get to shit on?

The lab, like everything else in a hospital is starting to have more and more defined customer service roles. And it's starting to piss me off. The lab has started to publicize their desire to become more customer service oriented. We have posters up all over the place about how to perform better customer service. One of our catch phrases is "You're right, we'll do better next time." UMMM, not cool.

I've learned that this phrase can help me, you'll learn how at the end of the post.

I had a situation tonight when I walked into the blood bank. On the previous shift there was some miscommunication about some FFP. The med tech on the second shift wanted to clear it up before he left and called to see if the patient was still going to need the FFP that was ordered 4 hours previous. She stated she never recieved a call saying it was ready, and never got an order from a Doc. This is happening more and more, docs are now ordering their own labs and may not communicate certain orders to the nurses. Anyway, she said she'd call back.

She calls back after shift change for us, and I was expecting a pretty simple, yes he needs it, or a no, he doesn't need it answer. Instead, I got a 10 minute lecture.
Mrs supersleuth had found the problem. She said one of our techs had called down and told the CNA that blood was ready, The Nurse then decided that because the patient's HGB was 13 that it must have been an on hold order, even though there was no type and screen done. She also decided to try and lecture me and tell me that there was a difference between blood and FFP and that we needed to differentiate. Just as a point of reference. I'm going to assume that a Medical technologist with a specialty in blood banking that has worked here 20 plus years, realizes the difference and probably said the right thing. It's pretty reasonable that cna and her six weeks of training was the one that didn't differentiate. Either way, don't call down asking me if I realize there is a difference between blood and FFP. That kind of arrogance pisses me off. She continued on by saying BLAH BLAH BLAH BLAH BLAH, or something like that.

Evidently she wasn't done bitching. At the end of all of it. She wanted to know why there was an order that was canceled in the computer and why did it say she canceled it? Shit lady, I have zero Idea. point 1. We don't use the same computer system you do. Point 2. We're not the IT department. It's amazing what people think the lab takes care of or more correctly, what is the labs fault. At any rate. I gave her the best possible customer service by only making one remark about the fact I was sure our med tech's no the difference between ffp and blood. and the promptly saying, you're right, we'll do better next time. and hanging up.

Bear with me a bit i'm sending this from my phone. i just wanted to let all the nurses out there know somwthing if you call and loudly proclaim i need this now! i'm not all that motivated to help you also if you lie to me about how long ago you collected something to make it sound more emergent.... i really don't want to help you. one more thing. calling every 5 minutes for results does not help. especially if i've already explained we're having issues. we have shitty equipment too.

Nurses = Children

As I get older I start to learn certain absolute truths. One of these truths is that everyone likes to feel in control, or that they have some sort of choice in life. Lately, I've been employing a favorite trick that I use with my 2 year old. It's working beautifully.... At work.

There are alot of times my boy freaks out about things, like every 2 year old does. Usually it's over not getting exactly what he wants. Often, it involves food. if he doesn't want to eat carrots, then I offer him a choice of eating his broccoli before his carrots, and for some reason it works, it's all a control thing, he thinks he's regained some semblance of control over his life.

I know, you're thinking "what the hell does this have to do with anything?" Lately, nurses have been giving me extra shit about having things recollected, so I've decided to distract/appease them by letting them think they have choices and that they're involved in their patients care. I've started running absolutely EVERYTHING I get regardless of the issue. Clotted,hemolyzed,unlabeled... anything at all. I will then call the patients nurse with the inevitable crappy results and say " I got such and such result, this was the problem with the specimen, I'll be happy to turn out the result, I just need to record your name here in the computer." It's pretty amazing, I haven't have anyone give me shit about doing this. I give them a pseudo-choice, and I guess it makes them feel like they're the one making the decision so it's all good in the hood. It's either that, or they sure as hell don't want their name on that shit... ha.

It delays patient care a bit, and it's borderline unethical, but oh well. At least I don't have nurses bitching at me... all because they now have the option to accept shitty results, so long as I can put their name on it.

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.

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.