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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Representation Hurts the Profession

Published November 12, 2007 3:27 PM by Glen McDaniel
A couple of weeks ago I was in a doctor's office and the young lady who took my history and checked my vitals introduced herself as "Dr O's nurse." I noticed her name badge read "RMA"-registered medical assistant. She was professional, competent and very friendly, but I wondered why she would represent herself as a nurse, when she clearly was not.

In the laboratory, the individual whom the customer (patient, public, doctor, nurse) most often sees-or speaks to first on the phone-is not a clinical laboratory scientist (CLS) or CLT, but a phlebotomist or customer service representative.

I have overheard such individuals overtly misrepresent themselves as a "lab technician," or at least not correct others who assume they are clinical laboratorians.  It does a dis-service to the profession and the customer if  those we serve receive or act on incorrect or incomplete information from someone they presume to be a CLS.

I think it also damages our image as a profession long-term when we let others in healthcare assume everyone who is associated with clinical lab science is a "lab tech" or can be accurately lumped together as "the lab."

In some states, at least it is illegal for a non-nurse to represent him or herself as a nurse. In most settings, registered nurses insist on making clear the difference in expertise, education and scope between registered nurses (RNs) and licensed practical nurses (LPNs).

While there might be a degree of elitism in that move, it is a very legitimate distinction that can only help patients, doctors and the profession itself. I see distinct similarities in clinical lab science.

5 comments

Interesting comments. As both Nick and Jacqueline pointed out, visibility is a key to educating doctors, nurses and others. I am sure that doctors feel better served when instead of sending specimens to a "black hole" they can actually speak to someone with whom they have a relationship of sorts. One opportunity laboratorians have is to identify themselves by name and title when they speak to others and also to seize every opportunity to get out of the lab, whether to serve on committees or simply to go to the floor to investigate an issue.

We also have to be  very careful about what name we answer to. By that I mean we help to perpetuate ignorance and confusion if we let phlebotomists, secretaries and Customer Service Reps speak for us. We should correct (over and over again) nurses who refer to phlebotomists as "techs”. Lab staff should be encouraged that if a doctor or nurse calls with a technical question to respond, for example "I'll let you speak to a technologist about that" instead of "I'll transfer you to someone else" or "let me get someone for you". Phlebotomists confronted with technical discussions on the floor should be instructed to say "I'm a phlebotomist; you need to call the lab and speak with a CLS/technologist for technical questions".

As Glenn suggests we do have different education and skills set and the term "someone" does not convey that, nor does allowing lab employees to take on questions they are not adequately prepared to answer.

It might appear useless and tedious to correct people all the time, but it's worth it. Some of my family members and friends had a hard time adjusting to my preferred moniker of "clinical lab scientist" over "medical technologist" a few years ago. I deliberately painstakingly corrected them each time, until they got worn down! Now they correct other people and explain to third parties exactly what CLS is.

Glen McDaniel December 12, 2007 12:21 PM

I found that when I worked night shift at a smaller hospital and also did phlebotomy, I got to meet more of the nurses and doctors.  In doing so, I was able to bring some light of what the laboratory did to them and educate them moreso on a few things as to why we do what we do.  

Why we call for recollects.

Why we want things labeled and done so properly.

Why we reject unacceptable samples.

Why we request redraws on samples with questionable results or big delta checks.

Why we and CLIA have an order of draw for phelobotomy.

In doing so, I (we-the lab) had a better repore with them on night shift.  

Nick Speigler, MT December 11, 2007 12:06 PM
NY

I think that management is key in fighting the misconception of the laboratory. If managers and pathologists do not appreciate the work that mt's and mlt's do than we are fighting a losing battle. I once had a lab manager address the lab staff and told us we were all replaceble and monkeys could do our jobs. %0d%0aI was fortunate to get out of the hospital setting(which is the worst for no recognition) and get into pols. All the doctors I have ever worked with trusted my job knowledge and insight on testing and patient treatments. Most even trusted me enough to ask which testing I would recommend. I feel that I am a vital member of the staff and am often asked my opinions on a variety of levels about patients and thier treatments. %0d%0aDon't settle- there are doctors and nurses out there that will respect you because you are a laboratorian and a specialist.%0d%0aAnd don't let management make you feel you are just a grunt worker with no knowledge

jacqueline murray, generalist - clt, pol December 11, 2007 10:26 AM

I couldn't agree more.  I worked in a physicians office lab as the only tech, with a medical assistant as my lab assistant.  She 'pretended' like she was a tech and never corrected those who assumed she was one.  She had seniority over me, and when I first started working with her, and the nurses or docs would come in with a question, they would go straight to her, where she would almost always give an incorrect or incomplete answer, which was scary.  It took me over a year to educate my coworkers on what a (competent) lab tech is and how it requires some higher education in order to completely understand laboratory science.  I too am leaving the profession (after 10 years) because of lack of recognition, low pay in comparison to others in health care with equal education, and a bleak outlook for laboratory medicine in general.

Jennifer , endocrinology - MLT December 6, 2007 7:02 PM
Portland OR

Beautifully stated. It is a diservice to the profession to be lumped together in the "lab". I would like to be sure that  I express my appreciation for the data entry staff and the phlebotomists that make our job focused more on testing and safety, but our scope of practice is much different. Unfortunately in Illinois the title is not protected, though I truly think it should be. I stress to managers and directors of our lab that specimen processing/phlebotomy is not the lab (a lab conducts experiements and generates valid data) collecting blood and data entry does not do that. Again though, as it seems to be everywhere, such professional woes fall upon deaf ears. I am offended when a nurse calls and asks for a "tech" to come and draw a patient. This is not what we techs do. Just as  I am sure they would not appreciate being called a patient care tech...neither do we appreciate being called a phlebotomist. The educational difference is even less in many cases between a PCT and a nurse then a PBT and a med tech (many RNs have only an AAS degree whereas a med tech has to have a bachelors degree at a minimum). With this lack of professional recognition, is it any wonder that the lab is losing it best and brightest (at the CLS Med Tech level at least) to other fields? I myself work in the lab only to supplement my Post Doc salary, and will be leaving the field in entirety within a year (either to law school or an academic research position). Couple the lack of professional recognition, with low pay (relatively), and the field is set to have some serious problems, because few are willing to go and stay in a field that is not even recognized by their direct co-workers.

Glenn , Hematology - Medical Technologist, Hinsdale Hospital/ Adventist Lab Partners November 21, 2007 8:17 PM
Hinsdale IL

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