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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Overkill Not the Same as Competence

Published December 3, 2007 2:24 PM by Glen McDaniel

A few days before Thanksgiving, I listened to a friend complain about having 20 people over to her house.  She talked about all the preparations and coordination needed and made it seem more like an onerous chore than a time to celebrate with family and friends.

The interesting thing is that every suggestion made to her was shot down. No, she wouldn't use store bought pies because they just weren't the same as her homemade. Everyone would be expecting her special dressing. Martha's potato salad was just not as good as hers.

Every offer of help was rebuffed. It's obvious she enjoyed doing it all herself and being perceived as either a victim or Superwoman, or both!

I have seen laboratorians like that as well. They do lots of things, but complain while they do them. They often turn down offers of help in order to claim martyrdom. Sometimes, for a particular task, they also go overboard, overcomplicating matters.

Often, they claim to be more concerned and competent than everyone else, when in fact, they are just more busy talking and "tasking." Why build in 10 steps in a process than can be accomplished by 5? What are you doing with log books when the information is also in the computer?

Why record temperatures every shift if daily will suffice? Why insist on doing what can be delegated? Why nitpick every one else's work instead of simply doing your own job well?


I agree wholeheartedly. If a system can only be performed by certain people, it's not a good system. Most of the time it's management responsibility to setup a smoth system so everyone can follow easily (even if they are put on the bench the first day).

I've heard from my professor that many many years ago. Doctors from this hospital only want PT/INR performed by this one Tech so they can get a consisten result. The laboratory technology had came a long way. However, many people resist to move on. The laboratory profession is an ever changing technology and many of us have forgotten that. We need to move on!

Benjamin Chan, Medical Technologist April 1, 2008 6:17 AM
Seattle WA

I, for one, am gratified that healthcare is finally adopting many productivity and quality tools used in industry. It is heartening that Stephanie's institution has adopted Six Sigma and LEAN.   Every productivity and "better practices" model I know recommends prioritization of tasks, delegating, allowing employee initiative and rewarding results. Yet many "busy bees" continue to put an emphasis on control.

Micromanagement is just one aspect of overkill, but I thought about this subject because of  a recent email I received. A middle manager expressed frustration at being constantly micromanaged by her boss. She is often given interesting, challenging projects but is  dogged by a boss who insists on randomly giving very detailed directions or revisions throughout the project.

It is difficult, if tempting, to tell your boss to buzz off. My suggestions to her included the following:

1. Outline (in writing) the details of discussions with your boss including the scope of the project, deadline and outcome expected.

2. Send an email summarizing your understanding of the discussion

3. Promise to give periodic feedback/progress reports-and do it! Control freaks must be kept in the loop or they go nuts.

4. Promise to ask for help/resources if needed. The  subtle suggestion here is also that if you dont ask it's because you dont need it.

If the boss piles on assignments, ask him/her to prioritize their requests; no backing down- don't do it for them, and be realistic. The email summary mentioned earlier can be used as a yardstick to guage how the project is going. It is much easier to have an objective measure of success if the outcome mirrors the email-which the boss had accepted and agreed with (or at least, not revised) earlier.

We can use this method for all sorts of assignments. This gives you your power back, the structure makes an overcontrolling manager feel more secure and it offers an objective measure of success.

Glen McDaniel December 10, 2007 5:20 PM

The hospital laboratory in Indiana in which I am currently working a temporary/travel assignment has put "Six Sigma" metrics and "LEAN" principles into practice.  We have a poster in our lab describing the "Five S's:"

Sort: separate and eliminate

Stabilize: a place for everything, and everything in its place

Shine: clean and polish

Standardize: organize and systematize

Sustain: day-by-day inspections

It would certainly be nice if my first employer after MT school, the blood bank of a level 1 trauma center in Winston Salem, had "stabilized" the work load a bit more when I worked there three years ago.  It had never occurred to anyone there that the "front desk" techs' job may be easier if specimens waiting to be received were placed in racks and their requisitions in corresponding order.  Instead, some flustered "baby MTs" accidentally dropped tubes on the floor while answering phones, dealing with patient record merges in the LIS, running back and forth between the paper files to check previous records on patients, AND issuing blood products to nurses, OR personnel, etc.  Certain so-called "colleagues" in this facility, who had worked there for 20-30 years, also prioritized "speed" and "efficiency" over such supposedly insignificant priorities as checking test results for accuracy and confirmation of compatibility.  They crucified said new technologists for not moving fast enough while attempting to perform at least 10 tasks simultaneously.  Scary, don't you think?  My advice to anyone reading this post and contemplating a road trip through NC would be to avoid finding oneself in a catastrophic highway accident anywhere in the Piedmont Triad area, unless the manager and blood bank technologists at this hospital have recently rearranged their priorities AND started appreciating one another as team members.  

Stephanie Mathis, Generalist - Medical Technologist, Medical Staffing Network December 7, 2007 9:38 AM
Winston Salem NC

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