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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Why There is a Personnel Shortage

Published April 6, 2009 11:37 PM by Glen McDaniel

There are many reasons for the personnel shortage in clinical lab science. Not the least of which are low pay (compared to lesser educated health care providers), high stress, terrible work hours and little recognition.

I have dealt with root causes and strategies elsewhere and in many settings, but I just read the results of a survey that made me stop and think. In a Workforce Survey published in Modern Healthcare magazine, they examined the results of asking nurses directly why they think there is a nursing shortage.

Not surprisingly, in order of importance were the following

  • Poor salary and benefits
  • More career options for women now available
  • Faculty shortage- not enough teachers available for all qualified applicants
  • Undesirable hours
  • Negative perception of the actual work environment
  • Nursing not perceived as a respected career
  • Nursing not seen as a rewarding career
    1. I suspect the reasons would be similar for clinical laboratorians except for 2 interesting observations. First, the numbers have decreased-signaling improvement- over the years e.g. in 2002 58% of nurses though the salaries and benefits for nurses were poor, compared to only 32% of nurses in 2008. In 2002, 38% of nurses saw the hours as undesirable, compared to only 26% in 2008. Negative perception of the work environment decreased from 29% in 2002 to only 15% in 2008.

      So these findings suggest progress is being made in nursing. Is the same thing occurring in clinical lab science?

      The second difference is that nurses identified that there are not enough educators to accommodate the numbers of qualified applicants to nursing schools each year. The fine print explained that educators with advanced degrees felt the pay for educators is not attractive enough. With more teachers, existing programs would admit more students and some new programs might even open.

      I suspect that for CLS, schools are closing due to lack of funding and other reasons such as less interest in entering a profession with low pay, little recognition and limited autonomy. To the educators out there: are you having huge influxes of qualified applicants each year, but you cannot accommodate them due to an insufficient numbers of teachers in your program? To those whose programs have closed: did you close largely because of not enough staff, or for other reasons?

      While the reasons for a shortage of laboratorians might mirror the traditional reasons for a nursing shortage, it appears that nursing has started addressing the core issues. In fact, there is such a renewed interest in nursing that current nursing programs cannot accommodate all the qualified applicants.

      14 comments

      There are no standards in this field. We need standards entry level. Standard Degree or Certification or national license.

      RN (NACLEX) $23-40 per hour

      PT (NAPLEX) $50-60 per hour.

      MT (ASCP, NCA <now merged>, AMT, AAB) $15-20 per hour

      You create standards, employers have to pay well!

      Brad BS, MT (ASCP) CLS (NCA) August 28, 2009 11:25 PM

      Mohammed:

      I am sorry your employer has not seen the wisdom of supporting you in your quest for advancement. There is a personnel shortage; trust me. I hear it from my readers frequently through email and at every professional meeting I attend.

      One problem is that some lab managers are willing to squeeze their current staff to the limit,  and will allow non certified personnel to occupy positions more appropriately held by certified laboratorians. It is unfair, unsafe and shortsighted to allow paraprofessionals to perform as CLTs/CLSs. That scenario reduces morale for everyone concerned, keeps pay low and futher exacerbates the shortage.

      One really good investment is to encourage lab assistants and MLTs/CLTs  to advance professionally while they keep their current jobs. There are many schools which have various bridge programs allowing laboratorians to take courses entirely on line while gaining corresponding clinical experience in their current lab.

      For example, you could rotate through the various departments and perform testing under supervision while you take corresponding academic courses from a  university online.

      In exchange for a flexible schedule and tuition reimbursement the lab could have you sign a 2-4 year contract to ensure they protect their investment. It has been proven many times over that an employee allowed that choice, and given that support,  usually feels more loyal to their employer; and more motivated to succeed.

      Have you openly expressed your desire to advance professionally?Have you had this discussion with your lab manager/director?  Have you checked out colleges with bridge programs?

      I suggest putting your plan in writing and presenting it to management: This is what I want to do. These are the colleges that offer the program I am interested in. This is my time line and this what I am willing to do. Will you support me and help me get there?

      Glen McDaniel April 29, 2009 7:52 PM

      Sometimes I doubt if it is really true that this lab personnel shortage  is a chronic problem for the Health Care Industry? Every once in a while I stumble into newspaper articles, or comments and blogs like this and I don’t know what to think about it. Because I don't experience it or the Lab personals i.e. directors or business units alike reflects this as a major concern. I have been working as a Lab Assistant for 7 years and I like my job, I don't mind the odd hours I also would like to advance and learn this trade to become a Tech and I also attempted several time to attend school and any available programs for this trade.  I don’t find any kind of support, or interest and most importantly any job schedule flexibility given by these industries to any existing employees. Especially for those who potentially could be a good candidate or already have their one foot in into this profession.

      Mohammed Rahman, Clinical - Lab Assistant, Hospital April 29, 2009 11:41 AM
      Oklahoma City OK

      Same here Glen, my original certificate was CSLT but I think couple of years after that, my registry card became CSMLS. Returning back to the issue, what bothers me though with your statement is that, what you are trying to say that the "honchos" of all the certifying bodies are not aware of what's generally goin' on entirely with the profession, or they are just in the state of denial? I know it's a shallow question but with that basis alone, unless they can convince themselves that there is a problem, they can sit in their mighty places all there life long doing nothing! You bet I will do my part, I will be attending a joint-sponsored spring meeting here in Oklahoma ( after 8 years of being here- I know it's a shame!) with AMT and ASCLS this 2nd week of May, let's see how they will respond with this particular issue. I will keep you posted.....

      Efren Ventura, Clinical Laboratory Scientist April 28, 2009 12:01 AM
      McAlester OK

      Efren:

      We have something in common. I, too was certified by CSMLS back in the days when it was CSLT (Canadian Society for Laboratory Technologists). I rarely use my RT (registered technologist) title because it is too often mistaken in the US for other professions like respiratory therapist or radiologcal technologist.  

      I hear you loud and clear when you say actions speak louder than words. One of the main problems with our profession is that many (if not most) laboratorians will complain about their lot while waiting (and calling) for "them" to do something about the state of affairs.

      When I write or speak I hope I can make someone think, feel more empowered and determined to ACT in some way to better his or her own personal experience.

      The reality is that EACH individual person has to do what he/she can do from wherever they are instead of blaming others and waiting for someone else to act. We EACH have to act-whether or not anyone else does anything.

      I am a strong believer in being a member of my professional organizations. But I also reserve the right to tell them exactly what I expect of them, rather than simply hoping they will act in my interest. No one has the right to complain about the game unless they first become a player in the game.

      As an example, NCA and ASCP have been conducting talks on uniting to form a single national certification agency-which is exactly what most labotratorians want. But how many of us, how many of you, have written and called NCA, ASCP and ASCLS (a  sponsoring organization of NCA) and told them in no uncertain terms to continue talks and sort out differences rather than aborting the project at the first hint of trouble?

      If you havent done that, why not? How else will they know how strongly you feel about the importance of a single certification agency?

      Much of my professional life has been outside of the lab. But even as a hospital COO when it would have been easy to forget my roots, I have always advocated for clinical lab issues and called out physicians, administrators and others who unfairly blamed the lab or sought to make decisions affecting the lab without getting laboratory input.

      We all have to be prepared to ACT- to do what we can- whether or not every one else around us is doing anything.

      Mother Teresa (quoting Mahatma Gandhi) was fond of saying "We have to BE the change we seek."

      So I'd say, join a professional organization, tell them exactly what you want them to do for you. Become active in planning and attending meetings. I have joined some organizations and not others. Those that I choose not to join know very clearly why I cant support them, and those I do support have heard from me (repeatedly) what I expect them to do for the profession.

      Lastly I continue to do what I can to support the profession daily regardless of what anyone else is doing, or not doing. Much of what I do for the profession is unpaid (or not paid very much). But I do it as my personal commitment to act and not just complain.

      We have to act even when it's not the easiet thing to do.  I firmly believe that's what we ALL have to do.

      Glen McDaniel April 27, 2009 6:54 PM

      Glenn,

         I made my statement to issue a challenge. Albeit we make a scholarly article about our plights, noble arguments about how we should be treated, but really, honestly ask yourself if this will really change (an overused word like hero, patriotic) a thing about the direction of our profession? I am a certified/graduate from the Philippines. I'm registered/certified with the Canadian Society for Medical Laboratory Science (CSMLS) and have the AMT (was the only available registry in the Philippines in the mid-80's, ASCP just had one available few years ago) for my US-registry. I'm a guest worker here since 2001 as a naturalized Canadian citizen under NAFTA. I already heard about this problem since then. There's a guy from Montana, his name is Doug, was very passionate about this issue making his postings on a message board with MedHunters. I really do feel for him, nobody was listening, and even just in my very first year here in the US, I 've observed that all what he said were true and still is. IF ( my biggest if ) I'm only a US-citizen, I will be the first one to walk in front of the White House yelling with a big sign, will write letters to all technologists in the country, I'm gonna quit my job and visit every officer of every state's technologist organization, etc....etc. Didn't your stomach cringe about what they did to Stephanie in Utah? Man! That is a big shame! I told my side of story about all what's goin' on in the field with a travelling tech here in our workplace. He told me that there was this Canadian lady who was so vigilant about this hospital administration on treating the techs. She got sent home to Canada. LOL! I still need my job and they treat me well here!

      Efren Ventura, Clinical Laboratory Scientist April 21, 2009 11:56 PM
      McAlester OK

      There are some very interesting comments here.

      Scott, I  have heard several individuals who are making mid-life career changes say quite unabashedly that they are choosing nursing for the pay and ability to call their own shots eg flexible scheduling.

      Choosing a career on pay alone is never very wise. Not only is such a choice likley to disappoint; but patients deserve better. If someone is motivated solely by money, where do empathy, concern and love of people fit into the priority?

      Several others have described the less than ideal work environment, low pay, flat career ladder and so on. This wide scale dissatisfaction is bound to exacerbate the shortage of clinical laboratorians.

      The wrinkle not often considered  is that licensure protects the scope of nursing. When there is a shortage of nurses, everyone can always point to how unsafe it is for patients and emphasize that more NURSES are needed. Not "people" or CNAs or laboratorians. Nurses!

      Clinical laboratorians on the other hand have never carved out a licensed role for themselves. Therefore in a pinch administrators including lab management will make do with a variety of individuals. They will farm out testing to nurses, pharmacists, respiratory therapists, medical asisstants and the like.

      The reluctance of clinical laboratorians to support legal protection of our practice has exacerbated a bad situation. I really think laboratorians should be more supportive of licensure where there are currently such initatives in progress.

      What types of action are you advocating, Efren?

      Glen McDaniel April 20, 2009 9:57 PM

      Talk is cheap. Taking a nationwide uncompromising ACTION will earn us a well-deserved respect!

      Efren Ventura, Clinical Laboratory Scientist April 20, 2009 10:37 AM
      McAlester OK

      Although our lab was advertised a being 8-5 M-F we now have to work until 7 or 8:00 PM. And on Christmas Eve when all the offices closed at Noon we could not leave until all of our work was finished at 2:30 PM.  And on top of that the pay sucks. I am making what a Lab Assistant makes at the Hospital Lab (we are owned by the hospital).

      Rebecca Smith, Laboratory - MLT, Stanly Medical Services Central Lab April 17, 2009 3:56 PM
      Albemarle NC

      Some professionals I've talked with are worried that people are choosing nursing for the wrong reasons (money, for one).  While the profession is attracting fresh talent, is it what the patients really need?

      Time will tell.  I wonder if the "permanent shortage mode" will eventually change the culture of nursing.

      There may be another reason for programs closing.  I've observed a high dropout rate in programs over the years.  Is this typical of other professions?  The laboratory is a difficult job to do well.  It may simply be hard to attract students and harder to keep them.

      A profound, prolonged shortage may be the only thing that wakes up the industry to the use of the laboratory in healthcare.

      Scott Warner April 13, 2009 7:36 AM

      Technology represents an essential part of the laboratory. That reflects on the payment of the people. Suprizingly, but it is a fact that the salary of the Medical Technologist ends where a new graduate with AS degree in dental assisting starts. The withdrawal from the profession is quite logical.

      Tony, laboratory - MT, MRMC April 12, 2009 8:39 PM
      Ocala FL

      As you stated in your article, many similar grievances are common amongst healthcare professionals.

      Yes, many HATE working evenings/overnights

      Yes, many of us hate working every weekend and every holiday

      Yes, we do burn out, waiting for all of the old women that work day shift to retire so that we can have a slim shot to get a day job.

      I aways enjoy woking every Christmas, Thanksgiving, Independence Day, Mem Day, Labor Day, etc...  so that those that have no spouses, children or family can have off so that they can stay home and play with their cats.

      We don't like that although we provide a vital service to the industry, we are perceived to be on the same level of the corporate ladder as the cafeteria - to some.  

      Yes, the pay sucks.  Our LPNs make as much as our techs.  RN's far exceed our salaries.  

      Many of us will be long gone before we would have ever had a shot at getting any kind of supervisory / management position.

      No, we don't like continually working short-staffed on off shifts meanwhile day people are tripping over one another - doing less.

      In case if you cant tell - I hate my job..  I would take a job elsewhere  doing almost anything else for significantly less money - if it meant that I could get a good night's sleep once again, have weekends free and be able to spend a holiday with my family - I would walk out the door - INSTANTLY !  (but unfortunately, my family depends on my income and I have to put my family first.)

      I used to enjoy all that went along with this profession, - seminars, journal articles, extra contin. ed's, teleconferences; but unfortunately, I am just biding my time and it has become merely a "j-o-b" and a $-check.

      Future students... take light.  Run.  Run to another career before you get stuck.  If you choose, use what you have gained with your B.S. or MT school education and go back and build on it towards a better career path.

      Take on a career that has more aspiring prestige -  MBA, engineering, anything computer science, accounting, a professional trade, PharmD., Physicians Asst., architect, teacher, or even a snow plow driver.

      Anonymous April 12, 2009 10:11 AM

      The causes you mentioned regarding the shortage of medical lab personnel are definitely worth taking note of. Other reasons for the shortage are licensing/certification requirements, lab managers who are not willing to hire and train even nationally certified entry level laboratorians. Depending on one's certification and experience a lab manager may turn them away. AMT considers its medical lab technicians entry level laboratorians who work under the supervision of a medical technologist. Yet, some of these lab managers will not recognize or consider AMT certified medical lab technicians.

      I've interviewed with lab managers who complain that I don't have the experience that they are looking for and that they would have to train me. These lab managers had to start somewhere. Somebody had to train them. They are so stuck in their selfish ways. These stubborn lab managers should hire and train us in one area at a time until we become proficient generalist. Even experienced lab techs have to be re-trained because new methods and analyzers are constantly being employed. Lab managers with this type of mentality certainly contribute to the shortage of medical lab personnel!

      Richard Covington, Medical Lab Technology - Medical Lab Technician April 11, 2009 2:11 PM
      Miami FL

      Glen,

      I recently responded to this article through facebook. I would like to help spread the word and make more people both laboratory and non laboratory aware of the happenings in this profession. I have several friends on my facebook who read these articles from time to time. Thank you so much for this helpful information.

      Brian, CLS April 10, 2009 4:56 PM

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