It’s Not My Job-Or is It?
matter what your job is, it’s likely you periodically encounter situations that make you
consider whether you should just look the other way or take ownership. This
might range from a customer service issue with a patient, to an interdepartmental
impasse to a human resource issue.
often we are tempted to take a pass on resolution of the problem because we already
have enough on our plate. We either ignore (or delegate) resolution of what is seen as just a nagging interruption to our already busy day.
not all challenges are created equal. As laboratorians we wag our fingers at
clinicians who constantly over-order or order inappropriately, but we say
nothing using the excuse, “He is the doctor,” or “I am just a tech.” Do we have
a responsibility to voice an opinion? I do not mean delivering a lecture, or outright refusal to perform
the test. But what about a concerted push for the development of a team looking at
utilization and developing algorithms for test ordering? Variation from of the algorithm would require some sort of justification. Pharmacists have developed drug formularies and
ordering guidelines that physicians must adhere to. You never hear, “Well, I am
just the pharmacist, I must dispense whatever the physician ordered.”
Some issues that arise are not merely policy-related or procedural, they have an ethical component as well. How
would you react to the following real-life situations?
supervisor who asks staff to “fix” QC and temperature charts before a survey in
order not to be cited.
lab manager who tweaks quality data like blood stream infection rate or
analytical error rate before the data is submitted to the organization’s Quality
A colleague who accesses the CFO’s medical record because she “heard” he was recently
diagnosed with….. (choose an illness)
MLS who modifies the rules for manual differentials or microscopic urines in
order to end his shift on time.
A colleague, Mary, who falsifies time by asking a colleague, Tom, to clock in
and out for her so she gets credited for more than her actual time worked.
-A phlebotomist who discovers she drew the wrong patient but chose not to correct the error since no one questioned the results.
are all real situations I have encountered in laboratories and the laboratorian
discovering the ethical lapse was reluctant to act. There is always the extra
wrinkle if the policy or ethics violator is a superior, but is that a valid
reason to ignore the issue?
would love to hear from readers who have you faced similar dilemmas in their workplace
and how they reacted.