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Press Start: Lead an Empowered Life as a Clinical Laboratorian

It’s Not My Job-Or is It?

Published November 24, 2013 4:32 PM by Glen McDaniel

No 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.


Very 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.


But 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?


-A supervisor who asks staff to “fix” QC and temperature charts before a survey in order not to be cited.

-A 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 Council?

- A colleague who accesses the CFO’s medical record because she “heard” he was recently diagnosed with….. (choose an illness)

-An 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. 


These 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?


I would love to hear from readers who have you faced similar dilemmas in their workplace and how they reacted.



This is a very important topic. I think first one has to know what ethics are. The typical medical technologist or even physician has a rigid and narrow view of ethics. They immediately recognize really obvious errors. They can recognize crimes.

But for the most part they rationalize bad behavior, unethical behavior. If it's done by my friend or boss then it's OK. If a patient is not killed or someone does not straight out falsify lab results then we can make an excuse. Also one-off behavior (just this one time) tends to be excused as being just human

In today's society we are more concerned about protecting our profession and our own reputation than we are about acting ethically.

Dr. Syvester T November 29, 2013 8:50 PM

That scenario about the supervisor is very familiar. At more than one job I have had supervisors ask me to do things that I am uncomfortable doing.

They sometimes play it off by saying it is innocent action with no real consequence. One woman told me t "99% of the time temperatures are in, what are the odds temp was out only for the days you forgot to record it, so just fill in the blanks." I had another lab manager to ask me to say I had seen a colleague do something which I didnt see. She needed a "colleague witness."

It is hard to go against the grain and be a tattle tale. It is harder when the person you would normally report issues to, is also breaking the rules. I think I am not alone in my experiences. This happens more than people are willingto admit or  talk about.

Marvin Walter, MLS November 25, 2013 6:21 PM
Baltimore MD

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