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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Are You More Than a Passive Technician?

Published July 26, 2014 5:59 PM by Glen McDaniel
 

I recently saw a discussion on a Medical Laboratory page on a popular social networking site. Someone started off a thread detailing an encounter with a nurse in which a request was made that was so ludicrous it was funny. Others weighed in with accounts of their personal experiences: mostly questions or requests from nursing based on ignorance of laboratory procedures and interpretation of results.  This sort of story-telling is a favorite pastime of medical laboratorians as we know.

 

I made a brief comment indicating that we needed to project ourselves more as knowledgeable professionals and less as “passive technicians” who followed orders mindlessly and offered no opinions at all. Sadly, one person took umbrage to my use of the term "technician" and accused me of belittling the role of MLTs such as herself. This is despite the clear context and even the blatant hint that “technician” was in quotes, indicating I was quoting someone else’s words.

 

Nurses and others on the healthcare team often refer to medical laboratorians at any level as ”the lab” or “technicians” and suggest implicitly and, sometimes explicitly, that as members of the ancillary staff we do not have much to offer in terms of independent thought or knowledge. This is clearly not true and I am bothered when we buy into this interpretation and passively (there is that term again) stand by and let others wallow in their ignorance or persist in their misconception of who we are.

 

It is sad we can muster up lots of whining, sense of self-victimization, hypersensitivity and criticism of each other while we passively let others misjudge and undervalue us and the contribution we make to the patient care. More than our ego is at stake. When we are not fully utilized, patient care suffers as well.

 

Members of the profession at every level- phlebotomist, MLT, MLS, specialist, pathologist- are all valuable and each has a unique body of knowledge from which they can draw and enlighten those who do not know. I have many friends who are physicians and they almost unanimously appreciate when I enlighten them about the proper selection, use and interpretation of laboratory tests. They are always surprised when I speak about our education or detail processes that explain turnaround time, how reference intervals are derived, quality control and the like. Am I unique in that regard? I refuse to believe that. Clinicians need and welcome our help, but we often do not give it. Instead we roll our eyes and joke among ourselves.

 

If someone calls us “technicians” as a way of relegating us to a vague inferior class of button pushers we do not have to accept it. Our energy should be directed at undoing that perception and not internalizing that label. It should certainly not be squandered on attacking those who work tirelessly to advance the profession. That is misdirected energy.

 

Each “stupid” question or request, each term of denigration is an opportunity to teach and to demonstrate that you are more than a “technician.”

 

8 comments

I think the key is to build a good relationship with your doctors and nurses and they will trust and respect you. Some nurses ask me for me every time they call the lab. Why? Because they know I will give them good information and I will be helpful.

I am a MLT and I realize my limitations while I know that I know more about medical technology that a nurse and many doctors. I know that a MT  have more schooling and that is OK. I don't begrudge them that.

If you hate what you do and who you are then that is YOUR problem. I know you are not looking down on MLTs but even if you were, I say if you don't like what you are change it. Go back to school.

If I was jealous of a nurse, I would not complain I would be a nurse. If I wanted to be a doctor, I would study and become a doctor.

The idea is to be the best you can be and be a professional about it. Don't sit back and just complain all the time. If you complain and don't speak up, then it's your fault. If you don't act professional, it is your fault.

Peter G. MLT August 3, 2014 10:01 PM
McAllen TX

I have to agree with this article 100% . I started in this field almost 40 years ago. Back then we were basically "Lab boys" and "lab girls" especially girls. There were not as many men. We were pathologist helpers- or so the pathologists thought.

We did everything from getting coffee to cleaning the morgue and all other duties as assigned. We made no independent decision on our own. We dressed like nurses in all white.  Even back then we had techs who were so good they read bone marrow smears and histology slides for which the pathologist took all the credit and billed.

Nurses used to get paid much less than us. But over the years they became more vocal, they advocated, they complained and they formed organizations that threatened. Now they are well recognized, paid more than techs and basically call their shots in terms of pay, shifts and so on.

We have indeed been VERY passive. Instead of being angry with you or someone else who points out the obvious, then do something about it. That is precisely the problem: complain  and fight with those who want to help. Just sit back and criticize.

I am recently retired but that is the one disappointment of my career. We have allowed ourselves to be shortchanged and we have no one to blame but ourselves. Many of us do have that "I am only a technician" mentality. Those of you (because I am retired) are the ones holding the profession back, sorry to say. but it is the truth.

Angela Thiboux July 31, 2014 10:48 PM
Miami FL

Great comments here. Thank everyone for weighing in. I am heartened that folks like  John and Bella find that their doctors and nurses do welcome helpful consultation from the laboratory.

I am grateful that Angela has responded as someone on the receiving end of our services. I commend her for giving (deserved) kudos to her friend-laboratorian.

SW from Wisconsin: I nodded as I read your post. I agree that repeating the same thing over and over can be exhausting, especially if it seems like such a no-brainer to us.  We are also pretty busy and sometimes those calls come at the most iinopportune time.

Some things I have found that work:Providing simplified handouts explaining troublesome issues, regularly getting on the agenda for physicians's meetings where they can express laboratory concerns and ask questions, inviting nurse-champions to the lab where they actually can see processes and ask questions. Many nurses now have daily huddles (short meetings) where they pass on iimportant information. I have even attended a few of those to share important laboratory information from new tests to troublesome areas to a changed process.

It certainly is more effective (although not always possible) if you can speak directly to a decision maker/stakeholder; someone who is invested in understanding an issue. At one hospital I worked, I insisted on speaking to the ED physician several times to explain unusual or spurious results. They appreciated it and the nurses often de-escalated the importance of an issue, once I requested to speak to the physician directly.

In terms of "getting what I want versus what the lab is giving me" many physicians will understand and appreciate communty standards, scientfic standards or best practices once those are explained. Some will accept studies or the literature if that's what it takes. I often refer to objective resources including peer reviewed journals, for the nit-picky or doubtful physician.

Doing it right the first time so a specimen is not rejected is also important. A repeat often means inconvenience for the patient, delay in treatment, increased cost and increased length of stay (LOS) for hospitalized patients. Those are all factors today's physician understands. I make sure to highlight those factors in when I speak to physicians or hospital administrators.

There is no one size fits all and no panacea, but every little bit of consultation helps and goes a long way from the "sorry, I am just a tech" excuse.

Glen McDaniel July 28, 2014 3:19 PM
Atlanta GA

I find myself constantly fielding strange lab requests in micro, like trying to explain why we don't test for C.diff on formed stool, why a scotch tape prep is the appropriate collection method for pinworm, not stool, etc. It gets exhausting because for every person who listens and appreciates what you are saying, there are three more who argue with you and just tell you to run it anyway.

Part of the problem may be that I rarely get to speak to the physician who ordered the test, it's usually the nurse or the health unit coordinator. If they are a repeat offender I will tell my supervisor so she can follow up at the source.

It's a never-ending battle, and I can understand why people might decide to just give up. I keep trying to educate because I believe our patients deserve to have lab tests done properly so they can get the best result, not just what's most convenient.

S W, Microbiology - MLS July 28, 2014 7:50 AM
WI

My best friend is an MD and she has been a great help to me and the physicians in the practice. She is a great resource for all issues laboratory.

I must admit that without her I would have floundered and even ordered wrong tests or misinterpreted results. Because of her I have a much better appreciation of the professionals in the laboratory.  I  also know not to call her lab technician.

Angela Beatty, CNP , Nurse Practitioner, Family Practice July 27, 2014 11:24 PM
Baltimore MD

I also find that physicians will accept our help if we give it. Many colleagues will say, I don't know or ask the pathologist, or will even say just say tell me what YOU want.%0d%0a%0d%0aIf that is the way we interact of course the doctors are going to think we don't know anything. It is our fault not theirs.%0d%0a%0d%0aI am VERY offended when I am called a technician, and it's not because I don't want to be confused with the good MLTs I have known over the years. But I know when I hear that term the nurse or doctor have no idea about my education and my experience. To them a technician is a person who has some skill but not necessarily any formal education. Many nurses are shocked that as "technicians" we go to school and are not all trained on the job.

Bella Gloren, MT July 27, 2014 6:42 PM
Washington DC

That is so true. I recently met a medical lab scientist from Eastern Europe. Over there they are called biomedical scientists. He told me how much input he has on healthcare and how respected he is I could not believe it. Doctors respect them a lot over there. We choose to hang in the shadows I think. It's our fault, not anyone else.

As for taking offense to the word technician, if you don't like being a technician go back to school  and get your degree. You are a technician if that is what you are. Get over it!! Don't blame other people for where you are in life. I hate that.

John Sweeny July 26, 2014 8:44 PM
New York NY

I saw that discussion on Facebook. First I was so upset that you of all people should be attacked and criticized that way. I have read your articles over the years. I have also seen you speak maybe 3-4 times.

You are known in the profession as someone who pushes for independent practice and stands up for us. You even helped me to get my employer to revisit our salaries based on our value as compared to others who were getting raises. I don't know if you even remember that.

Thank you for everything you do.

Medrina P. , 3rd shiftSupervisor July 26, 2014 6:22 PM
Atlanta GA

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