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Press Start: Lead an Empowered Life as a Clinical Laboratorian

More Negative Press for the Laboratory

Published May 17, 2015 1:58 PM by Glen McDaniel

 A little while ago I wrote a blog in which I referred to a great, balanced, intelligent article written about the medical laboratory  and printed in The US News and World Report. That article was remarkable by its rarity. I asked my readers to respond directly to the writer, thanking her for a positive article. Many of you contacted the journalist by email and Twitter, much to her delight.

This morning, another article crossed my desk. This one is a hatchet job written by a journalist for the Journal Sentinel. It is an indictment of the laboratory written using sources who have been harmed from inaccurate results generated by laboratories. Everyone from accreditors to MLSs/MLTs are assigned blame. Reference is made to shoddy habits like the use of expired reagents and mixing up samples.

To read this article it seems like there is no standardization, there is no quality assurance, and every lab test has the potential of leaving ruined lives in its wake.

Some of the "experts" who commented for the article are laboratorians and I would like to think they were misquoted or their words were taken out  of context. It's disheartening to think fellow laboratorians would allow such a biased and unbalanced piece to see the light of day.

There is a lot of buzz on social media about this article: mostly hurt feelings and righteous indignation. But as I pointed out on Facebook, commiserating among ourselves is not going to educate the journalist or the public; and will not change anything.

I strongly suggest you read the article and weigh in here. Feel as indignant as you want to, but , more importantly, respond by contacting the journalist ( reached at egabler@journalsentinel.com or (414) 224-2071) and her editor.

12 comments

A few days ago during the Miss America televised pageant one of the contestants, Kelley Johnson representing

September 19, 2015 4:00 PM

Hi, I'm the creator of the Facebook page lab humor. I wrote a response to the journal article you are talking about I read it and was livid . In my haste I admit I was quite harsh with my words , but  I did back up my statements with peer reviewed quantitative studies . Sadly the reality of what we see in the lab day in and day out is a combination of disrespect and misscommunication . You can see my response here www.facebook.com/labhumor .

I try to lay out the problems I have seen as best I can here

When I first started being a lab tech 3 years ago I noticed a few things . The first, and most important being the complete disconnect between the lab and nursing staff. They have some of the worst communication between two departments than I have ever seen . Here are some communication breakdown and disputes that are most common .  

1.

Collection criteria,  

in recent years budget cuts to hospitals have forced many places to not hire, or lay off all or most of  the labs phlebotomists leaving just nursing staff to draw the blood for the lab. When this transition occurs there is a major lack of training on the part of the nursing staff on how to draw blood , don’t get me wrong some nurses are great at the following the requirements and understand the implications of a bad collection   .  However many times, and my peers can vouch for this,  they submit specimens collected in a manner that would not be accurate for testing, so we are constantly calling them, telling them to recollect. This may leads to a sort of trial and error period where each nurse has to get the same thing wrong a  time or two before they get it right, then there will be a nurse who just thinks the lab is all a bunch of jerks for making her stick patients again and call them back after they already left because they were an out patient . Home health nurses have to drive back to the patients home . Having to get a specimen recollected is a major issue which happens way too often , the lab might never get a few specimens because of this error in communication and training. At some point nurses just give up trying and they have you come draw it . You have to leave the lab or your department unattended for 15 20 minutes or so to walk down to the wing of the hospital they are on and draw the patient . Meanwhile  in lab a specimen could be left on the counter by a nurse from the floor where a patient is losing blood rapidly. You get back and that one is not collected properly, this was meant for blood typing and they did not arm band the patient or transfer it from the syringe they drew it in. This means the lab must be left alone again all the while turn around times for the stat labs you so desperately need, not just for the blood bank patient , but the patients that are in every department of the hospital are  suffering, if you are a nurse reading this and are upset I mean no offense really my mother is a nurse , but this kind of thing happens quite often.

  2. Lab techs have to know what is important .

Being so far from the patient means there is no sense of urgency unless it is created by them from knowledge of results . If a lab runs efficiently then companies can grow by going above and beyond in patient services . Not only can we catch something important and do things like brave a winter blizzard to get out there and get you these results but we can keep  the patient from having to ; drive home , get a call the next day or at dinner time telling them they need to come back because of some results on some tests. An efficiently run lab can make things go more smoothly and save the medical staff and the patient valuable time in the back and forth .

3. Everyone blames the lab  they never see the breakdown in the chain of communication from our end . They just tell the Dr. , the patient every one that “the lab messed up “ not many nurses will straight up tell a patient “ i messed up” . This defensive behavior keeps the problem from coming to light .  

4. It’s 2015 and we can’t get faster data transfer from the Doctors and nurses ? We should be able to instant message the Dr./ nurses  at their keyboard by now . They should be able to easily find a test with a better system . Nothing is worse than when they order a wrong test and it was a send out to another lab . It may be a week before that problem can be resolved . that really isn’t even their fault it’s the hospital information system’s. Sometimes test have very similar names and with Drs handwriting being like it is there’s no wonder the wrong test gets ordered . A better system would fix this.

michael trudell, medical lab - mlt, makalapa clinic May 21, 2015 9:57 PM
honolulu HI

I was just plain mad when I read the article. I had heard nothing about it until I saw your blog. This writer is just sensational.

She might have scared away a few people and make them second guess the lab and even their doctor. But what good does it do?

In my entire career I have thought the lab is probably the most anal part of healthcare. We document, measure, run QC, record temperature and obsess about every process. We calibrate, we  correlate, we validate to death and then start over. we are legislated half to death.

Mistakes are made because we are human. However it is not the norm and t is not because of any cavalier attitude.

To suggest we secretly all decide to cover up is just nonsense.

Martha Hewling, Lab Manager May 21, 2015 7:47 PM
Miami FL

Education is definitely the key!! Continuing education is paramount. Too many of these issues stem from the fact that those with the "power" to ensure that laboratory staff (from the bench on up) have all the knowledge they need in regard to current blood collection practices, instrumentation etc. aren't doing their job. The issue, as I see it is that laboratory managers appear not to be required to even have an understanding of current practices. I have been on the receiving end of comments such as, "Well, I'm just not technical anymore" and, when running instrumentation comparisons (that weren't comparing) "Well, is it clinically significant?" Sure, these managers have "technical specialists" or "supervisors" or whatever you want to call those directly under them, but when they have the same skill set as the manager, where does that leave things? Where does that leave staff that need direction? And most importantly, where does that leave our patients. Licensing/inspection bodies need to begin to allow commentary in this area by the people at the bench and they need to listen. Something needs to be done.

Reading many of these comments here I think medicine is not going to be ready for me or my peers as patients. We are going to be the ones who ask the questions and know what the answers should be and I can only say get ready and good luck.

Laurie May 19, 2015 4:36 PM

I was appalled at the bias of this article and I did email the author with my views. However, I am almost more appalled at the response from members of our profession placing blame on everyone else or encouraging this reporter. This tells me we have a huge problem with the culture within the laboratory field. Many of these respondents are feeling under appreciated and over worked. They remind me of neglected children who feel that negative attention is better than no attention.  I challenge all lab managers to step back and consider if you are treating your employees like the professionals that they are or like workers on a production line. Also, we as a profession need to overcome the lab vs nurses, doctors, world mentality and foster  a culture of cooperation to support the care of our patients.  

Barbara Welsch, medical laboratory - Administrative director of laboratory services, Crossing Rivers Health May 19, 2015 8:01 AM
Prairir du Chien WI

Yes, all medical personnel are on the same team. We are there for the patient. We have to all remember that every single day. But I can't count the many times that a nurse has accused the lab of sitting on results, clotting the samples, pouring off micro-tubes, etc. all because we have some personal vendetta against that specific nurse. Yes, we have had that accusation made many times in my lab. We've also had the  'I have a for year degree' line.  It is very difficult to feel like we're all on the same team, when we are treated like vindictive brats. I personally find it insulting, and unprofessional.

Patient care could be greatly improved if we all remember why we went into medicine.

The lab is only trying to get accurate results out so patient care is not compromised. Because we are there for the patient.

Nichole , Medical - MLS May 19, 2015 1:43 AM
Salt lake city UT

"Stand up for the lab"? It would be much easier to do if pathologists had the lab's back instead of kowtowing to hospital administration. Join committees? I've been told, "Oh no, we don't need lab on this committee." Also, god help you if TATs on your bench are high because you were at a meeting and nobody was available to cover your bench (because of staffing shortages).

Christine Gasco, Generalist - Medical Technologist, Bay Pines VAHCS May 19, 2015 1:21 AM
St. Petersburg FL

Thank you for writing this article. I am unique in some ways because I am both a nurse and  a former tech. I see the healthcare world from both sides. I love nursing but I miss the lab sometimes and I am a friend of the lab forever!

I have been reading discussion of this article on Facebook and I also visited the site of the Sentinel where the article is printed.

On Facebook it seems the angle is to blame nursing and everyone else.  As you said, Glen, complaining among yourselves will not help. I educate nurses and doctors about the lab and have some clout. You need to educate people not just blame them and point fingers.

On the Sentinel newspaper site I read the article and the comments.  I really don't know if all the people who claim they are MTs really are MTs. but a fair amount of them agree that the lab make mistakes. It is important to be honest but the reasons labs make mistakes should be a discussion among y'all not attached to an article by a journalist saying the lab is always making mistakes. Use the opportunity to educate and tell your experience of high quality lab. Make positive supportive comments.

My advice is 1. don't complain among yourselves and do nothing else 2. don't point fingers at doctors and nurses because we are on the same team and 3. don't add fuel to the fire by writing the Journal Sentinel explaining the lab makes mistakes because some people don't care or the labs are underfunded. The writer and editors don't care. But they'll seize on that acknowledgment  and say even MTs/MLTs admit that the lab makes all sorts of mistakes. You are proving their point for them.

Thanks once again to Glen for bringing this to our attention and for advocating for the laboratory all these years.

Misty Taylor, RN, MT(ASCP), Nursing Supervisor May 18, 2015 11:27 PM
Decatur GA

Thank you for putting this piece together.  Many times people in the lab just sit back and complain.  But the thing is complaining doesn't do anything.  The saddest part is that most people think our only option is to complain, but it isn't.  We just have to learn that we can and need to stand up for ourselves.  Thanks for putting this out there and helping to rally the troops.  

Stephanie Noblit May 18, 2015 9:56 PM
Philadelphia PA

Terribly disheartening after the millions of accurate, life saving results submitted every year by good, dedicated, conscientious, over worked, underpaid techs, and underappreciated. I hope this woman never needs the lab.

Jonathan Thatterwhite, MT (ASCP) May 17, 2015 3:46 PM
Washington DC

This article makes me sad. We work hard every day without recognition. We are a valuable part of the healthcare team. There is so much good to write about.

I feel this lady deliberately took the low road. Notice she is soliciting people to call her with horror stories of their lab experience. What is she hoping to achieve? Have her sources been vetted?

I just think this is awful and a horrible generalization of a few bad apples.

JN MLS May 17, 2015 3:37 PM
Louisville KY

OMG. That article is awful and so unfair. I know everyone makes mistakes. Doctors, nurses, lawyers, journalists, no one is immune. But this article make sit sound that labs in general just makes lots of mistakes every day.%0d%0a%0d%0aThis article is meant to educate the public who may not know better. I hope it does not discourage people from using labs or not trusting the results. I am not sure what this lady's agenda was  but she seemed as if she set out to just write a negative article with no balance.

Junice Taylor May 17, 2015 2:57 PM
Atlanta GA

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