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It's All About the Nurses

Published June 19, 2008 11:36 AM by Scott Warner
Nurses are tough. Physically demanding, the work often requires them to work in cramped, confusing, emotional and dangerous situations. As the most visible caregivers in a hospital, they probably don't take enough credit for what goes right with patient care.

But--let's be honest--nurses get much of the blame. More precisely, they receive the emotional brunt of a mistake: the anguish of a family member, the frustration of a coworker, the ire of a doctor or the rudeness of a telephone call. Tough, indeed.

As the largest labor pool in a hospital, nurses also enjoy the most bargaining power in a union, the most seats at a department head table, the most resources in recruitment and retention, and (on off shifts) even authority over the whole house--laboratory included.

Much of the time, it's all about the nurses.

Maybe so. It can be frustrating to be a lab tech, at times, when dealing with nurses on issues like specimen labeling, patient identification, quality control on bedside glucose meters, or the best time to collect a specimen. Their culture can seem to dominate a hospital.

Lab techs are, in a word, underestimated. The unrelenting nature of dexterous precision combined with multitasking has to balance speed and accuracy. Lab work depends on understanding large, complex systems that interrelate, in vivo or in vitro. The bench worker has a culture of jikoda associated with Toyota Lean production systems that stops all work on a bench when an error is found or even suspected. The solitary authority of the lab tech goes largely unsung.

But we each see healthcare through our professional prism. Surely, to the nurses it's all about the doctors or even the laboratory some of the time. The old saw about walking a mile in another's shoes comes to mind.  Although, I wouldn't want to do it where nurses are concerned. My feet would hurt.


"If you are thinking of starting a blog--work related or not--ask first. There are likely opinions about

February 19, 2009 11:16 AM

An ED director once insisted that blue tops are drawn last and that I had "suddenly" changed the order of draw when I pointed out a collection error.  It was a nutty conversation with statements like, "I find it very strange that this has changed," as though it was all about turf.

For whatever reason there are nurses who don't recognize preanalytical issues as critical factors.  Perhaps, it doesn't occur to them that a laboratory tech has knowledge related to their job.  A simple "Why is that important?" would be a wonderful response.

Lab techs can also be critical of nursing or physician demands.  "Why did she wait four hours to pick up the blood on that STAT crossmatch?"  "Why does the physician want that test?"  We are all vulnerable to cultural bias.

Scott Warner July 3, 2008 6:27 AM

Do you sympathize with nurses? Answer our poll at

Kerri Penno, Senior Associate Editor July 2, 2008 4:08 PM
King of Prussia PA

I would also ask for the nurses to understand and respect when I tell them that a sample is unacceptable due to a variety of factors, diluted, mislabeled, improper collection technique, wrong tube, hemolyzed, clotted, unlabeled... whatever.  Not to insist on running it merely to get "a result".  

Ryan , MT July 2, 2008 3:59 PM
Buffalo NY

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About this Blog

    Scott Warner, MLT(ASCP)
    Occupation: Laboratory Manager
    Setting: Critical Access Hospital
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