As long as I’m on a how-to-find-a-job jag, it’s only fair to mention Facebook. According to the website Statista, as of the second quarter of this year there are 1.49 billion active members on Facebook, a number that has steadily climbed since 2008.
Facebook and other social media allow people to connect across states and even time as we create a living diary of our lives. We post where we’re going, what we’re doing, what excites us, and what upsets us. Facebook can reveal if we’re optimists, pessimists, complainers, helpers, bookworms, party animals, how much time we spend playing online games, and even what our sense of character is in choosing friends. Good, bad, or ugly, our Facebook face tells the world (at least our friends) who we are.
Rachel Ryan writes on the Huffington Post site that she caught her bosses Facebook stalking a potential hire. (One way around it is to change your name.) Kashmir Hill sums this up in Forbes with, “those who don’t want employers looking them up on Facebook pages are fighting a losing battle.” Indeed. As far back as 2009, 45 percent of employers screened using social media sites, and Facebook is the most common. An incredible 35 percent of employers did not hire based on content uncovered.
Think about that a moment. It used to be that work was work and play was play. But now lines are blurred. Employers use sites such as Facebook to find out what kind of people they have hired or applied. And why not?
It may seem unfair, but if in the 1980s you and your friends wrote comments on a bulletin board posted in a hallway at a local mall for everyone to see, it would not have been outrageous for employers to troll the comments. That’s what Facebook is, a public declaration of who you are, what you like, and whom you associate with.
This isn’t a freedom of speech issue. An employer has every right to protect its interests, especially when considering the financial wisdom of hiring you to do the same.
NEXT: What Are Your Skills?
In a paper world, a resume is a one-page flier tacked on a pole along the highway of your career, part lost puppy notice and part Call Me! for this or that. Since paper is an ideal medium for display
purposes, a resume can be dressed up with different colors, textures, and layouts to get you noticed.
In a virtual world, a resume is still written for paper. Fonts styles and sizes are carefully chosen and white space judiciously used to make it look just so. Saved as a PDF, it still looks exactly like a paper page,
which is the point of Adobe’s format.
But as Lisa Vaas writes on the career advice site The Ladders, “job seekers must
create an alternate, plain-text, internet-ready version of their resumes for those occasions when it is requested, and it often is.”
It’s common to register at a job portal and fill out an application with text boxes to paste a cover letter and resume. Sometimes you can attach a PDF, too. Since these text boxes accept text without any
formatting other than spaces, you’ll need a copy of your resume saved as a plain text document using Notepad or a similar editor.
Open your resume in Word, right click and choose “Select All,” then copy and paste the text into Notepad. You can use keyboard shortcuts or the Edit menu. The lack of formatting makes all text look the
same and left justified, but once in Notepad add spaces, carriage returns, and bullets using dashes or periods. When filling out an application, the process is reversed: open your text resume in Notepad, Select
All, and copy and paste into the text box in your browser.
I’ve wondered, “Isn’t the point of a resume to get me noticed? How does boring text do that?”
It doesn’t, but content does. It embeds your resume in the middle of your job application. It’s nice to make it look pretty, but it’s better for employers to see everything in one place. And if you don’t, your
competition will. Why take the chance?
NEXT: Your Facebook Face
Don’t you love business buzz phrases like low hanging fruit, thrown under the bus, thinking outside the box, and take home message? I recently attended a jobs workshop and received a great take home message. In fact I got several. If only business meetings were all so productive.
Here are two:
Create a master application. A resume contains some of the information that goes on a job application but not everything. The purpose of a resume, after all, is to get you the all-important interview. It’s a tool to market yourself, highlighting whatever aspects of your career make you stand out. But a master application contains everything in detail you need to copy and paste into an online job application. It can save a lot of time looking up addresses, telephone numbers, supervisor contact information, and other details. An online search can find PDF applications where you fill in the blanks. Your master application should be regularly updated alongside your resume.
Create a professional email. Giving a potential employer a cutesy, obscure, silly, or sophomoric email address tells them right up front you don’t want to be taken seriously. This one is so obvious I’m sure most people miss it or just don’t want to create a second, third, or fourth account.
Fortunately there are two really easy alternatives to creating extra email accounts:
- Yahoo - Yahoo mail allows “disposable” email addresses that can be used to route emails to your account. It’s easy to create a basename (you are only allowed one) and keywords for your search (up to 500 keywords are allowed). This is a great way to create a professional email address without the hassle of another account.
- Outlook - Microsoft Outlook (formerly Hotmail) is even easier. You can create an email alias. As far as I know, you can create as many as you want. This is more versatile than Yahoo, because you can delete an alias and even make it your primary email address, changing the character of the account.
These are outside the box take home messages. At the end of the day it’s a win-win.
NEXT: Plain Text Your Resume
Some time ago I read Good to Great: Why Some Companies Make the Leap... and Others
Don’t by leadership guru Jim Collins. The book describes why some companies are good and others are great. It’s a worthwhile read. It turns out that being great isn’t a huge leap, luck, or
circumstance. It’s a choice.
It fascinates me to consider two businesses that are identical on the surface: same service area, same customers, same services, etc. Yet one is just Ok to work at and the other is great. One complains
about a lack of good help and the other attracts talent. One has customers who treat it as a second choice and the other loyal followers. One is criticized and the other praised. One is avoided and the other loved. And one has no idea why the other is great, because it can’t see the real difference. Worse, it can’t imagine what the difference could be.
Customers experience the difference. I know I do.
There’s nothing wrong with “good,” but it amounts to settling for average. Don’t we all want to work for great hospitals, great labs, great bosses? Do we see “bad” as the only alternative?
Too often we’ll say, “My boss is Ok” or “this lab is a good lab.” There isn’t anything wrong with that per se - it beats working for a jerk or in terrible conditions with poor quality - but is that
really a benchmark? If we settle for good because it’s better than bad, we won’t be great. We won’t even think it’s possible.
“The good-to-great companies made a habit of putting their best people on their best opportunities, not their biggest problems. The comparison companies had a penchant for doing just the opposite,
failing to grasp the fact that managing your problems can only make you good, whereas building your opportunities is the only way to become great,” writes Collins.
Maybe I’m making too much of semantics but think about it. If someone asked you, “How is work?” what would your answer be? What do you want it to be?
NEXT: Job Search Tips
Since the laboratory is a mystery to many in your organization, it’s a good idea to use any arbitrary rules as teachable moments. You might be surprised how many of these exist.
- Specimen labeling rules
- Specimen rejection rules
- Wristband protocols
- Compatible blood types
- Reporting microscopic values
To an outsider, many of these seem subjective. A nurse in the ED with only one patient is reasonable when she asks, “What do you mean, I have to recollect that throat swab because it’s unlabeled? I only have one patient!” A laboratory is correct in rejecting an unlabeled specimen that is retrievable, but the rule can seem arbitrary in the sense that it doesn’t take circumstances into account.
In other cases, technical knowledge is lacking to understand the fine rules. For example, not every nurse transfusing a unit of packed cells will know what types are compatible; this can be even more confusing when giving multiple component types. I once dealt with a physician who didn’t want to switch a bleeder from O Negative to O Positive because she was sure it would kill the patient.
If your rules are consistently enforced, it’s possible that everyone will learn and no longer question them, but that doesn’t imply understanding or agreement. It’s likely that a nurse might think, “Not again!” and get frustrated (or angry).
It’s worthwhile to identify these rules that seem arbitrary to outsiders and ask if there is a way to be proactive, change a process, or use each instance as a chance to educate. This can be difficult in the moment, since someone asked to recollect a sample or accept an unusual value may not have the time or be in the mood to hear why.
But there are opportunities to be proactive: a newsletter, a standing slot in the nursing department meetings, daily rounding, regular check-ins with physicians, etc. There are always chances to explain why we do things. It’s always been my experience that people appreciate understanding why.
NEXT: Are You Good or Great?
Now that Windows 10 is here (it’s free if you have Windows 7 or higher) laboratories should worry about computers still running Windows XP. These include desktops in offices, laptops, and data managers attached to an instrument.
The problem with Windows XP is more than being old (it was released in 2001), ugly (the “Teletubbies” theme is outdated, to say the least), and limited (it can’t recognize more than 4 GB). Windows XP is a big security risk and getting bigger every day.
Microsoft ended official support for Windows XP in 2014, which means there are no more automatic security patches. About 17% of computers are running XP (the Windows 10 upgrade won’t affect this) as reported by CNET. That’s still a sweet target for hackers, especially since this percentage varies by industry. Public utilities still run largely on XP. As reported by Forbes, the reason could be that IT departments pay more attention to business and office systems than manufacturing and industrial applications.
This might be true in your hospital, too. Business and administration offices tend to get newer computers and operating systems, while data managers are upgraded with new instrumentation. IT departments tend to stay away from proprietary systems with separate service contracts.
It isn’t just operating system patches that have ended. Gradually, support for all software on XP will end or has ended already, such as Microsoft’s Security Essentials. That means XP is even more vulnerable to attack.
What can you do about XP?
- Ask your IT department about an upgrade schedule for any standalone PCs such as an office desktop. If there are no plans to upgrade, ask about more secure access such as a remote desktop connection. They may have alternatives in place.
- Inventory operating systems in your laboratory, including data managers attached to large analyzers. Anything older than five years might be running XP.
- Check with instrument manufacturers to determine the cost of upgrading any data managers. It might be time to upgrade the instrument, too.
Fortunately, the problem with XP is simple to fix: it’s got to go.
NEXT: Arbitrary Rules
Laboratories have policies about what and when to call results to providers. Usually, these are critical values or those that significantly delay treatment e.g. a positive antibody screen in the blood bank. We all have at least one story about that time a provider on call couldn’t be reached, was angry when he or she got the call, or claimed the patient belonged to another provider. As policies are written everywhere, the baton is ours until someone else takes it.
I worked evenings many years ago and once tried to call a critical value to the pediatrician on call. This was before cell phones, and he didn’t seem to be anywhere near a land line. His answering service didn’t know where he was, and the nurse manager couldn’t find him. “We even tried the donut shop,” she told me.
I’ve awoken a few docs in the middle of the night who complained that they didn’t need to know the result. That’s always fun. I’ve tried reaching docs on call at other hospitals in the area with critical results on outpatients during the evenings and weekends, too. That’s also fun. Depending on the personality of the provider, this can be intimidating to younger, inexperienced techs. The last thing anyone wants is to be yelled at or complained to for following a policy.
Alert policies are interesting in themselves, since they are developed and approved locally with a medical staff. Two hospitals thirty miles apart will have similar but different policies. I’ve run into that issue as well. One hospital, for example, may have a critical INR of 4 and another 5. Both labs follow their policy, but providers may see patients who have lab work done at either or both labs.
I’ve tried with mixed success to share, combine, or compromise on these local policies to help providers. It’s always struck me as a no-brainer to have a regional alert policy for those hospitals with overlapping service areas - has anyone done this? - but I don’t see it happening until EMR technology forces the issue. Should labs take the lead?
NEXT: The Problem with Windows XP
At a meeting our QI director at that time pulled out a folder and told me, “These are your troponin turnaround times.” It showed hardly any times under 60 minutes, an industry
consensus. Most of the times were over 90 minutes. When I returned to the laboratory to check the numbers from the information system, times were far lower.
In one study, the median diagnostic TAT was 122 minutes. Four points were measured: the time
of ED arrival, the time the test was ordered, the time when the blood samples arrived in the laboratory, and the time of completion and reporting. For many laboratories, only the last
two times are known with any certainty. In the above study, the laboratory time was half the complete diagnostic TAT.
Accurate timing is critical. In our case, the time of arrival was recorded from memory in the patient chart by the attending nurse. This was sometimes earlier or later than the
electronic registration time, depending on who visited patient registration. The electronic ordering time is known, but verbal orders and arrival of samples in the lab are not.
One scenario, for example, is that a patient with chest pain arrives by private vehicle to the ED. The attending RN places the patient in a room while alerting the physician, who gives a
verbal order to start an IV line and draw labs. A family member goes to patient registration. By the time the patient is prepped for the IV a patient registration clerk arrives with a
wristband, and the patient is identified and banded. Labs are drawn and sent to the lab. All before the physician sees the patient.
All this illustrates how subjective turnaround time is. This process is efficient from the ED point of view but does not capture data that reflects troponin TAT from a diagnostic
perspective. And while the consensus target is less than 60 minutes, it is from arrival to completion.
As another study points out, this is possible if ED and lab collaborate. This is a great improvement opportunity. Has anyone collaborated and been successful?
NEXT: On Call Providers
It makes sense for an employer to encourage employees to use their time off. It also makes sense to be as fair as possible. And here’s where it gets interesting.
As a bench tech you may feel that your vacation time is arbitrarily denied or other techs are given preference. The same thing happens to managers. I’ve worked jobs where I could
not have specific days off each month, no matter what, and others where a last minute inspection or crisis cancels time off. Managers get called back from vacation, too.
The word fair means “free from bias, dishonesty, or injustice.” Problem is “fair” is itself subjective.
What I think is fair and what you think is fair are often different. It doesn’t matter what our roles in the organization are. Seniority, desirability of the time off, existing policies, and union
rules all add to perceptions of unfairness.
Is something unfair if it happens to someone else and doesn’t affect you? I’ve seen new hires treated unfairly, and those with seniority in the organization will say, “We’ve paid our
dues.” They don’t have an opinion or believe it’s fair until it happens to them. Uh-hunh.
The solution is to schedule vacations in a transparent, open fashion with ground rules that everyone agrees upon and understands. That way a manager only has to be consistent to
be fair. Here are a few ideas:
- Set a minimum staffing plan that is clear to everyone with an agreed upon rule of thumb e.g. no more than 2 people off the same day.
- Map weekends and holidays as far ahead as possible, and hold people accountable to switch with each other as part of their vacation planning.
- As a manager develop a clear replacement strategy to avoid busting the budget. Don’t just let everyone have vacation and fill all the holes with per diems or overtime.
A great rule to establish immediately is “Everyone’s time is equally valuable.” This might be a tough sell in some labs, but without it unfairness is a given.
How does this work (or not work) in your lab?
NEXT: Faster Troponins
Vacation time - PTO (paid time off) or ETO (earned time off) - is a benefit offered by many organizations. There are no federal regulations regarding what employers should do, but most who offer it do so on a seniority scale. The longer you work at an organization, the more time you earn off, with a peak average of 27 days a year for 15 or more years, according to Salary.com.
Organizations may offer vacation time as a separate benefit from holiday or sick time. Or everything is taken from the same bank. Payroll is a fixed expense - employees are paid unless they are on FMLA or some other leave - and vacation time is an accrued expense that adds up quickly on the books. It’s in the interest of your organization to encourage you to take all your time off. Managers should create a staffing plan around how much time off people can take.
Does your organization encourage you to take time off? Does it have a consistent policy?
I’ve never heard of a place that encourages vacations, unless it’s the end of the year and it’s “use it or lose it” because time won’t roll over. Every organization I’ve worked in expects employees to track their vacation benefit and ask for time off as far in advance as possible, with or without guilt. Some employees plan vacations for a year, others use almost all their time during the summer, and a few ask for a day of vacation as soon as they accrue a day.
Suzanne Lucas writes in CBS Moneywatch that 47 percent of workers call in sick just to get a day off, but 72 percent of their coworkers are onto them. This could mean employees are being treated unfairly e.g. vacations are arbitrarily denied. “Getting a day off (one that you have earned), can be difficult. But, if you say, ‘Gosh, I'm sick,’ there's nothing a boss can do about that. Sick is sick,” Lucas writes.
Too much sick time is a clue. Next, I’ll consider a fair vacation policy.
NEXT: Scheduling Vacations
Summer is hot, even in Maine. We do more outside, stay outside for longer periods of time, and sweat more. Employees may exercise by walking a lunch break or may sit outside during breaks and meals to enjoy the weather. Laboratory environments can be hot and humid, and changes in temperature between the laboratory and patient rooms can seem extreme. All this adds to a need to drink more water.
Lost fluids must be replaced or dehydration results. What’s interesting is that even mild dehydration (1-2% of body water) can have noticeable effects on work performance.
Industrial Safety and Hygiene News reports that numerous studies link dehydration to lower physical and mental performance. Dehydration impairs motor tracking, short-term memory, and reaction time. It may even increase the likelihood of fainting when changing from a sitting to standing position.
WebMD reports that a study published in The Journal of Nutrition concludes mild dehydration can cause dampened moods, increased fatigue, and headaches in young women. A previous study on male subjects showed similar, if subtle, mental difficulties when dehydrated.
As we age we lose body water, increasing our risk of dehydration. This is a concern for the elderly but also for older techs working in hot, stuffy environments where they may not drink water throughout the day. It’s just easier to become dehydrated at 60 than it was at 20. (The more I hear about getting old, the less I like it.) Other factors include diabetes, medications, and stress.
Staying hydrated is easy, but it takes consistent effort. Plan to start your day with a glass of water and then throughout the day using the rule “a little but often.” It’s easy to underestimate the amount of water lost while sweating, in particular. Instead of using the “eight glasses of water a day” rule, go by the color of your urine. For lab techs, that’s easy enough. Pale yellow is just right.
All this might seem obvious until you start minding how much or how little water you drink throughout the day. Rehydration should be a constant effort to replenish water lost.
NEXT: How Many Vacations?
Catalase is an enzyme present in many living cells responsible for breaking down hydrogen peroxide (H2O2) into water (H2O) and oxygen (O2). It prevents peroxide, a byproduct of many reactions, from damaging cells. Catalase is also used in food and wastewater treatment industries.
The catalase test is a simple microbiology biochemical test to speciate Gram positive cocci. Using a loop, a colony from an agar plate is smeared into a drop of hydrogen peroxide on a glass slide. If catalase is present, released oxygen produces bubbles. Staphylococcus is catalase positive (bubbles). Streptococcus is catalase negative (no bubbles).
This reaction is so simple that it’s hard to forget. For many of us, it was one of the first tests learned to identify bacteria. It’s a classic manual test that hasn’t changed in decades (if ever). And for the most part it is foolproof.
Other common bacteria produce catalase, of course, including diphtheroids (Corynebacterium). Enterococcus is catalase negative. Most microbiology labs have flowcharts to detail how a catalase test is applied in identification of Gram positive bacteria in sources. For the most part these, too, are foolproof.
Well, you know how these things go. There are always exceptions that make laboratory medicine fascinating.
A novel strain of Streptococcus didelphis, for example, is catalase positive. Morphologically similar to other streptococci, this strain is unique, showing a strong catalase reaction similar to staphylococci. While its virulence factors are unknown it causes lung, kidney, spleen, and skin lesions as well as septicemia. The good news is that so far the literature only reports this strain in opossums and raccoons.
Two species of staphylococci are known to be catalase negative: Staphylococcus saccharolyticus and Staphylococcus aureus subsp. anaerobius. The latter has been isolated from diabetic foot ulcers, and it’s likely a human pathogen in other settings, although the incidence in unknown. We simply don’t look for catalase negative staphylococci.
While this is the kind of thing that could keep an infection control nurse up at night, it’s more of a typical exception in laboratory medicine. It’s one reason this job remains interesting after so many years.
NEXT: This Summer, Stay Hydrated
Consultant Rebecca Mazin complains on the website All
Business, “I have personally noted many examples of flagrant, highly inappropriate workplace texting.” What about your laboratory? Chances are, it’s happening regardless of policy
enforcement. A 2011 Pew Research Center report found that Americans age 18 to 29 receive five times as many text messages as telephone calls. It’s a safe bet some of this happens at work.
According to Career Builder, employers rank cell
phones and texting as the number one productivity killer (number two is the Internet). Technology has bumped old fashioned gossip around the water cooler and in the break room to
number three. Employers are scheduling break times, monitoring computer use, limiting meetings, and favoring open office designs to limit social time wasters.
Fortunately, most lab techs are parents of children 18 to 29, not so much into texting every thought and posting every feeling, and laboratory productivity is largely a matter of
monitoring automation. And who measures the productivity of paranoia?
All this is, I suppose, a natural adjustment period to what is relatively new technology. Imagine the furor in mid-15th century Germany as employers worried about the distractions
caused by employees reading books once Gutenberg came along. The reality of new technology is that it always brings change, much of it good.
Texting is a good way to communicate in a minimally intrusive, efficient way. I’ve received pages, texts about the arrival of a salesperson, reminders, and other short, useful
messages. Techs find it easier to text simple questions about scheduling. In every case these are simpler, quicker, and quieter than a telephone call.
Secure texting is also a reality, making it possible to text lab values directly to physicians or patient status updates to nurses. One service called TigerText, started in 2010, allows
secure messaging over cell phones, claiming to be in use in over four thousand healthcare facilities. As their site succinctly puts it, “By providing the ability to securely communicate in real-time, administrators, clinicians and staff are able to more rapidly address
patient needs and drive toward better outcomes.” 8^)
NEXT: Catalase Oddities
Layoffs, cutbacks, mergers, downsizing, and outsourcing, common in business, have come to healthcare and laboratories. What used to be a secure job with plenty of opportunity now is filled with unknowns in an uncertain economy. According to Forbes the average worker is interrupted seven times an hour and distracted over two hours during the day. It could be more for the average bench tech. And it’s no secret that healthcare has been struggling with a greater demand for services for less money. Cutting a budget only works so long, and any bad news from administration always seems like a threat. It all adds stress.
Reducing stress is crucial to better patient care and for you to make good decisions about your career. How do you do it?
First, recognize stress. Some of the signs are: feeling anxious or irritable, loss of interest in work, trouble sleeping, fatigue, stomach problems, loss of concentration. Even if you aren’t stressed, those who are around you will affect you in a negative way.
One site offers these tips:
- Take care of yourself. The last thing you need to lose is your health. Regular exercise, healthy food choices, a minimum of alcohol, and plenty of sleep will give your strength and perspective to reduce stress and make good decisions about your future. Think of it as a boot camp for going to war with stress. You can win!
- Act, don’t react. Prioritizing and organizing are two steps that will give you more control and better balance between work and family. Don’t over-commit, try to leave earlier in the morning, and plan to take breaks. All work and no play, etc.
- Improve emotional intelligence. You can learn to use your emotional energy in positive and constructive ways that draw people to you to overcome differences and work together to reduce stress. Recognize when you're stressed, paying attention to your body language and nonverbal cues. Use humor.
The site has other good information worth checking out, and there’s a lot of other excellent help to be found with a few searches. Why not start today?
NEXT: Texting at Work
ABC News reports Medical Professional as right in the middle of the most stressful jobs in America, right behind working parents, deployed military personnel, and police officer. These types of lists vary from survey to survey, but the reason stress is high is the same: when the stakes are high, the pressure is on.
The CDC reports alarming statistics: a quarter of employees view their jobs as their number one stressor; 40% of workers say their job is “very or extremely stressful;” 26% are “often burned out” by stress; most believe there is more stress than a generation ago.
Much of this stress comes from an accelerating pace of change and loss of control. In the laboratory, this includes increased regulation, increased competition, decreased reimbursement, and more demands on skill sets not taught in laboratory programs (think meaningful use). More and more, clinical professionals are being asked to be data analysts and business experts, and somehow more patients have to be treated with fewer resources, fewer people, and lower cost. Not all change is bad, but it all adds stress.
For a bench tech stress can be brought on by: low wages, excessive workloads, few opportunities for job growth, work that is not challenging, lack of support, lack of control, and unclear performance expectations.
Signs and symptoms include: feeling anxious, irritable, or depressed; losing interest in work; problems sleeping; fatigue; trouble concentrating; headaches and stomach problems; social withdrawal; using drugs or alcohol to cope.
None of that sounds good, but it sounds believable for a short staffed, overworked laboratory with an uncertain future as hospitals everywhere look to cut costs, downsize, merge, and outsource just to survive. It’s a recipe for less attention to detail, cutting corners to save time and money, and making more mistakes. That adds more stress, too. Does more stress make techs scared they will make more mistakes? You bet.
But change is here, the industry is not what it was a generation ago, and neither are we. How should we cope with this stress at work? How do you? Please share in the comments.
NEXT: Reducing Stress