Blood Bank Rotation

I interviewed in May 2008 for a position in the Transfusion Service department of University of Virginia Medical Center.  I discovered much more recently while browsing through the back of our new Advance magazine that this hospital is currently seeking an evening shift Blood Bank supervisor.  If I remember correctly, they are not requiring any previous supervisory experience of their candidates, just "at least three years of (clinical lab) experience."

I'm wondering now whether God may be calling me to at least apply for this position (in spite of my stressful past experience working full-time in the Blood Bank of a hospital this size) and find out whether I'm needed there.  It would be a HUGE leap of faith for me to jump from a night-shift generalist position to being someone's supervisor, especially in Blood Bank at a Level I trauma center (and only 5 years after I became certified as a MLS)!

Believe it or not, Blood Bank did not become my 2nd favorite clinical lab area until after I worked in a few approximately 200- to 300-bed hospitals as a generalist - my current employer and the hospitals to which I traveled as a temporary agency MLS.

During the first three months after I graduated from MLS school at a Level I trauma center in Winston Salem, NC, I felt as petrified as you feel right now going into work at this hospital's Blood Bank every day - and stayed that way for 8 hours straight, 5 days a week!  To make an extremely long story short, SPEED and EFFICIENCY were much more highly prioritized there than organization, teamwork, or positivity.  One "Front Desk" employee was somehow expected to simultaneously receive/accession new specimens thrown at her through a window (checking the LIS and paper files for prior BB records), answer all phone calls, AND issue all blood products (running from one end of the large department to another to pick up platelets/plasma from the "Component Prep area).  Oh, and let's not forget paperwork associated with every LIS "merge" on patient records when trauma patients (for example) were discovered later to have previous medical record numbers.

It did not matter to any of my "colleagues" that SPEED comes with EXPERIENCE; all they cared about was my taking too much time (i.e. more than 2 seconds!) double-checking records/products/etc. for accuracy, which made me a loser in all of their eyes.  The technologist assigned to perform quality control for BB in the morning was also responsible IN THEORY for helping out at the Front Desk when things inevitably got crazy, but any "COMPETENT" employee there was expected to be Superwoman and handle what seemed like a million things all at once herself. (All women there on 1st shift at the time I worked there, with the exception of one guy training for night shift, lucky him!)

The lack of a positive working atmosphere and heavy workload contributed to at least three of my 20-year veteran co-workers acting like female dogs all day - and even one poor girl around my age jumping on me about how she was "actually there to WORK" on a particularly horrible afternoon.  While I had the pleasure of working with her, that hospital's current MLS program BB instructor loved to nitpick and yell about trivial things such as "GLOVES IN A TRASH CAN!!!" located underneath our hand-washing sink.  (As if anyone had any energy in their emotionally exhausted brains to remember to pitch the gloves into a biohazard container EVERY TIME they finished working in that pressure cooker before walking all the way over to said sink!)

I was stunned to actually receive positive feedback from a sweet girl (also around my age) who worked 2nd shift after I helped her restock one of our trauma coolers.  Another rare good moment happened when a nurse told me she would put in a good word on my behalf with my boss.  You see, I had stunned her by asking, "How are you doing?" when she came to my window to pick up blood - something NO ONE ELSE in this Blood Bank had done in the THREE YEARS she had worked there!!

In the interest of keeping this as brief as I can, I will just say that stress at home with my now ex-husband combined with 100 times as much stress at work influenced me to resign my day-shift Blood Bank position exactly 90 days after my start date.  I believe that surviving this experience has made me a MUCH stronger person and medical laboratory professional!

I was like you when I started Blood Bank because I had to put forth a lot of effort in class to understand it. When I got into Blood Bank it was a different story, it was great. I understood it and everything feel into place. Don't worry you will be fine as long as you study hard. I know am a generalist at a 700+ facility and we are the reference lab in our area also. I love when I am in Blood Bank...It is now my absolute favorite.

Blood Bankers are the best. I am still learning new things every day in this field after 30 plus years. You learn the basics in school but you learn 3 times as much when you work in it and when you are bench savy.

Our job as trainers is to make you feel comfortable and confident about performing the tasks that we teach you.

Just listen up and you will do fine. You may even find that you love it.

I like Blood Bank almost as much as Microbiology because they're both very hands-on areas of the clinical laboratory.  I also enjoy the "process of elimination" and logical/critical thinking involved in interpreting the results of antibody identification panels.  In our Danville hospital laboratory, the technologist who works Hematology on night shift usually works in Blood Bank as well.  However, I always seem to be the go-to person who the less BB-comfortable 2nd shift technologists ask to help them with tricky antibody problems the second I come in at 10, and I like doing what I can to resolve that stuff even if I happen to be working on the Chemistry side that night.  Teamwork is GREAT! :)

The most serious, possibly fatal problem in Blood Bank is a hemolytic transfusion reaction - caused by a type O person receiving type A, B, or AB blood, for example.  That's why you should always make absolutely sure the identifiers (name, medical record number, date of birth, BB bracelet ID number  - whichever of these are designated by your hospital on BB specimens) match on your specimen tube AND whatever paperwork you receive with it.  A mislabeled specimen is unfortunately an extremely common cause of mistyped patients who are transfused with an incompatible type of blood.

Of the several transfusion reaction evaluations I've seen in the last five years, most of them turn out to be some sort of allergic reaction or something else other than a hemolytic reaction.  A couple of dead giveaways that you ARE dealing with a hemolytic transfusion reaction include a hemolyzed post-transfusion specimen (red plasma after the tube is spun down) and bloody urine specimens. (Post-transfusion blood and urine are collected in the event of transfusion reactions at pretty much any hospital, if I'm not mistaken.)

Have fun in Blood Bank, and don't stress out too much! :)

Do not fret....blood bank is an awesome place to be!  Remember, a mistake made anywhere in the lab can be fatal or cause harm to a patient. Doctors make treatment decisions based on the results we put out.  Bad results=bad decisions. Organization and accuracy are important for all lab departments not just blood bank.  I'm sure you will do just fine and learn lots of cool stuff.  Good luck!