Bringing in the Money

It's been busy, but I have also been procrastinating due to being bone tired at night. We are running just a tad short in one department of the lab and I have been making some serious bucks by working 8-16 extra hours a week covering until the new hires are trained. Just some quick observations:

• I ain't as young as I used to be, standing for 5-6 hours handling multiple specimens, answering phones and questions is something that I feel later on that evening.
• Phone skills- I used to be able let people go on, by I feel like most people calling, sound like the girl on SNL. "Hi, I'm a nurse on blah floor and my patient had to go to the bathroom and then the doctor came up and changed the order. We can't draw him, the moon is in the seventh phase, I have a headache...." And I'm like, WHAT DO YOU WANT! JUST TELL ME IN 20 WORDS OR LESS--Better yet in 10 seconds.
  
• No, really, I become hyper polite and perky on the phone, it's a game I have learned through the years. "When will my stat crossmatch be ready?" Me: Just as soon as I can get off the phone to finish it. I do try to be polite, but it's that imaginary conversation in my head that would get me in trouble if I ever let it out.
  
• Break time is 15 minutes, not 30 minutes and work starts at 6:30 AM. That means you pick up your little old phleb tray and get out and draw some blood.
• The phone, when it rings and I am pouring urine, that would be a signal for you to answer the phone. Three phones, three people working and why am I the only one answering the freaking phone?
  
• When I tell you to write on the requisition what you received, do it the first time. Don't act shocked when I tell you the next day that this is required.
  

Why am I subjecting myself to the extra work? It just doesn't make sense for me to market the place if we are having a problem with receiving and processing. The best part of working in the trenches, are the other lab techs, my warrior angels- when I call out for help, all it takes is one or two extra people to get through a "whoosh" moment. (Whoosh moment: a period of time when specimens are pouring in from everywhere, pnuematic tube, courier coolers and satellite drawing sites) Lab Techs are the best at team work and jump in to get the work done. It's the non- techs that need the extra help and guidance to develop a better work ethic. I'm sorry to say, but the workers who are in their twenties are getting a bad rap b/c they in the me versus us generation. (not everyone, but it is a different work world out there)

This past weekend was the prom and my son's girlfriend got her whole outfit for under $9 at the Salvation army. Too bad we didn't look there for the tux. She wore black and my son wore a black tux with white vest/tie and a black shirt, they were sharp. Here is a picture of the wrist corsage, it was gorgeous. It's nice to feel that your kid will behave on that particular night and come home when expected.They had a great time and oh by the way, she slept over in an extra room and was the first to wish me a Happy Mother's Day.

My Mother's day gift was 1.5 hours of "hard labor" by my two youngest in the front garden. The non stop barrage of verbal excuses and complaints was received with great humor. From one son being traumatized by the poor little worms being displaced to the other trying to figure out what were plants and what were weeds, it was endless comments. I loved having the physical help, and endured enjoyed the company. Now I just have to order in 4 yards of bark mulch, I wonder if I will get help with that

Saving Lives and Eating Alone- A tale of two jobs

The best part of my long work day yesterday was the evening shift spent in blood bank. I had just one GI bleed who only took one unit, but since I like to pump myself up, yes, I did save a life...the rest of the time, I was doing type and screens for pre-natals.
That little gel card on the side is what has made Blood Banking so much quicker! For antibody screens- this is where you mix patient serum with known cells to see if they have any abnormal antibodies to known antigens. We do two different cells with serum and if there is a positive reaction, a red clump at the top (this card is all negatives), then we have to do testing to see what the antibody is and then screen type specific donor units for negative reactions for that antigen. If everything is negative on the antibody screen , then we just have to pick a any type specifi unit that matches their type. Wow, that kind of made it sound like it's easy...if it's quiet, Blood bank can be the best place to work in the lab in my opinion. Even the busy times can be good. It amazes me how much has changed in 20 years in the lab.

So that's my extra shift work that I have been doing on the evening shift to make money and to help out with the tech shortage. By the way, if you know any young person looking for a steady career, Medical Technology including Cytology has a great out look. It's an active job with a lot of background knowledge and I have enjoyed working in the 4/5 labs that I have worked in the past 20 years. ( Lab people are nicer than teachers....another blog....) Let's just say that there is more of a team effort working in healthcare.

Now my day job was a lot different yesterday. I came from a very productive meeting with a doctor and two of our staff where we worked out some reporting glitches to emails that just pissed me off. And then the further I got into the emails, the more I got aggravated by what my job is supposed to be and what is expected by everyone else. I go back to the fact that I am only part time and some of the the things that is expected by others can no way in hell be done by a part timer and still be able to do what I think I should be doing. Thank God for a great supervisor. However, yesterday I just wasn't feeling the love and decided to eat lunch alone and go on the internet. I think I shocked two of my coworkers by telling them that I just didn't want to go to lunch with them due to the issues. You know, it was kind of empowering telling them how I felt.

Today I am off to the big sale at Macys with a friend to start some Christmas shopping. As I type, I have two "motors" going, Mini is lying across my stomach and Stash was just over my shoulder and is now annoying me by trying to chew on the computer. He's a nudge! No wonder he gets his whiskers chewed off!

Can a Monday get any busier?

Today I worked in Blood bank and had done 8 patients by 8:30 am after finishing the morning set up and it just didn't stop. It was the busiest day for me since I started back working in the lab per diem. I did leave to go to a meeting to determine if the directions I had for stool and urine collection were accurate. So you may be asking yourself, why directions for something we do everyday? Well, we do need somewhat sterile collections, properly labeled and brought to the lab as soon as possible. It has been an interesting topic of conversation the past few days about the stools and we have a "running" joke about needing "to go" and the creative methods that are available for specimen collection. My favorite line in the directions, is: Pick a large container that you won't need to use again.

This evening my middle son played his first baseball game in five years. It was a beautiful evening, the game was not that intense and guess what I was doing while sitting in my lawn chair? Yep, got two more squares done for the afghan. It's amazing how quickly I can make them now and can crochet without directions. Like I told Shelly, if a left-handed blonde can learn how to crochet right handed from on-line photo tutorials, then anyone can. Time now to get back to the squares to tuck in the ends. Shelly should be getting my first set of squares early next week.

The limericks are all in and the judging should be taking place tomorrow night! What a great showing of creativity.

What a Life!

This has a been a great week of blogging, work and family life. It has been fun getting back into the creative part of writing through blogging. Through the TT13 post, I have learned about the Poetry Train blog which I will check out on Monday. Plus, I am still reading through the blogs written for the group writing project last month at Inspiration.com. I read a few every other day or so and it's an interesting concept to see where people find their inspiration. So if you're looking for inspiration, reading through some of these blogs may lead you in a direction that you might not have thought of for yourself.

The limericks are coming in and there are links to all the limericks on the right. Rock Chick wrote a whole post in limerick form and you know, I think she could write a few tragedies and comedies in that fashion just like Shakespeare! Speaking of comedies, Shelly has a "Blow up My Dress" writing contest going on over at This Eclectic Life for your funniest posts. You know, the ones where you get a comment that tell you people laughed through reading it, the old "laughed till I cried".

Work was productive this week, but with "this time of the month", I am always tired. So at one particular meeting where my supervisor was talking about a new chlamydia (a sexually transmitted disease) test that we needed to bring out to the offices, I was too tired to say much, but caused giggles around the table when the directions for the male test were being read aloud....." Place the shaft in the tube and break the shaft"...... All it took was just raised eyebrows at one other person at the table and we lost it. Who says that you can't act like a pre-teen when you're over 45?

Home- Everyone is getting along. Whoopie, right? Ha! You just try working around one car for two teenagers, one working fulltime and the other still in high school with a part-time job. Kissinger's got nothing on me when it comes to bringing warring countries to peace, bet he would find it tough with two testosterone surging young males with one car. Yea! My middle guy is working at a fast food place and learning about the real world. Work is the best thing for teenagers, shows them how important it is to do well in school, so you don't end up making sandwiches for the rest of your life.

Weight Watchers- Went to a meeting this week and decided that it was time to do it on my own using WW etools. I have already lost over 23 pounds and the whining about being denied at the meetings gets boring. As a lark, I bought the Hostess 100 calorie packs, and it was indeed a lark, check out the "untruth" in advertising, I put the quarter up for size comparison. At the cash register, the cashier and I discussed the size and I was pretty close to the actual size ( or lack of). I would rather have a lindt ball for 2 pts than the three bits of cupcake.

Well, it's a rainy Saturday and I better get out my jewelry stuff and get creative. Uck, a James Bond movie is on tv, like when is one not on? Got two of my guys on the couch saying the lines before they're spoken, yep, we are cultured in this house.

There once was a day so rainy and wet
That Jen just wanted to sit and forget
The laundry to be folded,
The children to be scolded,
That she just beaded with nary a regret.

Drawing Blood is Like Riding a Bike

...I don't think sugar was the "sh" sounding word that she was thinking of...

Once you have been taught a skill and perform it for years, you never forget how to do it. Today, I realized that I had less than a week to pass my competency for drawing blood if I was going to work next Sunday. With some fancy pleading, I was able to hang out with my good friend A over at a Family Health Center versus the On campus patient care center. The difference?? Oh, about 40 years for the average age of patients. I got to stick some prime, young veins versus the senior coumadin crowd. Must say that I did okay, passed on one young lady who proceeded to yell "Sugar" when A drew her, I don't think sugar was the "sh" sounding word that she was thinking of.

The biggest difference for me is having to wear gloves for the whole procedure. Back in my day, we didn't wear gloves and liked it, course we didn't know any better. So I am back in the saddle again, ready to hit the road, in for the long haul, yep, I am officially a blood drawing Medical Technologist and not just the "suit" in the office. See, I can wear two hats and this old dog can learn new tricks.

So how was your Monday?

#11, 13 Facts about Blood Drawing

In honor of Lab Week, I am highlighting 13 random facts about Phlebotomy (fla-bo-toe-me:Jenny's phonetic spelling) since that it is the closest connection that most of you will have to the lab. The 13 facts should help to make your next lab test a better experience.

1. Phlebotomist - the official title of the person who draws blood for the lab. They would take being called a "phleb" versus blood girl/boy or lab girl/boy. Please don't call them vampires, they hear that all the time. It's not funny, but they won't tell you that.
   
   
2. When you are a patient in the hospital, your blood may be collected by a Medical Technologist ( someone like me!). We are the people performing the tests in the lab, but for morning draws, we all go out and draw blood to get all the routine work done in a timely manner.
   
   
3. When you are having your blood collected, we can tell you what tests were ordered, but we can't tell you why the tests were ordered. Your Doctor bases their orders on your history and condition, we don't know that information and the doctor is the person that you want to ask the why question.
   
   
4. If the person drawing you misses your vein, let them try one more time, however, if you are uncomfortable at anytime during the procedure, speak up! Ask for another phlebotomist, you are the customer!
   
   
5. Please don't tell the phlebotomist how hard you are to draw, it's better to say, "Sometimes people have difficulty drawing my blood and here (point to the spot) is where they got my blood last time." Everybody is different and just by being left-handed, I would be able to get people that others couldn't ( and I was never considered one of the best!)
   
   
6. When you see the size of the needle (if you are the type to watch) we don't stick the whole needle in. The 1 - 1.5 inch needles give us a better angles to draw the blood. Please don't ask for the butterfly needle if you think it will hurt less because it's a smaller needle. The butterfly costs a lot more and increases the time of collection. The butterfly needle should be used for difficult draws and hand draws.
   
   
7. Fasting? How long? When your doctor orders a fasting test, usually glucose or a lipid profile ( cholesterol, HDL, LDL) the test needs to be fasting to be able to have an accurate result to compare to reference ranges. Fasting is usually 12-14 hours without food or drink, however water is usually okay. Anytime you have questions, always ask your provider.
   
   
8. If you do have fasting bloodwork, just understand that when you come in for your blood to be drawn that early in the morning, everyone else is there for the same reason. It is the busiest time for blood work. If your blood tests don't have to be fasting, then wait until after 10 am for the morning rush to be over.
   
   
9. Different lab tests require different tubes to be drawn. You may have three chemistry tests ordered and only one tube is drawn. But there will be times that you may have three tests ordered and we will have to draw three different tubes. For some of the reference lab work, we may even have to draw more than one tube for a test.
   
   
10. Most tests that are drawn will have results available within 8 hours, the lab is unable to give you the results directly unless we have a signed form from you, please don't call for results. However other tests take a few days if they are sent out or only run during scheduled times during the week if it's a low volume test ( we don't get a lot of requests, so the lab runs the test less to keep the cost low)
    
    
11. We are drawing your blood, because your provider has determined that they need the results to base their diagnosis and/or care on the results of the lab test.
    
    
    
12. To prevent labeling errors, JCAHO ( Joint Commission Accreditation Of Hospital Organization) has recommended that specimens be labeled with two identifiers, your name and your date of birth. So even though we have your lab order in front of us with all information, we still have to ask for your name and date of birth and your specimens should be labeled in your presence.
    
    
13. Phlebotomists who draw blood everyday truly enjoy their jobs and the patient contact. I hope this list helps you to appreciate their skills and makes your next blood test easier to have done.
    
    
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Back to the Beginning of my Lab Career

Twenty years ago, I would spend the whole day looking into a microscope and performing cell differentials (Lab slang- diffs). Every patient with a Complete cell count got a slide made: just right with a drop of blood which you would put another slide edge on top of to spread out the blood to a feathered edge. Hopefully after the slide went through the stainer, your blood cells would look like the picture. We would count 100 of the large cells and differentiate what kind of cells they were. If you have a bacterial infection, you get an increase in the Neutrophils, with a viral infection, there is an increase in the Lymphocytes and in Mononucleosis, those lymphs get funky looking. We would also be the first to determine if a patient had leukemia.

This is a basic idea of hematology and it goes into far more detail than what I can explain within a blog. However, Medical Technologists are responsible for learning and understanding the differences and stages of cell development for all blood cells. Instruments now do most of the differentials by automation based on the biochemistry of the cells, however, anything flagged as abnormal has a slide made which a lab tech then reads and interprets. I remember my first days training on my first job reading diffs, I would go home, close my eyes and see cells float across my eye lids.

In answer to One Gal's Question, BUN stands for Blood Urea Nitrogen. Which is a Urea-Nitrogen containing waste product that's created when the body breaks down protein. The test is used to evaluate and monitor kidney function. Along with Creatinine, Bun is a test routinely ordered for older patients to determine if the kidney is working correctly. Both are tests that my grandmother used to ask me about b/c doctors would be concerned about her higher than normal values.

A really good website for basic lab test information is Lab Tests Online, the information is given in easy to understand English with minimal Medical terminology. I know that I promised to give more information about my career in Medical Technology, however the more I think about it, the more I realize how much there is to write. So today was hematology 101 and tomorrow I will write about the differences in what is available for Chemistry versus what we used to do 20 years ago. I have told an old lab friend about the blog and I am hoping that she can provide a guest blog with even more information. She is "just a little bit older" than myself and one of the best techs that I ever worked with.

It's Lab Week!

Do you know what happens to your blood after it gets drawn? Well, let me just say that if you think labs are anything like what you see on the soaps or CSI, you would be wrong.

Nobody can just walk in and switch the tubes or results. Quality is our number one concern for all of our patient specimens and we have checks in place for specimen identification to result verification. I realize that there are cases where a patient has been told that "the lab lost their specimen" which can happen, but extremely rarely. Usually this is a reason used by doctors' offices when they have lost the specimen or ordered the wrong test.

As a Medical Technologist, I was trained to label specimens after collection in the presence of the patient, and all of us from the lab do this. The specimens come into the lab where we accession (enter it into the computer system) and from that point it goes on an instrument that sorts it to be spun down or for whole blood specimens like complete blood counts, they get sorted into racks to be put on the instrument. Blood that is drawn for most chemistries need to be "spun down" in a centrifuge to separate the light yellow serum (liquid) part of the blood from the heavier cells. The serum is what is tested in the chemistry analyzers. Labs also have reference lab tests where we send specimens for specialized testing to a larger lab.

Compared to what we used to do 20 years ago, the number of tests that we offer 24/7 have increase dramatically with the advances made in technology. Chemistry panels were never offered after 3 pm and doctors could only get, glucose, electrolytes, calcium, creatinine, BUN and amylases. Now they can get anything we do on the day shift, from full panels to hormone assays to drugs of abuse screening. However, DNA testing shown on CSI takes a lot longer than 1 day. Another big error in lab testing was shown last week on Gray's Anatomy, I found it ridiculous that her daughter is in the hospital, Izzie gets tested for compatibility, drawn that day for a bone marrow and the daughter got transfused that evening. It would never, ever happen that quickly! I don't know for sure the actual super STAT turnaround time for bone marrow, but I can be safe in saying, definitely not in a day!

To keep up with the increase in technology, lab techs are continually learning and training. It is a great field for anyone interested in biology or chemistry and looking for a steady job. The average age of a medical technologist is around 46 years old. I haven't even touched the surface of what we do. Tomorrow's post will be about the different jobs that I have had and the various tests that I had to learn.

Glorious Spring Weather Finally

Two track meets on two absolutely gorgeous days here in New England started off a busy weekend for us. The first track meet on Friday was for five middle school teams. Now I don't know if you are familiar with middle school kids, but they are an enthusiastic group of kids who have been stuck inside the past couple of months due to our winter that ended last weekend. Everybody and their brother ran in the races. The meet went from 3:45 to 7:45 pm, but as I said to one dad who was itching to get home and complaining about the number of heats in the races, "Given the events of Monday in Virginia, this is a great place for us to be at this moment." I hate standing around at track meets since they are so long, so I volunteer to time the races. Volunteering makes the time fly and I so love giving the times to the kids and seeing their expressions. ( And oh by the way, so glad to be a mom of boys....eyeliner for a track meet? I can't put eye liner on to save my life! I got a kick out the girls.)

At the high school meet, I volunteered to help out with shot put since that is the event #2 son does along with discus ( where Dad volunteered). Our little volunteer stint now has my thighs crying out in pain due to the multiple squats of being one of the measurers. My husband's butt is hurting him which leads me to think that we have to compare squat techniques to tone both back and front. We were all pretty tired and cranky last night. Yes, all you blogging moms with little ones, cranky times occur with teenagers and it's definitely not pretty or pleasant.

Wish I could get more creative today, but lab week beckons and I have to work do for that. I will write more about lab week tomorrow to highlight the all the wonderful things that our laboratory staff does.

Monday Muddle

Thanks to all who have been helping me change my template, Annie over at BlogU is awesome and has a great how to site. Biz Whiz from Tips for New bloggers mentioned that I could expand my header and with all the playing around I did this weekend, I was able to expand it.

The picture at the right is of the same location in my header picture but at high tide. It's what I call my little piece of heaven, it's located up in Nova Scotia where my family has been going for over 30 years, my grandmother grew up in the house beyond us. We brought our kayaks up this past summer and it was the best time. Notice the lack of other boats out there! Even the two younger boys took them out to go around the island.

Muddle for today because that's how I felt. I had to make changes to a brochure that I had made in publisher, that once public affairs saw, wanted to make it consistent with the rest of the organization. It did come out well, but we played with some of the sentences. My job is a lot of this and that with the Lab and our outside clients so on Mondays after having Friday off, it's catch up time. Good news is that I am picking up an extra shift in Blood Bank. And do you want to know why I have to pick up some shifts? It's called paying for medical insurance, since it is taking a huge chunk of change out of our take home pay. (Another rant for another day)

Weigh in tonight for Weight Watchers, thinking it will be a good one. I will have to talk to the leader about the Core program. The meetings are still incredibly busy, when are these people going to fall of the wagon? ( Ya, I know, it's mean of me) But sometimes I do like to think that it's all about me!

That's an interesting case that the Supreme Court got today. In my opinion, I think the principal went too far, it was not on school property and there was already history between the student and the administration. I think he got pulled into a power struggle and could have just gone up to the boy and told him that it was inappropriate. The public will be split on this one.
That's my muddled musing for a Monday!

Blog Addiction- time for a new life?

Hi, my name is Jen and I just spent an evening reading medical blogs. Not just any evening, but a Friday evening.
Hey, Jen, get a life!
But seriously, I was able to get "hooked up" through just one random click to a blog written by nurse, thanks Laura , who had a ton of medical blogs listed on her blog. The one that hooked me for awhile was Lab Soft news.
On this blog I read an interesting account of a patient's experience with poor customer service at lab drawing station. Reading about the time spent waiting and the rudeness of the staff made me appreciate and respect the people that I work with who go above and beyond. Both of these women care about their employees and provide them with the skills and knowledge to be great phlebotomists and registrars who have excellent customer service skills. Maybe that's why they won't take me up on my offer to become competent to help out when short handed. LOL- I keep telling them, phlebotomy is like riding a bike and after 5 years of not doing one, I think I could be retrained. Only time will tell.....
But back to the blogs, I enjoyed the Thursday 13 and now have some ideas to think about. It was nice to get some comments and people reading my blogs. Thank you!