Leaderboard

Ok, here we go. First is from a personnel stand point. When promoted from with in you are no longer "one of the guys". This means that some of the staff will try to leverage your close friendship which in turn will cause problems with others. Both you and the rest of the staff need to recognize that things have changed on a personal level, at least in the work place. This does not have to be dramatic and should not be, but it is real. Some can do this and some find it very difficult. Now, when coming from outside your are exactly that, an outsider. Now the level of this can vary immensely depending on the situation. One time when I changed facilities it was just across town and I new many of the staff at the new facility so a lot of the unknowns were minimized. On the other hand, I also moved to another facility out of state and pretty much walked into an unknown from a staffing standpoint except for what little I could glean from the interview. As I noted in my previous post, be very judicious when using the phrase, "this is how we did it." I've had new employees who would say this at every opportunity and then go into detail about how we were either doing it wrong and that their way was just much better. This became very trying to everyone else on the staff and we finally just tuned them out. Because of that we probably did miss out on some good ideas. One last point, in either case be aware of any others staff who may have either applied for the position or simply been over looked. Depending on their personality they can either be a great help or a significant hinderance. Do everything you can to get them involved and engaged. They can be your greatest asset but it may take a little extra work on your part. For me, the personnel issues were always the most difficult. I'm assuming that you are new to the lead position and not knowing your previous experience here a couple of generalizations. Unless something is an obvious hazard to either patients, staff or the ability to pass an impending inspection/assessment don't be in a big hurry to make changes. As they say in the military, you need to understand the lay of the land. Become familiar with the blood bank/transfusion service medical director and let them have the chance to become familiar with and confident in you. They can and should be your greatest allies. Ultimately most of what you want to change will have to be approved by them. You need to understand the current processes before trying to change them. At one of the facilities I moved to I noticed that many of the staff were not following their procedures "to the letter". The way I dealt with this was at the monthly staff meeting we would go through a procedure as a group, line by line and I would ask the questions, "Is this how you are really doing it? If not, why not and how are you actually doing it?" This is when I would make suggestions for changes and generally a lively discussion would ensue. It took quite awhile to go through the procedure manual but by picking, what I considered the most important one first it was time well spent. This is getting a little long so I'll end with how I described my position as Transfusion Service Supervisor at a 350 bed level ll trauma center. My job was to provide the staff with the tools (equipment, knowledge, material and support) for them to do their jobs at the highest level possible. All this while keeping the dragons (administration) away from the door. Good luck and if I can think and anything else that others may miss I share a few more golden nuggets of wisdom with you. Above all else have faith in your self. Wow I think that's the longest post I've ever made.

Maintaining enough staff. Too many people use a large facility as a stepping stone to another job for more money. Having Senior Management understand the difference between a Blood Bank and Clinical Lab - we're not the same. Maintaining inventory. There is always a shortage of something. Competency Assessment - huge pet peeve of mine. You go to a talk by _____________ and hear them pontificate on how we all make competency assessment so hard on ourselves. Then say something silly like, all you need to do is watch them do a _______ proficiency testing sample, they will be processing regular samples at the same time. They'll do equipment maintenance, QC, and result entry. See, it wasn't that hard... Drives me nuts. In reality that never happens, we have 40 other staff we need competency for and obviously we can't share the PT sample. And then the Joint Commission wants competency every 365 days +/- 30 days. For a lab our size, it takes a tremendous amount of time. Sorry, this really does drive me nuts with the inspectors.

I would just replace the battery and not tell anyone.

Malcolm Needs - Thanks so much for the quick response. There's no ethnicity on the patient yet but I doubt she is Japanese by her last names (very Hispanic). We are not planning on antigen typing the red cells for M at this point since it only showed up at immediate spin. We didn't do the workup on the mom so although the other BB said they ruled M out we don't know for sure if they use the 3/3 homozygous rule that we use. You are definitely correct about the M still possibly being IgG, I do realize, thanks for correcting me. It's been a very weird year, since last July when we had our first true anti-U, then an huge increase in the number of extremely strong WAA, an anti-hrB at Christmas, and now this newborn. I hope this doesn't become standard for us but with our Hematology/Oncology clinic growing each year and all the solid organ and HPC transplants I'm sure we're only touching the surface. I miss the days when a children's hospital blood bank worried more about making smaller aliquots than dealing with rare antibodies.