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Follow policies / procedures.
Pay attention to details.
Don't be afraid to ask questions.
Pat yourself on the back when you make it through your first Massive Transfusion Protocol!
Let the adrenaline work for you -- keep calm and work on.
Enjoy Blood Bank -- I've been doing this for 30 years, and I love it!

I, too, am a generalist, and have been for my whole 34 year career. I enjoy Blood Bank, but after our small hospital was bought by a large hospital group, we were trained to do the work the way the the group does Blood Banking. It was good to go through the training. It wasn't that everything was changed, it was that we were now going to do testing the same way as all blood bankers in the group. So, as slsmith said above, you might want to wait to see how your BB does things. 
At our hospital, we run types, antibody screens, DAT's, fetal cell screens and crossmatches (electronic and serologic if indicated). Everything else is sent to the main central Blood Bank.
My advice to you is to figure out how you do testing (whether on your own or the "company way"), and always do it the same. Set up your tubes the same way every time; add reagents in the same order, etc. This way, if there is ever a question about your testing, you know that you always do it the same. Also, during training, don't just do the minimum. Test until you are comfortable with the process. You want to be confident in your work. Lastly, always take responsibility for your work. If a problem arises or your work is questioned, be ready to explain what you did. Knowing the procedures and processes will help you be able to troubleshoot these issues.   
Good luck in your new job as a Generalist. As I said, I have been doing this for a long time, and I still love what I do!

Being a generalist with Microbiology experience, here is my take on this: The unit should be reported as positive for bacterial contamination. I would not, though, report the gram stain as "positive" because that is changing the result that the microbiologist reported. They did not see any organisms on the gram stain, so it is negative. If the transfusion reaction workup only allows for a positive or negative result of a gram stain, with no place to report the culture result, then maybe report it as negative with a comment that the culture was positive. 
Ultimately, the culture shows that the unit was most likely contaminated, and that needs to be part of the transfusion reaction workup report. If the report doesn't allow for both the gram stain and culture report, maybe it should be changed to being positive or negative for "bacterial contamination" as opposed to "gram stain" (which, technically, isn't really reported as positive or negative).
 

Thanks exlimey for a really good explanation, with background information. Always nice to put an answer in an easy to grasp wording.
Cheers Malcom, gives me more confidence to seek out answers to questions (which I have plenty of)

I agree entirely with exlimey, except to say that even today's monoclonal antibodies need a potentiator.  Many of them include a small amount of bovine albumin in the reagent bottle.
I don't, however, agree with you Jermin.
The reason being is that there is no such thing as a silly or daft question.  The only silly or daft question is the one you (anyone) don't ask, because, if that question is not asked. the person who doesn't know the answer will never know the answer.  Sadly, there are numerous examples of silly or daft answers!

We would report the gram stain as negative and the culture as positive with the identified organism. Actually blood bank wouldn't be reporting anything....microbiology would since they are the ones performing the testing. Our BB and Micro departments worked together to set up a procedure for handling transfusion reaction workups that required micro so that everything is consistent with best practices. Micro even takes care of notifying the patient physician in accordance with their critical call policy. After they notify the physician then they notify the blood bank so we can notify our blood supplier etc.

Being a generalist with Microbiology experience, here is my take on this: The unit should be reported as positive for bacterial contamination. I would not, though, report the gram stain as "positive" because that is changing the result that the microbiologist reported. They did not see any organisms on the gram stain, so it is negative. If the transfusion reaction workup only allows for a positive or negative result of a gram stain, with no place to report the culture result, then maybe report it as negative with a comment that the culture was positive. 
Ultimately, the culture shows that the unit was most likely contaminated, and that needs to be part of the transfusion reaction workup report. If the report doesn't allow for both the gram stain and culture report, maybe it should be changed to being positive or negative for "bacterial contamination" as opposed to "gram stain" (which, technically, isn't really reported as positive or negative).
 

Being a generalist with Microbiology experience, here is my take on this: The unit should be reported as positive for bacterial contamination. I would not, though, report the gram stain as "positive" because that is changing the result that the microbiologist reported. They did not see any organisms on the gram stain, so it is negative. If the transfusion reaction workup only allows for a positive or negative result of a gram stain, with no place to report the culture result, then maybe report it as negative with a comment that the culture was positive. 
Ultimately, the culture shows that the unit was most likely contaminated, and that needs to be part of the transfusion reaction workup report. If the report doesn't allow for both the gram stain and culture report, maybe it should be changed to being positive or negative for "bacterial contamination" as opposed to "gram stain" (which, technically, isn't really reported as positive or negative).
 

Being a generalist with Microbiology experience, here is my take on this: The unit should be reported as positive for bacterial contamination. I would not, though, report the gram stain as "positive" because that is changing the result that the microbiologist reported. They did not see any organisms on the gram stain, so it is negative. If the transfusion reaction workup only allows for a positive or negative result of a gram stain, with no place to report the culture result, then maybe report it as negative with a comment that the culture was positive. 
Ultimately, the culture shows that the unit was most likely contaminated, and that needs to be part of the transfusion reaction workup report. If the report doesn't allow for both the gram stain and culture report, maybe it should be changed to being positive or negative for "bacterial contamination" as opposed to "gram stain" (which, technically, isn't really reported as positive or negative).
 

Being a generalist with Microbiology experience, here is my take on this: The unit should be reported as positive for bacterial contamination. I would not, though, report the gram stain as "positive" because that is changing the result that the microbiologist reported. They did not see any organisms on the gram stain, so it is negative. If the transfusion reaction workup only allows for a positive or negative result of a gram stain, with no place to report the culture result, then maybe report it as negative with a comment that the culture was positive. 
Ultimately, the culture shows that the unit was most likely contaminated, and that needs to be part of the transfusion reaction workup report. If the report doesn't allow for both the gram stain and culture report, maybe it should be changed to being positive or negative for "bacterial contamination" as opposed to "gram stain" (which, technically, isn't really reported as positive or negative).
 

Hi everyone,
I would really encourage you to take a moment to read a blog article I wrote regarding a lab scientist's connection to their patients from "behind the scenes".  This subject is very near and dear to my heart and I hope others find that it resonates with them as well.  Please feel free to share any thoughts below the article in the comments section. Thank you for taking the time to click!  And as always, thank you for being an integral part of our healthcare system.
https://www.staffready.com/patient-behind-scenes/

An excellent post JHH1999, however, if I made the cake today, with milk that had a use by date of tomorrow, there would be grave doubt as to whether the cake would be edible today, let alone in a few days time!!!!!!!!!!!!!

I think we are all missing the point.  I am guessing that the nurse has some idea of all of the yucky stuff we handle in the Lab.  And ALL hospital staff have it drummed into them to change gloves between patients and whenever gloves are soiled.  
Now, we in the Lab take this for granted, but how is a nurse coming into the Lab to know whether you are handling a unit of blood (or anything else that leaves the Lab for that matter) with clean gloves unless they see you change them.
"Cleanliness, in the absence of light, leaves nothing sterile" 
Scott
 

Today my dear chap you win the internet! (again)

You could always irradiate the blood bag (as well as the blood), while the stupid nurse is holding it!!!

David, where were you when I needed this information ?  Those would have been great!
 
I was really glad to send this procedure to the infusion clinic. However, I agree with previous comments...with practice you get better. And those high Hcts flow like thick syrup. Some of them will clot off before you get a full bag. On the bright side, once you get good with therapeutics/donor bags, you'll regard routine blood draws as a piece of cake. Even the hard draws. "Butterfly? I don't need no stinkin' butterfly!"

I agree with Kate - it is one thing if you have a dedicated blood bank staff on all shifts but when everyone is a generalist the more standardized the better.

I am a big fan of using standardization.  Especially in this age of generalists. 
That said, we do the exact same thing for every reaction workup - clerical check, post ABO/Rh, DAT, visual hemolysis inspection, other tests as indicated by reaction. 
Less confusion for the techs - a reaction is a reaction. 

We have been using the Vitek 2 for several years now. I have not used any of the other systems, but we are quite happy with the Vitek 2. My only complaint is that the computer programming is somewhat tedious. It was obviously not set up by a lab person! Once you get used to it, though, it flows well. We are a small hospital, and are all generalists working in Micro. Because the computer isn't so user friendly, the techs who don't spend a lot of time in Micro have a little more trouble getting around the computer.
The ID and sensitivity testing seem pretty well set up and their knowledge base and expert system is very good. They also seem to be pretty quick to inform the users when there is a problem with something. They recently had trouble with PIP/TAZ on gram negative sensitivity cards, and are keeping us informed about when the reformulation will be ready (FDA has to approve it).
Their customer support people are pretty good. We usually get help quickly and issues resolved in a reasonable time frame.
Overall, we are happy with the Vitek 2 and I would recommend it.