cbaldwin

I first posted this position in October 2020. The position is still open and there is now a $15,000 sign on bonus. Go to https://www.nih.org/careers/ This site states that the sign on bonus is $10,000 but my lab manager assures me that the bonus has been increased to $15,000. You can phone the hospital at 760-873-5811 and ask to speak with Human Resources or with the Lab Manager to confirm. Bishop California, population 7,000, is located on the east side of the Sierra Nevada mountain range near the Nevada border. We are 200 miles south of Reno, 300 miles northeast of LA. We are a vacation destination/retirement community. In the Sierra to the west, and the White Mountains to the east, there is hiking, backpacking, fishing, camping, hunting, skiing, biking, rock climbing, bird watching and more. In town there’s a golf course and a bowling alley, two excellent bakeries, several coffee shops, numerous restaurants, a really great hamburger joint and several yoga studios. The hospital is small. We have 3 orthopedic surgeons, 2 general surgeons, 3 OB/GYN doctors, a few specialists and numerous ED doctors, hospitalists and generalists. We transfer critical patients to larger health facilities with higher levels of care. In the transfusion service, our inventory includes 10 units O positive, 6 units A positive, 2 units A negative, 2 units B positive, 8 units O negative and 10 units frozen plasma. Our blood supplier is Vitalant in Reno. Monday through Saturday a courier delivers and returns blood products. On weekends and outside of courier hours we make other arrangement with the California Highway Patrol or a hospital courier. (We seldom need to make such arrangements). We use Ortho MTS gel (manual) and tube. We perform antibody screens with a 3 cell screening panel. We send out positive antibody screens (maybe one every one-two months). We perform 30-45 type and screens a month. We transfuse monthly 10-40 pRBCs, 0-4 frozen plasmas, and 0-1 platelets. In our lab we have 10 lab techs (generalists), 4 lab assistants, 5 phlebotomists. We are a happy, friendly group. If you would like to live in a quiet town with amazing scenery and great recreational opportunities, and if you would like to run a small transfusion service in a lab with great people, this job is for you!

This position is still open. Listed under "Northern Inyo Healthcare District Employment". Lots of beautiful social distancing space.

I am the transfusion service coordinator in the lab of a small rural hospital. I am retiring at the end of the year and my lab manager has posted my position on this site. I thought I would add some information. Bishop California, population around 5,000, is located on the east side of the Sierra Nevada mountain range near the Nevada border. We are 200 miles south of Reno, 300 miles northeast of LA. We are a vacation destination/retirement community. In the Sierra to the west, and the White Mountains to the east, there is hiking, backpacking, fishing, camping, hunting, skiing, biking, rock climbing, bird watching and more. In town there’s a golf course and a bowling alley, two excellent bakeries, several coffee shops, numerous restaurants, a really great hamburger joint and several yoga studios. The hospital is small. We have 3 orthopedic surgeons, 2 general surgeons, 3 OB/GYN doctors, a few specialists and numerous ED doctors, hospitalists and generalists. We transfer critical patients to larger health facilities with higher levels of care. In the transfusion service, our inventory includes 10 units O positive, 6 units A positive, 2 units A negative, 2 units B positive, 8 units O negative and 10 units frozen plasma. Our blood supplier is Vitalent in Reno. Monday through Friday a courier delivers and returns blood products. On weekends and outside of courier hours we make other arrangement with the California Highway Patrol or a hospital courier. (We seldom need to make such arrangements). We use Ortho MTS gel (manual) and tube. We perform antibody screens with a 3 cell screening panel. We send out positive antibody screens (maybe one every one-two months). We perform 30-45 type and screens a month. We transfuse monthly 10-40 pRBCs, 0-4 frozen plasmas, and 0-1 platelets. It was odd that I became the coordinator in 2007 because I had little blood banking experience. But I managed to get into a SBB program and pass the SBB exam. I also read the Blood Bank Talk site daily. With my SBB and information from BBT the department is compliant with standards and regulations. Joint Commission surveyors visit us every two years. Usually they find one or two “observations” but we passed the last survey with no “observations”. In our lab we have 10 lab techs (generalists), 4 lab assistants, 5 phlebotomists. We are a happy, friendly group. I enjoy working with our team. I have an excellent relationship with the nursing staff and meet with the nursing executives monthly to review transfusion documentation of signatures and vital signs and other transfusion issues. If you would like to live in a quiet town with amazing scenery and great recreational opportunities, and if you would like to run a small transfusion service in a lab with great people, this job is for you!

Has anyone been recently surveyed by the Joint Commission? We are expecting a survey in May, I am preparing for it, and I wondered if there were any trends this year in what they are “observing”. I am responsible for a small transfusion service in a 26 bed rural hospital. I am checking that documentation for reagents, QC, competency, training, proficiency testing, and patient testing is complete. I’m updating my P/Ps, and going over the QSAs. The Joint’s observations in 2017: 1. Not labeling uncrossmatched O negative units with patient’s name, DOB and MRN during traumas. (QSA.05.10.01) 2. Not periodically reviewing with our medical staff information regarding our BB inventory. (QSA 05.02.01) (The inspector explained that a new physician unfamiliar with our BB inventory could start a procedure that required more products than we have. The procedure could fail because of inadequate blood products, resulting in possible patient death and legal action) 3. Not always having the time of signature on transfusion consent forms— “in 3 of 3 consents for transfusion documents reviewed, the time of the patient consent had not been recorded.” (QSA.05.17.01) 4. Not readjusting the set point to simulate a high alarm when doing quarterly checks on our plasma thawer alarm. Biomed was checking the alarm, but not simulating a high alarm as the manufacturer requires. (DC.02.04.03) Around the time of the 2017 survey I remember others on BB Talk mentioning that they were cited for not labeling Uncrossmatched O negative units. That observation caught me by surprise. My reactions to the other observations were…well, I should have known better. We have a lot of traveling MDs and communicating with them regarding our inventory is very important. And I should have read the plasma thawer operator’s manual more carefully. I’m just wondering if surveyors are concentrating on anything in particular this year…. Thanks! Catherine

So now you have an exciting hobby?

Just found out...our reference lab charges $305. Thanks all for your replies...I am learning...have a lot to learn. Catherine

Thank you for this information. I just found the handouts from a lecture Sue Johnson gave in March 2016 at an Immucor Users meeting and I have attached them in case anyone is interested. It's very good. She discusses the molecular basis of weak D and partial D and the variability of reagents and methodology, also the recent recommendations of the Inter-organizational Work Group on RHD genotyping for managing pregnant women and transfusion recipients who have a serologic weak D phenotype. On page 18 she states that there is a new CPT code 81403 for RHD genotyping (Tier 2 molecular pathology procedure, Level 4) and that reimbursement rates for the Tier 2 code are being established. Also that the ACOG is updating its Practice Bulletin to recommend molecular testing. I just got a new phone number to call to see if I can get the price that we will be charged if we request this test. My OBGYN physicians would like to know. Catherine Johnson Handouts.pdf

Thank you! This is good information. I will call our Immucor rep. Catherine

I am working with our OB/GYN MDs on how we will handle weak D OB patients. First of all, we would like to know how available the test is and how expensive it is. When I contacted our IRL to inquire about the price of this test, which they list on their menu, I can only speak with technical people who know nothing about billing, and I do not expect them to--I am a technical person and I know nothing about billing. They did tell me they send the test to Grifols and they gave me a contact number which didn't work out. The very nice people at the other end of the line did not understand my question. (My fault?). Using the term "genotype" to describe the test sent them down the wrong rabbit holes--interesting but not helpful. Today I called our IRL again and they gave me another number. Nobody answered, but it is MLK day.

Those of you who send out samples from weak D OB patients for molecular testing, do you know, approximately, how much the test costs and whether insurance companies willingly pay for it? I am having trouble finding this information. Thank you! Catherine

What are the regulatory standards for checking the temperature alarms and verifying the temperature calibrations on blood warmers? Our BioMed guy has been doing these checks quarterly but just noticed in the operator's manual that the manufacturer's recommendation is to perform the checks annually. He asked me if AABB or the Joint Commission had standards for the quarterly checks. I looked through the AABB standards and TJC QSAs and can't find anything about quarterly checks. I will stay with the quarterly checks because that is good practice, but wondered if I missed the regulatory standards somewhere. Thank you! Catherine

What are the regulatory standards for checking the temperature alarms and verifying the temperature calibrations on blood warmers? Our BioMed guy has been doing these checks quarterly but just noticed in the operator's manual that the manufacturer's recommendation is to perform the checks annually. He asked me if AABB or the Joint Commission had standards for the quarterly checks. I looked through the AABB standards and TJC QSAs and can't find anything about quarterly checks. I will stay with the quarterly checks because that is good practice, but wondered if I missed the regulatory standards somewhere. Thank you! Catherine

Our rapid HIV kit is non-waived for plasma/serum and waived for whole blood. We just went through a Joint Commission inspection and the inspector, when giving us the heads-up about IQCP, suggested we only perform the rapid HIV testing on whole blood. It seems like a simple solution. Does anyone see a problem with it?

Thanks Liz for the explanation of the 3 month period. It makes sense and it will help me explain to physicians why we need to be concerned about more antibodies forming.

R1R2, No, our antibody screen on 4/18 showed the Jka reaction was definitely stronger. Also, I did not mention this before, in order not to distract from my main question, there was an antibody present to the 0.8% screening cell preservative. When we performed the gel antibody screen with our usual 0.8% cells, all cells were positive at 2+. The auto and DAT were negative, and when I XM'd all of our (8) units of O negative units, those XM's were compatible at gel IgG. So I suspected an antibody to the preservative in the 0.8% cells. As a backup, we have 3% antibody screening cells for tube, and I made 0.8% cells from these cells. The antibody screen with the 3% cells made into 0.8% cells was negative. On 4/18 I ran a antibody screen with the 0.8% cells and the 3% cells made into 0.8% cells. The 0.8% cells showed the Jka antibody and the antibody to the preservative. The 3% cells made into the 0.8% and tested with gel IgG showed just the Jka.