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Everything posted by jeanne.wall
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Glad you have joined us - there is lots of information is shared everyday.
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Best wishes - don't get too stressed during the test, stay focused on the questions, not on the details that don't mean anything. Jeanne
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Congratulations
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They sure will Deny - I remember a patient that worked in an MD’s office down the hill from the hospital. She was in her early 70's and used to walk up every afternoon, and it was a steep hill too, to pick up reports (guess I’m dating myself there) and drop off any specimens. Doctor thought she was a little pale and suggested she get a blood count, which showed a 2.7 gm hemoglobin! Well, everyone thought she should come right in for a workup and transfusion but she pointed out that it was Thursday afternoon and her son and his family was coming for a visit this weekend and she needed to clean her house and bake cookies. She’d come in for the bone marrow and transfusion next week. And she did! :disbelief
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After 30+ years of working in Vermont, I’m not surprise what the bad weather brings – 2 or 3 feet of wet snow and the lab staff all dragging in late. Guess who is in the waiting room, · first visit prenatals, in their third trimester - yah, after their center of balance changes so they aren’t so stable on their feet; · and Protime patients, just the folks that should be out shoveling heavy wet snow and slogging through the snow banks. You never have someone coming in for a critical diagnosis, acute illness, nothing like that, just the folks that could have waited for tomorrow and better weather. This is not an anomaly; it is some kind of rule. I've just never found out whose. It is nice to know that it isn’t location related Deny! Now I know it is universal.
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I don’t want to overstep the bounds of information from vendors on BloodBankTalks, but I’d like to clarify the information about Quotient’s support of schools. We have a program that provides in-dated products at low cost for MT/MLT and SBB programs and if we have any products that we are not planning to sell, such as short dated products or trial products, we distribute those free of charge to schools on a first come, first served basis. We also have a Competency Training Kit that provides antibody samples all ready for use. Hope the information can help someone. Jeanne (Technical Director, Quotient Biodiagnostics)
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This was during the hay day of the physician office labs - I remember when a chemistry tech had decided to “jump ship†for a physician’s office lab – great hours and no weekends and holidays. He was back in just a few weeks. When he arrived he found all the reagents in drawers, not the refrigerated storage as required. He asked about getting a refrigerator and replacing the reagents that had been stored incorrectly. They said No, it was too expensive, and the same went for control reagents as well! Who needs them, right? I bet the doctor still thinks that CLIA was unfair. Needless to see the few folks in the lab that were going to that office switched in short order.
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:raincloud Isn't it too bad we have to work so hard to afford the vacations!
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Your story reminded me of “Bence Jones Protein,†not the urine test – the drink! Many years ago it was a favorite of laboratorians and lab students, alike. It was made with grapefruit juice, “lab stock†ETOH or vodka (in a pinch) and served in a glass urine specimen jar. Looked just like a positive Bence Jones result. They probably don't even do the test by that method any longer, but I'm sure if you use your imagination you can picture the result, even if you can't smell it in your head like I can - I'm sitting here wrinkling my nose at the thought! I bet there are folks reading this, that have never seen a glass specimen jar but I worked my way through college washing them along with test tubes, pipettes and all the other things you use to need to make a clinical laboratory work. I learned a lot those summers. John you made my day! I hadn't thought of those times in years. Thanks, Jeanne
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Isn't it amazing what runs through your brain - I've had to "bite my tongue" more than once in my career. Jeanne
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Malcolm, I’m sure you have considered this already but, it wasn’t Anti-A,B that you absorbed and eluted was it? I wasn’t sure what you used for antibody. Jeanne
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I was just passing through the drawing area as one of the phlebotomists was quickly relocating a patient that had become faint (a prenatal that was bothered by morning sickness and thinking too hard about their impending blood drawn). She had had a little boy, maybe three years old, with her and I was concerned that he’d become upset with Mom being “taken away†and she wasn’t in the best shape to reassure him, so I stopped and asked what his name was. He looked a little taken back and said “Don’t you know me? I was born in this hospital†- so serious and so surprised I hadn’t recognized him. I just apologized for not recognizing him – what else could say? Jeanne
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I remember those docs as well! My experiences were when Hep C was non A, non B hepatitis and a long time before litigation - physicians were Gods and no one would consider suing a doctor! Now days, those kinds of docs would be out on their cans – no physician would consider that kind of behavior. Blood Banking certainly has changed in the last 40 years, it isn’t just about the knowledge, the technology, and the reagents – climate too! Maybe even for the better, although there is something to be said for the “good old daysâ€
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Doesn't fertilizer "flow" from the nursing units to the lab in your facility?
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Mabel - You are bringing back memories! I can remember going to a state lab meeting and one of the sessions was talking about the implementation of the Australia Antigen test and the potential impact on the Blood Banking industry! I remember drawing donors for emergencies and all we tested for was syphilis, times have certainly changed. The speaker didn’t prophesize where we are today. It is amazing when you think about the progression. Thanks for reminding me how far we have come. Jeanne
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Rashmi ~ I think you have it exactly. I know when I started grappling with Quality Systems when the FDA first started focusing in on quality, I started out thinking it was some big complex process. I went to a bunch of programs and people used boxes and arrows and much explanation – seemed rather magical and, frankly, I was confused. Then suddenly the light bulb went on. It seemed as soon as I started thinking about it as the structure or framework for work being done, I could just work on what I had. I quickly moved on to trim and prune and add a fair amount of fertilizer to what was already in place. Then, with a strong framework created, it was easy to pass all the quality audits and inspections that came my way. Jeanne
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I’d recommend the “Blood Component Visual Inspection Guide” that is published by AABB. It has great color pictures that really can help staff learn to appropriately evaluate all components.
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Quality Systems provide the framework in which work is performed, in our case immunohematology testing but it really can be applied to any work. The framework supports and controls the work by providing structure, organization, expectations, consistency, assessment, evaluation, and continuous improvement to the process. The outcome from the use of the framework is high quality results from the work performed.
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Oh - those were the days!
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Candice, you didn't say how many pregnancies your patient had had but with multiple pregnancies she my keep making that Anti-D for many more years. I remember those Mom’s with babies that needed several exchange transfusions - they would have extremely high titers and then another pregnancy would come along and the titer would go even higher. In the US, men that would have served in the Korean War show up with Anti-D. In that war, type O blood was transfused to everyone on the battle field, without regard to Rh type. Sensitized the Rh Negative, and a whole unit of blood (and they generally would be receiving more than 1 unit) would produce a high titer response as well. Jeanne Wall (one of those old Blood Bankers that remembers the world pre RhIG)
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My first lab job was washing glassware – showing my age there – but I did graduate to phlebotomy later in the summer. I can remember working morning collection rounds long after obtaining both my MT and SBB and was working as the Blood Bank Supervisor (nothing exempted you from morning rounds), I was able to wake my patient. Introduced myself and was preparing to draw the patient’s blood only to be asked how much longer I’d have had to go to school to be a nurse! As kindly as possible, trying to leave a good impression for clinical laboratorians everywhere, I explained that I would need to give back 3 years of education and a certification exam. I was still shaking my head when I returned to the lab and I think the patient still wondered why I would do all that “extra†work and not be a nurse.
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Just wanted to point out that, of course, I used both the interventions you mentioned plus more when the occassion needed! The description was provided only for describe - not to imply that I let the situations go out of control while I commented.
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I always liked the old one - "independent as a hog on ice" and have used it to describe physicians who would rather prove themselves fools rather than ask a question and staff who wouldn't ask for help if their life (or somenone else's life, for that matter) depended on it. You might need to be from hog country to get that one, but pigs are an independent lot and if you think you can get a hold of one on ice, forget it!
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Following a very inept question from a nursing supervisor, a technologist blurted out the question that has become the standard response - How many IQ Tests did you need to flunk to get your RN? It truely has become the most used "under your breath" or "behind closed door" response to let off steam. It really seems true, although from the other side the RNs do things I wouldn't want to do - just hope every one makes it out alive, so to speak.
