Most frightening thing?

[Max001]

Hi all,

IMO, going live with a new computer system in Blood Banking and Transfusion/Donor Services is one of the most frightening and stressful things you can do in a Lab; in fact maybe the most frightening thing you can do ever outside of being in a war.

You have to perform up to speed, and you can't make ANY mistakes, and if you can't figure out how to do something all you have left is to panic. The first time we went live, I nearly had a nervous episode and stopped being able to sleep or eat for almost a week (we were manual before then).

We had one tech shouting at the Director 'If I lose my baby (she was preg) over this I'm suing you!'. (This was a long time employee with an MT degree and normally very quiet and non-confrontational).

In addition there's 'Downtime' (shudder). When the computer goes down everyone had to suppress the urge to run for the doors. A lot of time it takes a full day and lots of overtime to re-enter all the data when it comes up again.

That and the fact that BB has a risk of killing a patient and I'm of the opinion that BB-ers should have double the pay scale of ordinary lab techs.

How does everyone cope these days with this and all the new GMP regulations?

[John C. Staley]

Max, step back from the ledge, take a deep breath and climb back in through the window!!!!

I'm coping by retiring. HAHAHAHAHAHAHHA, just had to say that.

Actually in my career I've put in 3 blood bank systems, and two lab systems. It's only as big of a deal as you choose to make it. The key for me has been to recognize that nothing is perfect and don't expect it. Try to anticipate most problems and be prepared. When one crops up you did not anticipate step back, look close and come up with a plan and by all means DO NOT try to do it alone. You are working with intelligent people, let them help.

The single biggest thing you can do it to test, retest and test again to make sure things work the way you expect. I'm leaving in the middle of a major computer install. We are putting SafeTrace Tx into 24 hospitals ranging from 20 beds to over 500. My facility will be the first to go live next June and I'm actually a little sad I won't be here to see it through. I've been involved in the project from the beginning.

Just remember, what doesn't kill you often makes you wish it had.

Oh, you are correct blood bankers never get paid enough.

Edited December 2, 2008 by John C. Staley
wanted to.

[krichards]

As a blood banker who was born in the 70s, I view life without computers as incomprehensible. How did anyone keep track of all their blood bank data on paper??? How was that possible??? It hurts my brain to even think about it.

Don't forget, there's always Prozac and Xanax;)

However, I will never give up hoping for the day when all lab personnel (and especially us blood bankers) are paid what we're really worth. Double the pay would be a good start, though.

[Likewine99]

Max001, You will be fine! Get your team together, you know you can handle the easy stuff and make a plan for your worst case scenario.

We just went live with a new BB system in 9/08, 7 hospitals on the same server/DB. We just knew we would have to pool cryo so we planned for the superusers to do it and if that failed do it on downtime.

You know what, we didn't have to pool cyro and pt care was not affected. About 30 minutes after we got onto the system everybody found their niche and in about 2 hours were were rocking and rolling.

I made a structured list of who was to do what, including approximate time frames. I'll be happy to share the plan with you if you are interested, organization and planning is the key to a successful go-live with ANY system.

Good luck and hang in there. Dry red wine is a good coping mechanism!

[Max001]

Hi, guys, thanks for the supportive posts, but if you check my post in 'Introductions' you'll note that I started in the 70s. From that you may deduce that I'm retired. I have been since 2002. I switched careers in 2001 to go into hospital administration and then into IT.

I helped introduce our first computer system in late 1980-something, I can't recall, might have been 1990. I -believe- it was the compiled Basic program from Hemocare and it was pretty good. Up until then we did everything by hand and I must have gone through a standard BIC pen every month or two. That's a lot of writing.

It was that transition which was most stressful, because you had to know where you were going in those menus before you went there or you had to back out and even a month's practice did not prepare you for going live. Later, we all became so good we could do all the entries needed to get the transfusion slip to print in a continuous stream of keystrokes.

But I kid you not about it causing me to have a nervous event and I actually went into a type of mode where everything was augmented and I actually felt I got more alert and smarter. I stopped sleeping and eating for at least 3 days and went on to only require 2 hrs of sleep a night for about three weeks. It seems my body actually jumped up a notch to help me cope. By the way I was already used to computers, being a guru in DOS and the IBM PC.

So, while I appreciate the kind words of support, it is not something I plan to go through. (smile) Been there, done that.

I have the greatest sympathy and respect for anyone who would go into Laboratory Medicine and Blood Banking these days. Little did we realize how complicated it would become.

My friends over in the hematology/chemistry section tell me of a very frightening system put in by Toyota called the 'Lean production' system. They put the techs in the center of a bank of analyzers, no chair, no cell phone, no pager (they actually search them) and there they stand for 2-3 hours doing nothing but flying back and forth in a two-foot radius. Many of my colleagues who are brilliant and dedicated workers are retiring or fleeing to other jobs, it is so stressful.

In the BB area, once we did the cGMP procedures, just thawing a unit of plasma went from a quick task to a laborious record-keeping process of writing down long series of lot numbers and data on a clip board. If someone at the Red Cross put the wrong weight on the unit (we weighed them again) and we put a different weight on the TX tag, even off by one number, it became an FDA reportable error. If we transcribed a number on the clipboard, off by even one digit, it became an in-house lab error, and you only get 20 of those before you are asked to leave.

Well, humans, even OCD bloodbankers are not perfect, so it didn't take long until people got to their limit. People were so stressed when I left that they were even forming prayer groups in the staff lunchroom, atheists and believers alike holding hands and praying and sweating (I kid you not!).

So maybe you guys are a different breed, but as smart as I felt I was, HS deans list, high SAT scores, Ivy League University grad, it had become so complex to do the data entry with zero errors, I felt my brain could no longer cope. (I was performing as a supervisor at the same time). Even the supervisory duties, reviewing page after page of clipboard records of data entries of lot numbers, had become onerous to the point of nausea.

Outside of something like NASA, I don't know of any job where slipping up even a little, could result in a potential for a patient mis-adventure, even death.

I am proud to say that nearly 30 years in the profession, I got out before anyone who I worked with caused any reportable error. Yes I saw a few patients die, but those were errors made by the nursing staff who mis-identified the units we gave them and yes a few patients did get an out of group plasma. But no Blood bankers caused any serious patient sequelae.

If I had it to do all over again, seriously, I would never have gone into Blood Banking. I'd have taken up something less dangerous, like Lion taming. Though I never had any nightmares during my working years, I did have them for about 3 years after I retired, finding myself on the carpet explaining myself to my director. (go figure).

I have to say I was clinically traumatized from working in such a lab, with that palpable undercurrent of patient death hovering over us all the time, if not from an error, from failing to get blood out the door fast enough on a trauma patient with a multiple antibody.

I don't mean to be maudlin, but people just do not realize the level of stress we all face, even if we don't realize it. For one thing, with look back procedures, anything you do can be scrutinized for 10 years after you do it.

Anyway, interesting to see a BBS devoted to Blood banking and sorry to be long.

Edited December 2, 2008 by Max001