Previous Error--Do you train them now?

[KBBB]

If you knew that a Tech in your lab previously worked at another hospital and made an ABO typing error that resulted in dismissal, would you try to train that person to work in your transfusion service? ...and BTW...without a BB computer system.

(Assume that they have adequate certification for the state/facility)

[Eagle Eye]

I do not think I would take a chance unless I know that the tech. has proven track record as an excellent tech.

[Marilyn Plett]

I think it depends. Talk to the tech. What is the tech's explanation for the error? Were lessons learned? People who accept responsibility for their errors and work to improve personal work practices can be good employees. I've known at least one person who made a significant error and became an excellent tech after that. I would definitely avoid a tech who has all kinds of reasons why it wasn't the tech's fault. Excuse-generators tend not to evaluate how they could improve their own work practices. What has been the experience with this tech in your lab so far? Does general opinion indicate sloppy habits?

There might also be some legal issues or fair-hire practices here. How do you know the tech was dismissed because of an ABO error? Was it mentioned in the reference? If this is not part of the original hire file, you might have to give them a chance. Just thinking..........

[KBBB]

Thanks Marilyn! You bring up several great points that I will remember as the issue continues. I found out about the situation by speaking to a former co-worker of this person (not a supervisor). The person in question stated that they worked in BB at that hospital, but didn't offer up any other info. There was no on-site transfusion service when the person was hired. My first impression and from examples from others is that there is a lack of focus/ attention deficit (ADD??) (I'm trying to keep this a little vague). From what I understand about the error, it should have been reported to the FDA.

[jcdayaz]

If I were in your position, I would not chance training this person in the Blood Bank.

Marilyn makes some very valid points--I still would Not take the chance. Yes, everyone makes errors from time to time--myself not excluded (unfortunately), but there are some errors that are unforgivable.

[Eoin]

Hi Folks,

I think it is bad to jump immediately to conclusions. A lot of assumptions may have been made here. I agree with Marilyn, talk to the person. I would like to know the circumstances (overworked, insufficiently trained, etc, etc). Was there a second checker, or was it on-call.

If we sacked all techs who had made a mistake in any areas of a lab (before you think it, yes, I know this is different as it is a serious error), the labs would be pretty lonely places. I am more wary of an employee who would tell me they have not made a mistake (or of those who would attempt to cover them up).

I also agree with Marilyn, that if this person has sound, logical reasoning, they will have learnt from this mistake and are unlikely to make a similarly serious error in the future. If this is not the case, simple observations of their working habits will soon demonstrate if they do not think in a systematic, logical progression for a given process. Try them on a simple double antibody mixture ident.

Who checked the references on hiring? Maybe they were told he/she was agreat worker, but for this single abherrent issue.

Lots of privacy issues here to be wary of too.

Good Luck.

Cheers, Eoin

[Lcsmrz]

"Eoin" makes a great point in not jumping to conclusions on hearsay evidence. The lab could have been an accident waiting to happen, and this tech was the unfortunate one to make it. I know of one tech who was rotated out of blood bank work for "errors" that he was never shown, and I suspect a personality conflict with the supervisor played an important part of that decision.

I find that I make the most errors at the end of a double-shift, trying to keep a woefully-understaffed lab operational by working unwelcomed overtime. Since I know this, I am also the most careful at this time -- a younger, less-experienced tech may not be so introspective of personal limitations.

Occasionally, labs will fire a good employee for being involved with a serious error, listing the corrective action as "employee terminated" when reporting to the FDA. While this makes it sound like it was negligence, it could have been a systems problem that no one bothered to address -- and it may happen again to someone else!

My answer for this one? -- the interview makes it or breaks it for most potential employees!

[jcdayaz]

"Eoin" makes a great point in not jumping to conclusions on hearsay evidence. The lab could have been an accident waiting to happen, and this tech was the unfortunate one to make it. I know of one tech who was rotated out of blood bank work for "errors" that he was never shown, and I suspect a personality conflict with the supervisor played an important part of that decision.

I find that I make the most errors at the end of a double-shift, trying to keep a woefully-understaffed lab operational by working unwelcomed overtime. Since I know this, I am also the most careful at this time -- a younger, less-experienced tech may not be so introspective of personal limitations.

Occasionally, labs will fire a good employee for being involved with a serious error, listing the corrective action as "employee terminated" when reporting to the FDA. While this makes it sound like it was negligence, it could have been a systems problem that no one bothered to address -- and it may happen again to someone else!

My answer for this one? -- the interview makes it or breaks it for most potential employees!

Lcsmrz,

You make very valid points here. However, there are many Techs who interview well and then don't perform well (or at all).

We all have "Bad Days"(once again myself not excluded--unfortunately), but there are some errors that just can't be okay.

I agree that any Tech who claims to have never made an error needs to be feared. They typically are the most dangerous ones! We have to recognize that we are all human. Each and every one of us has made an error in our careers. To me it is the severity of the error made that is of vital importance! There is a HUGE difference between entering an armband number incorrectly and issuing the wrong-incompatible-type blood to a patient and potentially causing their demise.

Just my thoughts.

[Likewine99]

Lcsmrz and Eoin make very good points in their posts. As a BB supervisor I've seen marginal techs makes mistakes as well as the stellar performers.

Since this person is employed by your hospital and working in your lab you might want to think about giving the person the best training you can with close observation to make sure they are capable of handing your workload in the BB.

My guess would be that HR didn't even ask about any "errors" the person made. At our place, HR just does a cursory interview, over the phone most of the time and if the potential employee is "eligible for employment" at the last place they worked HR usually passes them on to us for interview.

We are all human, we all make mistkes, myself included. Everyone deserves a chance but if you are concerned about performance and you have to option to not train the person in BB you could keep them in Chem/Hem.

Again, watch the privacy issues. If this person is going to make it they will, if not you'll know right away. Good luck!!

[AMcCord]

One other point to consider...how reliable is your source? Does that source have issues with the prospective tech that would cause him/her to make a false report for whatever reason?

[KBBB]

The source is reliable. More than one source reported poor performance but I would rather not go into the specifics. People generally do not offer the information that they were terminated from their last job, or allowed to resign rather than be terminated. That is why opinions of other Med Techs who previously worked with a prospective candidate can be invaluable. If they somehow have info to share (liked they actually worked with them at another hospital), then it is fair game. Hiring is ultimately up to the Director and they can ignore any and all information. They will find out for themselves soon enough. All your comments are good points to consider. Thanks for the input.

[blut]

A few comments....Seems that there are several related and competing issues:

1. Privacy rights of the job applicant

2. Reluctance to hire a person whose job performance, based on anecdotal past history, may jeopardize patient safety

3. Reluctance to hire a person whose past job performance, based on based on anecdotal evidence, may have been sub-standard

4. Fairness in hiring practices

Privacy rights are covered by applicable legislation. In Canada, for example, there is the Freedom of Information and Protection of Privacy Act (FOIP):

• Explanation of FOIP and hiring practices
  

Although Canadian, the explanation covers the main privacy issues involved when hiring someone regardless of location.

Regarding #2 and #3 above, as others have mentioned, it's never a good idea to base hiring practices on unsubstantiated anecdotes.

About patient safety and inadequate performance, this is often about systems that fail (not necessarily people) or training issues. Anyone can make mistakes, even big ones with dire consequences. With life-threatening errors, root cause analysis is needed to identify what reallly went wrong.

It's been my experience over a lifetime that we in the transfusion service often get away with our errors through happenchance.

Bottom line: If it's not a character issue (e.g., person is inherently lazy and inattentive), then proper training and competency assessment should correct deficiencies.

Regardless, to me the key issue is fairrness. Put yourself in the applicant's shoes and decide how you would want to be treated.

Cheers, Pat

TraQ: http://www.traqprogram.ca/whatsnew-chrono.asp

UA: http://www.ualberta.ca/~pletendr/

Edited August 28, 2010 by blut
typo

[KBBB]

Everyone...please re-read post #1 and #4. This IS NOT a hiring issue but the posters have morphed it that way. There are a lot of "ifs" and "assumptions" being made. Admonishments and points taken...

[LIMPER55]

<comments removed by admin>

Edited August 29, 2010 by Cliff
No attacks on members or the post will be closed - thanks

[blut]

Everyone...please re-read post #1 and #4. This IS NOT a hiring issue but the posters have morphed it that way. There are a lot of "ifs" and "assumptions" being made. Admonishments and points taken...

Sorry about the mistaken hiring focus, KBBB. I should have read more closely. After a re-read, the tech in question apparently already works at your facility and the issue involves whether the person should be trained for the transfusion service.

Some of the same precautions still apply (anecdotal evidence, what actually contributed to any error that may have occurred, role of training & competency assessment, and fairness).

Without the details it's hard to comment further. I'd just reinforce that serious errors are often due to systemic problems. Also that nothing beats open, respectful communication.

Based on my experience, it's odd that anyone involved in making a life-threatening error would want to go anywhere near the blood bank.

Cheers, Pat

UA: http://www.ualberta.ca/~pletendr/

TraQ: http://www.traqprogram.ca/whatsnew-chrono.asp

Edited August 30, 2010 by blut
for clarity

[jcdayaz]

<comments removed by admin>

Limper55--Please remember we are all professionals. We all have our own experiences and knowledge to bring to this forum. We don't always agree with each other--but I believe we respect everyone's opinions/procedures/whatever.

I have learned more from this site then I ever did in college/clinicals/etc etc. I hope you will benefit equally from the forum. I will look forward to seeing your contributions to all of our advancement in our careers.

[tbostock]

I agree that all of us are human and make errors, but it is our response to the error that speaks volumes about our character and potential to improve. As the other posters said above, if there are a lot of excuses or blaming others, probably not a good candidate for the Blood Bank (or any position in the medical field probably).