Newly promoted, overwhelmed.

[Kathy]

I have recently been promoted to supervisor of the blood bank in a pediatric hospital. While I have tons of experience in pediatric blood banking as a technologist, I have very little experience in this particular hospital and no supervisory experience. I was promoted for my technical expertise, but I am very much concerned about the amount I have to learn as far as how this particular blood bank works, what the regulations are exactly, and how we follow them. I am fortunate that we just passed an AABB inspection, but we can expect a visit from the FDA at any time.

If any of you have any words of advise for me, I would appreciate it.

[David Saikin]

The biggest thing is to make certain everyone follows procedures as they are defined. That is what the Feds look for. I am going to assume you are in compliance with the regulations - if you had a successful AABB assessment you should be fine with the FDA. If you have continuous QA reports, the FDA will be really happy, as it means you are staying on top of your operation (and it is less work for them - they should not cite you for anything which you have discovered and have fixed or are in the process of fixing). Always be straight forward with any inspectors, but esp the feds. Use these forums as the amount of experience/knowledge/comraderie is unbelievable. DON'T LET YOUR PAPERWORK GET TOO FAR BEHIND! Have a great time and good luck.

[DOGLOVER]

Hi, I would suggest you start by reviewing procedure manuals and while reviewing make sure that you match them up with AABB and CAP checklists to make sure you are meeting all requirements. You can write on each checklist item where it is documented . This will help immensely when it comes time for inspection. You don't want to have to review everything at once so set up some kind of schedulte (monthly/ quarterly/whatever) for doing these reviews. As long as you have copies of any variances/occurences along with any associated FDA reports the FDA son't be too bad. I'm assuming you don't have a donor center.

Check with your HR and education departments to see if any classes are offered for manager development/training. This is important because most people in healthcare are poromoted because of technical or clinical expertise, not because they know how to manage people. People are the tough part. its way more then just writing a work schedule.

Definitely use this forum. its great.

In my area our local blood supplier sponsors a quarterly luncheon meeting (coincides with AABB audio conference) where we get to know each other, discuss local issues and bounce ideas of each other. We are all very comfortable with e-mailing or calling each other with questions ranging from history on hospital-hopping patients to new equipment, reagents, procedures, etc.

Good luck in your new position and let us know how you are doing.

[Bill]

David & Doglover have given you great advice, the only thing I would add is: Do not look at everthing that needs to be done, it will overwehlm you. Break it down into managable segments so you do not get discourged. Remember that the paperwork is never done--so don't try to get it all done today.

[adiescast]

FDA also likes to see annual training that is specifically titled cGMP training. Otherwise you will spend time explaining how the non-titled training was, in fact, applicable to cGMPs. Make sure your staff is aware of the FDA terminology, as it sometimes differs from CAP and AABB.

[John C. Staley]

I take it that you are new to this facility. First and foremost be very careful when picking your battles. Make sure they are worth fighting and take them one at a time. My second suggestion is, you are working with college educated adults, treat them like that until they prove otherwise. The staff can make you look really really good if you let them. The last bit of advise is don't get in too big of a hurry to "fix" things. If they just passed an AABB assessment they should not be in too bad of shape.

Good luck.

[Malcolm Needs ☆]

My goodness John. As always, you talk a heck of a lot of sense and bring reason to the arguement.

Obviously, I've never had the pleasure of working with you (unlike some others on this site), but the fact that you are retired is a great loos to blood banking, and I really admire that fact that you are still willing to pass on your knowledge and experience.

[mmckee]

Regulations should be the same. I'd start with a 2 fold approach. Make sure manuals are correct and techs are actually following procedures as written. Read the HR manual and always use the HR people when doing any disciplinary action. Most new supervisors were promoted for their technical skills, so you have a lot of people to draw from. I live by the management theory that what is rewarded is repeated. It really helps to hear you are doing a good job and we too often let the 10% of problem childred distract us from the fact that 90% of our employees really care about their patients, jobs, and peers.

Plus, it helps to keep a big bag of chocolate in your office.

[bduff]

Plus, it helps to keep a big bag of chocolate in your office.

[L106]

Kathy -

All the preceeding posters have offered excellent advice! I might also add:

1. Refrain from saying "That's not how we did it at XYZ." It's a big turn-off to the staff, and you're not at XYZ anymore! Evaluate carefully and have a good reason before making changes.

2. Counsel/criticize staff members in private; Compliment staff members in front of their coworkers!

Good luck, Kathy. If your department has just passed AABB inspection, you must have a lot of staff doing things properly, so that's an excellent beginning. Don't hesitate to post questions on this site. I am amazed at the wealth of knowledge and experience of the participants, and so grateful of their willingness to share that with all of us.

Donna

[Malcolm Needs ☆]

Wise words indeed Donna.

[DPruden]

I agree with all the other postings! I would also suggest being collaborative with your approach, especially if you are new to the facility. There are always knowledgeable techs who like to do projects, take advantage of the expertise of your staff. I have found I have more buy-in if the staff has a say in the process. Good luck!

[Mabel Adams]

Just like on the bench--try to prioritize. Some days you will still be asking yourself "who's dying?" and take care of them first. Now they might not be so literally dying as they were when you were on the bench, but the same concept to prioritizing should help.

Listen to your staff. If they bring a problem, tell them you will "put it on the list" and try to prioritize it. Try to delegate or at least use whatever help is offered. Don't be too hard on yourself. It will take a good year or two before you feel like you know the whole place and how things work. You will never get everything done. Keep balance in your life besides work. And most of all KEEP YOUR SENSE OF HUMOR. Good luck.

[Eoin]

Kathy,

Congratulations. With your background I am sure you will not have too much trouble. After 40 years in BB (although in semi-retirement in Ireland, I have moved to Quality Management - yes Malcolm, I am probably older than you), I see the same old chesnuts arising, so there shouldn't be any nasty surprises for you.

From the regulatory side of things - I tell students - your Quality Manual should reflect what you do in response to the regulations; your SOPs should define this exactly; and lastly ensure that what is happening in the lab is what you say you do in these documents.

Good luck with it.

Cheers

Eoin

[Likewine99]

Congratulations Kathy!

L106 is absolutely correct, do not say, "we did it this way at XYZ place". I made that mistake when I was a new manager and it really alienated some of the staff.

Never ask your staff to do something that you wouldn't do yourself. Remember though, your primary responsibility is no longer being the best bench tech you can be. Even if you are going to be expected to work a bench, that now be comes your secondary responsibillity. Your primary responsiblility is to manage the people not "get the work out the door".

It will take you a good year and a half to feel totally comfortable with being a manager. Find a management mentor, it doesn't necessarily have to be someone in your lab but someone who currently manages people.

Good luck!

[L106]

Never ask your staff to do something that you wouldn't do yourself.

Good point, Likewine99. This is one of my rules, too. (Unfortunately, it frustrates me because the philosophy doesn't seem to be shared by some of my fellow supervisors! Ahh, such is life, huh?)

Donna

[Auntie-D]

Plus, it helps to keep a big bag of chocolate in your office.

That is the truth!!!

[tgambill]

I am in the same boat too, although much more recent, only 3 months in. i knew beofre accepting the position that the blood bank needed a lot or work. however, it seems that it would be better to bull-doze and re-build it. some days i am so over-whelmed but then take a look at what i have accomplished so far. I took the job as management and a new hire, so I have had some personnel issues along with all the problems. being the "new kid" isn't very easy sometimes.

[L106]

I took the job as management and a new hire, so I have had some personnel issues along with all the problems. being the "new kid" isn't very easy sometimes.

That's true, Tina. But sometimes there are also challenges and problems when an existing staff person is promoted to supervise all of his/her old work "buddies."

Donna

[tgambill]

i have heard that either way is difficult.

[Auntie-D]

The first thing I did was ask everything what bugs them and how can I help - I found there were lots of ideas bobbing around that my predecessor had vetoed. Really good ideas! Involving people with the decisions and shaping their lab how they actually wanted it really helped me settle in.

It was just little things like doing a workflow analysis to help the day flow more easily - samples moving round the lab in a circuit rather than back-and-forth. I also took the pressure off a bit - my predecessor was a stickler for turn-around-times and insisted every sample be processed as and when it arrived in the lab. I suggested that 3 batches a day was enough - 10am for the ward round things meant that the first hour was free for getting organised, then 2pm and 4pm. Anything non-urgent arriving after 4pm now waits until the next day. I've also said that preops need only be done once a day so if the 10 o'clock samples are all pre-ops for 3 weeks away then the 10am batch doesn't go on and waits until the next batch. This also frees up time for people to take time to do Continued Professional Development and the like. Changing the workload like this hasn't made it any more difficult at 10, 2 and 4 but it has made it a lot easier between times. Of course there's always the odd urgent crozzie to contend with but my staff are much happier knowing that they don't have to break their backs.

Oh and I've also introduced a radio!!

[Dr. Pepper]

Congrats, Kathy. What some great advice from the previous posters! I might add (or reiterate):

1. Review your procedure manuals. Aside from the technical issues, it's a very easy way to familiarize yourself with dept, lab and hospital policy & procedure. As you get more familiar with your dept, you can also see if there are some differences between what people are supposed to be doing and what they actually are doing. Check the format of the P&P; it should be electronically recorded and easily modified. Check to see what there is for a document control system.

2. Try to find out what the pressing issues are that need attention/improvement. Ask your staff, your supervisors, check minutes of your transfusion committee, check periodic or yearly reviews of QA. Try not to feel overwhelmed or feel that you need to solve them all in a week. You can prioritize and chip away at them. As has been said, you're probably in pretty good shape. If you're OK with AABB Standards and the CAP checklist, you're probably doing fine.

3. See about making some contacts with other players in the hospital. Helpful ones to have include folks in nursing, risk management, purchasing, clinical engineering, information services, OR and ER, etc. Your manager and your fellow supervisors can help here. The easy fixes are things in your own lab, the tougher ones involve other services, and having a bit of a personal relationship with them will go a long way. Again, it doesn't have to happen in your first week.

4. Don't be afraid to ask for help. As David said, keep up with your review and paperwork. Do what you say you're going to do. Stay in communication with your staff. Don't be afraid to delegate, most people like having some special jobs and responsibilities. Keep your sense of humor. Celebrate your successes. Have fun.

Good luck and keep in touch. You have a wonderful resource here in BB Talk. Phil

[John C. Staley]

When I first responded to this post I did not mention one thing that worked very well for me. Hold regular staff meetings and review one or 2 SOPs at each meeting. The first question I asked was, "Is this really how we are doing this?" It may surprise you how much SOPs morph at the bench without official changes to the manual. Most of the time the changes are good and the SOP can be rewritten to reflect what is actually occurring at the bench.

[AMcCord]

Wonderful advice from everyone (as usual)...here's a comment - I've been supervising for >10 years and there are days, sometimes multiple days in a row, where I also feel overwhelmed. That's always going to be true because it's the nature of the business. Things come up. Don't let it bother you. Just keep on going and you'll see the light.

Once you get to know your staff well enough to see their strengths, ask some of them to help you with some of the load. Start with smaller things. If you ask for the right thing in the right way, that person will feel good about it (which gives her/him some job satisfaction - who doesn't need that?) and they may volunteer additional help when it looks like you need it. That saves my sanity!

[Kathy]

Great ideas! Very helpful. I have taken on the SOPs and that is one of the things that is causing me stress...it is going to take me forever to get them all updated. The former supervisor was too busy to do it. One of my problems is the tension that is caused when I ask the former supervisor (who was promoted) about changes I am thinking of making. Why not just make the changes instead of asking her first? She knows the place better than I do and is a great source of information. There might be a good reason why she didn't.

By the way, we did pass that FDA inspection, no problem.