Jump to content

Bit of a rant....


Auntie-D

Recommended Posts

It drives me insane the lack of knowledge of people that I work with!! Local proficiency testing questions and one member of staff with 30 years experience was so far off the mark with the answer to one it was scary! I tried to point them in the right direction but they semi-recovered but still gave the wrong follow-up and type of follow-up. Hopefully when the powers that be see the answers they will educate...

 

Does anyone else ever have a day when you think 'How on earth can you NOT know that - it's absolute fundamental basics!'??

Link to comment
Share on other sites

It drives me insane the lack of knowledge of people that I work with!! Local proficiency testing questions and one member of staff with 30 years experience was so far off the mark with the answer to one it was scary! I tried to point them in the right direction but they semi-recovered but still gave the wrong follow-up and type of follow-up. Hopefully when the powers that be see the answers they will educate...

 

Does anyone else ever have a day when you think 'How on earth can you NOT know that - it's absolute fundamental basics!'??

Almost daily!

Link to comment
Share on other sites

it seems to me that there is a trend in healthcare in general, ofr less and less appriopriate oversight.  In the Lab, we have here a few managers, but there time is spent with HR duties and other administrative tasks, such as attending meetings.  They do not have time for major oversight of day-to-day activity.

 

We have coordinators for keeping track of technical issues in various areas, but no supervisors to ensure that bench techs do waht need to be done every day (techs are supposed to be independently motivated anyway - right?).

 

Other than continuing education for all for problems that keep popping up (time consuming for someone!), it seems like you need to fall back on discipline.  If a job description says a BB tech needs to file paperwork, and they do not do it, that is a deficiency and should be reflected in thier appraisals.  But keeping track of all this stuff takes time, which management does not have.  It seems to be a visious circle.  Remmeber to not sweat the smaller stuff.

 

One has to depend on those techs that will go the extra mile, and sometimes they are few and far between. The ones looking at retirement often do not seem to care much about anything, and too many fresh techs just don't have the experience or mature attitude to do what needs to be done.

 

All it seems we can do is try to set a good example.  This is especially important for management; who are after all, primarily responsible for the morale of the people who they are responsible for.

 

Scott

Link to comment
Share on other sites

Don't even get me started! :comfort:  :crazy:  The things i've had to deal with over the last 5 years have left me wondering how have we remained acredited.  I have had to learn how to apply the serenity prayer on a daily basis.  It's especially unnerving when the incompetence comes from the department manager. :bonk:  To have to daily correct your managers errors and oversights, while not appearing to challenge their authority is quite an interesting environment.

 

Link to comment
Share on other sites

Auntie-D, Your post was so timely for me! Due to short staffing (a rant for another day) I worked at the bench for two days last week and was appalled at the the things I found that I had been trusting to the techs. Tasks are organized on a clipboard: daily, weekly, monthly, etc.  The daily and weekly are apparently  signed off regardless of whether done or not, and the monthly, quarterly and semiannual lists appear to be written with disappearing ink on invisible paper !!!!

 

Link to comment
Share on other sites

Auntie and others, we share your pain. If I may add to the list of pet peeves:

 

1. Starting weekly temperature discs on fridge/freezers on the wrong day and/or time. Then 5 days in a row 5 different techs document that the scribe is OK.

 

2. Not recording medical record numbers and dates on panel scoresheets. Record keeping in general.

 

3. Not printing copies of panel scoresheets on both sides so you get the extended antigen typings on the the back. Not changing the scoresheets when you open a new panel lot.

 

4. Filing QC records etc. with bloodstains (hopefully reagent but you never know) all over them.

 

5. First cousin to the above: finding blood all over the counter, centrifuges, agglutination viewer, outside of the biohazard bin, drawers or cabinets, making you wonder if a worker had been shot or merely had sneezed violently during a torrential nosebleed.

 

6. Discarding packing lists from the blood center so I have to get copies to check the bimonthly bill. Happens pretty much each cycle.

 

7. Finding obviously broken thermometers, pipettors etc. in place. Whoever broke them knew they had done so but decided to keep it secret..

 

8. Not telling you when the last kit, vial, package, bulb or box was opened so you might have a ghost of a chance to order more before you run out.

 

9. I put out a half dozen pens and markers a week. Where do they go? Even if we supply the whole lab we should have reached the saturation point decades ago.

 

10. A tech asked me if it was OK in a pinch to just use one drop of plasma/serum per tube for an antibody screen; another tech had told him that was fine if you didn't have much sample. This was right before last year's competency eval, so I included that as a question. 5 people said it was OK. So we had a little inservice on the value of following the manufacturer's directions, our own P&P, and the need to validate any variations in protocols etc before you do so. I heard a great line a few years ago that went something like "Ignorance ain't what you don't know; it's knowing too many things that ain't so!"

 

Thank you, I feel better.

Link to comment
Share on other sites

Yes Dr. Pepper - Have seen all that too.  Our pen was not calibrated properly on the refrigerator temperature module and it was adjusted several times but poorly.  I found a week where it was reading 7C, but the techs kept reading it as 3-4.  Another week and it was recording a temperature of 0.  The techs that week recorded it as - you guessed it - 3-4!

Link to comment
Share on other sites

Many years ago on a day when I was in the middle of completing our MHRA return with no assistance from anyone and feeling very stressed I wandered from my office into the lab to discover about 10 such things in 30 seconds.

I - very unprofessionally - had a rant which was soto voce but in a somewhat menacing tone and continued through the silence for what seemed like a very long time and ended with me shrugging my shoulders and - even more unprofessionally - walking out and going home.

I am in no way proud of my behaviour nor commend such a course of action to anyone.

And I did apologise profusely the next morning.

 

BUT standards showed an instant, long-lasting and dramatic improvement.

 

I suppose the answer is to use media like this to vent your frustrations and then finding an appropriate way to communicate that to your staff.

Good luck.

Link to comment
Share on other sites

I've been having this issue with some people as well. One of my questions on the competency states "according to our policies and procedures," and somebody got it wrong because they didn't pull out the procedure. I felt that was a pretty big hint in the question. I've had some who want hand-holding and I can't write a procedure for every possibility that could happen; I'd fill a bookstore if I had to write that many. They just want to cookbook it like they can in other departments and I'm trying to get them to realize that some things you just have to think through and if you're not sure to call me. 

Link to comment
Share on other sites

Shortcuts! Don't forget the shortcuts some techs take to complete work - it's as if somebody has put a gun to their head and no one is going to come in next shift to continue further. They will shorten incubation time, not follow SOPs and give proper hand offs to incoming techs. I keep on streamlining work, make checklists and logs, but to no avail. I think with complete automation, technician errors will at least be taken care of with test procedures (hope???). I always tell everyone, at least use your basic commonsense, but then "commonsense is not very common".

Link to comment
Share on other sites

Yes Dr. Pepper - Have seen all that too.  Our pen was not calibrated properly on the refrigerator temperature module and it was adjusted several times but poorly.  I found a week where it was reading 7C, but the techs kept reading it as 3-4.  Another week and it was recording a temperature of 0.  The techs that week recorded it as - you guessed it - 3-4!

Good idea - this way, you can get your QC done weeks ahead of time! 

Edited by Dr. Pepper
Link to comment
Share on other sites

I think I will get away from the venting,(although venting can be very important to ones sanity at times) because although we have a few issues (generally minor, like not checking pending logs when they are supposed to and acting on them) for the most part my techs are very responsible and really take their jobs to heart. They all really care and I am so thankful to have worked with this group for the last 12+ years. I will be retiring Jan 3 and its been a great group to work with. I will still PRN a few shifts here and there but not as manager. I will still check in on BB Talk. Will have time to visit and spoil my little grandbaby. Hopefully get to move back to New England (New Hampshire or Maine), depends on the housing market. Anyway, Merry Christmas and Happy New Year to all of you. Thanks so much for this website, it is a great thing.

Link to comment
Share on other sites

Today so far we have had

- a manual crossmatch set up without a control done

- a run of samples being put on as a confirmation screen rather than a full screen as they didn't host query the computer

- a newly qualified member of staff getting a lab assistant to do the pre transfusion checks which is a bms 'job'

- someone ignoring a mixed field result - ' oh it will just be medication related'. Despite the fact is was a group A and the previous sample had been sent to the reference centre and further samples requested as it was insufficient

I'm on a late shift and this was all before my break :(

Edited by Auntie-D
Link to comment
Share on other sites

I think I will get away from the venting,(although venting can be very important to ones sanity at times) because although we have a few issues (generally minor, like not checking pending logs when they are supposed to and acting on them) for the most part my techs are very responsible and really take their jobs to heart. They all really care and I am so thankful to have worked with this group for the last 12+ years. I will be retiring Jan 3 and its been a great group to work with. I will still PRN a few shifts here and there but not as manager. I will still check in on BB Talk. Will have time to visit and spoil my little grandbaby. Hopefully get to move back to New England (New Hampshire or Maine), depends on the housing market. Anyway, Merry Christmas and Happy New Year to all of you. Thanks so much for this website, it is a great thing.

You're right about the staff; all but one of my vents were things that annoy me, not harm a patient. Congrats and good luck with the retirement. Do you really want to leave the south, though? It was -12oF in southern Maine (Alfred) this morning. 

Link to comment
Share on other sites

Shortcuts! Don't forget the shortcuts some techs take to complete work - it's as if somebody has put a gun to their head and no one is going to come in next shift to continue further. They will shorten incubation time, not follow SOPs and give proper hand offs to incoming techs. I keep on streamlining work, make checklists and logs, but to no avail. I think with complete automation, technician errors will at least be taken care of with test procedures (hope???). I always tell everyone, at least use your basic commonsense, but then "commonsense is not very common".

 

I love this-----"Commonsense is not very common"....

 

What have I started? I may keep this thread going as a place to vent ;)

 

Yes this thread will reach 100, 1000 marks in no time....

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Recently Browsing   0 members

    • No registered users viewing this page.
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.