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Auntie-D

Bit of a rant....

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Great topic!

We have had temperature charts not put in correctly so the temp is reading 7, but the techs who check the chart daily don`t seem to notice and put the temp down as 3 or 4.

My recent favourite - we send blood for irradiation to a nearby hospital. One day we received a call from said hospital asking why we had sent an empty box, what is going on. The tech had sent the box but forgot to put the blood in!

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Been telling my boss for months that our HPLC is giving too high a number of low patient A2s and have been met with 'well it's been calibrated and the qc is in' and being told l was overreacting saying we could miss a thalassaemia. Well today we got our EQA results and guess what - we are scoring too low to the point we now can't report any patient tests and may have to recall months worth of patients… Guess what?

 

I TOLD YOU SO!!!!

 

Why do they never listen?

Edited by Auntie-D

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Been telling my boss for months that our HPLC is giving too high a number of low patient A2s and have been met with 'well it's been calibrated and the qc is in' and being told l was overreacting saying we could miss a thalassaemia. Well today we got our EQA results and guess what - we are scoring too low to the point we now can't report any patient tests and may have to recall months worth of patients… Guess what?

 

I TOLD YOU SO!!!!

 

Why do they never listen?

They have beans in their ears. 

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Dr Pepper - I went the other way... I trained in Cyto and transferred to BB ;)

I did get to see things like microfilaria in spinal fluids, a lot of Burkitt's lymphoma, and since the cyto lab also performed sperm studies (for infertile marriages, not post-vasectomy), I did a little project looking for anti-spermatazoidal antibodies by crossmatching wife's serum with husbands sperms. They sent these guys into the bathroom with a petri dish to collect the specimen, and for several reasons my Peace Corps training French was inadequate to explain how to accomplish this feat!

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Do you think the standards have slipped because there are fewer dedicated Blood bank staff now- especially with folks being rotated between Haem and Biochem more frequently and introduction of 24/7 shift systems?

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I've never worked in a lab with dedicated bb staff (I am multidisciplinary and started my career in cell path). I think it's just that people are lazy and don't seen to care nowadays :( I'm fed up if being met by shrugging of the shoulders - in the old days people were mortified if they made a mistake...

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We also have the "too posh to wash" comments... .. staff who think it is beneath them to clean fridges etc- because they went to Uni !!! 

 

It is all about culture.

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We also have the "too posh to wash" comments... .. staff who think it is beneath them to clean fridges etc- because they went to Uni !!! 

 

It is all about culture.

 

We have that problem with filing paperwork! If I leave it with a polite sticky note at the end of my shift, it will sit through both evening and nightshift untouched.

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I'm discouraged :(

- same member of staff had set up a crossmatch again without a control being put up and also seems they don't ever put up immediate spin crossmatches :(

- not enough blood in stock for a 4 unit xm on a patient so just issued one unit. Then had the cheek to ask me why I hadn't put in an order for more blood. Pointed out, her patient, her blood, her responsibility. She ordered the additional 4 to come out on the afternoon delivery but didn't bother ordering any routine stock so now we have to wing it until the morning delivery or pay for transport...

- I came in at 12, said member of staff had done no authorising all day so as well as 6 haematology patients to crossmatch on my start I also had about 100 results to authorise

- same member of staff electronically issued normal blood on a patient requiring irradiated blood :(

Lots of incident logs for me to fill in today :(

I'm discouraged :(

 

 

Do you think that maybe the lab has some significant issues that need resolving? Just keep filling the incident logs- and ask to see the corrective actions (remember to keep a note of your incident reference number), as I know sometimes reports can go "missing". Every incident reporting system should be open to scrutiny by any member of staff. Sometimes as managers we don't always make the right decisions and it is good to have someone else look things over from a different perspective. 

 

The error with issuing normal blood for a patient requiring irradiated- should be MHRA/ SHOT reported- also, the incident should be addressed by ensuring your LIMS prevents this happening- ask to see what corrective actions were done for this one.

 

Since you obviously care, then it may be that you have to set the cultural changes and standards in your lab.

Edited by RR1

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To all,

If you are CAP inspected, AABB assessed, or your hospital is inspected by The Joint Commission you can file a complaint directly with them if you feel management is not responsive. If you are inspected by the above agencies the hospitals/labs are required to post the ways to contact them. If in the USA lot of the above are required to be reported to FDA as BPDs.

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To all,

If you are CAP inspected, AABB assessed, or your hospital is inspected by The Joint Commission you can file a complaint directly with them if you feel management is not responsive. If you are inspected by the above agencies the hospitals/labs are required to post the ways to contact them. If in the USA lot of the above are required to be reported to FDA as BPDs.

Would this not be considered as Whistleblowing in the U.S ? In the U.K - this is what it is classed as and even though the reporter should not be punished for highlighting problems, there are very few staff who still have a job afterwards.

Edited by RR1

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So much for quality!

 

I agree, but we are going through a cultural revolution now in the UK- so in a few years time things could be much better.

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Here is my twopenny worth.  We have evolved into a culture where everything has to be done 'by the book'.  There's an SOP for everything and if the instrument says a reaction is + because it's interpreted a dust fibre as a positive reaction you can't change the result.  Well, it's not a bad thing to be standardised, but the problem is that when this becomes extreme, people stop using common sense.  In fact, they stop thinking altogether - sometimes thinking is just too dangerous.  Look back at some of the posts we've had where technicians have gone on to do further tests (because they were obviously needed) but were reprimanded because the doctor hadn't requested it and who's going to pay for it.  Also, we ask our 'qualified' people to have excessively high qualifications and get 'unqualified people' to do the majority of the work because it's cheaper that way.  But they're only allowed to do so much, and even if you've got someone who shows really a lot of aptitide they can't go any further unless they're prepared to opt into a long course of studies, for which they may well have good reasons for not being able to do.  Result - frustration and a lot of 'it's not my job' attitude.  I personally don't think that this is very good practise, and I can see why most of the problems listed above can be the result of these two factors

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All of our staff working in blood bank are degree level so shouldn't have this attitude. We don't have lab assistant in any of out labs any more which to me is a nonsense - we have people new out of university who as now coming out state registered refusing to do jobs as they feel it is beneath them. You aren't even allowed to call them trainees any more...

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I tell anyone who refuses to do a job they think is beneath them to look at their job description, or look for another position.

 

I am a Band 8b, and I regard this to mean I am prepared to do any job from a Band 1 up to a Band 8b; in other words, I may not be qualified to do something a Band 8c or above, but I can sure as Hell clean down a bench.

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In my job, my team is responsible for the quality plan for an 11 facility hospital system. We create the processes (with input from the facilities) and write the procedures.

In preparing for our next CAP/AABB inspections we have performed mock inspections at all facilities (6 AABB and 5 CAP). If I see another scribble on a record, improper error correction or unsatisfactory maintenance interpreteted as "S", I might scream! When the correct range is listed on the form and they still can't interpret a result... #$%#$&^%# (that's me saying inappropriate things). And then it gets reviewed by someone else who also accepts it!!! Makes me want to retire early.

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Prioritising is a big bug bear of mine - example from today is all the routine groups were all finished but the positive antibody screen needing sent to the reference centre was still sat on the bench untouched when our driver arrived. I pulled the staff member up about it as it had been sat there for 2 hours. I've just gone into the lab and it is still sat there and has missed the second van! It's now going to have to go on Monday or in a taxi... I'd have done it myself had I not been so snowed with immediately urgent stuff :( looks like I'm going to have to now.

We've had a meeting today and I have stressed the importance of prio

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Would this not be considered as Whistleblowing in the U.S ? In the U.K - this is what it is classed as and even though the reporter should not be punished for highlighting problems, there are very few staff who still have a job afterwards.

 Rashmi, that could happen in the US as well, so those agencies have a mechanism whereby they can be contacted anonymously. Our hospital has a similar system in place where any healthcare worker can report an unsafe condition anonymously.

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Love it Anna, but what I meant was, if I (as the boss, as it were) am prepared to do such things, I expect my staff to be prepared to do them as well, despite the fact that they may think that they are too senior to perform such tasks. If REALLY NECESSARY, I will do the task in front of them (to shame them) and I have never had them say it is below them a second time. I don't often have to do that for three reasons.

1. The most important one, by far, I have wonderful staff.

2. IF I have to do it, then they are in BIG trouble.

3. I have honestly forgotten what on Earth I was going to put down as my third reason (I was also going to say that I must be getting old, but it would appear that I have already got old)!!!!!!!!!!!!!!!!

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