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On call phone calls


amym1586
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Does your lab have any sort of phone call curtesy for calling the blood bank supervisor/ tech spec after hours? I feel like I have some that have no respect for me and abuse calling me at home.   One called me last night after 10 pm to put me on speaker phone because the saline replacement procedure was too hard.  I have full intentions of addressing this when I get to work that this tech has signed off that she understood this procedure and calling me at home with a patient is not the time to address her lack of understanding with a procedure. 

  /rant

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I'm the Lead Tech of my department and I have my phone number posted in the department so the techs can call if they have questions. I tell them I'd rather they call me and I solve their problem/question quickly (hopefully) instead of them either spending a lot of time dithering about it  and delaying results/care or doing something incorrectly, especially in the LIS, and it taking me hours later to sort it out and make the corrections. Additionally I live close by and have told techs, especially on evenings/nights that if they have something come in that they are having trouble handling to call me: example trauma/massive with antibodies. Some techs are comfortable calling me so will be more likely to call, others not so much and won't call even when they should have. I am never upset with someone calling even if they wake me from a sound sleep because if they are unsure enough to call me I don't want them to hesitate because they think I might yell at them. If it's something that they should have known how to do or should be able to follow the procedure I take that up with them the next day/shift that they work. But at the time they're calling me it's all about patient care and getting done what needs to get done.  I was a third shift tech for many years so I know what it's like to be having a problem in the middle of the night and needing someone to ask for help. Luckily no one abuses the courtesy of having me available 24/7 so it's never been an issue for me.

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5 hours ago, Malcolm Needs said:

We have a supervisor with a mobile telephone available 24/7/365, BUT, this is only for serological advice (or advice on something in the laboratory that is really unusual, but not serological.  Woe betide anyone who misuses the service!!!!!!!!!

I agree jalomahe.  The "Woe betide" bit would definitely be the next time I saw them, and not at the time (and for the same reason - I wouldn't want to put them off either).

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2 minutes ago, jalomahe said:

I'm the Lead Tech of my department and I have my phone number posted in the department so the techs can call if they have questions. I tell them I'd rather they call me and I solve their problem/question quickly (hopefully) instead of them either spending a lot of time dithering about it  and delaying results/care or doing something incorrectly, especially in the LIS, and it taking me hours later to sort it out and make the corrections. Additionally I live close by and have told techs, especially on evenings/nights that if they have something come in that they are having trouble handling to call me: example trauma/massive with antibodies. Some techs are comfortable calling me so will be more likely to call, others not so much and won't call even when they should have. I am never upset with someone calling even if they wake me from a sound sleep because if they are unsure enough to call me I don't want them to hesitate because they think I might yell at them. If it's something that they should have known how to do or should be able to follow the procedure I take that up with them the next day/shift that they work. But at the time they're calling me it's all about patient care and getting done what needs to get done.  I was a third shift tech for many years so I know what it's like to be having a problem in the middle of the night and needing someone to ask for help. Luckily no one abuses the courtesy of having me available 24/7 so it's never been an issue for me.

Basically the same for me. I do try and come in with them at a later date as an "after action review," to go over the events and related procedures to help identify resources they had on hand to accomplish their objectives. I would much rather prevent a problem from happening than to pick up the pieces of one later (doubly worse if something egregious occurred and a technologist needs counseling or an action plan).

If someone calls for something less than serious I can always refer them back to the procedure and ask that they put any complaints/suggestions/etc into an e-mail.

Most recently I've had several calls for de-escalation of circumstances when a technologist rejects an improperly labeled tube and the RN is upset and wanted to speak with me to complain and/or ask me to override.

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My cellphone number is on speed dial in the blood bank.  I wish they would call me more often than they do, but some folks just won't do it--even in the afternoon.  I have told them I wouldn't have put my number on speed dial if I didn't want them to use it.  I was working late in my office one day (across the hall from the department) when a tech didn't know what to do about a problem with the computer system.  Our lab director heard the discussion and convinced her to call me.  They were both surprised when I walked in and solved her problem. ^_^

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I guess I'm still struggling with a respect issues here.  Most of the people I'm supervising are older than me and end up bossing me around.  I feel like as techs they should pull procedures, troubleshoot and use their brain before calling me.  They don't do that they just call.

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"older than me and end up bossing me around"

If they won't listen to you, they shouldn't call. This sounds like something you should discuss with your manager.

That said, I would rather have them call me at 2am instead of having to spend 3 hours the next day fixing the mess.

My favorite: "The patient has a previously identified anti K, do I need to set up K neg RBCs? OH, never mind."  The light bulb went on when he asked me the question!! I

didn't have to say a word.

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The other thing is (I presume), you have the qualifications that they have not and/or you went for the position they either couldn't (because they lack the qualifications) or didn't want the position, or they did go for the position, but you won fair and square in an interview - so age shouldn't come into it.

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2 hours ago, amym1586 said:

I guess I'm still struggling with a respect issues here.  Most of the people I'm supervising are older than me and end up bossing me around.  I feel like as techs they should pull procedures, troubleshoot and use their brain before calling me.  They don't do that they just call.

I would also advise caution with exactly what you say on a public blood bank discussion group.

Editing: I hope this didn't come off as rude as it sounds when I read it after the fact, just a suggestion in a world where the online persists forever.

Edited by goodchild
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I'm on call 24/7.  I tell them to consult the policy first.  If you try and can't find it anywhere in a policy, ask your coworkers to show you where to find the answer.  If nobody else on your shift can point you to it, THEN you call me.  Do not guess!

I get a lot more text messages than I do phone calls.  Usually they already know the answer, they are just wanting me to confirm their answer.  We have quite a few generalists on my eve and night shifts that are not very experienced with difficult BB issues, so I have no problem with them calling me.  I would much rather that than a patient gets hurt.  I feel like it's part of my job as BB Manager to support them and have them feel confident in asking for help when they need it.

I think the key to "weaning" them from calling too much is giving them really great policies (written very simply so anyone can follow them, even if they have not done the test for a while) and some good flowsheets (which I am still working on) for antibody workups, RhIg workups, etc.

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I'm with Terri. With those things in place and as they learn and grow, the calls get fewer. (Until you get a new employee :P and you start over.) If the call was something someone should have know, I ask them the next day if they've looked at procedure #(whatever is appropriate), ask them to read it and coach as needed, as often as needed. They get the idea pretty quickly - if I don't bother to look it up now, I'll have to look it up later anyway. There have been occasions where I needed to make a change to the policy to make it better-that's a good thing. Students and trainees are the best for calling those things to my attention. Sometimes they are just stressed out and they can't pull what they need out of their brains under pressure. Bottom line, better to get it right up front than fix a mess later.

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I'd say the fact that you are getting so many calls means that either training/competencies aren't up to scratch, or the SOP is lacking. You say that the tech had signed to say they were competent in the task - who had verified this? It sounds like you need to look at your own management, rather than blaming the techs.

I've been in the situation you are in as a young supervisor with people who are older (and more experienced in terms of years) below me and it is a hard place to be. Ironing out the issues with poor performers is the hardest thing to do and the only way to do it is with good competency-based assessments. Another thing to consider is including a list of changes when putting a new SOP out - you will find that 'old-timers' think they know the SOP so won't bother to read it (I've been guilty of that myself). Another thing I did was introduced an hour a day for each section where one person (on rotation) could spend the quietest time of the day (usually 11-12 or 2-3) getting up to date with any outstanding training. It meant that everyone (in theory) got an hour a fortnight. 

Do keep in mind that how they perform, and your response to it, will reflect directly on you - it's a good idea to keep them on side and make sure competencies are absolutely spot on. Anything that isn't can be brought up at their appraisal as a goal for the next year (not a stick to beat them with). Help your staff, keep them happy, and they will start having the confidence to trouble shoot themselves without fear of reprisals or looking stupid.

You could really make something positive out of this situation and get brownie points for it in your own appraisal.

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  • 2 weeks later...
On ‎8‎/‎1‎/‎2016 at 6:28 AM, amym1586 said:

I guess I'm still struggling with a respect issues here.  Most of the people I'm supervising are older than me and end up bossing me around.  I feel like as techs they should pull procedures, troubleshoot and use their brain before calling me.  They don't do that they just call.

A few comments:  first, I really like what was said above about this being a pubic forum.  You don't want your employees seeing comments like that.  Second:  if you are in charge then YOU are in charge.  Set the ground rules and enforce them.  You will need your Medical Director to back you up.  Blood Bankers are notorious for not letting go, esp the older ones (like me).  If you feel your techs are not able to perform up to their performance programs document, retrain, document - once they see you documenting things they will get the hint.  Don't let them boss you around.  Ask them what the procedure says.  That's why there are manuals.  If you think they are busting your chops, keep a record and then you can "retrain" as indicated but you also have a record for competencies at evaluation time - but you must make the effort to provide retraining.  If they balk, document . . . It's a fine line to walk.  When you have more management experience you will understand.  In many instances we were promoted to management because we were good serologists . . . suddenly we had to learn to handle people - a whole different ball game.

To the person that started this post:  getting calls at all hours is part of being in charge of the BB.  On the off shifts, I have found that a bit of extra time for training goes a long way in reducing the calls.  No matter how simple the procedure seems to you, esp if you are dealing with generalists, and it is something that occurs infrequently.  Don't make it so they don't call when they really should.  If you have a dedicated BB staff it might be a different story.

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Having managed many different teams and mentored new leaders for years, I suspect from the posts that your team does not feel that you respect them or their experience.  Despite their behavior (and I agree with David about accountability and documenting unacceptable behavior or practices) you need to make them feel heard and valued.  Try and include them by discussing the need for change and soliciting their opinions. When they are involved they then have ownership.   Then perhaps (no guarantees) the behavior will start to change.  Being "the boss" is not for wimps! 

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  • 2 weeks later...
On 8/1/2016 at 9:18 AM, Malcolm Needs said:

The other thing is (I presume), you have the qualifications that they have not and/or you went for the position they either couldn't (because they lack the qualifications) or didn't want the position, or they did go for the position, but you won fair and square in an interview - so age shouldn't come into it.

Malcolm, I have to ask, What's the color of the sky on your planet???  :lol:  

Being the negative sort that I am, I wonder if those calling for no apparent good reason, do so simply to remind you that they can.  Over the years I've had a few who worked for me who subscribed to the theory, "I would rather screw it up than look it up!"  I think I preferred the calls over the repairs I had to do the next day if they hadn't called.

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