This is not just a phase. There has to be a drastic way in which clinical laboratories are managed now.  Acute care centers such as hospitals cannot function without a laboratory.  Many systems have taken a cue from reference labs and consolidated their various facilities testing by creating a centralized lab for all but STAT work.  I think this is the way to go.  Smaller hospitals will have to cooperate with each other regionally if they want to provide reliable care for their patients.

Scott

Other than myself everyone that works the BB also works another department or more. I currently in a battle with the Lab Manager who seems to want everyone trained in BB.  It is very hard to get her to accept that BB needs to keep their skills up more than any other department, not to mention the yearly competencies. The dayshift and night shift isn't so much a problem as the Techs rotate into BB quite often and at least for dayshift the other Lead and myself are usually here for questions. The evening shift however some Techs don't get into the department for a month at a time and are terribly uncomfortable when they do and that is where she really wants more people trained.  Grrrrrrrr, the frustration

We have dedicated blood bankers on each shift.  This was suggested to us by an FDA inspector.  We supplement with generalists on evenings and nights.

The patients should be genuflecting to the FDA inspectors.  I know I would were I a patient who required a transfusion!

We have 2 half time people who work Blood Bank only. The rest of the staff is all cross trained

On ‎7‎/‎3‎/‎2018 at 10:09 AM, Baby Banker said:

We have dedicated blood bankers on each shift.  This was suggested to us by an FDA inspector.  We supplement with generalists on evenings and nights.

Interesting!  Could you please share the size/complexity of your transfusion service?

We are a pediatric hospital with about 330 beds.  That does not include the bascinets.  We have a very active Heme/Onc program, as well as CV and neonatology, and Level 1 trauma service.  Those are the services that use the most blood.  

We do stem cell, heart, liver, and kidney transplants.

And we do aliquots in syringes and bags.  We also reconstitute whole blood to a specified crit.

With the COVID pandemic, my institution demoted me and resulted in a significant pay cut. I decided to leave and go where I feel welcomed and valued for my 30+ years of experience in BB and as a generalist, LIS and manager. I have been on call, even during my vacations for over 5 years, coming in the middle of the night, holidays and weekends. I am leaving a no one is trained to do elutions, Ob titers, Dara protocol and master log review. I feel bad, but administration seems to realize nor care that I am just leaving an empty opening in the schedule! I have read all the previous postings from 2018, and the shortage and lack of recognition of our profession keeps getting worst!

That's awful Frenchie.

So much for all the talk about our 'valued public service workers'.

I'm a huge fan of dedicated BB staff for larger facilities. Currently, only day shift is comprised of dedicated staff and 2nd and 3rd shift manned by generalists who work in at least one other specialty. With a 6 on/8 off schedule, some of the 3rd shift work only 1-2 days per month and are VERY uncomfortable given that we are a Level 1 trauma center, large outreach services and serve as the "reference" Blood Bank for 7 other satellite hospitals.  Turnover is a problem on 3rd shift because of the extra stress caused by only being scheduled 1-2 days per month and being responsible for at least half of the massive transfusion activations.

My Medical Director wants dedicated BB staff but with the current administrative/financial climate it is a steep hill to climb.

Wow. I didn't realise how lucky we are at my hospital.

We process around 7,000 samples a year, so not a large facility.

It is not a lack of expertise that stops us doing elutions/titres/adsorptions rather that it would not make financial sense for us to.

We have 4 full-time transfusion specialists for routine (9-5) hours. Outside of these times is covered by multidisciplinary on-call. Any biomedical scientist in the pathology department can join the rota. On call samples are processed in haematology, transfusion, biochemistry and a few micro tests by the lone worker.

Training in transfusion for the on call staff is much longer and more in depth than for the other labs. Each rota member has to work and train in BT for 10 days a year and be signed off as competent for all aspects. The 4 transfusion scientists are available to process Ab ID and FMHs if need arises.

This means that more than 50% of routine hours every year are dedicated to training on call staff.

We have dedicated staff.  There were too many errors otherwise.

Hi- we are a 360 bed T level 2, we have dedicated Blood Bank staff on first and second shift and 3 FT BB rotational staff. It is imperative for us- even with the continuity, it's still an issue to know all the needs of each recurring pt...competency biggest issue - glad not numerous generalists.