Saturday, July 3, 2010

Lab

At our hospital, the lab sucks. Like, really. I want to pull my hair out regularly when dealing with them. I understand they are busy, and I understand that I think of them as "the lab" when really it's two people on nights spinning dozens of blood samples in the bowels of the basement - they aren't all knowing. But really, do they have to be such raging idiots?!

For example, I recently partook in a massive resuscitation and trauma code. Over 25 units of blood products were pumped into the patient in the ER, and when it was discovered the patient had maybe fixable internal bleeding, he was shipped to the OR. As the primary nurse, I went with so I could help out. By "help out" I really mean stand in the corner of the OR without booties or a hair net while the anaesthesiologist sends me dirty looks, and frantically dial the lab every 8 seconds for the trauma surgeon. "Hi, this is Shrtstormtrooper again, I'm calling for the results of that repeat CBC which we sent 35 minutes ago. I'm in the OR, and Surgeon really wants the results. Like yesterday."

"Oh, they aren't resulted yet. Can you call back in 10 minutes?"

Um, no. Its been more than enough time, and this is the priority. How about I just hang on the phone line until it's ready?

"Whatever. it won't be resulted for a while."

So I'm on the phone, and hear the lab hmmm to himself. "That's weird," he says, "that still can't possibly be right. Let me run it again..."

Naturally I ask what the results were, and no shit, he tells me, "well, I'm not going to release that information to you because it can't be right. There is no way there was that much of a change from the last set."

I'm raging inside, and as politely as possible inform him that well yes, this is a massive resus and I don't expect it to be normal. You do realize, lab tech, that this patient has gotten his volume in blood multiple times over, and was a code, so was pumped full of drugs? Yes? His labwork won't be peachy. Finally, after arguing with him for over 5 minutes, he relents and gives me the numbers. Whatever.

Fast forward to this week. I had a patient with some weird serologies ordered. Usually I call the lab and double check with them to make sure I sent the right tubes. Usually I speak to someone who isn't a total asshat, and who takes 14 seconds to tell me which tubes I need. Not this time. Instead, I get "you can look it up online, I don't feel like going through that with you right now."

Seriously. Not even an excuse. Straight up - I don't want to do this. It took me, no lie, 10 minutes to look up all the tubes. Because the info system is crap, our computers are crap, and the lab is lazy. Whatever. I sent the bloodwork, and fumed and then moved on to more important things, since it was hella busy and I don't have time to deal with that.

Until last night. I had a dialysis patient, and the lab ordered a redraw on his stuff. Obviously the patient had no good access, and skipped dialysis for a week because "I had better stuff to do." Whatever. I find the tiniest vein in his eyebrow or something, and send off the redraw. 20 minutes later, redraw. Again. I call lab, and they tell me they can't result it due to "faulty blood" or some crap like that, and no, they won't come redraw it themselves. I'm fruitlessly arguing with them to just release the results, and the MD notices.

Now, this MD is the nicest, most soft spoken guy ever. Nothing phases him, he isn't rude to anyone, and you can always ask him questions. Sometimes I wonder if he is even real, since he's that nice. Very politely, he ambles over to me and asks for the phone.

"Hi, this is NiceMD. I'm the attending for this patient. I understand there is some problem with the resulting? Why so many redraws?...Oh, the results are abnormal? That's why you're not releasing them, they can't possibly be right?...Let me ask you something. Which medical school did you go to? What letters do you have after your name? Where is your license from? Because I went to medical school, and I went through residency, and I'm the doctor for this patient, and that means I know what his labs should and should not be. You are not a doctor. You are a lab tech. Your job is to run the bloodwork, and my job is to interpret the results. This patient is sick, and this patient in the ER. His blood will not be normal. I expect it not to be. You withholding results on this patient is tantamount to practicing medicine without a license on him, and I strongly suggest you result the bloodwork to me right this second - If you would like to continue withholding results to interpret without a license, go ahead, but know that you will be written up and I will take this to your supervisor or whoever else I need to. Have a nice night."

And he hung up. Every one of us stared, slack jawed and googly eyed, as the nice doctor turned back to his computer and kept charting.

It. was. AMAZING.

Score one for the ER!

6 comments:

indya said...

Is 'Yeeeeeeeeeoooooooooo!' a Northern Irish thing? Or do you get what I mean?

Love or Nothing said...

suck on that, lab! get it. :)

newnurseinthehood said...

That is amazing. Same shit, different bag at hood hospital- our blood is always hemolyzed, even if it's a draw from a 14 gauge. They actually came to one of our staff meeting to adress this issue, where they told us that this was happening because we weren't prepping the draw sites right. Bitch please! I just wish someone would serve their asses like they deserve.

AtYourCervix said...

I guess we're lucky then - when we have abnormal results, or "critical lab values" the lab will call use immediately, and can only give the results via phone to an RN. We then have to take it down and write it on a special sticker that's slapped into the patient's chart. So glad that our lab techs do not try to use "critical thinking" skills and re-run an abnormal result and refuse to give out the existing abnormal result/lab values.

Anonymous said...

Your ignorance is appalling. Phlebotomists are not authorized nor trained to analyze blood. The job of a phlebotomist is to DRAW blood: it is the job of a lab technologist or lab technician to run the analyses. Like nurses, lab techs have a 2-year and 4-year education option. It is a job requiring highly specialized education and training, just like the job of a nurse.

You really should educate yourself about "the lab." You look like a fool.

Start with the American Society of Clinical Laboratory Scientists.

shrtstormtrooper said...

Anon - you're right. I made an oopsie and called the lab tech a phlebotomist. My bad, yo. The point still stands; the job of the lab tech is to run the blood, the job of the MD is to interpret what that means for the patient. Witholding results is a Bad Thing.

Also - you're my first troll comment! Holla Back!