Meeting Terry Jo Gile, scheduling in a high-volume core lab, learning to say no, and keeping a positive attitude

Edited by Christopher S. Frings PhD, CSP

Meet Terry Jo Gile

This month is the fourth of five updates to help you get to know the people who write this column each month. This month we will feature the MLO Management Q&A panelist Terry Jo

Terry Jo Gile, MT(ASCP)MA Ed., has more than 35 years experience as a certified medical technologist. She has a bachelors degree in biology from Drake University in Des Moines, IA, and a masters degree in education from Central Michigan University in Mount Pleasant, MI. She is a member of the management team at Barnes-Jewish Hospital Department of Laboratories in St. Louis, MO, and serves as the laboratory safety officer as well as a laboratory safety consultant to the BJC Healthcare System. Ms. Gile is also an assistant professor at the Jewish College of Nursing and Allied Health at Washington University Medical Center.

As president of her own consulting firm, Gile and Associates, she lectures and consults worldwide on the proper implementation of safety programs which cover topics like chemical hygiene, bloodborne pathogens, formaldehyde, ergonomics, tuberculosis, and the handling of diagnostic and infectious specimens for transport. She has received the Outstanding Speaker Award from the American Association for Clinical Chemistry
(AACC) and the Sterling Service Award from the Clinical Laboratory Management Association
(CLMA). Ms. Gile is known by her peers as the laboratory safety guru.

Ms. Gile is the author of four books published by the
CLMA. She has seven CD-ROM safety training packages produced by MediaLab Inc. She also has three books published by Avatar Press, including her latest book, Tulip Plays It Safe, a childrens book about safety. 

She serves as president-elect of the St. Louis Chapter of the National Speakers Association
(NSA), Safety Exam Chair of the American Society for Clinical Pathologists
(ASCP), and is a past national board member of the Clinical Laboratory Management Association
(CLMA). She is a healthcare safety advisor for Ms. Gile can be reached by e-mail at
[email protected].

Scheduling in a high-volume core lab

Q: I am the laboratory manager in a high-volume laboratory where chemistry/urinalysis/hematology and coagulation are one big department. My questions are 1) Do you use generalists? 2) Are they expected to know every bench test including periodic (not daily) maintenance? 3) How do you schedule them (for example, one-week hematology, one-week chemistry, or are they in a different area every day?) 4) Do you have more than one technical supervisor in the area that shares scheduling duties)? 5) Do you have core techs that do only hematology or only chemistry? Any insights would be greatly appreciated.

A: Alton Sturtevant advises, Our laboratories function in a variety of ways regarding cross-training and organization into departments. Our high-volume laboratories (greater than 2 million tests annually) have specific departments (for example, chemistry, hematology, etc.). When organized into departments, they have technical supervisors over each area. When organized in this way, we still have floaters that work in different departments. They rotate at least once each month to maintain competency. We use generalists in this role. They are expected to know the most common procedures, including test procedures, trouble-shooting, maintenance, etc. The staff in most of these departments are core techs that only work in one department. We also utilize generalists to cover all departments on weekends and holidays. Our other labs function as one department, regardless of whether they perform chemistry, hematology, etc. We still use core techs in those labs, but do use cross-training and rotation as is needed to maintain core competency.

According to Terry Jo
Gile, We started our core lab with individuals from the specific labs (chemistry and hematology), and they trained for about six weeks in departments they did not know. Their original lab is their primary spot where they work; however, they help out wherever needed. As openings occur, we seek out generalists, usually new grads, to fill the openings. Rotations are by section weekly. This allows for continuity; however, on weekends they may have to work several benches. Preventative maintenance is done by whoever is on that bench on the day it is done. The core lab offers a limited test menu and a limited number of instruments to keep the generalist work requirements manageable. We have only one technical supervisor, who varies her shift so she can touch base with all employees on a weekly basis.

Larry Crolla adds, We use semi-generalists, and they work only two departments, (chemistry and hematology or microbiology and hematology). They are expected to know the job in the departments they are working. They are not however, experts (i.e., super expertise on a particular instrument). Scheduling is for three to four week periods. We do have core techs. The chemistry department has two co-supervisors.

According to Marti Bailey, Our high-volume ATL (automated testing lab) seems to be a close match with yours. When our chemistry, hematology (including coagulation), and urinalysis were originally merged into one, we struggled with the same kinds of questions that you have. Now that these various sections of the lab are one, it seemed so logical that the staff should become uniformly trained to handle any of the workstations within the new department. In reality, this seemingly logical conclusion turned out to be lacking in the element of human nature. It didnt take long to find out that with total generalization, we lost the continuity thats needed within the different areas to ensure consistent quality performance. A prime problem was that preventive maintenance was easily overlooked because there was a new face at each workstation practically every day.

Ms. Bailey adds, When the supervisors consulted the staff, they responded as a group that neither all generalists nor all specialists seemed to be the right fit, but individual responses varied greatly. What was really needed was both flexibility and depth. Some of the staff felt extremely uncomfortable having to work so many different workstations, to the point that they doubted their own proficiency with some tasks. Other staff members were thrilled with the opportunity to build their skills. The decision was made to try to honor these differences, so the staff was polled concerning whether they wanted to generalize or specialize. The results of the poll were extremely favorable in that people sided one way or the other in numbers that would allow manageable scheduling. The folks who wanted to specialize were allowed to do so with the stipulation that they would be the ones to maintain the continuity within the section of their specialty. They are responsible for ensuring that maintenance is performed on a timely basis, monitoring inventory, following instrument problems, etc.

She continues, We also have one senior technologist assigned each to hematology, routine chemistry, and special chemistry who perform special projects and handle serious instrument problems. These folks add additional continuity within the various disciplines in the ATL lab, and two of them also handle dayshift scheduling. There is also one senior technologist on second shift and one on third shift who handle scheduling for their shifts. Our generalists remained just that. They are given the opportunity to learn as many workstations as they want to. Generalists are plugged in wherever they are needed, so they pretty much rotate on a day-by-day basis. Since they are folks who like variety, they can deal with the flexible nature of their work assignments. If they are assigned to a workstation that has an instrument that requires maintenance, they do it. During their training on any workstation, they are given a full service checkout, meaning that they learn all the tasks assigned to a particular workstation. During a 24-hour period, our ATL lab requires staff to be assigned to 35 workstations. We have four technical supervisors who share responsibility for this 24-hour operation both technically and as administrative managers.

Bottom line. There is no one right way to schedule or staff in a high volume core laboratory; however, there are many wrong ways to do it. Several right ways that work are give by the panelists.

How to say no

Q: I find that I am not good at saying no. This causes me to be overloaded with other peoples priorities and I dont get my work done. Can the panel tell me how to say no diplomatically so that I have time to do my work and at the same time keep my colleagues happy?

A: Saying no effectively and diplomatically is a learned skill. Those who dont learn how to say no effectively are usually ineffective, highly stressed managers. They seldom are good leaders. If you have a reason for saying no, give the reason, and then offer the person another way to meet the objective. Four steps to saying no are: Listen, say no, give reasons, and offer alternatives.

Alton Sturtevant advises, There are several answers to this question, depending upon where the requests are coming from. If those under your supervision are asking you to complete tasks for them, you can work with them to determine why they are bringing tasks to you. Are they not capable of performing the task? Do they understand the assignment? Do they have time to perform the task? Once you determine the reason, directly address the reason and give the task back to them. Review with them the desired result that you expect, the time frame for completion, and any other parameters pertaining to the task. If this action continues, then they are not capable of performing the expected job. Do not allow upward delegation unless there is an acceptable reason for it. If your supervisor is overloading you, then you should inform him or her that you have more tasks than you can complete in the required time and ask for help prioritizing the tasks and get definitive guidance for the project completion.

Terry Jo Gile adds, I cant say no either, although sometimes I say, Can I get back to you about that, which gives me time to prioritize and determine whether or not this is a good use of my time and then respond. If I have to say no, I may offer an alternative suggestion how the individual can get the request accomplished. For example, if someone wants me to give a seminar, I might tell him or her I cant do it on the date he or she has suggested, but perhaps I can find a date that would fit into my schedule. Or if someone asks me to serve on a safety committee, I might suggest someone else in the organization that is just learning about safety that would benefit from the committee work. Or if someone asks me for a reference for anthrax, instead of looking it up, I might suggest they go to the Internet and look it up themselves.

Larry Crolla advises, You need to be polite and say, I have priority items/projects to accomplish and wont have time to get to other projects until I complete my current projects. My current projects wont be completed for X amount of time. After I have completed my current assignments, I would be glad to discuss other projects.

According to Marti Bailey, Although it isnt realistic to think that you should never be overextended, if youre feeling that way all or most of the time, then you probably are taking more on than you should. Since not being able to say no could be an indication of poor time management, take a course or read up on time management in general as a way to approach your problem on a broader scale. For example, if you learn to delegate more effectively, you may find yourself in the position of having to say no less often. Managing your time effectively involves setting priorities correctly and then exercising self-discipline as a means of protecting those priorities. Im sure you realize that the self-discipline portion is the hard part, and thats very much at the crux of learning to say no. Saying no goes beyond learning the magic words. Its just one small aspect of managing your time effectively and you probably wont get the desired relief if you focus only on learning to say no versus the other aspects of good time management.

Ms. Bailey recommends, Your own goals and priorities are set correctly when they are aligned with the mission and goals of the institution. This is a very important concept because it lends credibility to the way you set your own priorities. If your own priorities are clearly meshed with the institutions, you will more easily be able to justify to yourself and to others why you cant accommodate certain requests that will keep you from achieving your goals. However, if someone needs your help in order to complete a project that relates to an institutional goal, it would be not only appropriate, but also imperative that you re-prioritize to include this new project. All this boils down to being well-informed regarding institutional goals and initiatives and letting this be your guide to whats important. Weve all heard many stories about people who wake up one day realizing that theyre working so much that they have little or no time to support and enjoy their family. They finally sort out whats really important and end up taking a lower paying but less demanding job or working at home in order to get their priorities straight. Its really no different at work. Spend the vast majority of your time on activities that contribute to the accomplishment of your goals, which are based on what you and the institution determine to be important. Feeling comfortable with what youve chosen as your priorities is the best way to be able to say no. If you feel that its necessary to explain, then by all means outline what youre working on that prevents you from wearing more hats. You can still be a resource by pointing the requester to someone else who might be in an even better position to help out.

Bottom line. No is the most powerful time saving word in the English dictionary! Knowing when to say no is important. If your supervisor is overloading you, then you should inform him/her that you have more tasks than you can complete in the required time and ask them to help you to prioritize the tasks and get definitive guidance for the project completion. To say no effectively: Listen, say no, give reasons, and offer alternatives. When you learn to prioritize and say no effectively, you have the skills to practice good time management. 

Positive mental attitude

Q: I keep hearing from hospital administration that everyone needs to have a positive mental attitude. They have never defined the term. Can the panel elaborate on exactly what this means and how I can meet their expectations?

A: My favorite definition of a positive mental attitude is giving 100 percent when less would be sufficient. A positive attitude wont help you do anything, but it will help you do everything better than a negative attitude. Do you know anyone who likes to be around someone with a negative mental attitude? Probably not! Most people like to be around those with a positive attitude. A positive attitude is a choice. I choose to have a positive attitude and try to surround myself with those who have a positive mental attitude. Life is 10 percent of what happens to you and 90 percent of how you respond to it. 

A positive attitude and a good sense of humor are essential to deal with the worlds reality. Our attitude toward life determines lifes attitude towards us. Our attitude toward others determines their attitude toward us. You usually have a choice as to what attitude to adopt. Negative thinkers make things rough on themselves and others. Nothing is so contagious as enthusiasm and a positive attitude. You can get a lot more done through other people, faster and more easily if you are a positive thinker.
Listen to audiotape of yourself in a conversation. Most people are surprised at the amount of negative thinking that they do. Chances are, you are not as positive as you might think. Ask several friends to let you know when you start to get negative so you will know when you are doing it. As you try to be more positive, you will become a more positive person. Success comes before work only in the dictionary. Having a contagious positive mental attitude takes work. You look at each situation and determine the best way to react to it.

Larry Crolla advises, You need to believe that you can succeed. Your mind will point your body in the direction that you believe in. If you keep a picture of success and what success looks like when you achieve it, your body and mind will help you achieve the picture.

Alton Sturtevant adds, I would define a positive mental attitude as being one that is exhibited through a can do approach to the staffs tasks. A positive mental attitude begins at the top, meaning from your administration on down. The example set by your administration should set the tone of your efforts. Your administrations lack of help in this matter should not deter your efforts to comply with the mandate from the top. There are sources from which you can get information and guidance on a positive attitude. These include the library, the Internet, and bookstores. Zig Ziglar is well known for his books, tapes and seminars relating to this subject. There are many other authors and trainers on this subject. Once you gain knowledge of how to exhibit a positive mental attitude to your staff, you should soon see that it is quite contagious and will soon be more apparent among your staff. Perhaps you can encourage your administration to purchase tapes and conduct training through your training department as an aid to your endeavors. By asking the question, the need for help in this matter may become apparent.

Terry Jo Gile recommends, Making work fun can be a great help in motivating employees to being positive about work. Humor goes a long way toward making work fun. Being able to start the day on a positive lighthearted note can do wonders for morale. It may be something as simple as the joke of the day (clean, of course), or a supervisor wearing a clown nose when he or she walks in. Perhaps upbeat music in the lounge or an occasional treat for the staff that is unexpected.

According to Marti Bailey, Having a positive mental attitude is acting, feeling, and thinking in an optimistic rather than a pessimistic way. On the job, there are certain attitudes and behaviors that are indicative of a positive mental attitude. These include smiling, being cheerful, respectful, courteous and friendly to others, making complaints in appropriate ways and at appropriate times, being interested in others and what they have to say, being calm, being receptive, handling anger appropriately, and doing a good job. On the other hand, attitudes and behaviors associated with a bad attitude include looking grumpy or unhappy, constant complaining, losing ones temper, whining, ignoring people, having a generally negative reaction to ideas and problems, and doing a poor job. There are lots of good reasons to have a positive attitude on the job. The most obvious are keeping your job and having a better chance for promotion or receiving a raise. But beyond that, you will make more friends, be able to better deal better with and have more success with your customers, and work better with your co-workers and staff. There is every good reason to have a positive attitude on the job and to do whatever is needed to avoid a negative attitude. If you find that you have slipped into a negative state, its time to take stock of both your work and personal life and find out what the problem is. It may be that your job itself is the source of negativity flowing into your life and that the best course of action would be to move on. On the other hand, it may be that negativity has made its way into your personal life which is bound to spill over into your work life.

Ms. Bailey adds, Negative thoughts develop into negative actions. Thinking you cant do something keeps you from physically going after it. Negativity is generally thought to stem from low self-esteem and lack of confidence. This may be true in many cases, but there may be situations where people fall into a cycle of negativity, and low self-esteem is not a particular problem. This could occur when you have no control over major changes that are affecting your life, leaving you feeling victimized. In either case, breaking out of the cycle of negativity is similar. Knowing that only you can allow yourself to be a victim and believing in yourself are really one and the same. Thinking positively about everything and taking steps to remove yourself from victim status are likewise two sides of the same coin. Developing an attitude that you can solve any problem and accomplish anything you want or need to do is only part of the remedy. You also need to surround yourself with positive people as well as remove yourself from negative people. Surrounding yourself with positive people creates a built-in support system for that lifestyle. You can see the benefit of positivity because being around positive people makes you feel better. Having a positive attitude in your personal life is a prerequisite to having a positive attitude on the job. If you find that negativity has crept into your attitude at work, this could well be a sign that you need to look deeper.

Bottom line. A positive mental attitude is a choice. A positive mental attitude is giving 100 percent when less would be sufficient. A positive attitude and a good sense of humor are essential to deal with the worlds reality. Being positive can help you in your career. Being negative will almost certainly hurt you.

Christopher S. Frings is an internationally known consultant and speaker on the topics of leadership, managing change, time management, reaching goals, and stress management. His consulting firm, Chris Frings & Associates, is in Birmingham, AL.

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