Reader's Respond

July 1, 2010

Letters to the Editor

Reader's Respond

Number of phlebotomy attempts
Most places I have been, we had a cutoff of three attempts before we brought in a pinch-hitter. Of course, if the patient said “Stop,” we stopped.

In any case, contact the clinician and let him/her know what is going on. If the collection is routine, it may be able to be postponed or even canceled. If not, try to get the clinician to speak to the patient and explain the importance of the collection and testing. Arterial, femoral, or other “critical necessity” sticks should be addressed in your phlebotomy policies. Train your phlebotomists, but also teach them to know their limitations and when to “holler for help.”

With reference to military blood-donor centers, we routinely provided excess-to-our-needs blood units to civilian hospitals, especially where we had large troop concentrations and correspondingly large donor pools. Since military blood-donor centers have to meet the same AABB and FDA requirements as their civilian counterparts, there should be true interchangeability between facilities. Military facilities — do not let those guys charge you for blood this month if you provided blood last month. Fair is fair.

—Chuck Millstein, MBA, MT(ASCP),
CLDir(NCA);
LTCol, U.S. Army Retired
Bartlett, TN

CLS managers' role in the profession
I have concertedly sought to find an answer as to why the medical laboratory science (MLS) profession is treated as a second-class in the U.S., in spite of the indispensable services it renders to humanity…. MLS managers hold the enviable position of impacting the profession positively; and, consequently, it is crucial that they are given the required training necessary to handle subordinates in a fashion that does not lead to questionable decisions or discrimination of any kind.

There is the urgent inevitability of managers providing support to their scientists in a fashion that is fair, healthy, and consistent…. Managing people [can] be difficult; however managing professionals should not be too difficult. It is crucial for managers to take into consideration factors such as the [gender], race, nationality, age, health, and mental capacity of their workers in dealing with them. A good manager should be all-embracing without compromising patient care but, at the same time, recogniz[e] that nobody is above mistakes. He should be able to also distinguish between mistakes that have directly impacted the patient and those that did not!

Managers must recognize that each working MLS has met a minimum requirement; otherwise, he would not have been employed. Without an iota of doubt, no man is perfect and the same is applicable to standard operating procedures (SOPs). There is no single SOP that can effectively address every concern that pertains to a given test or procedure. As a result, there is always the urgent necessity to understand both the plight of technologists … using the SOP and [its] limitations. In a nutshell, the SOP can never be the “alpha and omega” in the laboratory but should act as a guide toward patient care.

Furthermore, the profession must also consciously encourage professionals to exercise their … quest for knowledge …supported by their institution as one of the ways to acquire further understanding of what they are doing. A situation whereby an MLS's role is limited to testing on biological specimens in a fashion that suggests he or she has little or no academic qualification or certification is not pragmatic.

Moreover, there are some leaders in this profession who, unfortunately, either by omission or commission, are adamant [against] change and supporting … intelligent young stars in this … field of medicine.

By and large if the profession hopes to resurrect it[self] from the prevailing “dead” status quo and anticipate encourag[ing] younger stars into the field, it must set up checks and balances or a professional arbitration panel that should be willing at all times to review in a detailed fashion possible ways of protecting the professionals' work, enthusiasm, and commitment. Until we have such a system, the fate of subordinate MLSs will continue to be at the mercy of their supervisors or managers.

I love the medical laboratory profession; however, I shall not be part of the kind of system that seeks punitive actions against individuals who deserve favor or a system that discriminates, since such a behavior greatly compromises the ethics of practice. We have the obligation of encouraging the young folks into this venerable profession and helping them to grow and flourish in it, not to become frustrated and disillusioned to the extent that they might become antagonistic.

—Peter Odeh, BS (HONS), MT(AMT),
AIMLS(NIG), CLS/MT
Department of Medical Microbiology
and Urinalysis
Sinai Hospital of Baltimore
LifeBridge Health
Baltimore, MD

Editor's note: We appreciate Peter Odeh's commentary, and his willingness to have our staff trim the longer version so we could share his thoughts with MLO readers. Mr. Odeh has sent other letters in previous years in which he addresses his ongoing concerns about the state of the medical laboratory profession.

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