Why don’t we get paid the same as nurses? We work our butts off getting them the results they need as fast as possible (they certainly are nasty if we don’t get them fast enough) yet when I call to give them a critical, they are either annoyed or act like it is not important. We have much more technical skills than a nurse and often hold higher degrees, therefore should be paid more, if not the same. What gives?

Dear Hard-Working Scientist,

There is a lot of history around both the nursing and the lab profession that informs us why there are pay differences. First, nursing is so much more consolidated and understood than lab. If you are a nurse, while there are several educational degrees that make you so, you are a nurse. What are we? We are MTs, MLSs, CLSs, MLTs, CLTs, etc. ASCP is doing their best to consolidate all bachelor degreed lab scientists to MLS but there are still some training schools that graduate MTs or CLSs. There are even some lab scientists in the workforce that refuse to change to MLS. It is fragmented and confusing to those who hire us, which unfortunately can translate into a perceived lesser value.

Nursing also has significant industry support by a well-known and respected industry giant Johnson & Johnson, particularly when they launched the “Campaign for Nursing’s Future” back in 2002. Lab does have industry support from many of our vendors but not to the public degree that nursing has. And speaking of the public, nursing is a public facing profession. With their direct patient care responsibilities, they are more seen and heard by patients who fill out satisfaction surveys. Nursing has also done a good job of creating career ladders up to administration. In several of my previous jobs, I reported to a nurse VP or a COO that was a nurse. Because nurses work directly with physicians, often these physicians advocate for their nurses, and many hospitals are physician driven. It also doesn’t help any that the U.S. Bureau of Labor Statistics still lists Clinical Laboratory Technologists and Technicians together with one salary.

You are correct that laboratory scientists bring highly technical skills to patient care. It is also true that nurses bring a different set of skills that laboratory professionals don’t have. Our expertise is often behind the scenes—essential to patient care, but less visible. Many laboratory professionals are comfortable working behind the curtain, and that preference is perfectly valid. However, it can become a challenge when it keeps us from speaking up, participating in broader conversations, or helping others understand the value of our work. Historically, our profession has not always advocated for itself as strongly as it should.

There are several things you can do to advocate for your profession: meet regularly with your leadership so that you can create awareness for what you do; hold lab tours or lab fairs that involve other healthcare professionals; use any published data on wages, such as the ASCP Wage and Vacancy survey, MLO Salary Survey, or Lighthouse Lab Services Wage and Morale report to justify salary increases; and volunteer for your professional societies so you can become a lab ambassador. You can even get involved in activities such as visiting Capitol Hill, which can educate our legislative leaders on the importance of laboratory medicine.

I am sorry to hear that you don’t seem to be having a good relationship with your nursing team. This is also something that you can improve. Does your facility offer shadowing opportunities for nurses to spend some time in the lab? In my experience, once they realize the work and expertise that goes into a laboratory value, they understand the time it takes for accuracy. Is your supervisor willing to work directly with the nursing supervisor for process improvements? Finally, while everyone has a bad day now and then, if you are being treated unprofessionally by a nurse, or anyone on the healthcare team, see if your organization has a quality reporting tool to report unsafe conditions. Incivility in the workplace must not be tolerated and can lead to adverse events that should be reported.

I really like my job in the laboratory and feel like I help patients, but I get so frustrated with the lab instruments! They just seem to be broken all the time, and there are times I have no idea what to do. Am I supposed to be an engineer or an MLS? 

Dear Emerging Engineer,

Sorry but the truth is, you are both an MLS and an engineer. That is the nature of the beast in laboratory medicine — we are driven by automation and sophisticated equipment. While challenging, there are so many great advantages to technology that help improve efficiency and accuracy in the lab. That is, if it is working properly. It is a debate between all labs: What is the best chemistry, blood bank, hematology (fill in the blank) analyzer? Some are certainly better than others and even two of the same pieces of equipment can work very differently. Your greatest asset becomes the manufacturer’s hotline. Sure, there might be someone on your team who you can ask what to do but there will always be a time when you need to learn for yourself. Calling the hotline is so helpful because many times, they can walk you through a simple repair and you are back up and running. Even if it doesn’t work and they need to dispatch service, you have learned something about the analyzer that is great knowledge moving forward. The hotline is also there for any technical questions you might have and when it came to interpreting coagulation curves, I was very grateful for the expertise from the manufacturer that got me through a jam on night shift! The machines do seem scary at first but once you get trained in replacing some parts and troubleshooting errors, it will eventually become easier. Hang in there, you will become an expert engineer soon enough!

I have been on the bench for five years now and there is an opening for a supervisor in my lab. I am excited to learn something new but not sure if this is what I want to do. The other techs I work with love to complain about the supervisors. I wonder if I might make a difference or am I just setting myself up for failure? Is being in leadership worth it?

Dear Difference Maker,

Leadership is absolutely worth it, but there are teams where you can make a difference and teams that will frustrate you. I will say the hardest part of my career was starting out as a peer and then advancing into a supervisory position within the same team. I did not fully understand how relationships with my peers would change. Mostly, you will begin to see the larger picture of why things are. This broader view will open your eyes to things that you will not always be able to share with your friends, and your friends will not always understand. Some of your peers will respect the boundaries and be happy for you. Others will think they have an “in” to getting everything fixed and might become resentful when change doesn’t happen or doesn’t happen fast enough.

You will need to learn how to set boundaries while maintaining good relationships which, for some, can be a challenge. I am not trying to discourage you, just the opposite! I applaud you for wanting to make a difference, I believe that is the foundation of leadership! My greatest advice is to join an ASCP local chapter or get involved with ASCLS. Both have great mentorship opportunities, and you will learn from great leaders in a more relaxed environment. I recommend learning what you can about Servant Leadership as it will teach you how to lead, putting your team first. There are also a lot of great books, podcasts, webinars, and conferences where you can obtain great leadership knowledge. Learning leadership skills is a valuable asset that will not only increase your opportunities within the profession, but it will also provide you with significant growth towards meaningful connections in all your relationships. Also remember that any leadership skill you learn can be taken to the next job, if you feel you are not making the difference you so desire with your current team. Best of luck and reach out if I can help in any way!

I have worked in several different laboratories: one was a physician office lab and two were in hospitals. I am now working for a large reference lab. Is it just me, or has there been a shift in expectations for staff? I am not trying to sound old, because I am not (I am in my mid-30’s) but it almost seems like nobody cares anymore. I see many of my team members on their phones and not helping others, I work with someone who really smells bad, I wonder about the people who never seem to show up, and there seems to be a revolving door for staff. I don’t think this is because I am now working in a reference lab, I left my last hospital for the same reasons.  What has happened to the laboratory profession? It seems as if everything changed after COVID.

Dear COVID Survivor,

I would agree that COVID was a defining moment in the laboratory profession that changed a lot of professionals, many of whom left the laboratory profession. I also know that during the pandemic, many lab training programs (while doing the very best they could) were compromised so that some of their graduates did not get the same hands-on live lab experience as some of their colleagues. It was also a very challenging time for many institutions that had to look at their staffing in a different way as many stopped non-emergent services such as surgeries and repurposed those staff to meet the demands of the time. I was a lab manager during COVID and while many hospitals were laying off staff, my facility kept everyone working even if you were emptying the trash, serving food in the cafeteria, or working at the front entrance screening patients. Then, as the pandemic wore on, the additional stress of too many tests, not enough supplies, and not enough staff created a level of burnout that still triggers some to this day.

Burnout is a real thing, but does that justify the behaviors you are experiencing? Certainly not, I don’t believe professional expectations for laboratory staff have changed. I do fear there is an accountability problem that has become pervasive in most institutions. It is hard to address inappropriate behavior and/or personal hygiene with another person. Unfortunately, it is far easier to avoid difficult conversations than to make yourself and others uncomfortable, but that is role of leadership. Whether a person has been promoted to coordinator, team lead, supervisor, manager, director or any other position that is responsible for another person or a team of people, the expectation of holding yourself and others accountable is part of the job description.

I would recommend that you look at your facility’s policies regarding phone usage, attendance, and dress code (which usually includes personal hygiene) and find out what the expectations are of your organization. Then if they are not being followed, take that to your leadership, your leader’s leadership, and possibly HR. My guess is that your revolving door of staff is because there is a lack of accountability, which always drives away the best employees, because most of us want to follow the rules and get discouraged when others don’t. We get especially annoyed when leadership does not do their job and the problems never get better — that only exacerbates the burnout. Hang in there!