Stupid S***-For-Brains Slack-ass Morons

Sometimes I feel like I've just had it up to here. Like I just cannot go back to work one more day and witness the ignorance. But you know what? I will go back. I will drive back up to that hospital tonight, and do it all over again. Because I have had about 15 Dove milk chocolate Promises, and am now sipping a mug of Tazo 'Calm' tea, and have had about 4 hours away from work to put things in perspective.

No less than 3 times during the night did I take phone calls whereupon I was asked by someone outside my department how to do *their* job. A strange phenomenon takes place during the nightly weekend computer down-time periods. This occurs each and every weekend, has for years, yet suddenly no one knows how to order, label or process specimens to send to the lab. It becomes a complete and utter mystery. Much retraining must occur. And do they ask someone in their own department or area, who would actually share knowledge of their job? No. They call the lab. We also are the fountain of knowledge for what to order when the handwriting on the order slip is completely illegible (we are actually supposed to see this over the phone), when the label printer stops working, when the laser printers stop working, or when any other 'thingy' in areas completely outside our jurisdiction won't work. Can you believe a medical professional would actually use the term 'thingy'? Believe it.

Now I don't know if it was an RN, LPN, or an AA (Administrative Assistant) who I talked to this morning, but here's more or less how the conversation went:

"Hi, this is Kathy in the lab. We got a specimen down here that's labeled correctly, but just has 'CBC (Complete Blood Count)' written on it, and no lab label. And we got no down-time requisition slip with it. What's up?"

"Well, my label printer won't work. I can't print labels."

"You can't print labels? Did you call MIS for help?"

"No."

"Okay, well, we still need to have an order on this specimen. When I look up this patient in the computer, I see an HAH (Hemoglobin and Hematocrit) from 0100 that was cancelled, and then there's another ordered, but not until 0900. Would you like a CBC for now, 0430?"

"Well, yes, we want...*gasp of dawning awareness* You know what I did? *titter* I used the wrong stamper!"

(A stamper is a plastic card that you can run a carbon copy or sticky label over like the old-fashioned credit card slide that has the patient's name, medical record number, room number and age on it)

"Uhhh...Okay, so you're saying this is totally the wrong patient label on this tube of blood."

"Could you send that back up to me?"

"Absolutely not."

*stunned silence* (Even though this is a highly hated and dreaded situation [an incorrectly labeled specimen], a part of me just loves to tell them 'no' to this question. The fact that this happens with frightening regularity, and they have the cojones to ask you to help them cover up their mistake ought to be sufficiently appalling.)

"But..."

"The policy is that if a specimen is known to be mislabeled, and it makes it all the way down here to the lab, we discard it. It's gone, out the door." (This policy has been in place for, oh, going on TEN FREAKING YEARS)

"So it's gotta be redrawn?" (Oh my God, the light...it's blinding me!!)

"Yes."

*Noise of exasperation* "Well! Then the lab is going to have to come up and do it!"

"Fine. I'll put the room number on the bulletin board." (Yes, please, since you, bitch, are obviously too incompetent to order, collect, and label patient specimens, by all means, let the lab phlebotomists come up there and draw the patient, after you've stuck at least one hole in him this morning. ~PLEASE~.


You should know we are in the process of changing over the responsibility of who draws the blood specimens from the patients. For the last 7 years, courtesy of the misguided and greatly misunderstood and mysterious 'Patient Focused Care' policy, this was given to the nurses and floor personnel. Well, after 7 years of mislabeled tubes, grossly hemolyzed chemistry specimens and clotted CBC's, it has been deemed, after many studies and comittee meetings, that this responsibility is now being resumed by a team of phlebotomists from the lab. After SEVEN YEARS, someone finally sees that it was a very, very, very bad idea to let nurses collect blood.

Well, halle-freaking-luia.

It'll probably get worse before it gets better, but with time, the situation has got to be better than this. Back in the good old days, when I worked for St. Joseph Hospital in Flint, mislabeled specimens were completely unheard of. Why?? Because trained phlebotomists drew all the blood specimens.

True, this hospital does many times the volume that long-gone institution did, and shit is still gonna happen, but what gets me, and gets all of us in the lab, is the 'I don't give a shit' attitude the floor people have. I made a mistake? Send it back let me cover it up. IV-contaminated specimen? Well, I drew that myself, I just know that fat emulsion couldn't *possibly* be in that tube. I discarded 10 cc! (as we are looking at plasma in the tube that resembles chicken gravy). Are you sure you don't want a redraw to check this low hemoglobin? You know 5 grams is awfully low. Are you sure you didn't draw that near an IV line? Oh no, that's the right result. The patient is almost dead anyway. (As we grit our teeth and think 'how crass', and wonder why the f*** we show up every night if we're just here to provide results on nearly dead patients. And then get a redraw shortly afterwards from the same patient that amazingly looks quite normal!!!)

I could go on and on. And no, this isn't 40-something burn-out, angst, bad attitude or whatever. The 20-somethings get even more pissed than me sometimes. I've seen 17 years of this shit, and the idea is dawning that things probably aren't going to change. They're catching on, too. My 25-year old co-worker half seriously thought of placing a very derogatory screen saver ("Nurses Suck") on the CBC analyzer. I half seriously cautioned him not to.

There have got to be good professionals out there. Just got to be. I'll go mad if I don't believe that. It's the slack-ass idiots that stand out from the crowd, I guess. They're the ones that leave you steaming the whole drive home from work and make you hope you never EVER end up in the hospital. I'm begging all of you to do whatever it takes to stay healthy and injury free. But because life is full of unexpected shit, if you do end up in a hospital, you must get someone to go with you and watch each and every thing any person does to you the entire time you are admitted. Seriously. People, when you check into a hospital, you lose your name and basically your entire identity. You become '3178' or '4205' or whatever your room number happens to be. I still cannot understand, after all the years I have spent working in a hospital why the floor personnel continue, almost defiantly, to refer to every patient by only a room number. The lab doesn't do that. The bodies that oversee and accredit hospitals flatly forbid this practice, yet it continues. And guess what? Patients move! They change rooms! How about that??! So you may move to 4102, but the moron at the desk will order bloodwork on you, and a new moron will take the labels, go to 4205, not bother to check the patient armband (which might be worn by the bed, stuck on the wall, lying on the windowsill..) draw the patient that moved in behind you, slap your labels on that person's blood, and send it off to the lab. Think it doesn't happen very often? It probably happens more times than we catch. We have selected flags and guards set up when we are resulting, but if two patients' results are similar, we never would catch it.

But what the hell? Your nurse won't give a crap. Your 'results' just printed off on their thingy, and the doctor making rounds will have numbers on a piece of paper waiting for him, and won't bug the desk for missing results. And that's all that matters.

I think I'll take about 3 Motrin and go to bed now...