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Need help from Microbiologist

Dilworth bactitech at hortonsbay.com
Tue Aug 28 23:58:10 EST 2001


That's an interesting question.  I work in a clinical hospital lab. 
Everyone complains (and has been complaining since I started working in
labs 27 years ago) that we are always the last to know anything.  Of
course, employees always grouse about stuff like this.

Currently, we have a "mailbox" system included in our Sunquest LIS
(laboratory information system) that helps bring immediate procedural
changes to the attention of everyone (we have about 30 people in our
department working two shifts and some are just part time or work
contingent).  We have formal lab meetings - for the entire laboratory at
different times so that all shifts can attend.  They usually talk about
general lab topics, budget, wage issues, rumors, that type of stuff.  We
also have departmental meetings for the micro staff.  Lately the
meetings have been held on first shift, with second shift getting short
shrifted.  There is a lot of complaining about that (I work second) and
hopefully that will change.  We talk about procedures, problematic
organisms, workup changes, and topics of choice presented by our head
microbiologist.  Last meeting he talked about bioterrorism and organisms
we need to know about that fit under that topic.  It was pretty
interesting.

At my previous job, our department was much smaller, so we had more
informal meetings, usually monthly, to talk about workups and other
issues.  All changes of procedure were posted on a central bulletin
board and we had to initial the changes.  I think this is required by 
our accreditation people.  We do this at my current job also, but it's a
little bit more laid back about it, which can either be good or bad
depending on your point of view.  

The management staff itself has LOTS of meetings - more than are
probably necessary according to our second shift team leader.  He seems
to think they drag on way too long and rehash the same topic for a long
time without summarizing and moving on.  

In a clinical micro lab, each tech is assigned to a "bench" that
includes certain types of cultures for the day.  Our "benches" consist
of urine cultures, respiratory cultures, anaerobic cultures, stool
cultures, genital cultures, blood cultures, miscellaneous cultures
(everything else), ova and parasites, and LCX (DNA probe testing for
Chlamydia and Gonorrhoeae).  We also have once/week assignments for
fungal cultures and acid fast cultures (i.e. tuberculosis).  Each bench
has certain organisms we look for and work up and certain protocols for
identification.  We don't work in groups, but obviously ask questions of
each other as we have some of us with many years of experience, and
others with less experience, so there are different approaches for
identification that are discussed.  We also read direct gram smears of
the specimen by microscopy.  Sometimes we ask questions of each other
when something we see is unusual or weird. Again, it's a group learning
experience.  If we see something unusual, we usually show it to whoever
is around to expand their knowledge so that they can file it away for
the next time they see it (which may be years down the road).  

At another lab I moonlighted at they had internet access and had a
formal email system.  Some of the techs would read their email, others
never bothered.  It was a large medical school and a lot of the email
sent to every mail box and didn't pertain to lab people at all, so this
wasn't really that unusual.  

In our new continuing ed format, we are going to do quickie
presentations to keep everyone up to date on procedures, both new and
old, so that everyone's on the same page with them.  These haven't
started yet but will soon.  

We don't do lab reports in the college sense (where you do an experiment
and write it up in a formal predetermined way).  Each specimen sent in
to the micro lab has a report generated for it (and there are formal
protocols for each type of specimen's reported format).  We use a
paperless system totally on computer where we type in the specimen
number and the patient record for that specimen comes up on the screen. 
Included is the patient's name, room number or outpatient location,
ordering physician, age, sex, diagnosis, source of specimen, and date
and time collected.  Each organism is described in a numbered workup and
the identifying tests for that organism are entered with their
reactions.  Susceptibility testing is performed and our automated
system, Vitek, is interfaced with the computer system.  When the
sensitivity is done, we bring over the sensitivity pattern into the
patient's report and check it before releasing it.  Sometimes manual
sensitivites have to be done with an overnight incubation, and zone
sizes for each antibiotic have to be hand entered.  Obviously automation
is much faster, but there are certain organisms that can't have
susceptibilities done by this method.

For your information, the lab I'm currently working in does micro work
for four local hospitals.  We handle upwards of 300 incoming specimens
per day.  It is a busy place.  Lots of things have to be kept track of
on a daily basis.  In the old days, there was a paper worksheet for each
specimen.  The patient's paper order or computer generated sticker was
applied to the worksheet and the worksheets doled out amongst the
benches.  Then you had to file all of this stuff.  With 300+
specimens/day every day except SAturday and Sunday, and with blood
cultures and anaerobe cultures being kept for 5 days, you can see the
nightmare.  Thank goodness for computers.  Many small labs still use
paper for micro, though.  It works fine in a smaller setting. 

As I said, I don't work in an academic setting per se, although we do
have medical residents calling us for reports.  The one institution that
sends us specimens is a medical school, so many of the specimens taken
are ordered by residents.  A research setting is probably totally
different, and I have no experience with anything like that.

Good luck with your paper.

Judy Dilworth, M.T. (ASCP)
Microbiology (Clinical) 27 years

P.S.  I have a B.A. in Biology, earned way back in '71 from a small
liberal arts school.  I went through medical technologist training for
one year at a local hospital's school of medical technology, and earned
my M.T. (ASCP) in 1974.  ASCP stands for the American Society of
Clinical Pathologists, probably the largest accreditation agency for
medical technologists in the US (see web site below):  

http://www.ascp.org/bor/index.asp

Jason wrote:
> 
> I am a student in college, and need some assistance with a research paper I
> am doing... If you would take the time to help me I would be very
> appreciative. If anyone has a BS in Microbiology, or any Microbiology
> degree, please answer me this one question...
> 
> 1) How do you communicate in your everyday job environment? Do you do lab
> reports? Formal Presentations? Email? Do you work in groups? If so, how many
> people?
> 
> I am trying to do a study on how communcation exists in the Microbiological
> field after college... Any help would be greatly appreciated.




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