Happy Medical laboratory Professionals Week! A Trip Down Memory Lane

When I think of Lab Week, I think of all the Lab Week celebrations we’ve had in the past: Food, games, from “Guess whose baby picture?” to word searches and coworker trivia, and of course, more food. I’ve seen the same games over and over, but with new coworkers they’re always fun. Probably the most unique game I’ve seen, was “whose sample is this?” Smushed chocolate candy bars were stuffed into sample cups (and looked like you know what) and we had to guess which ‘sample’ came from which candy bar. Lab week also helps us remember the techs we’ve worked with in the past and the good times we’ve had in the lab and outside. And, of course, Lab week always seems to bring up reminiscing, and the question “Remember when?”

As a nod to lab week, I’d like to take you on a little trip down memory lane. Those of us who have been around for a while can laugh and add our own stories. The new techs in the lab, the younger generation will look at us and say “No way!”” or “You’re joking, right?”

I work in a lab that is very fortunate to have a few wonderful techs in their late 60’s and 70’s who still work for us part time. But anyone who has passed through our lab in the past 60 years remembers Irene, who is over 80, and has been here since 1963. That’s before many of us were born! Now Irene doesn’t work every day, or even every month, but she’s there for our students and newly graduated employees when we can use her talents for a few days. She has boxes full of teaching slides and comes in to review WBCs and RBC morphology with them and shares many stories about ‘the old days’ in the lab. Recently she was talking to a new grad and mentioned the old lab and the rabbits they kept in the lab.

“Rabbits?’ he asked.

“Yes, youngster, let me tell you about it.”

Rabbits were used for the first pregnancy tests. The first HCG tests came out in the early 1970’s, but before then, the question “Did the rabbit die?” was associated with a positive pregnancy test. Young rabbits were injected with urine or blood from a woman, and several days later, the animals were dissected to look for enlarged ovaries, a sign that HCG was present in the injected specimen, and a positive pregnancy test. So, in reality the rabbit (or mouse, or frog) always died, whether the woman was pregnant or not.

I fortunately missed the live animals in the lab era. Now that I’m working with techs who are younger than my kids (and not that much older than my grandkids!), when us ‘old timers’ talk about what the lab used to be like, we get incredulous wide-eyed stares.

 “You didn’t wear gloves??”

“They drank coffee in the lab?”

“No computers?”

In my very first job out of college I worked in a hospital lab, and trained in Hematology, Chemistry and Blood Bank. It was the time of the rise in automation, and we had some great ‘new’ analyzers. We had a Coulter S in hematology, the first automated hematology analyzer. The Coulter S offered 7 parameters. In about 1 minute it could analyze and report the WBC, RBC, Hgb, Hct, MCV. MCH and MCHC. Before this we had to prepare samples, lyse RBCs to count WBCs, perform hemoglobin measurement on a spectrophotometer, and calculate the indices! If a physician wanted a differential, we stained slides by hand and counted a 100-cell diff. Platelet count counts fortunately were not ordered on every CBC because those were counted manually!

I remember training in the chemistry department with a lot of instruments which each did only one or 2 tests. Individual tests were done on single test analyzers. Which meant a lot of techs in the lab, and you could be assigned to a bench where you did just Na and K on the flame photometer or just Glucoses and BUNs on single test analyzers all day. We did have a STAT analyzer which did electrolytes, glucose and BUN, and a larger analyzer that did 12 test panels, but they were only used when the full panels were ordered. These multi test analyzers were new and exciting, but in 1980 we were still uncapping and pouring off all our samples by hand. Without gloves!

“What?? No gloves?”

No gloves. We drew blood and worked in the lab with no gloves. Analyzers had glass coils that techs changed with their bare hands, and there were accidents. Techs contracted hepatitis and in the 1980’s the fear of contracting HIV was real. It wasn’t until 1992, when the Occupational Health and Safety Administration (OHSA) published the Bloodborne Pathogens Standard. There was increased awareness of HIV, and OHSA implemented universal precautions to protect workers who may come in contact with bodily fluids. OSHA’s standard required employers to provide personal protective equipment, including disposable gloves.

I once read an article that said that medical technician/technologists were the profession that drinks the most coffee. Now, I don’t know about that because I don’t drink coffee, but what they didn’t mention in the article was that they used to drink it in the lab! Yes, the cup of coffee often sat next to the microscope while doing diffs. And remember, no one wore gloves. I remember a doctor walking through the lab smoking a cigar. And while I don’t remember if I ever saw eating in the lab, I’m pretty sure it happened. These things are so taboo to us now that sometimes we wish we were camels because we often go for hours without a sip of water! We may have been the profession who drinks the most coffee, but today we may be the most dehydrated because the closest ‘clean ‘area to get a drink is way down the hall! And we’re too busy to leave our work and go get a drink!

People often use the term ‘The Good Old Days’ when talking about the past, but in the lab, these times weren’t always ‘good’. Yes, we had good times. But there were also practices that weren’t what we would today consider safe. Besides the lack of gloves, and coffee in the lab, there was also mouth pipetting. Remember spit strings? Techs kept them in their pockets for use in mouth pipetting body fluids (shudder). We washed glassware, even literally rinsing blood out of test tubes and reusing them.

We also love to reminisce about obsolete lab tests. I remember when AST, LDH and CK were used for markers of myocardial infarction. Then we had a new test, the CK-MB, which is now designated antiquated and has been replaced by cardiac troponin I for diagnosing MI. Bleeding times were once widely used as a platelet function test. Today this rather crude test is rarely used and not even offered by many labs. Glass in the lab has been replaced by plastics from vacutainer tubes and blood bags to graduated cylinders and beakers. We no longer count platelets on a hemocytometer because our automated analyzers perform platelet counts. In Urinalysis, we used to do confirmatory tests for glucose, bilirubin and protein in urine. And so many more tests that have been replaced by newer and better testing. What is your favorite or no so favorite ‘obsolete’ lab test?

We’ve certainly come a long way in the last 60 years! Lab Week is a great time to generate new awareness and excitement about the laboratory medicine profession while having some fun with your lab coworkers. Thanks to everyone who is part of the laboratory team for your hard work and dedication. Happy Laboratory professionals Week!

DOWN
1. favorite drink to sip at the microscope while doing diffs
2. standard PPE that wasn’t so standard before 1990
3. standard set of guidelines for prevention of bloodborne pathogens

5. old confirmatory test for urine bilirubin
8. type of pipetting common in the old days
9. you probably won’t use one of these for heating in the lab today
10. historic method for testing for glucose in urine
11. animal kept in lab for pregnancy testing
12. old school test for MI
14. plastic blood collection bags have replaced these

ACROSS
4. used to draw blood before vacutainers
6. carried in your pocket as a pipetting aid
7. used for manual platelet counts
13. obsolete platelet function test
15. dark field microscopy was first test for diagnosis of this STD in 1906

Socha-small

-Becky Socha, MS, MLS(ASCP)CMBBCM graduated from Merrimack College in N. Andover, Massachusetts with a BS in Medical Technology and completed her MS in Clinical Laboratory Sciences at the University of Massachusetts, Lowell. She has worked as a Medical Technologist for over 40 years and has taught as an adjunct faculty member at Merrimack College, UMass Lowell and Stevenson University for over 20 years.  She has worked in all areas of the clinical laboratory, but has a special interest in Hematology and Blood Banking. She currently works at Mercy Medical Center in Baltimore, Md. When she’s not busy being a mad scientist, she can be found outside riding her bicycle.

Medical Laboratory Professionals Week Approaches

Print

In light of Medical Laboratory Professionals Week 2017, I wanted to take this quarter’s post and thank all of you who work hard in so many ways to get patients the results they need. You truly are “All Stars.” I thought it would be interesting to have an interactive sort of post; feel free to write in the comments examples of how you and your lab go above and beyond to help patients.

Here is just one example of how the Molecular Diagnostics Lab here at Nebraska Medicine continues to do our part to serve our patient population. Our hospital (University of Nebraska Medical Center) has become a participating center for the TAPUR trial. This stands for “Targeted Agent and Profiling Utilization Registry” study; it is a non-randomized clinical trial that is essentially matching anticancer drugs to genomic variants in the patient’s tumor. Currently, most drugs are given based first on what type of tumor it is, then by the genomic variants. For example, if a patient has a gastrointestinal stromal tumor (GIST), and that tumor has a duplication in the KIT gene (p.A502_Y503dup), that tumor is sensitive to a drug called Imatinib, among others, and that drug has been shown to help fight the GIST. The TAPUR study’s goal is to see if any tumor that presents with that KIT variant is sensitive to Imatinib, whether the tumor is a GIST or some other type of cancer.

What does this have to do with our lab? Well, there are certain criteria necessary for a patient to be eligible for this trial. In addition to being 18 years or older, not currently pregnant or planning to become pregnant, the patient must have a solid tumor, multiple myeloma, or B cell non-Hodgkin lymphoma that is not responding to standard anti-cancer treatment and they must be able to be active for at least half the day, every day. Lastly, they need to have had a genomic or molecular test performed on their tumor. I and the technologists that I work with have seen an increase in our testing since our hospital has become a center for this trial because of that last point. We run an assay that tests areas of 50 genes that are known to contain “hotspot” regions that are commonly mutated in different types of cancers, and we run this by next generation sequencing (more to come regarding this type of technology–stay tuned for next quarter’s post!). We have been testing tumors of patients that have not been responding to treatment, and we all realize that each one of the tests that we perform has an impact on how that patient’s tumor will be treated. And here I have to commend the techs in our lab for thriving when faced with the challenge of this increase in testing–they have done an excellent job with the added workload and with keeping up with the changes that are made in this rapidly evolving area of the lab. I think we all appreciate this aspect of our careers–knowing that the hard work we put in every day to do our jobs to the best of our abilities can and does have an effect on people’s lives. Thank you all for everything you do!

For more information on the TAPUR trial, follow this link: http://www.tapur.org/.

 

rapp_small

-Sharleen Rapp, BS, MB (ASCP)CM is a Molecular Diagnostics Coordinator in the Molecular Diagnostics Laboratory at Nebraska Medicine. 

So, What Does MLPW Mean to Me?

So, I’m going to continue the thread from my previous blog post next week since this is Medical Laboratory Professionals Week (or what we affectionately refer to as Lab Week). Coincidentally, for a public health-oriented person like me, Earth Day (April 22) is also during this week; globally, some celebrate the entire week as Earth Week. So, I encourage you to celebrate both.

Pathology can be a hidden or invisible profession to many, even more so on the lab side. Even though we are dependent on lab results to guide clinical care (at least 70% of clinical decisions are guided by lab results), it’s easy to forget that there are lab professionals and pathologists working assiduously, sometimes late into the night, behind the scenes to make sure we receive timely and accurate, lab results for our patients.

So, what exactly is Lab Week? It’s the time each year when we celebrate and recognize these lab professionals and pathologists, a time where we recognize them as more than nameless faces but as team members who vitally and equally contribute to patient care. Many hospitals and health care centers will highlight the work of those in their clinical labs with poster sessions and talks on relevant topics this week. Some will also cater Lab Week celebrations for their staff as a thank you for all their diligent work that often goes unrecognized or taken for granted during the rest of the year.

So, as we residents, what can we do? Well, first, we can get to know our lab professionals and this week in particular, personally thank them for all their hard work. I’m pretty sure it’ll bring a smile to their faces if you make a deliberate effort to recognize and say “thank you” this week. We can learn their names and get to know them on a personal level and not just when we need a test result or to troubleshoot a lab related issue.

I’m on pretty friendly terms with most of the lab techs from my clinical rotations. They have invited me to department holiday celebrations (even when I’m not on their rotation), gave great feedback about me to my rotation director/attending (trust me, they often do get to comment on how you perform during a CP rotation), and gave me a heads up to help me out of potentially difficult situations. I’ve learned a lot from them and they’re always happy when we show interest in their work. Plus, I never treat anyone in a formal hierarchical manner (no one calls me “Dr. Chung” but rather “Dr. Betty” or just by my first name). I acknowledge that there is always something that they teach me and that I believe that we are colleagues working together on a team…not that I am the doctor and they are not. And often, lab professionals will be the first to detect a potential patient clinical issue, even if they have limited patient history access, so I totally give them props when they help me out in this way. And having a good attitude with your lab staff, as I mentioned, can go a long way for both your learning and advancement on the rotation.

As residents, CP rotations are often when we have the opportunity (as opposed to surgpath) to take vacation time and many look at these rotations as unofficial boards study time. But spending physical time in the lab is still learning. And for me, I learn better by doing as opposed to sitting in a lecture or sitting at my desk reading a textbook. The lab regulatory policies and management issues (and even the basic science concepts) we need to know to pass boards, we can learn more efficiently if we spend actual time IN the lab working alongside our lab professionals on these very issues. In the lab, we can also serve as consultants for our referring physicians on the intricacies and appropriateness of specific lab tests and help with regulatory (CAP/CLIA) inspections – even if your rotation doesn’t specifically require this, you can still ask to be more involved – trust me, you’ll learn more this way (and it is boards studying).

So, how are you planning to celebrate Lab Week and acknowledge those in the clinical labs this week? While you’re at all, you can help contribute to Earth Day/Earth Week as well by committing yourself to being more environmentally conscious (don’t forget to recycle!) from this week forth.

 

Chung

Betty Chung, DO, MPH, MA is a second year resident physician at the University of Illinois Hospital and Health Sciences System in Chicago, IL.

Laboratory Professionals Week Celebrations Around the World

Happy Laboratory Professionals Week! Lab week is celebrated not only in the United States but around the world as well. As in the United States, labs get in on the fun on an individual level as they recognize their employees and the importance of the lab, and larger organizations organize celebrations and community outreach events.

In Cote d’Ivoire, located in West Africa, there is a week’s worth of activities and celebrations planned. The activities include ceremonies recognizing laboratory professionals throughout the country, demonstration sessions, and community outreach to the general public via radio broadcasts, information pamphlets, and text messages, among other activities. The official lab week ceremony will take place on April 22nd in the largest city of Cote d’Ivoire, Abidjan, at INFAS (the Institut National de Formation des Agents de Sante or the National Institute for Training of Health Workers). Speeches will be given by high ranking government officials, including the Minister of Health, as well as representatives of CDC-PEPFAR, and the Association Ivoirienne de Biologie Technique (l’AIBT), the national lab association.

In Tanzania, located in East Africa, the Tanzanian laboratory professionals association, Medical Laboratory Scientists Association of Tanzania (MeLSAT) has organized awareness raising activities and celebrations as well. Throughout the week they will provide community outreach by offering testing and educational information on HIV, diabetes, and high blood pressure. They will also be collecting blood donations for the national blood bank. The lab week closing celebration will be a parade in the town of Sumbawanga to celebrate laboratory professionals and their achievements and to raise awareness among the community.

What are you doing to celebrate in your neck of the woods?

 

Levy

-Marie Levy spent over five years working at American Society for Clinical Pathology in the Global Outreach department.

Lab Week Fun

Since it’s National Medical Laboratory Professionals Week–aka Lab Week–we’d like to start off the week with a poll.

Happy Lab Week, everyone!

Edited 4/25/14 to add: Thanks for playing, everyone! The correct answer–which over 88 percent of you knew–is Saccharomyces cerevisiae.

Photo courtesy of Wikimedia Commons