I guess I am a bit surprised that the GIs etc are not providing call coverage at these hospitals. One call night in GI pays more than what most lab medical directors receive for a monthly stipend in my area (some find it OK to work for free). As far as how the urologists in my area work, they either submit to one location because they own shares of the hospital or submit to a reference lab because my prior colleagues never fostered that relationship to obtain that business. It has been a struggle to get this type of business with the exception of hemepath.
On another side note, how does everyone feel about CMS/CLIA allowing individuals with a nursing degree to perform moderate/high complexity testing?
"We do not have any reason to believe that nurses would be unable to accurately and reliably perform moderate and high complexity testing with appropriate training and demonstration of competency." Love, CLIA/CMS
www.regulations.gov
Not a fan of nurses doing high or moderate complexity testing. You can teach a high school kid how to run a sample on a lab analyzer just fine. The issue comes in understanding enough of the science to know when a result doesn’t make sense, why ti might not make sense, why machines give certain errors (ie heme analyzers will flag for high monos because it can’t differentiate from reactive lymphs), how to troubleshoot, why things need to be done a certain way, plus qc stuff.
I organized a CNA and nursing skills fair at my previous employer and taught the point of care testing station, Point of care. it was really disturbing. This was all stuff they’d been doing and over half weren’t doing at least one test properly in a way that could definitely give wrong results. This was just urine dipsticks, fecal occult bloods, and glucose testing. I later found out the surgery was doing their own urine pregnancy tests when I went for a scope. I was having trouble giving a sample and I said, what do you need like three drops. She said we can do it with less. It required three drops. She didn’t know you could get false negatives with too few drops.
Nurses are often trained by other nurses and just told what to do and not why, and if you don’t understand why you should or shouldn’t do something you’re less likely to follow it.
It’s been studied and non lab trained people are far more likely to do things wrong, cut times short, use too little specimen, not follow qc, not calibrate, get repeated errors and then take the first thing that passes without troubleshooting why the error was happening in the first place. that’s just POC.
Also seen lots trouble with them collecting something in the wrong tube and thinking they can just pour the specimen into a new tube. OB nurses at one hospital got their privileges revoked by the blood bank for putting blood bank wrist bands on patients and drawing the samples when the blood bank supervisor went to draw a patient and saw two different patient wristbands and two unlabeled filled bloodbank tubes of blood on a tray. So many other head bang moments.
Plus nurses already get a crap ton of other extra crap dumped on them. This is just another way for admins to pile work on already short staffed and over extended nurses to save a buck and shortchange lab scientist, not show them respect, and not give them a reason to stick around.
