tag:blogger.com,1999:blog-880418218083230158.post1015631065506568277..comments2023-10-28T11:39:49.358+01:00Comments on Two Weeks on a Trolley: The HSE and Cost Cutting Part 2) Getting a blood test done: Posted by Dr. Jane DoeThe two weeks on a trolley teamhttp://www.blogger.com/profile/05117875014631764039noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-880418218083230158.post-74137757203791496982009-02-24T09:48:00.000+00:002009-02-24T09:48:00.000+00:00Here I am trying to get back into work as a phlebo...Here I am trying to get back into work as a phlebotomist and cant get any because of the HSE freeze on employment. The HSE really do not have a clue nor do they care to be honest because if it were me I would be quite happy and capable to train in whatever area needs to be covered. Heck i'd even volunteer but ive been out of it so long that now i need to do the course with the national amublance training but they seem to only let people in who are already working with the HSE .... its all about who you know. Sorry off topic, frustration is showingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-880418218083230158.post-69047349061476924132008-08-06T04:23:00.000+01:002008-08-06T04:23:00.000+01:00"Ok, so this is obvious to you, you're a ..."Ok, so this is obvious to you, you're a doctor, you know the consequences of transfusion f*** ups, but this is why the medics taking G&H bloods is insisted on. It's buck-stopping-here responsibility, and while phlebotomists are a damned sight better at taking bloods than most doctors, and highly educated to boot, I can still understand why it's done the way it's done here."<BR/><BR/>The phlebotomist is not prescribing the blood. They are not consenting the person for the blood. They are not administering the blood. <BR/>They are sticking a needle in the patient, getting blood out, and labelling the tube then sticking it in a bag. <BR/>This is not rocket science. If they can't do that- then they shouldn't be phlebotomists. That's what they have to do with all blood samples. It's their ONLY job. They have no distractions. Unlike us, with our bleeps going and nurses and juniors and seniors and patients all wanting that very chunk of our time. <BR/>Explain to me why a doctor is better at sticking a needle in a person, getting blood out and labelling a tube than a phlebotomist. It doesn't take a medical degree to take blood. As for buck stopping responsibility-this is the problem with Irish healthcare-thank you in fact for highlighting that!<BR/>No one wants the responsibility of ANY job in Irish medicine. Anything that can be passed on or shafted to someone else usually is. Phlebotomists will not accept the responsibility that comes with their position, and fob off the parts that worry them onto doctors. In fact they are misinformed, if they mislabel a U&E wrongly, the consequences can be as bad or worse-a potassium level comes back at 6.9 when it's really 2.0 due to mislabelling-you whack in the insulin, dextrose, salbutamol, calcium gluconate, and bang-patient has a fatal hypokalaemia induced arrhythmia. <BR/><BR/>This is another huge problem within Irish medicine-SHAFTING jobs onto people that one could do themselves to avoid responsibility. The whole first dose IV drug thing was a way of doing that-in fact, it is usually the second dose that gets people as they have become sensitised-so no logic at all there, but it was a way of passing the buck onto doctors because a certain part of the job involved a perceived small element of risk, and no one wanted the responsibility. <BR/>If phlebotomists cannot handle the responsibility of taking and labelling bloods correctly then they should not be phlebotomists. Hell, we transfuse based on results we get from the CBCs they take! Based on your logic doctors should take all bloods, and indeed, do everything else as they have somehow a deeper level of understanding of the implications of doing something wrong. Is that it? <BR/>If someone is too dumb to understand that people get transfusion reactions, then they have no business working in a hospital. Anywhere in the hospital. I think, however, that you are doing the phlebotomists a disservice. They never mislabel anything. I myself through sheer hurrying and often through unfamiliarity with different Group and Hold forms have filled them in incorrectly. Almost every junior doc I know has done so at some point. <BR/>I don't know of any nurses or phlebotomists who have done so. They two groups above usually receive training we don't get because of attitudes like yours-we have a greater knowledge somehow of procedures surrounding simple blood taking. WRONG. Irish intern did not used to receive any training in cannulation or phlebotomy, we were expected to learn "on the job" which believe me does not work so well. I don't know if they've changed that yet. <BR/><BR/>I give up though. Ultimately Ireland will never change its inefficient procedures. It will never look and see where problems are and address them. It will never utilise its staff and their knowledge and experience correctly. <BR/>Change. It's scary. And sure, it's all good.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-880418218083230158.post-20247063816178700992008-08-06T02:59:00.000+01:002008-08-06T02:59:00.000+01:00Ok, as a Medical Scientist in a Crossmatch Lab I h...Ok, as a Medical Scientist in a Crossmatch Lab I have to say I disagree with phlebotomists taking Group & Hold/Crossmatch bloods (though I admit this might be purely be because I was raised in the Irish system, as it were, so this is "the norm" and change is bad ;)).<BR/><BR/>This is primarily because a transfusion is a prescription, so obviously only doctors can prescribe it. Since that very sample of blood is what we're going to use to provide a unit for that specific patient, we need as much certainty as it humanly possible that we're getting the right blood in the right tube. I'm not sure of the risk of other blood tests being mixed up - I'm sure there is risk, such as treatment being withheld, or inappropriate treatment being given - but if there's a mix up with Crossmatch bloods the patient could at best suffer serious morbidity and at worst die. Ok, so this is obvious to you, you're a doctor, you know the consequences of transfusion f*** ups, but this is why the medics taking G&H bloods is insisted on. It's buck-stopping-here responsibility, and while phlebotomists are a damned sight better at taking bloods than most doctors, and highly educated to boot, I can still understand why it's done the way it's done here.<BR/><BR/>Believe me, there are a lot of blood transfusion practices in, say, the US that I wam horrified by. Just because something is being done in another country doesn't necessarily mean that it's better or more advanced or what have you.<BR/><BR/>OTOH, if Crossmatch Med Scis were allowed take the bloods, at least the Crossmatch forms'd be filled in correctly ;)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-880418218083230158.post-10872921926873327512008-07-31T14:53:00.000+01:002008-07-31T14:53:00.000+01:00That is just crazy (the Irish system)... hospitals...That is just crazy (the Irish system)... hospitals where I am in Australia are similar to NZ - one form for all pathology requests (bloods, urine, CSF, micro on anything and everything etc etc) and another form for transfusion requests. All rather easy.Pollyhttps://www.blogger.com/profile/07979522029667756035noreply@blogger.comtag:blogger.com,1999:blog-880418218083230158.post-82243719523398465472008-07-31T10:12:00.000+01:002008-07-31T10:12:00.000+01:00Well-said! JaneI'm sure your grandfather would be ...Well-said! Jane<BR/><BR/>I'm sure your grandfather would be proud of you for your cost-saving measures.<BR/><BR/>Simple ideas which could save the HSE a fortune, without any need to call-in the special advisers at enormous expense.<BR/><BR/>The "Ah sure, it'll do" mentality of the Irish is partly to blame here but unless/until the HSE starts to listen to people like you, nothing will change. <BR/><BR/>Keep it coming!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-880418218083230158.post-35129015042784288502008-07-31T08:27:00.000+01:002008-07-31T08:27:00.000+01:00Amen! to that Jane... I couldn't agree moreAmen! to that Jane... I couldn't agree moreDr Michael Andersonhttps://www.blogger.com/profile/05340927185641717290noreply@blogger.comtag:blogger.com,1999:blog-880418218083230158.post-61233508495943953242008-07-31T06:57:00.000+01:002008-07-31T06:57:00.000+01:00Every hospital in England where I have worked has ...Every hospital in England where I have worked has operated an Irish system. Where I currently work there are too many forms to count. The medical time wasted trying to find the right bit of paper is enormous. The problem is beginning to be solved with computerisation of requests. We were born too soon.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.com