Wednesday, May 1, 2013

One from Column A, Two from Column B

Not all my posts are going to be about dumb co-workers, dangerous antics, nor dastardly management horror stories. With over 30 + years working in Medical Laboratories there are plenty of good heart warming moments to share.  While this entry is neither heart warming nor that good for the soul, it does point out an important ritual that goes on every year in teaching hospitals across this great land.

What I am talking about is "New Resident Transition".  Every year new resident MD's start their training at teaching hospital facilities and wind up spending the next 3-4 years advancing their studies in the hands on clinical setting.  Most common time of year for this activity is the mid summer, July or so.  For University Hospital at StonyBrook New York, the tradition was a coming of change every year for basically the whole facility.  Come July, new residents would start all over the place in various disciplines of health care.  It made for an exciting time, a chance to meet with and work with them in a professional capacity, and also a chance to "Show them the ropes".  Working in the Dept. of Pathology, Clinical Laboratories, Hematology section, I had great opportunity to guide some of these individuals through the clinical lab.

After, the anticipation of late June musings about "New Residents" starting soon, there would be a calm before the storm period. These new folks really did not get introduced to the lab until mid-late July or early August for more timid of the resident kind.  Learning how to order tests was almost as challenging for some of them to figure out as what tests they needed to order.  Back in 1985, the PC was mostly a dream device seen in techy-science magazines much like someone would gaze at the pages of Car and Driver seeing the latest Ferrari or Lamborghini.  PC's were rare back then and very expensive.  It was not until the early-1990's that my brilliant Father in Law; Mr. Robert North told all us young adults "Computers will be the big thing in the near future".  He told us we would be able to shop for groceries via computer, pay for the groceries with a credit card via the computer, pay bills also, and have the groceries delivered to the door.  He was right and I have done all that and pay my bills on line; with my wife's help of course! We were so Techy-naieve back then.  But, back to the residents...Sometimes, there were over achieving Docs who would just order tests, numerous tests, and more tests just for the sake of being able to do so.  We would call that shotgun testing.  They did not know what was wrong with you so the Doctor would order a whole slew of tests hoping to find some abnormalities.  Other Docs were more level headed and really tried to control themselves after they got a smakdown from the hospital administration.  Working in Hematology I had direct access to the "New Hematologists" every year.  Hematologists, were special folks to us in the hematology lab.  All who could gather around would often do so to discuss cases, healthcare in general, discuss testing strategies, and review blood smears on a multi-headed microscope.  As a Lab Tech, being able to sit one on one with the Doctors at the microscope and discuss blood smears  was a wonderful experience. I will treasure those experiences the rest of my life.  Yes, we had some good times around the microscope!  Not to far off a year or two later Dr. C...pulled something out of his pocket while sitting at the microscope...oh that's for another story; I am getting ahead of myself.

Anyway, one evening; that is the shift I primarily worked at University Hospital (UH) (The Mecca -  as affectionately called by the lab folks) we had the pleasure of meeting the new Hematologist.  He was friendly and all but his ulterior motive was not to be social.  He had to order some tests on his assigned patients and he did not know how to do that.  So Dr. A... strolls into the lab that evening, introduces himself to us staff members and proceeds to shoot the breeze.  After a few minutes of niceties, he gets down to business.  "So" he says, "How does one order testing around here?"  "I have a patient upstairs that I need to do some testing on but I don't know what to do."  Well, being the helpful slobs that we were, we were more than happy to help him.  He signed onto the computer system.  Oh-wait let me explain...  Back then PC's were too expensive to own, but UH did have a"Main-Frame" IBM System for a Hospital Computer System.  There was a mysterious 14th floor of the hospital where the "Main-Frame" computer banks were housed and only a select few were lucky enough to even know what hallway to traverse to get to the computer room door.  It was so cloaked in secrecy if any of us lowly lab techs ever found the computer room we would have been shot on site.  Anyway, Dr. A... signed onto the "Main-Frame" with his ID.  Next he found his assigned patient and pulled up the medical file - we call that EMR & PHI now which stands for Electronic Medical Record & Protected Health Information.  Then we guided him to the ordering screen which was categorized by discipline such as Hematology, Serology, Flow Cytometry, Toxicology, Urinalysis, etc. etc.  "Oh!" he said - "I can order anything on these lists by just clicking the light pen on the test name?"  You see back then, cir. 1980's the computer mouse was not invented yet but we were special.  We had "Light-Pens!" Hard wired stick like devices that when pointed and tapped on the green monochrome screen, the test name would highlight with a strikethrough.  The light pen would activate on that strikethrough and viola; test ordered.  Well after a couple of clicks with the light pen Dr. A... was clicking Sed Rate, Platelet count, Chem 7, CBCD, Fibrinogen.  He had ordered about 10 different tests and profiles, when my co-worker yelled "STOP"!  "Do you think this is a Chinese Menu...ordering one from column A, two from column B, and TEN from column C?"  Dr. A.. said "Oh just one more test".  Click and he was done.  Well we all had a laugh, he got a valuable lesson, and Dr. A... became a good friend of the evening shift for his tenure at the "Mecca".

Those were the days of residents, the dawning of computerization in health care, and the antics of providing health care for patients on evening shift.  Those were the days.
Good day my friends...

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