A great way to get into lab work is to start off as an assistant. Especially useful for someone who’s just starting out or even new graduates depending on their circumstances. After I completed my lab degree I really wasn’t ready to get into lab work because I didn’t have any background. And at that time I was getting married and planning to move and it was just not a good time for me to settle down into a lab just yet. But I did want to work in a lab and the best option at the time was to work as an assistant. Assistant’s don’t need degrees and aren’t involved in actual medical lab testing. So the work is available and most people only require few weeks for the completion of initial training. Keep in mind, “initial training” can be fairly quick; proficiency will obviously require a lot more time and skill.
Medical laboratory analysis is usually departmentalized for the most part. With people working mainly in one or a few departments of the lab. Working as an assistant you get a generalized understanding of the different departments. And I highly recommend it for someone who’s considering lab work as a career.
Lab personnel mostly work independently. There are times when there’s communication and we’re assisting each other, but our tasks are completely different. Each person in the lab is performing a specific task(s) for a particular patient’s care, whether we’re talking about accessioning by an assistant or analysis by a technician. Prioritization in most cases is the same whether a specimen is being received by an assistant or analyzed by a technician. Depending on the patient’s condition or the specimen type; a different priority needs to be assigned to it and this changes from patient to patient.
I wanted to give my impression of the daily work as a lab assistant. Now let’s take a look at what you might find in a job description, for example at indeed.com or ZipRecruiter.
Essential Duties and Responsibilities:
– Follow safety procedures.
– Follow and ensure compliance to regulatory standards (CLIA and State regulations).
– Support pre-analytic phase of Clinical Laboratory testing duties including specimen receiving and handling, accessioning, labeling, treatment processing of samples, and verification of data entry.
– Provide timely service.
– Resolve issues and communicate with teammates regarding laboratory documentation and results.
– Conduct general laboratory maintenance including cleaning and stocking lab equipment and supplies
– Data entry into LIS, verification of data entry, faxing results, filing and record retention.
This is actually a pretty good description of day-to-day work as an assistant. But let’s break it down to see real life practical applications of each of these skills and duties.
So it’s a Monday morning; I work at a fairly large hospital with close to 500 beds. First thing I’ll do is put on nitrile gloves, a face mask and a lab coat. Just routine safety practice to prevent contact with specimens or materials that may present a biohazard. Next I’ll walk over to a computer and login to the labs LIS or laboratory information system. 80% of the day involves using the LIS for various tasks. The remaining 20% usually involves specimen processing or filing documents as well as simply maintaining the lab. Lab testing can be something simple or it could be complex. Testing differs based on each individual patient’s case. It could be a single test or it could be numerous tests on a panel(s).
Doctors and nurses use a different computer system than the LIS that a laboratory will use. Let’s say a patient’s doctor orders extensive blood work that needs to be done. The MD or RN will use their system which is almost always Epic for the order. Once they’ve ordered a test in the Epic system, it transmits over into our computer system or LIS.
Initially this is what’s called a pending test because it’s the starting point. It’s been ordered by a doctor or nurse. And the next step is the collection of the specimen that this test requires. Let’s say we want a blood specimen for a metabolic panel or CMP. This panel has 12 different tests on it. But only requires a single tube of blood.
Next a nurse or phlebotomist will collect the blood and send it to the lab.
The lab assistant’s job begins at this point. Once the required specimen is collected and arrives at the lab the next step is what’s called accessioning or laboratory receiving. Receiving is the verification step in the laboratory computer system (LIS). Here I would verify a patient’s information, the tests that’s on the label of the tube, the tube used, the specimen; as well as what’s in the computer system and make sure everything matches up. This verification makes up a lot of the work that’s done from day to day.
It sounds simple, but it can be complicated because ordering of tests gets more and more complicated if you think about the different nurses that take care of a patient and the different doctors that take care of any given patient. All kinds of problems can arise between conflicting orders between two different doctors for one patient or even different nurses ordering for a patient. The job of the lab assistant is to verify these tests as the specimens come into the lab to make sure that they’re needed, and they’re valid. As well as to make sure that the specimen meets the criteria for the test that’s being ordered. Different types of blood specimens or test tubes may be required for different types of tests.
I can’t tell you how many times I’ve gone into a patient’s profile and see what appears to be conflicting test orders. But if there are multiple doctors involved then they may be valid orders. You have to keep in mind it’s the clinician’s discretion to order a test so as long as this has been confirmed and the possibility of unnecessary testing has been ruled out, we can move forward to the next step. From time to time even doctors and nurses can make mistakes. So careful attention does need to be made by the assistant to make sure that orders aren’t being ordered erroneously.
This includes orders that were never completed as well; sometimes orders are forgotten by nurses or phlebotomists, and we never received the specimen. And other times it may be an error made by an assistant; whereby a specimen may have been received but overlooked. The fact is, especially in busy hospitals, many things can be overlooked. If one person slips up, it’s the job of the next nurse or the next doctor or people in the lab to rectify the problem. And we do this every day. It’s just a job requirement; mistakes may happen from time to time, but the important thing is that the problems are identified and rectified.
Sometimes the cause of these delays is out of people’s control. For example, if a patient just can’t produce enough blood or body fluid because of their condition at that particular point in time. This of course will delay the testing. This is one example of what could happen. There are many other scenarios that also delay testing. Hours may go by and as a shift change occurs the next nurse who comes in may not even be aware of the test that requires attention. Although most nurses are reviewing the charts and should be aware of all pending tests.
From the perspective of an assistant looking at a patient’s profile; or anyone else for that matter, it may look like a test has been overlooked. One of the other problems that occur with questionable testing is that tests are simply no longer needed or canceled by doctors and nurses. Some nurses are more focused on patient care, so they may not take the time to go into Epic and make the necessary changes to remove any erroneous or unwanted test orders.
Fortunately; patient care is team effort; we’re all working to correct these mistakes whether it’s a nurse or a doctor at the patient’s bedside, reviewing information in their computer system or whether people in the lab are reviewing the patient’s profile in their computer system.
Lab assistants are in constant communication with doctors, nurses and the technicians performing the testing. When in contact with nurses or doctors it’s usually to verify information or to correct mistakes. Most communication with technicians is usually to relay information from nurses and doctors. For instance, to inform them that a doctor is calling about when test results will be available.
So we’re ready for the next step which is specimen processing. Some specimens don’t require much, they can be used for immediate testing. Processing refers to preparation. Certain volumes or tubes are needed to preserve or prepare the specimen for testing. Centrifugation may also be needed for some tests. Both body fluids and blood specimens may require centrifuging depending on the test being ordered. Another part of specimen processing involves transferring the specimen. All this means is taking the specimen out of the original container and putting it into another type suitable for testing. Most laboratory testing is automated, but that means specific containers maybe required for that automation.
Everything I talked about during specimen receiving, pertains to what we call pre-analytical. Simply meaning all of the preparation before the actual testing is done. We’ve talked about the verification of the test and a specimen, the handling, the labeling, then the specimen processing.
Now keep in mind this is the workflow for every single patient in the hospital. A single patient in a 500 bed hospital may have anywhere from a single test to numerous tests and each one of those tests requires the same process that I have just explained. That’s why specimens come in batches so we are working on numerous tests from numerous patients and that’s how the testing is done too; it’s not a single test at a time. The automated testing systems allow many different patients to be tested sequentially.
It’s a lot of multitasking and if you happen to be in a busy ER hospital; it can be nerve-racking. A common misconception is that lab work is much more relaxed. That’s not exactly true because you may have hundreds and hundreds of nurses in a large hospital but only a handful of people in a lab. Laboratory workers may be experiencing the same pressure as overworked ER nurses on a busy day due to the volume of specimens coming into the lab for testing.
Depending on the hospital, some laboratories are not only receiving specimens from inpatient and ER; they’re also working on outpatient testing that comes into the lab. This is because a centralized hospital maybe working with smaller offices and clinics in the area. Since smaller clinics in offices don’t have laboratory analyzers to perform the lab testing; they’ll have a medical courier deliver it to the lab for testing and those results are then made available electronically to the doctor or clinic. Because hospitals are working with other labs and clinics; specimens are sent in and sent out like clockwork at regular intervals throughout each shift.
Once all of this work is done and things are a bit calmer we focus our attention on other things like maintaining the lab by cleaning the benches where specimens may have spilled or restocking laboratory equipment.
At the end of the day, everyone in a hospital providing patient care has similar burdens and responsibilities. Working in healthcare can be a challenging and rewarding profession.
After I became very proficient at my work as a lab assistant I was pleasantly surprised with the skills I had obtained. No course lecture or practical experience would equate to the hands-on work experience you actually get when you’re working in a lab. Since I decided that it wasn’t time for me to be a lab technician, because of the things going on in my personal life, working as a lab assistant instead allowed me the flexibility I needed and at the same time provided some useful skills that I could definitely use in my workflow as a technician, when I begin the analytical aspect of lab work.
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