It is not your duty. It is your liability.
- Sen. M. D. Santiago
I’m not really writing this from the viewpoint of an expert on the subject (although I started as a BSN student, I never finished the course), nor do I write this as an overtly critical piece. I do, however, feel that this has to be directed to the current crop of BSN students and RN Heals trainees, most of which may be perfectly good nurses technically but fail to appreciate the finer points of hospital duty, at which case the laboratory receives the short end of the stick, so to speak. Yes, I am not so pig-headed as to reject criticisms; however, I’d rather accept rational rather than emotional WT@#$&! ones.
First, the student nurses. It’s quite understandable to take the mantra of service cynically; not all patients are easy to handle and take care of. More importantly, everyone is not a superman enough so as to commit no errors at all during night duty But really, to fail to endorse just because you have finished your case, a case in which, by the way, you submitted a mislabeled specimen AND failed to rectify the error properly even when advised how? Hospital service entails continuity of care and correct patient identification, especially in a chronically crowded public hospital. This is not actually being ideal, it’s simply applying common sense. Obviously, if you give a drug to the wrong patient, consequences may be fatal. Why do you assume that the same is not true for laboratory work-ups? Wala kang magagawa kung magagalit ung pasyente kasi kukunan mo uli ng dugo. You have to take it because it was your error. If the patient refused blood extraction, refer to the resident on duty because he/she has the authority and training to “force” the patient.
As for the RN Heals trainees, it’s understandable again: phlebotomy (blood extraction to the uninitiated) is a skill that takes some time to get used to. Practice will eventually help you gain that skill. However, it does not excuse the idea that some collect blood for blood chemistry from the same arm that they inserted an IV line in. Obviously, you will collect blood contaminated with IV fluid, which is then submitted to the laboratory for serum sodium and potassium levels. Results will inevitably be erroneous. We then have to call you and say that the sample has to be recollected. What right have you to get angry at us for asking you to recollect the sample when it is your fault? It is also your fault that the patient gets angry at you, not ours. Again, it’s not being ideal. It’s common sense of the most basic order. If you cannot collect blood from an arm uncontaminated with IV fluid, then get from the foot. May ugat naman doon.
These are but two examples why internecine warfare exists between the Nursing Service and the Laboratory. I could of course recount examples where it is the Laboratory that is in the wrong and the Nursing Service correct, but that is another
story blog post.
In conclusion, there are certain reasons why the demands of the laboratory affect nursing care, especially in tertiary public hospitals where the nurses and the residents act as the blood collectors. (In *spit* private *spit* hospitals which are generally smaller, it is the medical technologist/MT intern who collects blood). And yes, I am obviously ranting. But then, all allied medical professionals have the same goal. Why not a semblance of cooperation, even if it means more work?