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Develop your personal DRG survival plan.

These days, negotiations between unions and management tend to focus largely on job security. For steelworkers or coal miners, this emphasis is nothing new. But for the first time, a large number of health care workers across the country also face the real possibility of losing their jobs. The transition to prospective payment is largely responsible. Unaccustomed to fiscal challenges of this magnitude, many hospital administrators will resort to crisis management--hiring freezes, across-the-board layoffs, and elimination of overtime.

Hospital employees, whether staff or management, have dual responsibilities: first, to give their best effort to save their organization, and second, to maximize their job security without hurting the organization. Even if your institution isn't on the brink of financial peril, it's important to start preparing now for eventual staff cutbacks.

We will examine the various attitudes that can help or hinder your career under budget-cutting conditions. Then we will describe several examples of how laborations at different levels can expand, diversify, and market their skills in new directions for maximum security in the future.

Let's first analyze typical reactions to real or threatened personnel cutbacks. Most of us respond in one of four ways:

1. We do nothing. One version of this is the head-in-the-sand attitude. ("It won't happen to me.") Another is fatalistic. ("There's nothing I can do about it.")

2. We look for a job elsewhere and abandon ship. ("This situation is going to keep getting worse.")

3. We improve our security on the present job by working the pumps instead of jumping for the life raft. ("My job and my organization are worth fighting to save.")

4. We combine the last two strategies and put on our life jackets as we go to the pumps. ("I'll keep my options open.")

Our personal and professional goals help determine which of these attitudes we take. Before you panic--and before you chart a new course--stand back and take a good look at yourself and your aspirations. Ask yourself these questions: What are my goals? Can I best attain them by fighting for my present job or by seeking other opportunities here or elsewhere? What are my strengths and weaknesses? How can I capitalize on my strong points and shore up my weak ones? What sacrifices am I prepared to make? What barriers lie in the way of my career goals, and how can I overcome them?

As you assess your strong and weak points, pay close attention to the factors that enhance your ability to cope with change. Laboratory coping skills include the ability to perform a large menu of tests and a willingness to alter work schedules. It also helps if you can modify or change duties and responsibilities, have teaching or supervisory skills, possess unusual or above-average professional qualifications (provided that the service in question will continue to be in demand), and are known as a good teammate with a strong work ethic.

Concentrate on your own unique set of coping skills as you begin to weave your security blanket. Review your position description and underline all the duties that can only be performed by a laboratory professional with your level of qualifications. (Figure I lists a representative sampling of professional duties in various areas of the laboratory.) Then note all those duties that could be performed by less qualified personnel.

Now consider ways to branch out and make yourself more valuable to the organization. In a solo brainstorming session, look for ways to raise more of your duties to the professional level and to broaden the range of your testing capabilities.

Don't be strictly hemmed in by the confines of your job description. Volunteer for special assignments such as quality control, inventory control, instrument troubleshooting, or data processing. Or offer your services for committee work, especially in activities related to cost containment. At these and other meetings, demonstrate your problem-solving ability, decision-making skill, and professional know-how. Don't be afraid to speak up when you have an ideal or opinion; your creativity is a valuable commodity.

It also pays to expand your skills into new areas. You might enroll in courses in administration and supervision, time management, or communication skills. Instruction is available in techniques of problem solving and decision making and in improving your performance at meetings as a member or moderator. Keep up to date in your field through professional societies and other sources of continuing education.

Finally, consider looking for employment outside the clinical laboratory. Review your goals and your particular situation, and ask yourself honestly whether continuing a clinical laboratory career will help or hinder you in reaching those goals. Take a positive approach, and investigate other options. Figure II lists just some of the positions for which a medical technology background can serve as a springboard.

Here are some hypothetical case studies of laboratory personnel who drew up constructive DRG survival plans in response to their feelings of job insecurity.

* Jane Brown, M(ASCP), B.S., microbiology technologist.

Primary responsibility: performing routine mycology procedures.

Fear: elimination of job if mycological specimens are sent ot an outside lab.


Jane applies for a job as hospital infection surveillance officer and requests permission and funds to attend a CDC course on hospital infection control.

She joins the microbiology supervisor at monthly meetings of the hospital infection committee.

She volunteers for the task of helping the current surveillance officer, a nurse, retrieve culture reports.

She suggests to her supervisor that she rotate with other microbiology personnel to gain experience in various aspects of the department.

* Jack Jones, MLT(ASCP), chemistry technician.

Primary resonsibility: operating automated chemistry analyzer and flame photometer.

Fear: demotion to staff level I (laborator helper).

Special ability: instrument repair. Jack is frequently called in to troubleshoot balky instruments. Supervisors in other sections often request his assistance.


After a discussion with his supervisor, Jack sends a written proposal on instrument maintenance and repair to the laboratory director. He suggests that the service contract with an outside company be modified or canceled and that he assume responsibility for the discontinued service. He includes an estimate of cost savings.

Jack reviews lab maintenance and repair records to familiarize himself with the kind of work involved and how much of his time would be needed.

He accompanies maintenance service representatives to observe how they perform their work, and determine what additional instrument testing tools would be required.

If encouraged, Jack goes on to study instrument manuals. He may request permission to visit instrument manufacturers to learn more about their products.

* Donna Hernandez, MT(ASCP), B.S., hematology section supervisor.

Primary responsibilities: administrative and supervisory duties in a section with one full-time and two part-time employees, and performance of routine and special hematologic procedures, which take more than 50 per cent of total job time.

Fear: downgrading of job. Donna has heard a rumor that her supervisory position may be eliminated by merging the hematology and immunohematoloy sections. The supervisor of the latter section has seniority.


Donna presents the laboratory director with a plan that would add the phlebotomy team to her section. This would strengthen her supervisory status by doubling her span of control.

She volunteers to serve on an ad hoc committee that plans to recommend alternative methods of reducing the laboratory staff.

She decides to participate more actively in weekly laboratory staff meetings. In the past, Donna has been reluctant to speak unless called upon, since she has always felt that the laboratory director was unimpressed by her leadership ability.

* Michael Chan, MT(ASCP), B.S., assistant microbiology supervisor.

Primary responsibilities: supervising five full-time employees, teaching benchwork, and lecturing in the school of medical technology.

Fear: job elimination if the school program is terminated, in which case he may be transferred to another laboratory section as a bench technologist. He has received verbal warnings about the likely closing of the MT school, so it is a strong possibility.


Michael applies for a position soon to be open--evening laboratory supervisor.

He gets approval to spend an hour a day in other laboratory sections reviewing procedures performed by the evening staff.

He postpones his plans to prepare for the certification examination for microbiology specialist. Instead, he enrolls in an evening management review course given at a local college.

* Geraldine Marks, MT(ASCP), M.S., technical director of the school of medical technology.

Primary responsibilities: directing the MT school of 12 students and serving as education coordinator of the clinical laboratory.

Fear: that the school of medical technology may be closed and her position eliminated as a result.


Administration recently announced that the ratio of technologists to technicians is to be drastically reduced and that high school graduates are to be trained as laborator helpers. Geraldine draws up a position description for lab helpers and outlines an appropriate training program.

In discussing this new position description with the laboratory director, she points out that if the laboratory plans to employ less educated personnel, the ongoing training program must be bolstered and procedure instructions simplified.

She also applies for the recently established position of hospital DRG coordinator.

* Sue Blackwell, MLT(ASCP), blood bank technologist.

Primary responsbility: routine immunohematology procedures.

Fear: layoff. Sue, a 1984 graduate of a local two-year college, is the most junior employee in the lab. A recent announcement about possible staff cuts stated that seniority will be the major factor in determining who goes and who stays.


Sue watches newspaper and journal job advertisements closely and submits resumes to other hospitals.

She makes an appointment to be interviewed by a hematologistoncologist who plans to set up his own laboratory. Meanwhile, she goes out of her way to see that this oncologist gets prompt service from the blood bank. As opportunities arise, she asks him pertinent questions about patients with cancer and hematologic disorders.

Time permitting, Sue audits the student hematology lectures.

She studies peripheral blood smears from the hematology teaching sets during slack periods.

By now, the idea should be clear. With a little planning and some extra effort and imagination, you can sleep easier even when change is in the air. You may be surprised to discover that your efforts to enhance your job market prospects lead to a host of interesting new activities--and possibly a different and more rewarding future than you had planned on.

It's also nice to know that a self-preservation strategy can benefit your institution as well!
COPYRIGHT 1985 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1985 Gale, Cengage Learning. All rights reserved.

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Title Annotation:medical laboratory employees
Author:Umiker, William O.
Publication:Medical Laboratory Observer
Date:Mar 1, 1985
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