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It's time to go on the offensive!

It's time to go on the offensive!

By Annamarie Barros, M.A.,

CLS, CLDir(NCA) MLO CONTRIBUTING EDITOR

As nursing shortages reach critical levels nationwide, hospitals are trying to maintain patient services with too few personnel. Bedside care is suffering because nursing has been fragmented into special care areas, management, and staff responsibilities.

Nurses perform many functions that other professionals could handle -- functions, in fact, that others may have once performed.

Now may be the right time to examine ways that laboratory personnel can relieve nursing's burden by reclaiming laboratory-related services and replacing nurses in certain job positions. Such actions would create a broader scope of responsibility that might attract more recruits into clinical laboratory sciences.

Perhaps those who have left the lab could be enticed to return to new and more challenging jobs. Expanded roles and responsibilities might enhance the status of technologists and eliminate that "image problem" cited as the reason for lack of job satisfaction in labs.

Let's look at some areas where laboratorians could relieve nurses. Bedside testing is expanding, and it is commonly done by nurses -- cost and lab reluctance to do the tests are two major reasons. Shouldn't laboratories reclaim responsibility for bedside testing?

A nurse usually heads infection control activities, but microbiology provides major input. Why not have a microbiologist serve as an infection control officer who then would interact with nurses? The competence of laboratorians in this role has already been demonstrated at some institutions.

Quality assurance is an area that fits perfectly with the body of knowledge and skills of the clinical laboratory scientist. Technologists have a natural ability to establish criteria, organize quality assurance programs, and coordinate these activities. The same lab-cultivated skills would be appropriate for DRG and utilization review coordinator positions. Again, technologists are already holding these jobs in some institutions.

The typical hospital in-service education department is headed by a nurse -- because a high number of nursing programs are needed, the rationale goes. But couldn't someone else with a health background and educational and organizational experience do an acceptable job as head of the education department? Non-nursing education department heads have done a good job in several hospitals.

Several labs conduct liaison programs or regularly scheduled ward rounds that reduce nursing time spent translating physicians' orders, preparing patients for lab tests, avoiding duplicate and unnecessary tests, and interpreting and correlating lab results.

It won't be easy to convince administrators that technologists are highly competent to assume positions thought to be part of nursing. It will mean developing justifications that translate clinical laboratory science knowledge and skills into generic terms fitting other jobs. It will mean getting assertive with administration and not giving up after the first "no."

Those of you who want new functions for technologists in your hospitals will have to collect examples of institutions where technologists already hold such positions or perform such tasks. When you go to seminars and workshops, talk to fellow attendees and find out what they are doing.

Professional organizations can also help by expanding advocacy roles to help promote laboratorians in positions outside the traditional lab arena. And lab educators should provide students with all available information about how the technologist's knowledge can be used in areas outside the lab.

I have long believed that nurses became preeminent because they were not afraid to accept challenges and to recognize that their skills could be expanded into new roles and responsibilities. They continually publicized themselves as the critical factor in patient care.

Shouldn't laboratorians therefore come out of their insular, narrow-focused shell and establish their rightful place in the health care hierarchy? The primary goal should be their concern for maintaining quality patient care. The rewards could be greater recognition, professional status, and personal satisfaction.

It really is time to take the offensive in an inoffensive way.

The author is a management consultant and educator; director of Health Management Analysts, Los Gatos, Calif.; and laboratory operations advisor, Ernst & Whinney, Chicago.
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Title Annotation:expanding roles for medical laboratory technicians
Author:Barros, Annamarie
Publication:Medical Laboratory Observer
Article Type:column
Date:Apr 1, 1988
Words:659
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