Excuse Me??

[mattcastens]

OK, who's heard of this one.

I was taking care of a woman s/p ORIF of the hip. In ICU for cardiac monitoring (needs a new pacer generator). Hgb post-op = 9, which is down from 13 two days ago.

The lab calls me and says that "Her Hgb is down significantly -- what did she have done?"

I responded, "What's the value?"

"I can't tell you that until you tell me what she had done."

EXCUSE ME???

This is an agency assignment. I've worked in several hospitals and never had lab refuse to give me a value; nor have I ever had them inquire as to my patient's condition. Aparently, this is fairly common at this hospital.

I was not in a happy place (and in a bit of a hurry) so I simply told him and got the result.

Thoughts?

[shygirl]

INCONCEIVABLE

[nursegoodguy]

A lab tech wouldn't tell you a lab value until you explained what procedures a patient had done... Hmmm Just who does the lab tech think s/he is anyway? If you didn't tell them what the patient had done and they had critical values would you have gotten in trouble for not contacting the doctor? I think the lab thought they made a mistake and wanted to make sure the patient did have something done to cover themselves? Hey Matt I lived in the Twin Cities for about a year back in the mid eighties!

[ChemoRN]

I actually have had people in the blood lab suggest treatment!!

I had a patient who was bleeding. Not gushing or anything, but bleeding and we couldn't get it stopped. The plt count that AM was Patient had gotten a 4 pack (gone are the days of 6 packs ) 8 hours later, patient had a nosebleed that wouldn't stop for hours. Had done packing, pressure, ice EVERYTHING. Dr orders another unit of platelets. Chic in the blood bank calls and tells me that it is MY responsibility to get the MD to order another platelet count and coags!

HELLO?!?!

Cancer patient... No platelet count for days and coags were normal at 5AM. It is not a shock that this guy needs platelets. Besides, the last time I checked, nurses carried out orders, doctors gave them. (OK, OK, I know the power of suggestion, but still...)

So I told the lab that I would be happy to charge my patient for the above labs that they requested. HOWEVER, the patient was still bleeding and the platlets were ordered STAT.. So irrelevant of what the lab values are I NEED THOSE PLATELETS!!!! So would you mind sending them while I draw those labs? Oh and by the way, could I have your name to give to the MD so that he knows who's orders to countersign?

Platelets came up pronto. Labs never done - per MD. Platelet count next AM - :D

[joannep]

I have used the tubes regarding blood & speciman transportation. Yes, it can occasionally break down, leaving a canister with blood in limbo. Yes, it has happened when we needed the blood urgently, and we were yelling down the phone "where is the blood" and they were saying "we have sent it". Lucky we always have an engineer on site.

Joanne

[purplemania, BSN, RN]

Our lab will phone the nurse when the current value differs from the previous value significantly. They require an explanation as to the difference even when the current value is NORMAL. Sounds like someone is not applying logic to the thinking process. A waste of time for lab person and nurse, a waste of $ and does not help the pt at all. Another CYA episode no doubt.

[micro, RN]

purplemania........

that would be my bet.......

health care is getting so stressed from all sides and all the dept's are feeling it.......

cya'ing is probably what it is.........

[CATHYW]

originally posted by karrn3

speaking of the lab, i had a crashing post op cabg,no bp-suspect hemothorax. i ordered stat h/h with type and cross.after 15 minutes-no sign of the lab, i called them and was told they were busy and would be up when they were ready. i reminded them the meaning of stat and told them if i didn't see someone in the next three minutes i was coming down there.my patient ended up 5/15 h/h a 2/l

hemothorax and a trip to the icu and the lab a visit from the surgeon.

matt, i am totally with you on this-that lab person was simply being nosy, and trying to wield the tiny scrap of power he had. he obviously didn't recognize the implications for your patient. karrn3, when this occurred in our er, our management decided that, in the best interest of our stat patients, the rn's should draw the blood and do the ekg's! this is all the while you are starting iv's, getting hx, etc. we loved it-not!

[oldgirl, RN]

Hi everyone. New to posting here, but have been reading for a few months. These computer thngs are pretty cool, even for us over 50 folks! One possibility I know of for this kind of question from the lab is that they are checking that the right patient was drawn. I have a close friend who is "lab", and results that seem out of line from supposedly the same patient throw up a red flag to them as a possible mistake in the draw. I guess it happens more then we would like to think. Not that that is an excuse for being rude. At our place, if that is the suspicion, the techs will tell us that when they ask for the patient dx or change in condition. Just another twist in the long line.

[jurbyjunk]

Hi Matt. I've also got a lab story.

I'm left-handed, and when I "tick" something, I tick "backwards" (according to my right-handed co-workers). One day, I ticked off CBC, lytes, BUN, creat on a lab slip and phoned the lab. When the tech arrived, she said "so, what do you want done?". I said "I've made out the req". Her response, "oh, but you've ticked off what you don't want done. See, when you make the mark going this way, that means that you don't want this done".

[CATHYW]

jurbyjunk,

#######GROAN!########

How in the world do you respond to something like that?