Published Feb 11, 2005
sharann, BSN, RN
1,758 Posts
To our lab it seems to mean anywhere from 20 mintues to 1 hour from the original call order. This is crazy. I know they can be there fast(see it for ER)but from the ICU or the floor I noticed they take longer than acceptable.Maybe they are understaffed, don;t know, but I know that when I have a stat H/H on a bleeding post-op in PACU I want it drawn within 10 minutes.
AM I being too harsh?
medpsychRN
127 Posts
Where I work there are scheduled lab times. 6A, 10A, 2P, 8P. They only draw stats after 10:30 at night, weekdays only. If you want a lab at any other time, you draw it yourself or have the resident draw. Actually, it's faster if we do the draw as we can tube it and have results in 30 minutes.
fergus51
6,620 Posts
Stat means nothing to them. If something needs to be drawn stat, I draw it myself, send it in the tube system and call them to tell them it's on its way and ask when I should call back for results. A bit pushy maybe, but it gets the job done.
JVanRN
406 Posts
That's the way we do it to. And in NICU we have to draw our own labs (not so with the rest of the hospital). If its stat I prefer to do it myself anyway.
I'm in NICU too, but the only labs nurses have to draw are venous samples or if the kiddie has lines. Still, I'll do heel sticks or whatever if it needs to be done fast. It isn't worth the aggravation of having to call the lab and waiting for them to come.
VivaLasViejas, ASN, RN
22 Articles; 9,996 Posts
Our lab is pretty good about STAT draws.........when I was in the hospital earlier this week, no sooner had the doc written the order than the lab tech was at my bedside! Of course, that was sort of unusual, but they're usually there within 5-10 minutes. :)
Spidey's mom, ADN, BSN, RN
11,305 Posts
We are a small hospital . . .stat means stat . .. they are there quickly. It is the running of the labs that takes time .. . I've run CBC's and chem's myself as a supervisor at night when we have no lab and the CBC is maybe 3 minutes. The chem is longer because you have to spin it down and then put it in the machine. Probably 20 minutes in all.
I also draw my own labs on the floor if I need it stat and in the ER we draw all our own labs.
steph
TracyB,RN, RN
646 Posts
30 minutes, but on my previous unit, we RARELY & I do mean rarely had the necessary equipment to do a draw, so we either had to call lab to tube us stuff, or page them... it was quicker & easier to go snag stuff from our neighboring unit...
NOW, employee turned pt... ASAP means 5 days!!! (my personal experience)
begalli
1,277 Posts
I've run CBC's and chem's myself as a supervisor at night when we have no lab and the CBC is maybe 3 minutes. The chem is longer because you have to spin it down and then put it in the machine. Probably 20 minutes in all.
I think that's pretty accurate for most labs. The hematologies can be run within minutes and that's why it's usually the first result you see when looking for your labs. It can take longer however with really low cell counts (white/red/platelet). It means they have to make a slide and do it manually.
Labs usually don't (or shouldn't) let coags sit around either due to the compromise of the integrity of the coagulation process after the blood leaves the body.
With chemistries, I would agree that once the specimen is on the machine it takes about 20-30 minutes, then the tech has to review the results and confirm them and enter them for viewing by healthcare staff. In the larger hospitals, they usually do this in "batches" of about 25-50 individual specimens.
Our lab defines stat as results within 1 hour. I used to work in a place that accepted "dire" specimens. The only tests that could be done this way were blood gases, potassium, i-calcium, glucose, and an h&h. There were no other tests that could be done dire because of the impossibility of the equipment to run other types of tests that fast. Dires had to be hand delivered to the lab and handed directly to someone there and told it's dire. Whoever accepted this specimen dropped whatever they were doing and took it to a tech where likewise they drop what they are doing and run the specimen. The result was always called within minutes.
Something I think nurses don't understand about hospital clinical labs is that they receive literally 100's of specimens on any given day. Each specimen has to be accessioned and labelled with labels that are recognized by the laboratory equipment that runs the tests (a lot of places have gone to using lab equipment labels on the floor). If something comes with a label that is skewed (hanging off the bottom of the tube or covering the stopper), it has to be undone and redone so it will go into the not only the centrifuge, but also the machine that runs the tests. Most lab machines read the bar code on a label in the vertical position. So even if the label is crooked on the tube, the label has to be re-printed and the tube relabelled - this is for ALL labs, not just chemistries. Also, all serum and plasma chemistries have to have a "pour-over" tube made for them with identical labelling as the original tube.
The tubes go into a centrifuge that will take about 3-5 minutes or so and then each and every single specimen needs to be aliguoted (the serum or plasma only is sucked up into a pipette and put into the pour-over tube - cells remain in the original tube). Then the pour-over tubes are delivered to the med techs who usually run a full batch unless it's a stat in which case they will run whatever they have ready to go at the time along with the stat.
Furthermore, the techs usually have to add chemicals to the specimen to conduct the tests (reagents) that are necessary to run tests = more time.
Any number of things can slow this process down. Hemolyzed blood will sometimes not run on a machine and special care will have to be taken or special observations made. Mis-labelled tubes that tie up the accessioning process. Nurses calling saying "where's my results!" after only an hour for a routine specimen, not enough specimen in a tube (takes extra time with both the processing and running of such a specimen), messy specimens such as a bloody stopper or blood inside the bag (always wipe the top of your tubes off with alcohol before sending them down - these folks don't usually wear gloves to reach into bags!), and I'll add poorly managed labs and some employess who might be having too much fun at work. Oh! and the floors calling for lab draws take staff away from usually the accessioning/ pour-over process.
Also, people who work in labs are some of the most anal retentive/overly analytic people around--and for good reason, they deal with hundreds of specimens that all look the same and lives depend on what they result.
Toxicology can be really fast or take forever depending on the complexity of the test.
And we all know micro takes days to grow. Serologies and virologies take longer because labs usually receive fewer of these specimens and save them up to run at a certain time of the day or week.
I get frustrated with our lab because our computer interfaces are sometimes VERY messed up. I do have a back-up to look at, but that means opening a new program, but I don't expect too much and I understand that it can take time. I always draw all of my own labs unless I'm extremely busy and even then, only for cultures or a culture when I've already done one.
I have been known to say that nursing school does not emphasized lab enough. I am forever speaking up when my co-workers start slamming the lab. There is always some tension between lab and nursing. I have experienced both sides. It comes down to the fact that each doesn't have a thorough understanding of what the other does. But both are paramount to patient care.
So remember when you send down that tube of blood, yours is not the only one there and it goes through a relatively lengthy process before it's actually on a testing machine.
I hope someone learns something from my post. I think both sides frequently get slammed unfairly.
The end. :)
KaroSnowQueen, RN
960 Posts
All I know is we draw the blood ourselves, put on the preprinted barcoded label, haul it down to lab ourselves, sign it in as STAT, holler out to the lab techs, "Got a STAT here", go back upstairs and wait and wait and wait and wait and wait.
Somedays it'll be done in less than an hour and other days it takes 4 phone calls and 4 hours. And if the pt is a labstick, hang it up. They come draw it when they danged well want to and STAT be d*mned.
UM Review RN, ASN, RN
1 Article; 5,163 Posts
I hope someone learns something from my post.
Fascinating post! Yes, I did learn something, thanks!
Our lab's really very good about stat labs. Usually the entire process is complete within an hour from draw to result. I think they're pretty amazing, on the whole. The only beef I have with our lab is that they call all abnormals--except troponins. Which I think is illogical.
SharkLPN
109 Posts
The only beef I have with our lab is that they call all abnormals--except troponins. Which I think is illogical.
I think we work at the same facility! :chuckle
All our labs are drawn by the nursing staff and sent by pneumatic tube system to the lab. Stats are still drawn by nursing, but sent to a different receiving station in the lab. We also call lab to alert them that a stat was sent.
It seems that on most of my weekend shifts, the lab will have to be called numerous times in the span of an hour asking for stat results. Occasionally for fun the lab will drop the tube, and call us back an hour later declairing the specimen as hemolyzed, and we need a redraw..... :smackingf