For those of you who don’t know – since I honestly have no idea if I’ve ever mentioned it before – I work in a hospital’s medical lab. I work in a portion of it known as a reference lab, which acts as the go-between for outpatients visiting their doctors and the actual running of the tests in hospital’s main lab. The upshot: I don’t actually run tests or create results. I act as a pass through, for tests coming in from offices or tests going out for specialized testing in other labs, such as Mayo Medical Laboratories.
The Main Lab runs incredibly efficiently; our hospital has the busiest Emergency Room in our city, and is designated as a Primary Stroke Care Center. When a doctor in the ER or on a floor decides to order a test, he or she uses a computer program to create that order. That same program notifies the Lab’s Central Processing Center, who assigns a phlebotomist to collect the necessary specimen. The program will let the phlebotomist how to collect the specimen properly, and how to maintain it (refrigerated, room temperature, etc) until they can be processed.
When the specimens arrive, staff uses this same program to receive and log the specimen, and take the specimen to the proper department for processing. When the tests are finished running on the diagnostic equipment, that equipment tells the program what the results are, and program proceeds to alert the medical lab technicians that a test is finished and needs to be verified and released back to the ordering doctor. If the test has an alert value – either low or high – the tech is alerted to phone the doctor for immediate verbal notification of the life-threatening result.
When I walked into work on Tuesday, that nerve-center program had completely and utterly blown up. A level-1 IT crisis, that resulted in top brass across four hospitals being rolled out of bed, and found the heads of the company who created and maintained the program scrambling for causes and solutions and all of their IT professionals hauled into work.
I don’t know if I can accurately convey the chaos and potential mayhem this caused. Across four hospitals, the crash impacted hundreds of patients (perhaps thousands) and thousands of tests. Doctors couldn’t order tests. Phlebs didn’t know who to draw for what. Results couldn’t get back to the doctors. When speaking of a stroke patient, where every lost minute is paid for by loss of motor, cognitive and speech function, the situation becomes much more than an inconvenience – people could die.
Most people don’t know or even much care what a medical lab does. Blood goes away and results magically come back, for better or worse, but have you ever stopped to consider what must be going on in there? On a good day?
Our lab – all of the labs in our hospital system, actually – have procedures for just this sort of thing. Managers and supervisors stepped up, began directing action. Doctors filled out paper requisitions and sent them through a pneumatic tube system to the lab. The lab organized the orders and sent the phleb techs out to collect specimens. The arriving specimens were logged and sent to the proper department for processing. The departments ran the tests, manually processed the results, and faxed or tubed the results back to the doctors. All of this, normally done electronically, carefully relegated to endless stacks of paper covering every available flat surface.
For hundreds of patients. For nearly a thousand tests. Stats and routine. For a crisis extending over 10 hours. Standing on the outside, dealing with our own crisis management in our little bubble, it looked like tightly controlled chaos. Drifts and stacks of paper, of results, prioritizing testing order, getting the stats out in the required time frames. Voices calling back and forth, techs darting this way and that, on a night that would have been busy even under normal circumstances.
Folks, we are never going to meet you. We do our work behind locked doors and biohazard warnings. All we ever know of you is a name, and a number, and a specimen. We can make some guesses about you based on which labs were ordered and their results, but frankly, we don’t usually have the time for that kind of idle speculation. But we’re never going to talk to you, hear your worries about treatment, understand what your life is like, or have any opportunity at all, really, to become invested in who you are.
But those people who have never met you busted their collective asses that night. Techs pulled 12, 13 hour shifts. One manager worked nearly 20. They skipped meals and cigarette breaks. They got their acts together, they kept their heads under unimaginable pressure, and they did their jobs and did them damn well. For you, someone they’re never going to meet.
I can only hope if you have the misfortune to wind up needing critical medical care, that you are lucky enough to wind up in a place where even the people you’ve never met are so dedicated to your care. That people who have no idea who you are will work themselves into exhaustion in order to make sure you have the best possible outcome in your situation, no matter what personal or professional hurdles they may be facing.
And I hope you now have some idea how lucky you really are. Because I know I am damn lucky to work alongside them.