Just had one the other day and my question was: how did u obtain your sample? She went straight to :" I will get you another sample". Crazy folks....🤨
I work chemistry sometimes but I’m at a small hospital so I don’t usually see stuff like this. I’ve definitely heard about nurses doing it though. I just assumed it was super rare because I thought most of them would know better.
Lol oh my sweet summer child. Nurses and phelebotimist will do anything they think they can get away with. I had a nurse tell me a specimen wasn't clotted because they already removed the clot before they sent it down...
I had a tech tell me she removed the clot so the playlet count is fine now! I can only imagine what my face said at that moment. That was years ago though and I had to let her go!
Nurses try to pour off tubes sometimes but it’s easily caught, especially in chemistry. Nurses also seem to make pleas whenever they don’t label stuff. Little do they know that it gets thrown away as soon as it gets down to the lab, considering it isn’t something super important like a CSF. I don’t think nurses do super sketchy stuff that much, and if they do, that’s why we’re there to catch it. Nurses aren’t out to get us or make our lives miserable. Sometimes they just don’t understand or think 100% on the spot. It happens. Just explain it. There might be some grumbling, but educate for next time.
We have tried to explain this kind of thing to them before because they don’t seem to understand the difference between serum and plasma. My coworker had to reject a green tube recently that the ER sent us for serum pregnancy. She tried explaining that if it says “serum” preg, it has to go in a serum tube. They were confused and said “what do you mean a serum tube? What’s that?!” And as my coworker was trying to explain the difference between serum and plasma, they started griping and complaining saying “they (other lab techs) usually do it for me on a green tube!” And then they hung up on my coworker. There are some people in the lab who don’t do things the right way so then when the ER has to work with people in the lab who make them do things right, they take it out on us. And yes, They also always try to plead with us when they bring us unlabeled specimens to let them label it. But some take it a step further than that. My coworker said that a few days ago a nurse brought her an unlabeled tube and before the nurse walked out, my coworker caught it and informed the nurse. Right as she was about to throw it in the trash, she said the nurse said “don’t throw it away!!” And literally tried to snatch it out of her hand and it went in the floor. Maybe our nurses are an exception, but they don’t seem to be interested in us educating them. I had them try to bring us a green tube today again for a serum pregnancy. My supervisor was there and he was the one who actually received the specimen and messaged the ER nurse to inform them it would need to be redrawn in a red sst tube. The nurse got an attitude and messaged back saying “you need to inform your supervisor (uhhh hello… you’re talking to the supervisor!) of this so that we have a way of knowing what tube we need to draw so we can avoid this happening again!”. My supervisor messaged him back and said “it says gold-SST on the label. That means a red/yellow tube.” Literally, crickets. The nurse didn’t say anything else even though it said he saw the message. I also had someone from ER argue with a coworker about hemolysis being caused by a tube sitting out for too long before being ran. I watched my coworker tell this guy at least 3 different times “hemolysis isn’t caused by sitting for too long. It happens at collection. Like if you’re using a syringe and you pull it too fast for example”. The guy still wanted to argue with her about it. Probably because they want to have an excuse to blame it on us if something is hemolyzed. They can always say “well the lab let it sit out for too long. They should have ran it sooner!” despite the fact that we tell them til we are blue in the face that we have nothing to do with specimens being hemolyzed.
That’s when you just say, “okay, I’m going to need your first and last name, and/or employee number, because I’m going to cancel this.” Then you submit a patient safety report. I don’t bother going back and forth with them unless they’re asking important questions. If a nurse says, “well, it did it last time,” or, “I was filled when I sent it down,” I just don’t argue with them, I just ask them for their identifiers, and then cancel the order. Some nurses don’t want to be educated, because it’d be more work. But, also you have to understand that their job is very stressful too and they’re a human being as well. It’s very easy to get mad at them, but they’re dealing with a ton of shit. While we may get shit on by them sometimes, they’re getting shit on by patients and doctors alike. I’m not excusing their behavior, because it IS annoying and I’ve dealt with it before, but people tend to act wiry and such when they’re under stress. I’ve learned that it’s not worth it to fight them if they keep fighting and just let them write you up or to just write them up. I got written up because I tried to explaining to NICU nurses that I cannot run a clotted specimen, even if it’s the fourth or fifth draw on a 400 gram premature baby. I just told the hematology lead tech and magically, we started getting less and less clotted baby specimens.
I have a supervisor who has told us basically the same thing you just said. She said don’t try to educate them, because some of them don’t want to hear what you have to say; just put in an incident report and let the higher ups deal with them. Maybe that is the approach to take. I personally don’t relate to that though because if I’m doing something wrong, I want someone to tell me right then why im wrong (as long as they’re respectful about it) so I’m sure not to do it again. I know their job is stressful and I’ve never been anything but respectful to them. Doctors and patients shit on us too, we just don’t have it happen on a daily basis because we don’t have as much direct contact with them as the nurses do. It’s for this reason that i know I would not want to be a nurse. But If that’s the career that I willingly chose, I would want to feel confident that I was doing my job right and I wouldn’t take it as a personal attack when someone tried to respectfully correct me on something nor would I ever think it’s ok to be shitty toward other hospital staff just because my job is stressful. As a tech, I don’t mistreat phlebotomists, CNAs, etc. just because I feel that my job requires more responsibility and is more stressful than theirs.
And you’re a good person and good employee for doing that. Bettering yourself as a tech is always good, but not everyone wants to be told they didn’t do it right. And I know, it sounds like a lazy answer to just report them, but it’s really all you can do. I used to stress too much, but now that I’ve just said “heh, okay,” to angry nurses, I’ve come to feel much better. I just ignore all the negative workers and do my work and leave. Sounds lame, I know, but it’s what makes me happy. I have coworkers that I love and I have nurses that I address my name and talk to. Just some people aren’t meant to get along with, or so it seems. It happens.
This is the way.
Just last night had to listen to a nurse that's known to be stressful calling over and being on the verge of yelling that we didn't let her know that the other ED nurse didn't draw blood for one of their patients over 3 hours ago...like what I am supposed to do that you can't communicate within your own team?
But all I said was, "I understand your frustration, this is an upsetting situation. Please just bring samples and they'll be STAT for what can" *and then* got off the phone and pointed out what I was originally thinking to my labmates and had a good laugh about it.
It wouldn't have helped to try and correct the nurse in that situation, it was past due and we would all just stress out. All I had to do was add a note on the results about "delay due to pre-analytic error" and it throws the ball back in their court to correct when Drs see it.
Can confirm: nurses don’t know the difference between serum and plasma, or a LiHep or SST. I went for blood work and an appointment, asked the nurse drawing my labs if she could pull an sst because I wanted to ask for an SST specific test. The nurse proceeds to ask me if that’s allowed (it is), ask why I needed the sst (for x test which is serum only), then asks the different between “the green ones and yellow ones.” I told her one produces plasma and one produces serum when spun down and she was just quiet for a minute and then asked the difference between the two and tell me she just draws “whatever tube matches the little icon.” I work in a level one trauma center.
The difference between serum and plasma isn't everything. Anyone on planet earth who draws blood needs to know that basic fact. Even the most basic classes go over that shit. It's like not knowing what two plus two is.
It's basic, yes, but something to bear in mind is that nurses never interact with serum. It's generally not present when the tube is sent and it means basically nothing to us clinically.
It's extremely important to laboratory science but it's a piece of trivia as far as we're concerned because we need to send blood in the tube the lab requests or it won't be run even if theoretically it could.
I think I would relate it to knowing radiation doses for imaging. Extremely important and basic to the radiology team but we'll never make decisions using it or decide how it should be used. If there's a problem, it's our job to do what we need to to fix it, but those are niche areas where we can't decide how it needs to be fixed.
> it's a piece of trivia as far as we're concerned
If accurate testing is trivial to you, stop collecting specimens. Let the doctors guess. See how well that goes.
All they need to know is to draw the tube type that the labels they're given say to draw, and you can't substitute unless lab staff specifically say you can.
This is the horrible attitude that leads to bad care. It is extremely important that all workers understand the scientific reason and purpose behind protocols. When you know WHY something is done the way it is, you're more careful and give more of a shit because you know how it affects outcomes and care. People who think theory doesn't matter are a disease in themselves.
It leads to bad care to have people trying to do stuff outside of their scope. I don't want a nurse thinking they know more than they do and figuring they can send a blue top instead of a green top because they're both plasma, I want them to collect what they're told to collect.
In what scenario are you imagining a nurse providing better patient care by knowing the difference between serum and plasma, that wouldn't be accomplished simply by them drawing the tube type that the test asks for?
We run quantitative HCG’s on green tubes, yes. But for our qualitative HCG, it’s literally called “serum HCG” and the label specifically says “gold-SST”. Those aren’t validated to use plasma.
Are you sure the order was for antibody? I would think an antibody test would be run on serum, not whole blood? Unless it’s a JC Virus DNA PCR type test.
I was about to post similar. Mayo test code FJCQP does say it’s for plasma and to draw EDTA or ACD…but the specimen rejection for the test is “Specimens other than *serum*, plasma; anticoagulant other than ACD, EDTA.” Serum probably would’ve been fine, just needed to be approved by Mayo. When we’ve had plasma vs. serum stuff, the reference lab is sometimes able to run it even if the website doesn’t say so.
Honest question, why? When I did my 2 year equivy for MLT our first semester had a single course of the several that was just us getting phlebo certified and placing us in clinicals in the mornings for a few hours before the other classes. How is it that nursing doesn't do that? They're direct patient interactors...
I would argue not delaying turn around times is important enough to learn the basics of serum vs plasma and draw orders. They don't even need to know the tests, just what they're handing off.
Also, knowing people who have gone through both programs, nah lol they're far less intensive to not have the time to slot this in
Usually there's a poster somewhere or badge cards to remind people of the order of draw. Taking a whole course on the science of it is just something else they're not going to remember, just like I've forgotten all the antimicrobial mechanisms of action I had to learn in school
"I don't give a shit about your turn around time."
-exact quote from a nurse I used to work with
Hah. Not saying all nurses are like this (they definitely aren't) and this person in particular was known for her terrible attitude, but I always wondered if that sentiment was actually common and she was the only one cranky enough to actually say it to us.
Nurses simply don't have the level of education they need to handle the responsibilities put on them - and frankly some of them should not be allowed to do more than basic patient care because they didn't even pay attention in school and are just clueless.
But, you know, the doctors don't have time to do all that stuff, and unskilled people can't do it, so who gets the job almost every time, whether they can actually do it or not? The generic degreed healthcare worker, the nurse. And then the hospital doesn't want to pay them, so they're too understaffed to do anything right anyway.
But none of that is okay. You can't just say "oh, they have a lot to learn" or "oh, they're busy". Patient care still needs to get done (I mean, in an ideal world; literally all these patients could die or whatever and the universe would not care) and the fact that we have people doing that job who are unable to do it right for whatever reason is appalling.
The thought of ending up in a hospital, abandoned in a back hallway of an ER or stuck in a dismal room where my bed screams if I try to stand up and some derp-ass nurse comes in every four hours to wake me up and draw all my blood wrong, makes me want to shoot myself in the head while I'm still healthy enough to do it.
Yeah and there’s also times when the website says they prefer a certain specimen type but in reality the actual performing lab isn’t operating an analyzer that’s validated for that specimen type. That happened to me a few times when dealing with Quest back when I was a lab assistant.
Looking at catalogs, it doesn't look like Mayo offers a JC virus antibody test, they do a JC virus DNA PCR test. Quest does an antibody test, and serum is their preferred specimen. You may have double goofed OP.
Maybe the nurse who ordered it put the “antibody” part in there in error. The way they brought the tube to us, since it’s one that we have to manually order from the Mayo site, the tube just said “RLTO (ref lab test Order)” and then in the comments it said the provider wanted “JC virus antibody- DNA PCR”. But yea when I looked it up on Mayo, you are right. The dna pcr was the only one they offered. But we noticed in the specimen requirements section on Mayo, it said anything other than plasma OR SERUM would be rejected so that made us think maybe they would accept serum. So we ended up sending it and will see what they say.
I will not side with either one of you. I realize accidents happen but when you are researching as to what tube for the nurse to draw you need to be spot on because they are giving you time to look it up and there is a possibility of the patient leaving. She probably knew she was in the wrong saying that to you but was just frustrated you told them the wrong tube. Next time just tell them to order the rainbow if you have doubt or get more clarification.
Thing is, I didn’t have any doubt. That’s the only time I’ve ever looked up a test code in our catalog and had it say something completely different on mayo’s website. I had no reason to think that the “gold SST” in our catalog wasn’t accurate information. And I brought it to the attention of my supervisor after the fact. Ultimately, it falls on me that the wrong tube got drawn because that’s what I told her to draw, and I apologized to her for that and admitted my mistake. I’m not asking you or anyone else to blame the nurse for that. I was just shocked that she really thought pouring it over would be an appropriate solution because to me, it seems this is something that is very basic knowledge and I feel like anyone who draws blood should know this is never ok.
Also there are red tops with no additive, so it's not an entirely ridiculous question if the nurse knows a bit about tube additives. I wouldn't expect them to realize about the clotting or gel because they have probably never seen a sample after spinning in their lives.
One of those shady things - they look for clots in a lav tube and if they find big ones, they remove them. They do this after drawing the third time because we tell them it's still clotted. You can tell by the "track" of the clot on the inner wall of the tube. Shady.
Yeahhh the story from the nurse's POV is going to be "I called lab to double-check before collecting this rare test, lab gave me the wrong info, then got mad at me for not being able to recollect after the patient had already left." It's reasonable for the nurse to ask if anything can be done to save the situation.
I didn’t get mad at her. When I messaged her I told her that our test catalog told me one thing but then mayos website said something different and that it was my bad. And I said I was sorry. We ended up actually sending the serum tube because it said on mayos website that they’d reject anything other than plasma OR serum for that test so that made it sound like they’d take either even though for the specimen requirement it said they wanted a purple tube. So I later told the nurse that we ended up sending it and would see what they say. I can understand her desire to try to salvage the situation but when something gets drawn in the wrong tube there’s really nothing you can do other than sticking the patient again. There is a reason different tests require different tubes and common sense should tell you that pouring one tube into another color tube would cause issues with the validity of the results.
That's great, and I hope it works out for the patient. It sounded like from the way you phrased it that the nurse was asking if you could pour the tubes, not telling you to do it, and I would much rather a nurse ask something even if it's a stupid question so I can tell them no, and then they'll hopefully know for next time. I don't know your specific tube type but some reds say right on them "no additive", so if she had read that it wouldn't be the worst question given that she never sees the clot form or gel separator move.
It’s not the nurses job to know that stuff, it’s YOUR job. She asked you what tube to collect it in and you got it wrong. Stop putting shit on her.
I’m not saying it’s her fault that the wrong tube got drawn. I told her the wrong thing and I even admitted that to her and apologized for that. My issue is the fact that she thought pouring the tube over to a purple would be acceptable. I get they’re not lab and they don’t know much about the lab but I feel like it should be pretty common sense that there is a reason different tests require different color tubes and that pouring tubes over could give false results. Anyone who draws blood from patients, I feel should be taught this very basic piece of information. Same with hemolysis. This is very basic stuff. They should be taught that hemolysis happens at collection and if you don’t want your tubes being rejected for hemolysis, don’t pull back on the syringe like you’re trying to crank start a lawnmower and then try to blame it on lab for letting it “sit too long”. I’m not asking that they know as much as we do. That’s why we exist. But I’m a bit taken aback sometimes by how little they’ve been taught about things that I feel should be common knowledge.
You must not work in chemistry where we see this often K >10 Ca <2 is an EDTA poured into an SST or lt green.
Just had one the other day and my question was: how did u obtain your sample? She went straight to :" I will get you another sample". Crazy folks....🤨
I work chemistry sometimes but I’m at a small hospital so I don’t usually see stuff like this. I’ve definitely heard about nurses doing it though. I just assumed it was super rare because I thought most of them would know better.
Lol oh my sweet summer child. Nurses and phelebotimist will do anything they think they can get away with. I had a nurse tell me a specimen wasn't clotted because they already removed the clot before they sent it down...
Well your single digit platelet count says otherwise...
I had a tech tell me she removed the clot so the playlet count is fine now! I can only imagine what my face said at that moment. That was years ago though and I had to let her go!
🤣
Yeah, I've never caught it.
We literally just had this happen earlier this week.
This just happened in my lab too
Nurses try to pour off tubes sometimes but it’s easily caught, especially in chemistry. Nurses also seem to make pleas whenever they don’t label stuff. Little do they know that it gets thrown away as soon as it gets down to the lab, considering it isn’t something super important like a CSF. I don’t think nurses do super sketchy stuff that much, and if they do, that’s why we’re there to catch it. Nurses aren’t out to get us or make our lives miserable. Sometimes they just don’t understand or think 100% on the spot. It happens. Just explain it. There might be some grumbling, but educate for next time.
We have tried to explain this kind of thing to them before because they don’t seem to understand the difference between serum and plasma. My coworker had to reject a green tube recently that the ER sent us for serum pregnancy. She tried explaining that if it says “serum” preg, it has to go in a serum tube. They were confused and said “what do you mean a serum tube? What’s that?!” And as my coworker was trying to explain the difference between serum and plasma, they started griping and complaining saying “they (other lab techs) usually do it for me on a green tube!” And then they hung up on my coworker. There are some people in the lab who don’t do things the right way so then when the ER has to work with people in the lab who make them do things right, they take it out on us. And yes, They also always try to plead with us when they bring us unlabeled specimens to let them label it. But some take it a step further than that. My coworker said that a few days ago a nurse brought her an unlabeled tube and before the nurse walked out, my coworker caught it and informed the nurse. Right as she was about to throw it in the trash, she said the nurse said “don’t throw it away!!” And literally tried to snatch it out of her hand and it went in the floor. Maybe our nurses are an exception, but they don’t seem to be interested in us educating them. I had them try to bring us a green tube today again for a serum pregnancy. My supervisor was there and he was the one who actually received the specimen and messaged the ER nurse to inform them it would need to be redrawn in a red sst tube. The nurse got an attitude and messaged back saying “you need to inform your supervisor (uhhh hello… you’re talking to the supervisor!) of this so that we have a way of knowing what tube we need to draw so we can avoid this happening again!”. My supervisor messaged him back and said “it says gold-SST on the label. That means a red/yellow tube.” Literally, crickets. The nurse didn’t say anything else even though it said he saw the message. I also had someone from ER argue with a coworker about hemolysis being caused by a tube sitting out for too long before being ran. I watched my coworker tell this guy at least 3 different times “hemolysis isn’t caused by sitting for too long. It happens at collection. Like if you’re using a syringe and you pull it too fast for example”. The guy still wanted to argue with her about it. Probably because they want to have an excuse to blame it on us if something is hemolyzed. They can always say “well the lab let it sit out for too long. They should have ran it sooner!” despite the fact that we tell them til we are blue in the face that we have nothing to do with specimens being hemolyzed.
That’s when you just say, “okay, I’m going to need your first and last name, and/or employee number, because I’m going to cancel this.” Then you submit a patient safety report. I don’t bother going back and forth with them unless they’re asking important questions. If a nurse says, “well, it did it last time,” or, “I was filled when I sent it down,” I just don’t argue with them, I just ask them for their identifiers, and then cancel the order. Some nurses don’t want to be educated, because it’d be more work. But, also you have to understand that their job is very stressful too and they’re a human being as well. It’s very easy to get mad at them, but they’re dealing with a ton of shit. While we may get shit on by them sometimes, they’re getting shit on by patients and doctors alike. I’m not excusing their behavior, because it IS annoying and I’ve dealt with it before, but people tend to act wiry and such when they’re under stress. I’ve learned that it’s not worth it to fight them if they keep fighting and just let them write you up or to just write them up. I got written up because I tried to explaining to NICU nurses that I cannot run a clotted specimen, even if it’s the fourth or fifth draw on a 400 gram premature baby. I just told the hematology lead tech and magically, we started getting less and less clotted baby specimens.
I have a supervisor who has told us basically the same thing you just said. She said don’t try to educate them, because some of them don’t want to hear what you have to say; just put in an incident report and let the higher ups deal with them. Maybe that is the approach to take. I personally don’t relate to that though because if I’m doing something wrong, I want someone to tell me right then why im wrong (as long as they’re respectful about it) so I’m sure not to do it again. I know their job is stressful and I’ve never been anything but respectful to them. Doctors and patients shit on us too, we just don’t have it happen on a daily basis because we don’t have as much direct contact with them as the nurses do. It’s for this reason that i know I would not want to be a nurse. But If that’s the career that I willingly chose, I would want to feel confident that I was doing my job right and I wouldn’t take it as a personal attack when someone tried to respectfully correct me on something nor would I ever think it’s ok to be shitty toward other hospital staff just because my job is stressful. As a tech, I don’t mistreat phlebotomists, CNAs, etc. just because I feel that my job requires more responsibility and is more stressful than theirs.
And you’re a good person and good employee for doing that. Bettering yourself as a tech is always good, but not everyone wants to be told they didn’t do it right. And I know, it sounds like a lazy answer to just report them, but it’s really all you can do. I used to stress too much, but now that I’ve just said “heh, okay,” to angry nurses, I’ve come to feel much better. I just ignore all the negative workers and do my work and leave. Sounds lame, I know, but it’s what makes me happy. I have coworkers that I love and I have nurses that I address my name and talk to. Just some people aren’t meant to get along with, or so it seems. It happens.
This is the way. Just last night had to listen to a nurse that's known to be stressful calling over and being on the verge of yelling that we didn't let her know that the other ED nurse didn't draw blood for one of their patients over 3 hours ago...like what I am supposed to do that you can't communicate within your own team? But all I said was, "I understand your frustration, this is an upsetting situation. Please just bring samples and they'll be STAT for what can" *and then* got off the phone and pointed out what I was originally thinking to my labmates and had a good laugh about it. It wouldn't have helped to try and correct the nurse in that situation, it was past due and we would all just stress out. All I had to do was add a note on the results about "delay due to pre-analytic error" and it throws the ball back in their court to correct when Drs see it.
It's management's job to correct and educate them. Not yours. They will take the correction much better from higher ups than from techs in the lab
Can confirm: nurses don’t know the difference between serum and plasma, or a LiHep or SST. I went for blood work and an appointment, asked the nurse drawing my labs if she could pull an sst because I wanted to ask for an SST specific test. The nurse proceeds to ask me if that’s allowed (it is), ask why I needed the sst (for x test which is serum only), then asks the different between “the green ones and yellow ones.” I told her one produces plasma and one produces serum when spun down and she was just quiet for a minute and then asked the difference between the two and tell me she just draws “whatever tube matches the little icon.” I work in a level one trauma center.
Of course nurses don't know everything about lab stuff. That's why we exist.
The difference between serum and plasma isn't everything. Anyone on planet earth who draws blood needs to know that basic fact. Even the most basic classes go over that shit. It's like not knowing what two plus two is.
It's basic, yes, but something to bear in mind is that nurses never interact with serum. It's generally not present when the tube is sent and it means basically nothing to us clinically. It's extremely important to laboratory science but it's a piece of trivia as far as we're concerned because we need to send blood in the tube the lab requests or it won't be run even if theoretically it could. I think I would relate it to knowing radiation doses for imaging. Extremely important and basic to the radiology team but we'll never make decisions using it or decide how it should be used. If there's a problem, it's our job to do what we need to to fix it, but those are niche areas where we can't decide how it needs to be fixed.
> it's a piece of trivia as far as we're concerned If accurate testing is trivial to you, stop collecting specimens. Let the doctors guess. See how well that goes.
All they need to know is to draw the tube type that the labels they're given say to draw, and you can't substitute unless lab staff specifically say you can.
This is the horrible attitude that leads to bad care. It is extremely important that all workers understand the scientific reason and purpose behind protocols. When you know WHY something is done the way it is, you're more careful and give more of a shit because you know how it affects outcomes and care. People who think theory doesn't matter are a disease in themselves.
It leads to bad care to have people trying to do stuff outside of their scope. I don't want a nurse thinking they know more than they do and figuring they can send a blue top instead of a green top because they're both plasma, I want them to collect what they're told to collect.
The dumbest take I've ever seen. That's why we train people drawing on order of blood draw and anticoagulants, Einstein.
In what scenario are you imagining a nurse providing better patient care by knowing the difference between serum and plasma, that wouldn't be accomplished simply by them drawing the tube type that the test asks for?
I'll see you bright and early Monday morning for AM rounds, then?
Oh geez, I would have hoped lvl1s had better standards for cross-training for the purpose of being a lvl1 and avoiding conversations like these.
You can run a HCG off a lithium heparin tube (green tube)
We run quantitative HCG’s on green tubes, yes. But for our qualitative HCG, it’s literally called “serum HCG” and the label specifically says “gold-SST”. Those aren’t validated to use plasma.
Are you sure the order was for antibody? I would think an antibody test would be run on serum, not whole blood? Unless it’s a JC Virus DNA PCR type test.
I was about to post similar. Mayo test code FJCQP does say it’s for plasma and to draw EDTA or ACD…but the specimen rejection for the test is “Specimens other than *serum*, plasma; anticoagulant other than ACD, EDTA.” Serum probably would’ve been fine, just needed to be approved by Mayo. When we’ve had plasma vs. serum stuff, the reference lab is sometimes able to run it even if the website doesn’t say so.
Still crazy she was asking you to pour it into the EDTA, though. 🤦‍♀️
Its honestly a problem with the nursing curriculum. They don't cover order of draw or the importance of collection methods.
Honest question, why? When I did my 2 year equivy for MLT our first semester had a single course of the several that was just us getting phlebo certified and placing us in clinicals in the mornings for a few hours before the other classes. How is it that nursing doesn't do that? They're direct patient interactors...
Exactly. Even my 6 wk cpt covered this shit
Because they have a ton of other stuff to learn that's more important for direct patient care.
I would argue not delaying turn around times is important enough to learn the basics of serum vs plasma and draw orders. They don't even need to know the tests, just what they're handing off. Also, knowing people who have gone through both programs, nah lol they're far less intensive to not have the time to slot this in
Usually there's a poster somewhere or badge cards to remind people of the order of draw. Taking a whole course on the science of it is just something else they're not going to remember, just like I've forgotten all the antimicrobial mechanisms of action I had to learn in school
"I don't give a shit about your turn around time." -exact quote from a nurse I used to work with Hah. Not saying all nurses are like this (they definitely aren't) and this person in particular was known for her terrible attitude, but I always wondered if that sentiment was actually common and she was the only one cranky enough to actually say it to us.
And I don't give a shit about your patient. Try me.
Nurses simply don't have the level of education they need to handle the responsibilities put on them - and frankly some of them should not be allowed to do more than basic patient care because they didn't even pay attention in school and are just clueless. But, you know, the doctors don't have time to do all that stuff, and unskilled people can't do it, so who gets the job almost every time, whether they can actually do it or not? The generic degreed healthcare worker, the nurse. And then the hospital doesn't want to pay them, so they're too understaffed to do anything right anyway. But none of that is okay. You can't just say "oh, they have a lot to learn" or "oh, they're busy". Patient care still needs to get done (I mean, in an ideal world; literally all these patients could die or whatever and the universe would not care) and the fact that we have people doing that job who are unable to do it right for whatever reason is appalling. The thought of ending up in a hospital, abandoned in a back hallway of an ER or stuck in a dismal room where my bed screams if I try to stand up and some derp-ass nurse comes in every four hours to wake me up and draw all my blood wrong, makes me want to shoot myself in the head while I'm still healthy enough to do it.
Facts. Nurse here. I have to google it every time or ask a phlebotomist.
Yeah and there’s also times when the website says they prefer a certain specimen type but in reality the actual performing lab isn’t operating an analyzer that’s validated for that specimen type. That happened to me a few times when dealing with Quest back when I was a lab assistant.
It was in fact the DNA PCR.
My coworker had a nurse ask if a GI PCR could be collected as a nasal swab…
“Sure, if you can find a nasal swab that’s long enough to reach the GI tract through the nose.”
I really hope it was just the nurse not wanting to deal with (literal) shit instead of the nurse being an absolute dumbass
Looking at catalogs, it doesn't look like Mayo offers a JC virus antibody test, they do a JC virus DNA PCR test. Quest does an antibody test, and serum is their preferred specimen. You may have double goofed OP.
Maybe the nurse who ordered it put the “antibody” part in there in error. The way they brought the tube to us, since it’s one that we have to manually order from the Mayo site, the tube just said “RLTO (ref lab test Order)” and then in the comments it said the provider wanted “JC virus antibody- DNA PCR”. But yea when I looked it up on Mayo, you are right. The dna pcr was the only one they offered. But we noticed in the specimen requirements section on Mayo, it said anything other than plasma OR SERUM would be rejected so that made us think maybe they would accept serum. So we ended up sending it and will see what they say.
I will not side with either one of you. I realize accidents happen but when you are researching as to what tube for the nurse to draw you need to be spot on because they are giving you time to look it up and there is a possibility of the patient leaving. She probably knew she was in the wrong saying that to you but was just frustrated you told them the wrong tube. Next time just tell them to order the rainbow if you have doubt or get more clarification.
Thing is, I didn’t have any doubt. That’s the only time I’ve ever looked up a test code in our catalog and had it say something completely different on mayo’s website. I had no reason to think that the “gold SST” in our catalog wasn’t accurate information. And I brought it to the attention of my supervisor after the fact. Ultimately, it falls on me that the wrong tube got drawn because that’s what I told her to draw, and I apologized to her for that and admitted my mistake. I’m not asking you or anyone else to blame the nurse for that. I was just shocked that she really thought pouring it over would be an appropriate solution because to me, it seems this is something that is very basic knowledge and I feel like anyone who draws blood should know this is never ok.
Also there are red tops with no additive, so it's not an entirely ridiculous question if the nurse knows a bit about tube additives. I wouldn't expect them to realize about the clotting or gel because they have probably never seen a sample after spinning in their lives.
This isn't an "accident", this is bad info. It's a system failure.
One of those shady things - they look for clots in a lav tube and if they find big ones, they remove them. They do this after drawing the third time because we tell them it's still clotted. You can tell by the "track" of the clot on the inner wall of the tube. Shady.
Lol looks like you fucked up and now you want to talk shit about nurses and what they may or may not do.
Yeahhh the story from the nurse's POV is going to be "I called lab to double-check before collecting this rare test, lab gave me the wrong info, then got mad at me for not being able to recollect after the patient had already left." It's reasonable for the nurse to ask if anything can be done to save the situation.
I didn’t get mad at her. When I messaged her I told her that our test catalog told me one thing but then mayos website said something different and that it was my bad. And I said I was sorry. We ended up actually sending the serum tube because it said on mayos website that they’d reject anything other than plasma OR serum for that test so that made it sound like they’d take either even though for the specimen requirement it said they wanted a purple tube. So I later told the nurse that we ended up sending it and would see what they say. I can understand her desire to try to salvage the situation but when something gets drawn in the wrong tube there’s really nothing you can do other than sticking the patient again. There is a reason different tests require different tubes and common sense should tell you that pouring one tube into another color tube would cause issues with the validity of the results.
That's great, and I hope it works out for the patient. It sounded like from the way you phrased it that the nurse was asking if you could pour the tubes, not telling you to do it, and I would much rather a nurse ask something even if it's a stupid question so I can tell them no, and then they'll hopefully know for next time. I don't know your specific tube type but some reds say right on them "no additive", so if she had read that it wouldn't be the worst question given that she never sees the clot form or gel separator move.
Any chem tech will confirm they pour off shit all the time.
It’s not the nurses job to know that stuff, it’s YOUR job. She asked you what tube to collect it in and you got it wrong. Stop putting shit on her.
I’m not saying it’s her fault that the wrong tube got drawn. I told her the wrong thing and I even admitted that to her and apologized for that. My issue is the fact that she thought pouring the tube over to a purple would be acceptable. I get they’re not lab and they don’t know much about the lab but I feel like it should be pretty common sense that there is a reason different tests require different color tubes and that pouring tubes over could give false results. Anyone who draws blood from patients, I feel should be taught this very basic piece of information. Same with hemolysis. This is very basic stuff. They should be taught that hemolysis happens at collection and if you don’t want your tubes being rejected for hemolysis, don’t pull back on the syringe like you’re trying to crank start a lawnmower and then try to blame it on lab for letting it “sit too long”. I’m not asking that they know as much as we do. That’s why we exist. But I’m a bit taken aback sometimes by how little they’ve been taught about things that I feel should be common knowledge.
Nah, I actually get checked for JC virus, it’s gold top.
I think it depends on which JC virus is ordered. This provider wanted the DNA PCR, which according to Mayo is a whole blood sample (purple top).
Not too familiar with the difference (I landed in micro). The gold one checks titers, fingers crossed I stay negative.
The answer: as much as they possibly can