We’ve neglected it, so someone else was asked

So you know that I’ve been in school (for quite a while now) working towards earning the DCLS degree.  I had a conversation very recently that I would like to share with you because it was quite a revelation.

But first I want to share a phone conversation I once had with an amazing nurse practitioner.

I received a phone call from a pediatric nurse practitioner because she had made an astute observation: every mono screen test that she had ever ordered on younger children and infants was always negative.  She also had a 3 year old in her office who was symptomatic for mononucleosis and had a 15 year old sibling that had tested positive a few days prior.  She called because, through her observation, she knew that if she ordered the mono screen on the 3 year it would be negative, but she was sure this child had mono.  Well, her observation was correct.  The vast majority of mono test kits do not detect infectious mono specifically, but instead they detect heterophile antibodies.  Heterophile antibodies are typically associated with infectious mononucleosis but they can be found in other conditions like cytomegalovirus.  The problem with this is that infants and young children do not make heterophile antibodies so even if they are infected with mono, the test will not be positive because they are too young to make the antibody the test detects.  The test will always be negative because they are too young for the test to work correctly.  I explained this to the nurse practitioner on the phone and she was like “wow, OK, that makes sense.  So what do I do now?”  I went through the appropriate Epstein-Barr tests to order (Epstein-Barr is the the virus that causes infectious mononucleosis for the muggles) and she was genuinely grateful for my help and assistance.  Since that conversation she has reached out to me on multiple occasions about various tests.

Even the mid-level practitioners want our help. We are needed!

Now for my conversation that occurred very recently.

I was speaking with a clinical pharmacist and she was super excited that I was joining her rounding team.  Then she said this: “The physicians ask lab questions about specimens and lab methodology all the time, but they ask those question to us.”

Yes, you read that correctly.  The physicians ARE asking lab-related questions.  I can confirm this from my personal experience.  BUT … it appears that we as lab rats stuck in the proverbial basement have neglected this gap in healthcare for so long that the physicians have turned to the only ones that have rounded with them and have made themselves available to them: the pharmacists.

It is no wonder that pharmacists are constantly wanting to do more and more laboratory testing.  By our neglect, they have ended up picking up the slack.  This is fault of the laboratory as a whole: both the medical laboratory scientists overall reluctance to join the clinical patient care team and the pathologists overall unwillingness to do it as well.

WELL NO MORE!  I will not stand for it and neither should my fellow medical laboratory scientists.  For the sake of patient safety and patient care, we cannot stand by and let this continue.  Pharmacists are highly trained medical professionals, but they are not trained in laboratory testing, methodology, cross-reactions, the list could go on and on and on.  I highly respect them and work very closely with them –  but we are not them and they are not us.

We, the DCLS, are in training to ensure that this gap in healthcare between the physician and the laboratory is addressed and that it is addressed by those with the advanced training in laboratory diagnosis who are best suited and qualified to answer the questions.  Change is coming!  I am a part of it … are you?

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