THE SHIELD OF EVERY PHLEBOTOMISTS

No soldier goes to a battle unarmed that's why a Phlebotomist is armed with lots of weapons in his warding tray for his blood extractions. So the first thing he has in mind is to prepare his warding tray. This is where his weapons are found like syringes, tubes, tourniquet, swabs and anything necessary. No phlebotomist comes to go to a blood war without any extras too. So he has to see to it he gets the right things as he enters the patient's room. Let me introduce to you our warding trays in the lab.

the GRAY WARDING TRAY

This is the light-weight warding tray. This is the tray that I used during my first few weeks being a phleb in the hospital. I take this one if the shift is not busy. Although it's easy to carry but it has lots of disadvantages (for me). You can only take 5-10 samples of patients's blood (what if CBC with a chem test for instance). This will also take your busy time refilling when you're out of tubes or syringes. You have to take a look on your requests as it may fall out from the make-shift compartment. What's the good thing of this tray is that it makes your warding extractions faster. You can easily walk through the hallways swinging this tray in your hand. :-)

the WHITE WARDING TRAY

This is the heavy weight warding tray. At first,I find it so heavy with my little hand and short arm to carry, but I'm now used to it. So organized and clean to look at. It has compartments to make your requests secure from missing. Recommended for morning extractions. It can carry up to 45 samples. You can load enough supplies in it. This will make you look more legit phlebotomist too.

The good thing of getting big warding trays is that you can also take the big waste container (that yellow one where you put the used syringe, alcohol swabs, gloves). It doesn't require too much refilling from time to time. Just after your shift is done.

the BLACK tray

This tray is used for home service requests, This contains enough supplies for extraction. There is a butterfly syringe set in this tray in case of patients who have fragile veins. This is lightweight too and keeps the samples secure for transport.

At the end of the shift, the phlebotomist refills his ammunitions for the next day. This is to make sure that as another blood war comes, he is ready to take his shield whenever the call arises.

Working in a hospital-based laboratory

Our first week in CDUH.

After seven months of working in THCDC, I took my biggest decision of whether or not to transfer to another workplace for the better. Honestly, there's nothing I could say about THCDC (because my workmates there were OK) but I do think a hospital experience would be a great advantage as a medical technologist.

I do admit I was already in my comfort zone when a friend of mine urged me to apply in the hospital she's working. At first I had second thoughts but with the help of my family, I took the courage to pass a resignation letter to the clinic and start to submit my application to the hospital. I didn't settle for less.

Working in a hospital-based laboratory is a whole lot different from the freestanding laboratory. In my first few weeks I made some mistakes but eventually it taught me to be careful and at the same time precise in what I'm doing.

Here are some of my RANDOM list of comparisons:
1. FREESTANDING: Some lab tests (even electrolytes and prothrombin time) are considered send-outs.
HOSPITAL:  Because of the wide variety of equipments/machines used, one can simply run the test required. The 'send-outs' are only those considered special tests

2. FREESTANDING: Seldom do we receive STAT requests.
HOSPITAL: Should take note STAT requests time to time or else you'll get Incident Reports from doctors.

3. FREESTANDING: Arterial puncture is prohibited.
HOSPITAL: I perform arterial punctures in situations where patients have difficult veins (esp edematous). Arterial puncture is considered as the last resort when 2 to 3 attempts of venipuncture failed.

4. FREESTANDING: Sunday is day-off.
HOSPITAL: Shifting of schedules w/ a tedious night shift. There's 16 hrs duty depending on the staffs available.

5. FREESTANDING: Less exposure to microbiology and blood banking department.
HOSPITAL: In Micro department, you'll be hands-on in different clinical work-ups to be done in each specimen. A lot of gram stain, AFB, KOH, water bacteriology and culture/sensi to do.
In Blood banking, you''ll get exposed to cross matching, preparation of blood units and platelet apheresis. In case of Rh negative patients, we do Weak D testing for confirmation.

6. FREESTANDING: Most of the walk-in patients (for annual physical exam, employment, etc) are giving normal lab results
HOSPITAL: You'll encounter critical patients giving you abnormal results. So correlation of other tests and even documenting patient's history and their previous results are very important before releasing.

7. FREESTANDING: There are only Pap smears.

HOSPITAL: Biopsies, FNAB, cell block and cytology are being performed by pathologists.

8. FREESTANDING: Only routine lab tests are performed.
HOSPITAL: As warding medtechs, we are the ones to perform special procedure tests like Osmotic fragility test, urine myoglobin, fibrin split product, etc with the approval of the Pathologist.

9. FREESTANDING: Not so much trainings for medtechs.
HOSPITAL: Trainings/seminars by medical lab companies are conducted to ensure continuing education to the lab personnel.

During an annual mobile physical exam in THCDC
courtesy from miss ingrid's photoS.

To sum it up, there are more advantages in working to a hospital-based laboratory. No doubt it is a requirement for us if we want to work abroad. TBH, It is in this hospital I developed my skill in phlebotomy especially in getting blood from newborn babies and geriatric patients. Though stressful at times but I think that's a part of being a hospital lab personnel anyway. I met several people and I got to work with them every other shift. Just mind your own business by the way :-)

Well, it is true that the pay of hospital-based laboratories isn't that much compared to the free-standing laboratories but the experiences of working in a hospital esp to the departments in the laboratory are worth it.

Nevertheless, I'm so thankful for THCDC for giving me the experience to work in such a short time. It helped me to prepare in working for a hospital setting. Who would have thought I landed at Cebu Doctors' University Hospital?