What is MEDICAL TECHNOLOGY and why I chose it?

As I graduated from high school, I was really firm with my plan of choosing Information Technology course in a well-known university. It was a neat plan to start building my future career until suddenly.... fate have shifted its direction...it changed my life...and the next thing I knew, I found myself in a medical school taking this course I'm not so familiar with... the Bachelor of Science in Medical Technology. 

Let me introduce to you my chosen profession... 

What is Medical Technology? 

BS Medical Technology is a four year degree program that equips students with knowledge and skills in laboratory tests used in the detection, diagnosis, prevention, and treatment of diseases (finduniversity.ph).  Medical technologists also known as medical laboratory scientists work in hospitals or free standing laboratories to collect and analyze/process patient's blood samples and other body fluids. They are trained to operate the machines used in each sections. They are the key players in patient diagnosis by providing accurate results to the physician. 

They are well-trained in the areas of:

• clinical chemistry- where tests like lipid panel (cholesterol, triglycerides), fasting blood sugar, creatinine are performed
• hematology - CBC
• microbiology - identifying isolated bacteria, fungi, viruses in cultures
• immunology -  performing Hepatitis panel, HIV Test, Thyroid panel
• immunohematology (blood bank) - crossmatching, preparation of blood units, operating the platelet apheresis machine
•  urinalysis and body fluids - stool exam, semen analysis

Why did I choose this course?

My father wanted me to become a doctor and he told me that this is the best pre-med course to take. Also, I've always loved science and it made me realize that the course is not so common as compared to information technology. Because of that, I defied the odds and choose this interesting course.

About my college life...

Choosing medical technology was very challenging yet interesting. To add, I had a scholarship to maintain. There were times when I don't know what subject to prioritize. All of them are difficult but then I had friends who made medtech life fun for me. I learned that it's not just always memorization on terms but also you should be able to understand its concepts. This was the time I was not that good in phlebotomy but I got better as internship came. It was a balanced learning actually, as we were fed with lots of theories during lower years and immersed with its application during the internship

Am I using what I learned in college?

Yes. During school and internship, I was able to apply everything I learned.  In school, I learned the manual method in the microscopic examination of urine as well as manual differential counts already. The identification of each cells made easier because of the morphology our instructors taught us. It made me appreciate more  the concepts that I learned in books in the actual practice. 

How long did it take to find a job after graduation?

Since most of the laboratories prefer licensed medtechs, I spent 4 months of preparing for the licensure exam. After I passed the boards, it took me only one week to find my first job. I worked as a all-around medical technologist in a secondary primary laboratory with a good chief medtech that served as one of my mentors.

My current job?

I'm now working as a registered medical technologist in one of the private hospitals here in Cebu.

Do I recommend studying Bachelor of Science in Medical Technology?

Of course. The Philippines needs more medical technologists. Aside from being considered as the best course if you're going to pursue medicine, being medical technologist has a lot to offer.  This profession provides you a continuing education. The pursuit of learning new techniques regarding new clinical advancements are endless and so are the employment opportunities. 

Advice to people who are thinking of studying this course?

Be in mind that this course is a survival to the fittest. If you're already in it, you have to finish what you've started. Medical Technology entails sacrifice, dedication and confidence in your part, may it be while you're still studying or in a working scenario already. You have to possess a positive attitude that you will pass. Focus in your studies and learn to know the subject matter by heart. Theory and application should come together. The microscope is your friend so expect for practical tests on identification on various organisms. A licensed/registered medical technologist gets higher salary compared to those who are not so it is better if you pass the board exam.

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I hope this blog will enlighten your mind on choosing the right course. Good luck!

Phlebotomy 101: How to extract difficult veins? Must-see tips!

I think none of us phlebotomists would want to stick a needle twice. If only the patient knows how we tried our best to get his blood once. BUT...We can't avoid having patients with difficult veins and because of this, we might fail to extract some of them. As a result, patients will get angry and all we have to do is to sigh and act like we never heard them.

But then, we're just humans. We're not perfect thus we make mistakes. Letting go might be hard but just like in getting blood where you think it's hopeless and it's hurting, maybe it's best to just pull it out. Well, if you want to know how I deal my patients in situations like these, then this might be of help for you. I tell you a secret: All extractions starts with setting the patient in a good mood before we stick the needle in them.

TRICKS TO ASSURE THE PATIENT...

I think one of the things to keep a patient comfortable is to show to them that you really know what you're doing, Make an impression that you can be trusted. Sometimes, a patient might ask: Are you a sharpshooter? Are you the senior phleb? To gain trust, you must be confident and set a positive attitude that you can do it. Always act like you're an expert. VEIN ASSESSMENT IS VERY IMPORTANT. Do not haste and take your time in finding the right vein. Just with that manner, the patient will understand that you are really taking time and didn't take him for granted. If must, communicate to them but not to the extent of being talkative (I usually ask them if their lab tests are on a monthly or weekly basis and later they do the talking).

WHAT IF IT REALLY FAILED...

Based on my experience, patients tend to understand why the extraction went wrong when you explain to them what happened and also the mood that you set for them can be helpful. So, the next thing you gonna do is to convince him/her to extract again.

If the patient is already angry, it is best to keep calm. Don't contest the patient's high temper. Deal them in a professional way. Don't argue. Why not try these options for yourself?

Option 1: See if there's a basilic or cephalic vein in that arm.

- Although median cubital vein is ideal but sometimes you need to consider other veins as well such as the cephalic vein in which obese ones have more palpable cephalic vein.

Option 2: Find vein in the other arm.
- Go try palpate the patient's other arm. You may find a vein there. As what I've said, take your time. Mostly, palpable veins are located in the dominant arm so it is helpful to ask if the patient is right-handed or left-handed.

Option 3: Look for a vein in the dorsal hand of the patient

- If there's no hope to find a vein in both arms, we can get blood in patient's dorsal hand if they allow it. Sometimes, I'm surprised how some people have palpable veins on their hands while they're having deep and thin veins in the arm.

Option 4: Use small-gauge needle or a butterfly

- An assessment of what to use when extracting blood can help you achieve a one-stick only goal. Take note that thin veins can't stand bigger gauge needles as the vein will collapse upon insertion. Butterfly method is advisable if the veins are thin and superficial or if you're going to extract in the dorsal hand.

Option 5: Ask help from a senior phlebotomist
- Only and only if the patient insisted..but if not, why not try your best? It's not always your senior will come and rescue you. Show to your senior that you made an effort and at least you've tried. If it still failed for the second time, allow the senior to do the job.

PLEASE STAY TUNED FOR AN UPDATE OF MY PHLEBO TIPS

The rainbow colors in our phleb area

Ever wondered why phlebotomists/medtechs fill different tubes in one extraction?

Here is why:

- Each tube has different kinds of what we called as ANTIcoagulants. An anti-coagulant is a substance (be it liquid or spray-dried) inside the tube that prevents the blood from clotting. Take note, some tests require PLASMA as it retains some substances essential for testing. Also, there are also tubes that needs the blood to be clotted so as to obtain what we called as SERUM.

Now, you maybe asking what anticoagulants are inside each tube and which one hasn't? Let me explain to you starting from the left tube up to the last tube.

First, the phlebotomist makes sure to practice the correct ORDER OF DRAW to avoid anticoagulants mixing up (coz it could affect some results if not).

• Light Blue-Top Tube

This tube contains sodium citrate as an anticoagulant. We use this for coagulation studies such as Prothrombin time (PT), APTT, D-dimer, and Fibrinogen split product in the lab.

I've come across different kinds of citrated tubes having different fill lines but what matters most is that the tube must be completely filled on the line. The ratio of blood to anticoagulant (mostly 9:1) is critical for valid prothrombin time results.

• Light orange tube

This is the Serum Gel Tube. This tube contains a clot activator and serum gel (thixotropic gel) separator. This is commonly used for chemistry tests. Not recommended for clotting time studies and in crossmatching though.

• Red-Top Tube

This tube is a plain tube. That means no anticoagulant. This is widely used for the collection of serum for chemistry tests (Fasting blood sugar, lipid profile, serum electrolytes) as well as clotted blood for immunoserological tests (Hepatitis panel, Thyroid Panel, Allergy panel).

• Green-Top Tube 

This tube contains sodium heparin -- used for collection of heparinized plasma or whole blood for special tests such as Venous Blood Gas, Ionized Calcium in our case. This is a good tube for parallel testing in coincide with the red top tubes in chemistry.

• Lavender-Top Tube (EDTA)

This tube contains EDTA as an anticoagulant -- used for most hematological procedures (Complete blood count, retic ct, peripheral smear morph), Troponin I, and HBA1C.


Invertion is a must after getting the samples filled inside the tube. This is to ensure that the blood is getting mixed with the anticoagulant. There maybe times the phlebotomist has to recollect blood because of the clots being detected in the machine (like in CBC where Platelet clumps could lead to inaccurate results if not to be examined manually through the patient's blood smears).

These are just commonly used blood collection tubes in our laboratory. Yes, there are other tubes that you may come across with. So check out my other posts later.

REFERENCES:

www.mayomedicallaboratories.com/customer-service/faq/specimen/collection-tubes

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?

This MedTech student has just Graduated!

MAY 22- In my four years of putting a lot of effort to college, here I am reaping the fruits I've sown. Finishing the degree of Bachelor of Science in Medical Technology (Medical Laboratory Science) in Southwestern University is the major accomplishment I've reached so far! Thank you Lord!

The four years I've spent including the internship had created wonderful memories and experiences though I'm not saying I didn't go through a lot of sufferings and sacrifices. It's worth everything I've felt throughout my college life. Right now, I couldn't believe I've graduated and survived. It's still fresh on my memory the time when my parents enrolled me in the university and passed the entrance exam. Back that time, I have little knowledge of what's this Medical Technology is all about until I understand the whole of it as I journeyed.

For me, it's all worth it. Although I didn't graduate with honors but to see my parents happy as I went up to the stage is much more any medals could give. Through them I didn't give up and didn't lose hope that I can get through this. They didn't give up on me especially the times when I need financial support. I'm so thankful they are at my side on those times when I think I would fail. My family as well as my friends gave me the courage to go on and never surrender.

success together with my family

Again, I would like to thank all the people who were with me throughout my journey. My professors who were part of molding me to become an equipped medical technology student and to Southwestern University that made my dream possible. The road was indeed steep and rocky but you guys made it easy for me. I thank God for the blessings and his guidance. Right now, I'm proud to say that I successfully completed the four year degree course of Medical Technology! I did it! Yehey!

Next step: To pass the medtech board exam. I can do this! (With God's grace...Hopefully!)

Happy Graduate,
Cindy

feeling disappointed and nervous this semis..

Problems..Problems..Problems.. I'm sooo tired..physically, mentally, emotionally.. Why the world seems so selfish to me? Why?  

I've done everything but it seems all that I've sacrificed and worked hard didn't turn out so well. I don't know what to do especially when I realized that my status this semi-finals isn't great. Why? I failed the blood banking exam! Huhuhu..

Whenever I think I'm gonna fail, I can't breathe. The thought of what would my classmates think of me and how would I break the news to my parents horrifies me. Am I that dumb enough I was not able to pass it this term? (sigh)

PROBLEMS

• While I'm struggling to make our research done this month (because no one opted to help me) I think I can't have it too because we have to wait for a month for the needed chemical to arrive. 

• I keep on telling myself to think positive but the negatives keep coming to me. I did well in Pre-lims and Mid-terms in my Seminar 1 when suddenly I was shocked on how I failed some quizzes and exams during the semis. 

• I was not able to answer the first quiz in Blood banking. (but I studied hard, it's just that time was not just enough)

What an inconsistent student I am! I can't keep my grades high. I'm so stressed now and I don't know if I will be an intern for the next semester or not. Why things turned so complicated right now? 

Just like from the excerpt of the song 'I will sing' by Don Moen....

"Though I haven't lost my faith I must confess right now that it's hard for me to pray"

I still believe that good things will come at the end but on the other side, how will accept it (with open arms) if in case I'll fail? huhu.. I hope God will shower me the gift of wisdom to grasp things easily with full understanding.

Finals will be over in a week or two. Can I make it? Only me and my fate can answer it. I will cling to the LORD no matter what! If I will fail, then maybe there's a reason why.....

RECOMMENDED MEDICAL TECHNOLOGY BOOKS

Hey co-medtechs!!! As each one of us is getting a next step higher towards our dream to be RMTs, we should be aware that more difficult challenges will come in our way. Maybe we should burn more candles and break a leg more often. HAHA. so I think studying in advance can help you to understand the concepts that you'll be taking in the next sem. So, I will share to you books which might be of help for your understanding to the next level...

NOTE: THE BOOKS SHOWN IN HERE ARE NOT INTENDED TO GAIN PROFIT WHATSOEVER. THIS IS BASED ACCORDING TO THE AUTHOR'S AND THE SCHOOL'S REFERENCE MATERIAL. 

SECOND (2ND YEAR)
ANATOMY

PHYSIOLOGY - 

THIRD (3RD) YEAR

PARASITOLOGY - 

CLINICAL CHEMISTRY -  

BACTERIOLOGY, MYCOLOGY, VIROLOGY - 

CYTOGENETICS -  

PHARMACOLOGY - 

HEMATOLOGY - 

ANALYSIS OF URINE AND BODY FLUIDS (CLINICAL MICROSCOPY)

IMMUNOLOGY AND SEROLOGY

FOURTH (4TH) YEAR
IMMUNOHEMATOLOGY (BLOOD BANKING)

SEMINAR 1 AND 2 

I did my best.... but that best was not good enough

You know guys, my third year life of being a medtech stud is such a mess! Being bombarded with quizzes and assignments, it gives me a freaking feeling of what will I do first and what will follow next. Every night, I pore myself on studying hoping to pass for tomorrow's exam but when the exam papers are returned, I felt like crying blood.......................... I'M 'FAILED' AGAIN!!!!

Why? I did everything I can to pass and this is all I got? Poor me!