We can work it out (Musings on transfusion medicine succession planning)

Updated: 21 Mar. 2016 (See Further Reading)

This month's blog derives from a news item in TraQ's monthly newsletter that resulted in my thinking about a topic I've spoken and written about often, succession planning. 

• Why clinical labs and anatomic pathology are at risk because of no formal succession plan to develop their next generation of management leaders (Dark Daily, 16 Mar. 2016)

The Dark Daily report focuses on succession planning in US clinical labs and anatomic pathology. To me it encompasses several related issues.

My musings focus on why succession planning is a challenge in today's clinical laboratories and what I see as the main way it can realistically happen.

The blog is written from a medical laboratory technology perspective, as that's my background, but the issues also relate to nursing and physicians.

For example, as someone involved with helping seniors in their 90s who often go to Emergency Departments in ambulances, and later become what are disparagingly called 'bed blockers' in acute care hospitals, I see how short-staffed and stressed nursing staff are in both acute care and long term care facilities. To think these nurses, or the health care system in general, could ever prepare for succession planning beggars belief. Yet many nurses no doubt mentor their colleagues.

As for physicians, and hematopathologists in particular, mentoring happens due to the efforts of exceptional physicians. These professionals give above and beyond. I often see them answering queries at 11 pm, well after their work day ends, indeed after they've tended to family responsibilities.

The blog's title derives from a 1965 Beatles ditty.

For links to news item and resources, see Further Reading at the blog's end. Please take time to read the sample quotes from those who lived through restructuring and centralization. They're enlightening.

MUSINGS
CHALLENGE #1: Decreased CPD / CE
Decreasing budgets mean less money to train managers. Indeed, often money for continuing professional development (CPD) / continuing education (CE) all but dried up post-laboratory consolidation.

If money were available for regional and national conferences, it went to medical directors, and perhaps to a lab manager, if any was left over. Sometimes medical directors paid part or all of their own expenses, leaving CPD/CE budgeted funds for managers and supervisors.

Today in Canada, some 20-25 years post-regionalization of laboratory services, clinical lab staff are mostly unionized and have contracts giving some degree of support such as 3-5 days paid leave for CPD/CE. But transportation to and accommodation at conferences often run over $1000, making attendance all but impossible without support.

In many cases, attending conferences also requires a supportive spouse and family to tend to extra duties with children, and generous colleagues to take up the slack at work, because while you're away, adequate replacement staff (if any at all) are seldom brought in.

Although valuable, the main benefit of conferences is not so much in hearing the latest and greatest from speakers (researchers and 'thought leaders'), but rather in socializing with peers.

It's in the socializing that you learn the goodies and tidbits not found in journals and not presented at conferences.

CHALLENGE #2: Decreased Mentoring
Staffing cutbacks leave remaining managers and administrators little time to mentor those with promising management and leadership skills.

Today it takes staff all their skill and energy to produce reliable lab test results that physicians rely on to diagnose and treat patients.

For example, with centralization and regionalization of laboratory services in the 1990s in Alberta,Canada, the first to go were middle managers. In this case, career lab technologists in affected hospitals - all experienced managers and supervisors - were left competing for the few remaining positions.

• To see the reality of what lab regionalization means to people, see CSTM's blog on Dianne Powell below.

Under such circumstances, successful candidates often find themselves stressed to the max, not only with an extra workload, but often in unfamiliar surroundings (e.g., a different hospital in the same city).

Other contributing factors to stressed and overworked staff following lab centralization include

• After significant change, many staff are so stressed that they may become negative, opting to do the bare minimum required for the job and fostering 'bitch sessions' at coffee and lunch. Even 'keeners' can be brought down by a steady diet of negativity.

• Some staff come to believe, sometimes with good reason, that the organization is not loyal to them and they reciprocate the perceived feeling. Work may then become a '9-5 job' (just to earn $) as opposed to a career (lifelong journey to fulfill personally rewarding goals).

• With centralization, more automation invariably follows because volume makes the instruments more affordable, especially given that fewer higher paid technologists are needed. To some lab workers, once the thrill of something new and shiny subsides, automation is 'okay' but not particularly rewarding.

Frankly, working with their hands and problem solving were the magical magnets that drew many to working in transfusion labs (and also microbiology). Loading mega-specimen trays, pushing buttons, and watching the instrument's software spew out results is not the most rewarding to such folks.

At the same time as automation occurs, specialized staff are lost and more generalists, as well as laboratory assistants, are hired to be supervised by a shrinking number of specialists. All of which contribute to overwork and increased stress in managers. The priority is for labs to become huge factories churning out products (lab results).

Mentoring future leaders becomes tougher and requires incredible effort by truly dedicated lab managers.
 
LEARNING POINTS
1. Health professionals should give themselves every educational advantage.

Especially in the 1990s, many exceptional Canadian laboratory technologists (and those of many nationalities) were forced to leave the profession due to lack of jobs. Others with appropriate credentials found work internationally. A BSc in Med Lab Science helped. Suspect a BSc in Nursing helped too, at least for working in the USA under NAFTA.

2. After large-scale centralization, or massive change of any kind, managers must have emotional intelligence.

• Emotional intelligence (OED)
• Emotional intelligence (Psychology Today)

From my brief experience in the world of management, managing staff is more important than all the experience and knowledge in the world (which also counts on the respect metre).

3. Formal succession planning? Are you kidding? A formal plan is tough. Mentoring is where it's at.

I know several med lab technologist leaders who continue to mentor staff informally. Mentoring occurs in nursing and among transfusion physicians too. All by folks I call the 'special ones' - health professionals who love their careers and go the extra mile to share the nuggets they've learned over many years.

Personally, I've had many talented mentors over the years. The first was Catherine Anderson, the lab manager at Canadian Red Cross Blood Transfusion Service in Winnipeg, when I was a kid of 21 years. She had CRC-BTS fund my way to local, national, and international conferences and workshops, had me speak in her place at conferences (at first I was 'shaking in my boots'), and left me in charge of a few administrative tasks when she was away. 

Plus when I screwed up, and I did, it was a learning experience, not the blame game. 

I'll mention one other mentor, Dr. David Ferguson, Medical Director of the UAH transfusion service in my days in MLS, University of Alberta, where I was also a clinical instructor for the UAH blood bank.

What David did was treat me as an equal, although I definitely was not. We shared many a laugh over student oral exams (Delicious biflorus being an answer one student gave to 'What is the the anti-A1 lectin?'). We also co-authored an immunohematology paper published in Transfusion. His reaction to reviewer feedback still makes me chuckle  today.

Mentoring is what develops future leaders in any field. Mentors come in all shapes and sizes. Some fear and resist change, others are big-picture visionaries who welcome change. A mentor's key characteristics? 

• Encouraging staff to be all they can be.
• Modelling how exemplary professionals think and act.

As always the views are mine alone and comments are most welcome.

FOR FUN
I chose the blog's title song for its lyrics about life being short and there's no time to fuss about. Mentor potential lab leaders NOW or the proverbial poop will hit the fan as experienced staff retire in increasing numbers.

• We can work it out (Beatles, 1965)

Life is very short, and there's no time
For fussing and fighting, my friend
I have always thought that it's a crime
So I will ask you once again

Try to see it my way
Only time will tell if I am right or I am wrong....

FURTHER READING

• Why clinical labs and anatomic pathology are at risk because of no formal succession plan to develop their next generation of management leaders (16 Mar. 2016)

• Developing the next generation of lab leaders (Nov. 2015)

CSTM 'I will remember you' blogs (in alphabetical order) 

Sample quotes related to this blog's theme

NOTE: These blogs are based on my interviews with health professionals, leaders in their field, to celebrate their outstanding careers, awards, and accomplishments. Refreshingly, besides all the things they loved about their transfusion medicine lives (read the blogs!), they also speak frankly about regrets and the realities of laboratory consolidation and cost constraints.

• Kieran Biggins (17 Jan. 2016)
• Also, I regret allowing myself to be consumed by change fatigue during the last few years of working for Alberta Health Services.
• ...I became the first Transfusion Safety Officer (TSO) in Alberta. Unfortunately, as the healthcare system in Alberta was consolidated yet again and again, my employer felt it necessary to add additional responsibilities to my new position such that I soon had two full-time equivalent responsibilities: TSO and Laboratory Quality Assurance Supervisor!
• In the last few years of my employment with AHS, there was an overwhelming culture of DON'T question any changes, keep your head down, don't make waves and don't rock the boat. Unfortunately,  this (as you know) is not me....

• Kathy Chambers (8 Jan. 2016)
• Accomplishments and fun: Managing a team of smart, empowered women who made the transfusion service as good when I was not there as when I was.
• This happened at RCH in New Westminster. From designing a new lab, working in less than good circumstances... moving into the new space and doing great work in their day-to-day duties, I think we truly had a quality system before it was introduced into labs.
• Others: Having good mentors to make me a better person...
• Attending conferences all over the world, meeting and networking with fellow TM practitioners. Loads of memories and great friendships.

• Kate Gagliardi (20 Mar. 2016)
• 'Regionalization – most of us minions had no control over fundamental changes in the environment which led to multi-sited organizations – and yet I sincerely missed the glory days of a single-site academic institution and the world within it that we had created.  It would have been nice to retain some of the good things – tight, dedicated teams, which endured despite changes in the personnel and services.'

• Dianne Powell (7 Feb. 2016)
• As a cost cutting measure, the RAH and Charles Camsell Hospital laboratory services were to merge. The process involved much uncertainly and anxiety. Our laboratory manager at the Camsell was given a package and quietly disappeared and staff felt quite un-tethered. As supervisors, we tried to provide support for the lab staff as we were dealing with the uncertainty, but as supervisors we were also dealing with maintaining the daily routine in the lab and ensuring testing got done.
  
  And we were told almost immediately that
  
  • We would need to submit our resumes and compete with our counterparts at the RAH Laboratory for our positions.
  • If unsuccessful in the competition, there was no place in the organization for us.
  • We would be given a package and be asked to leave immediately so we should have our personal stuff packed up.
  • Sounds like the reality TV show 'Survivor', no?

Take a chance on us (Musings on mentoring)

Canadian TM professionals may be aware of Bloodtechnet's learning competition but others may not.

Briefly, Bloodtechnet is a program sponsored by Canada's national blood supplier, CBS, that funds educational projects. One neat thing is that winners are determined by votes by Canada's medical laboratory technologists.

For the 2012 competition I submitted a proposal on mentoring that was lucky to be one of the winners:

• 'I will remember you. Once in a lifetime mentoring opportunity'

The proposal was later renamed to more closely describe its goal:

•  'Online mentoring in transferable skills and project management.'

This blog briefly describes the mentoring proposal. Its purpose is to encourage submissions to the 2013 competition because those submitting proposals in 2013 will participate in the mentoring project.

The blog's title 'Take a chance on us' is a take-off on a 1978 ABBA hit, 'Take a Chance on me'.

Will the project be able to fulfill its goal of creating a global mentoring community that can facilitate succession planning? Only time will tell.

Currently, the most exciting news is that many mentors from across the globe have already generously agreed to participate:

• Australia
• Canada
• Ireland
• Switzerland
• UK
• USA

The mentors have illustrious careers and we are so lucky to have them.

As well, mentors are interdisciplinary: medical laboratory technologists, nurses, and physicians.

Fortunately, Shanta Rohse, who manages Bloodtechnet for CBS and transfusionmedicine. ca is a key collaborator in the mentoring proposal and will take the lead.

The Bloodtechnet website that Shanta manages for CBS will be upgraded to facilitate mentoring.

BACKGROUND

Increasingly, MLTs require a complex set of transferable skills but suitable continuing education (CE) resources are few:

• communication
• leadership
• networking
• problem solving
• project management
• team work
• time management

The 2010 bloodtechnet survey noted:

"We often see learning as a solitary, independent pursuit, one of accumulating facts and information. On the contrary, learning is also a deeply social activity and there are a number of reasons why learning from and with others is a foundational part of continuing education. First, individual learning is supported by being exposed to and reflecting on how others think....."

Mentoring is a social way to foster transferable skills and professional development. Mentoring also supports succession planning of one generation to another.

• For example, see an earlier blog: "I will remember you" (Musings on mentorship)

What is mentoring?

Many definitions of mentoring exist. Regardless of definition, mentoring is a partnership between colleagues, a bond of mutual respect and trust from which everyone gains valuable insights and personal satisfaction.

This project will develop a network of informal mentors drawn from transfusion professionals within Canada and beyond and a framework with guidelines to support mentoring.

BOTTOM LINE

To all volunteers who have agreed to participate, heartfelt thanks. You are busy professionals whose time is consumed by professional and family obligations. The mentoring project is a grand experiment with much unknown.

Your willingness to give this project a chance is admirable. You are truly the 'good guys' who deserve the kudos of colleagues.

Canadian TM professionals

Please consider submitting a proposal to Bloodtechnet's 2013 competition. You will have the advantage of interdisciplinary and international mentors. Many opportunities to meet colleagues worldwide. Who can resist such an opportunity?

All those interested can keep track of the project's progress on twitter @TransMedmentors

Finally, thanks to CBS for sponsoring such an innovative endeavour. I know of no other like it worldwide. With Bloodtechnet you got it right.

Readers are encouraged to browse Bloodtechnet to get a sense of what it's about.

REQUEST

If you have ever been a mentor or a mentee, please comment below on what you think are the most important characteristics of each. 

Or let us know if there are similar opportunities in your country to compete for funds to create CE for medical laboratory technologists and others.  

FOR FUN

• Take a chance on me (1978 ABBA hit)

And a favorite song (You may have guessed I'm partial to the Beatles)

• Here comes the sun (George Harrison)

As always the views are mine alone. Comments are most welcome BUT, due to excessive spam,  please e-mail me personally or use the address in the newsletter notice.  

With love from me to you - Blood buddies (Musings on staff shortages & succession planning in transfusion medicine)

This blog was stimulated by the August 2011 issue of AABB News, which explores laboratory workforce shortages soon to be exacerbated as baby boomers* retire in large numbers. (*Boomers are generally anyone born between 1946 and 1965, meaning they will reach 65 between 2011 and 2030 and 60 between 2006 and 2025). I particularly enjoyed "Where have all the blood bankers gone?", the focus of this blog.

The title derives from an early Beatles song that illustrates the blog’s ‘big idea’.

Although the blog deals with medical laboratory shortages, I encourage physicians and nurses to read on and assess how the discussion applies to them since pathologist and nursing shortages are well documented. Recent Canadian examples:
Saskatchewan regulation breach linked to pathologist shortage (CMAJ, 9 Aug. 2011)s

• Pathologist shortage and delays in lab test reports get publicity in Saskatchewan (Dark Daily, 15 Aug. 2011)
• Experts warn of nursing shortage
• The nursing workforce

LABORATORY WORKFORCE SHORTAGES

In my area of the world, and perhaps in yours, we've struggled with a lab work force shortage for close to 20 years. See an old record I wrote about events in Alberta as they happened:

• History of 1990s Laboratory Restructuring in Alberta

ABBB News covers many of the salient issues related to lab staffing shortages but the proffered solutions seem like treading water to me. Perhaps I'm skeptical but, as the French say, plus ça change, plus c'est la même chose.

In particular, I wish the AABB article had mentioned one of the most pertinent consequences of staff shortages and the impending exodus of the boomers: loss of expertise, especially the 'tacit knowledge' missing from text books or journals.

If tacit knowledge can be transferred, it is likely transferred by ongoing close interaction between experts with tacit knowledge and those who lack it. More on this later.

To my mind, what's needed is a big idea to supplement the series of bandaid solutions currently on offer. First, let's examine some aspects of the AABB News article, "Where have all the blood bankers gone?"

STAFF RETENTION
On the issue of staff shortages related to technologists leaving the profession, "Where have all the blood bankers gone?" reports that poor salary is acknowledged as the main reason people leave and offers these additional factors:

1. Stress
2. Scheduling
3. Limited potential to advance
4. Increased workload as staff numbers decrease
5. Lack of recognition as a profession

To combat these ‘drivers’, several strategies are proposed:

1. Evaluate wages & benefits

Musings

In an age where mergers are increasingly common to save entire organizations such as blood centers, are the wages of medical technologists likely to be high on management's agenda?

As noted in the round table discussion in the July 2011 issue of Journal of Blood Services Management, the CEOs who arrange the mergers seem able to keep their positions, perhaps renamed but at similar salaries (in the $300,000 to $500,000 range judging by those publicly available).

Fact is, one executive salary could likely pay for 5-10 additional technologists, thereby reducing stress and workload and helping to retain staff. Or one CEO salary could increase the annual salaries of 5 senior technologists by perhaps $50,000 each (or 10 technologists by $25,000/yr), thereby motivating them and those who succeed them to stay on the job. Similarly, one executive salary could fully pay for 60 or more staff to attend annual conferences (or 5/yr for 12 yrs). Or subsidize 50% of the cost for at least 5 people to attend for 24 yrs.

But that ain't what's happening or likely to happen, is it?

2. Engage & empower staff with learning opportunities

Musings

Good strategy, but hard to institute given today’s cost constraints.

When staff struggle with inadequate time to do the actual work, setting aside time during the work day for good stuff like journal clubs becomes increasingly difficult. Also, when staff feel devalued, motivation to learn outside of work time wanes significantly. Doesn't make it right, and is short-sighted, career-wise, (we are all responsible for our own learning), but there it is.

As well, in the current climate funding for attending conferences has dried up for all but the most senior staff. Some enlightened organizations partially fund congress attendance for one of more junior staff but this is fairly rare today.

3.. Develop career ladders for professional growth and advancement

Musings

Using USA terminology, creating special programs for MLTs/CLTs who want to move to the "scientist" level is a good idea, but how many universities are currently interested in creating NEW programs with limited enrollment? How many MLTs/CLTs can fund additional education? How many can leave work and family, even for short hands-on sessions to supplement distance education study? Some can but many cannot.

4. Create efficient work flow processes

Musings

'Lean' is supposedly not about reducing staff but about reducing waste and the need for skilled staff to do rote or manual tests so they are free to perform more skilled, interesting tasks.

Rote is one thing, but as someone who started in the profession when most blood bank testing was manual, that was one of the benefits of working in blood bank, as opposed to clinical chemistry where instruments have ruled for decades.

If Six Sigma & other lean management programs reduce waste and free up worker time, in the article’s context, lean can help reduce stress and workload and therefore act to retain staff.

But it's all pretty theoretical. Lean can assist many desirable outcomes, but has anyone seen a paper whereby, post-lean, laboratory staff retention rates are shown to improve significantly?

Who knows - maybe lean is like IVIg, the cure-all for every disorder known to humankind.....

5. Integrate automated solutions

Musings

Of course, automation has now infiltrated even the manual bastion of the transfusion service.

Like lean, blood bank instrument manufacturers promote automation as a way to free staff from routine work so they can do more interesting things. However, at the same time automation is promoted as a way to lessen the need for knowledgeable staff so that cross-trained techs, who are not transfusion specialists, can do the work. As well, manufacturers always note the number of staff that can be eliminated by their marvelous machines often named after characters in Greek mythology.

So which is it?

• Automation enhances staff retention by freeing them from boring manual tasks and letting them do interesting things? Any studies on this?
• Or automation helps eliminate the need for knowledgeable, specialized staff?
• Or both? That is, automation has the potential to be totally liberating, liberating staff from boredom and ultimately from their jobs, all the while making clinical laboratories lean, efficient and error free.

TRAINING PROGRAMS

The AABB article also discusses the decline in medical laboratory science training programs. From my experience in Canada, here's what happened:

1. Governments withdrew funding from health care and laboratories in particular. See 'History of 1990s Laboratory Restructuring in Alberta'
2. Faced with decreased funding, health care organizations instituted lab restructuring, regionalization, and automation, which led to a dramatic decrease in the need for medical laboratory technologists (and pathologists).
3. The same trends made it increasingly difficult for laboratories to find the staff and time to train student technologists.
4. The drop in demand, along with decreased funding for educational institutions and the inability to find adequate internship placements, led to schools closing.
5. Move forward several years and severe shortages appear, exacerbated by the lack of training programs and non-existent internship spots, as well as the reality that skilled health professionals take years to educate and train.

Now we're in catch-up mode, as described in the AABB News article. Proposed educational strategies include career ladders (discussed above) and online education to obtain sustainable numbers with decreased cost.

Unfortunately, new or expanded programs are a hard sell in most locales, especially with the rise of automation, regionalization, and centralized testing, all designed to require fewer highly skilled staff.

Increased awareness of the profession is also discussed in the AABB piece. Although worthwhile, improved recognition for medical laboratory science as a career is such a long goal I will not discuss it here. Medical laboratory science professional associations and education programs devote much time an effort to this elusive goal.

BIG IDEA?

So, while we stumble along with bandaids, the hemorrhage of knowledgeable lab staff continues and with them the tacit knowledge that cannot be found in print.

If the number of training programs and clinical placements magically increase, will there be any specialized transfusion experts left to pass on knowledge missing from textbooks and journals to the next generation? I doubt it. Not without adding a big idea to the bandaid mix.

So what's mine? I suggest an old idea that has never been fully adopted by the transfusion medicine community - a succession plan for transfusion professionals as a whole based on mentorship.

Granted, mentoring still happens informally to varying degrees some of the time but mentoring has decreased in recent years.

Mentoring is not a solution to staff shortages per se but rather an adjunct to help with succession planning for the profession as a whole.

And just because it's a big idea doesn't mean it cannot be implemented in baby steps by far-sighted leaders.

BLOOD BUDDIES

Call the mentoring program something catchy, a name that reinforces that's it's fun and unpretentious, e.g., Blood Buddies.

Funding
Employers, governments, professional associations, manufacturers. Time they 'walked the talk', don't you think?

How?

• Get by-in from local power brokers
• Recruit newly close-to-retiring and retired experts willing to act as mentors*
• Identify workplaces willing to test the concept
• Generate topics where tacit knowledge is the norm
• Assess mentee needs with their full participation
• Develop prototypes and pilot projects to test the idea ("proof of concept")
• Draft ways to evaluate pilot projects, including measuring outcomes

* Why older workers? Because they know what the current generation does not know that’s important to know. Because many are motivated to transfer knowledge as a parting gift ‘with love from me to you’. Oldie goldies have a wealth of experience to share.

Once mentoring program details are fleshed out, ask newly retired professionals (nurses, medical technologists, physicians), those with the respect of colleagues, to contribute one day a month, or whatever works for them, to pass on to the next generation what they see as the most important lessons from their careers, to include scientific, clinical, managerial, educational, and political aspects.

Solicit not just the 'big names' that speak year after year at conventions but respected professionals who have toiled out of the spotlight, the unsung heroes, as it were.

Think Global

Facilitate communication between retired transfusion professionals across the globe to discuss mentoring ideas and international mentoring sessions using the Internet.

Why not? The technology is there for free face-to-face sessions between individual and small groups.

Based on my experience, there are many experts that, depending on your country, you may not have heard of.  I know from MEDLAB-L that we can all learn from each other, regardless of profession and country.

SCENARIOS

So, what could 'Blood Buddies' look like?

• Medical technologist, nurses, and physicians participating in interdisciplinary mentorship programs
• Local, regional, national, and international programs
• F2F: Series of informal, interactive workshops at local blood centers and hospitals, focused on practical aspects of key lessons learned over a lifetime. Notice I did not say presentations and topics would be co-generated by mentors and mentees.
• Online: Individual and small group learning facilitated by Skype and similar free tools.
• Integral components would be case studies to illustrate tacit knowledge.

BOTTOM LINE

Staff shortages of transfusion professionals will worsen in the coming decades. We can continue to apply the same bandaids, even though many do not appear to be working well. Best to evaluate their effectiveness to assess which ones have made a difference.

Will transfusion leaders - the powerful physician-CEOs and medical directors who run TM - do what it takes to improve staff shortages and the loss of tacit knowledge? I doubt it. Most of the talk in professional newsletters like AABB News about staff shortages is so much smoke and mirrors.

I'll know everyone is serious when

1. Post-merger, some extraneous blood center CEOs are let go and a proportion of their salaries is applied to wage raises for medical technologists or new hires or CE funding.

2. CEOs, VPs, and assorted medical directors at the top of the food chain voluntarily forego some of their salaries to make those of medical technologists more competitive (Okay, stop laughing....But as CEOs earn 5-10 times as much, or more, as technologist, why not, especially if they are serious about solving shortages.)

3. Employers, especially the pathologists who run transfusion laboratory services, actively and forcefully lobby governments to strengthen existing medical laboratory science programs

4. More medical directors donate some of their CE funding to allow technologists to attend conventions.

5. Employers designate more funds for educational initiatives for medical technologists.

6. More medical technologists volunteer to participate in CE programs on their own time.

7. Governments fund more MLS educational programs and provide funding for more clinical training placements.

Unfortunately, the 'movers and shakers' have NOT taken serious action yet and likely never will.

Call me an idealist but these are the things that concern me when reading the fuzzy thinking and hypocrisy that passes for expert opinion about staffing shortages in AABB publications. This sounds harsh, and it is. But if I wrote only nice things, readers would soon be comatose. Just like a 'goody-two-shoes' police inspector in a mystery, 'nice' has no legs.

Mentoring by near and recent retirees is a suggestion to supplement current bandaids. Mentoring addresses a real knowledge loss, one that is happening now and will continue to worsen as more people retire.

Maybe it doesn't matter that tacit knowledge is lost. We probably won't know until it's too late.

In the meantime, enjoy

• With love from me to you (early Beatles ditty)

Two ‘beauties’ from my 2010 post on mentoring:

• I remember you (Sarah McLachlan's fitting sentiment for all mentors and mentees)
• Islands in the Stream (delightful duet by Dolly Parton & Kenny Roger)

As always, the ideas are mine alone. Comments are most welcome BUT, due to excessive spam, please e-mail me personally or use the address in the newsletter notice.  - see several  Comments below.

Further Reading on mentoring

1. Saskatchewan nurses
2. CLMA
3. Women in leadership
4. Beck SJ, Laudicina RJ. Passing the torch: Mentoring the next generation of laboratory professionals. Clin Lab Sci. Winter 2001.
5. Beck, SJ, Laudicina, RJ. Mentoring tomorrow's leaders in education. Clin Lab Sci Winter 2001.
6. Kapanka ARH. Journey to the millennium: mentoring in the clinical laboratory. Med Lab Observer, May 1998.
7. Laudicina RJ. Mentoring for retention and advancement in the multigenerational clinical laboratory. Clin Lab Sci. 2001 Winter;14(1):48-52.