tag:blogger.com,1999:blog-87297722024-02-03T04:53:26.853-07:00Musings on transfusion medicineA blog for health professionals about transfusion medicineBluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.comBlogger203125tag:blogger.com,1999:blog-8729772.post-83474365072762461122021-05-31T16:35:00.006-06:002022-08-18T12:19:27.959-06:00Bad Moon Rising (Musings on being fired for having 'long haul' COVID-19)<blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><p style="text-align: center;"><span style="font-family: arial;"><i>Updated</i>: <span style="background-color: #fff2cc;">31 May 2021</span></span></p></blockquote><p style="text-align: center;"><span style="color: #0b5394; font-family: arial;"><b>INTRODUCTION</b></span></p><p><span style="font-family: arial;">The idea for the blog was stimulated by news of an American clinical laboratory scientist being fired after she had been infected with COVID-19 and was recovering from 'long haul' COVID-19, even though she had worked for the employer (Community Hospitals of Central California) for 33 years. The news item came about because she has sued the employer for wrongful dismissal.</span><span style="font-family: arial;">(Further Reading)</span></p><p><span style="font-family: arial;">The blog's title derives from a 1969 song by Creedence Clearwater Revival.</span></p><p><span style="color: #0b5394; font-family: arial;"><b>PERSONAL ANECDOTES</b></span></p><p><span style="font-family: arial;">First, please note that I had a minor disability (suffered from acute lower back pain attacks) when I first joined UAlberta's Medical Laboratory Science first as a lecturer and clinical instructor for the hospital's transfusion service and later became an assistant professor. Was a candidate for surgery but the Drs decided to treat it conservatively, for which I'm grateful. </span></p><p><span style="font-family: arial;">The attacks were severe and my colleagues kindly would pick me up and drive me to work. I managed with a 2-wheel folding walker, and by taking mega doses of the pain killer ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID).</span></p><p><span style="font-family: arial;">The university's Faculty of Medicine/Department of Laboratory Medicine and Pathology always supported me, even when I had to take extended time off. What they did was designate a hematopathologist resident to give my classes until I could return. One who helped is now in a senior position.</span></p><p><span style="font-family: arial;">NOTE: If you've read this blog before you will know I'm a <a href="https://dictionary.cambridge.org/dictionary/english/contrarian ">contrarian</a>.</span></p><p><span style="font-family: arial;">Over 36 years working as a medical laboratory technologist and educator, I've seen only<span style="background-color: #fff2cc;"> two medical lab technologists who ever faced being fired</span>. </span></p><p><span style="font-family: arial;"><b>#1</b>. One was when I worked at Canada's then blood supplier (Canadian Red Cross Blood Transfusion Service, also a transfusion service for the entire city) in Winnipeg. It failed. A compulsory Dr. exam was needed after you were hired, and the Dr. said a girl with deformed hands due to a medical condition could not perform her duties, as we then largely worked manually, did a lot of pipetting by hand. Staff saw she could do the work and I decided to get every lab worker to sign a petition saying she could do the work. She wasn't fired and went on to work many years for the organization, including becoming a supervisor.</span></p><p><span style="font-family: arial;"><b>#2</b>. The second I heard about as an educator and it disturbed me. I've decided not to give many details to respect her privacy. </span><span style="font-family: arial;">I knew her well when she worked in a hospital transfusion service and was helping her get her ART (Advanced Registered Technologist), then offered by the </span><a href="https://www.csmls.org" style="font-family: arial;">CSMLS</a><span style="font-family: arial;">. </span><span style="font-family: arial;">After losing her license to practice as a med lab technologist she became a medical lab aide and to me didn't deserve her fate. I </span><span style="font-family: arial;">wish I had been able to help her at the time.</span></p><p><span style="color: #0b5394; font-family: arial;"><b>SUMMARY</b></span></p><p><span style="font-family: arial;">I've read several news items about the story and also the lawsuit , which is available online. What follows is my interpretation of the basic facts of the case. Yours may be different. Most is from the lawsuit, some from news items. The Plaintiff asked for a jury trial.</span></p><p><span style="font-family: arial;"><b>1</b>. Plaintiff began working for Defendant, Employer, on or about 1 July 1987 as Clinical Lab Scientist. She received good performance reviews and salary increases and was not subject to discipline for her job performance over the more than 30 years of her employment.</span></p><p><span style="font-family: arial;"><b>2</b>. Plaintiff suffers from several medical conditions including diabetes, cardio-pulmonary disease and traumatic brain injury. Defendant, Employer, is aware of Plaintiff’s medical conditions.</span></p><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><p style="text-align: left;"><span style="font-family: arial;">On several occasions when Plaintiff had to take time off work due to illness, Defendant, Employer, subjected her to discipline based on her attendance.</span></p></blockquote><p><span style="font-family: arial;"><b>3</b>. In mid-April Plaintiff contracted COVID-19. Her health care provider put her on medical leave for about six weeks.</span></p><p><span style="font-family: arial;"><b>4</b>. Plaintiff’s health care provider suggested that she request intermittent medical leave due to her continued illness combined with her underlying medical conditions. Plaintiff requested the appropriate paperwork from Defendant, Employer’s leave of absence department. However, Plaintiff’s supervisor told her “you better not” referring to Plaintiff’s request for leave. In addition to this threat from her supervisor, Plaintiff was shunned by her supervisor and coworkers.</span></p><p><span style="font-family: arial;"><b>5</b>. Within the year last past, without excuse, justification or privilege, agents of Defendant, Employer, including but not limited to supervisor Carol Kelley, published and republished, orally and in writing to third persons, including prospective employers of Plaintiff and other persons who are not parties to this action, the false and defamatory statements about Plaintiff, stating as matters of fact that, among other things: Plaintiff violated company policies; and Plaintiff deserved to be terminated.</span></p><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><p style="text-align: left;"><span style="font-family: arial;"><span style="background-color: #fff2cc;">My comment</span>: Wow, they spoke to prospective employers and under which circumstances? My experience in Alberta, Canada is when FOIP (Freedom of Information and Protection of Privacy) became law, prospective employers who were not listed in an applicant's application for employment, would not comment except to say the person worked there. </span></p></blockquote><p><span style="font-family: arial;"><b>6</b>. The Causes for Action in the lawsuit, which all relate to violations of Government Code §12940:</span></p><p><span style="font-family: arial;">1) Discrimination Based on Medical Condition, Disability and/or Perceived Disability in Violation of ...</span></p><p><span style="font-family: arial;">2) Failure to Accommodate Disability in Violation of ...</span></p><p><span style="font-family: arial;">3) Failure to Engage in a Timely, Good Faith, Interactive Process To Determine Effective Reasonable in Violation of ...</span></p><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><p style="text-align: left;"><span style="font-family: arial;">“It shall be an unlawful employment practice . . . For an employer. . . to fail engage in timely, good faith, interactive process with the employee . . . to determine effective reasonable accommodations . . .”</span></p></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><p style="text-align: left;"><span style="font-family: arial;">Defendant, Employer, knew of Plaintiff’s medical condition and her need for accommodation which consisted of additional medical leave. Yet, Defendant, Employer, failed to accommodate Plaintiff and ignored her requests for accommodation. Defendant, Employer, refused to explore any options to accommodate Plaintiff but, instead, subjected her to unjust discipline and terminated her employment. Accommodation of Plaintiff would not have caused Defendant, Employer, any undue hardship, significant difficulty or expense.</span></p></blockquote><p><span style="font-family: arial;">4) Failure to Prevent Discrimination and Discrimination Based on Medical Condition, Disability and/or Perceived Disability in Violation of...</span></p><p><span style="font-family: arial;">5) Retaliation for Requesting Accommodation in Violation of...</span></p><p><span style="font-family: arial;">6) Retaliation for Exercising Rights Under California Family Rights Act in Violation of 2 C.C.R. §11094</span></p><p><span style="font-family: arial;">7) Wrongful Termination in Violation of Public Policy</span></p><p><span style="font-family: arial;">8) Defamation</span></p><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><p style="text-align: left;"><span style="font-family: arial;">Within the year last past, without excuse, justification or privilege, agents of Defendant, Employer, including but not limited to Carol Kelley, published and republished, orally and in writing to third persons, including prospective employers of Plaintiff and other persons who are not parties to this action, the false and defamatory statements about Plaintiff, stating as matters of fact that, among other things: Plaintiff violated company policies; and Plaintiff deserved to be terminated.</span></p></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><p style="text-align: left;"><span style="font-family: arial;">The statements made by Defendants and their agents were and are false and constitute defamation on their face in that they communicate to third persons as matters of fact that Plaintiff was a problematic and poorly performing employee who deserved to be terminated from her job. This constitutes defamation per se as false statements tending to injure Plaintiff in her profession.</span></p></blockquote><p><span style="font-family: arial;"><span style="background-color: #fff2cc;">Plaintiff asks for the following</span>:</span></p><p></p><ol style="text-align: left;"><li><span style="font-family: arial;">For general damages in excess of the jurisdictional minimum of this Court, according to proof;</span></li><li><span style="font-family: arial;">For special damages according to proof;</span></li><li><span style="font-family: arial;">For exemplary punitive damages, according to proof;</span></li><li><span style="font-family: arial;">For interest on the amount of losses incurred in earnings, deferred compensation and other employee benefits at the prevailing rate;</span></li><li><span style="font-family: arial;">For reinstatement to her job with Defendant, Employer;</span></li><li><span style="font-family: arial;">For costs of suit, including reasonable attorneys’ fees; and</span></li><li><span style="font-family: arial;"> For such other and further relief as the Court may deem just and proper.</span></li></ol><p></p><p><span style="color: #0b5394; font-family: arial;"><b>FOR FUN</b></span></p><p><span style="font-family: arial;">Had difficulty choosing a song for this blog but settled on the following, as I wonder how many 'long haul' COVID-19 folks will suffer a similar fate of the med technologist in this blog. </span></p><p></p><ul style="text-align: left;"><li><span style="font-family: arial;"><a href="https://youtu.be/w6iRNVwslM4">Bad Moon Rising</a> (Creedence Clearwater Revival) </span></li></ul><p></p><p><span style="font-family: arial;"></span></p><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px; text-align: left;"><blockquote><p><span style="font-family: arial;">I see the bad moon a-rising / </span><span style="font-family: arial;">I see trouble on the way...</span></p></blockquote></blockquote><p><span style="font-family: arial;"></span></p><p><span style="color: #0b5394; font-family: arial;"><b>FURTHER READING</b></span></p><p></p><ol style="text-align: left;"><li><span style="font-family: arial;"><a href="https://www.darkdaily.com/hospital-based-clinical-laboratory-scientist-is-suing-her-former-employer-after-being-fired-due-to-long-haul-covid-19-illness/">Hospital-based clinical laboratory scientist is suing her former employer after being fired due to long-haul COVID-19 illness</a> (5 May 2021)</span></li></ol><p></p>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-78129761310746720302021-04-30T16:27:00.005-06:002021-05-01T10:27:34.373-06:00Stand by me (Musings on ongoing bullying in healthcare)<div style="text-align: center;"><span style="font-family: arial;">Stayed tuned for updates, which are sure to occur.</span></div><p><span style="font-family: arial;"><b><span style="color: #0b5394;">INTRODUCTION</span></b><br /><span style="font-family: arial;">
The idea for the blog was stimulated by news of a celebrated, experienced UK nurse who faced being stuck off after in 2017 she saved a woman's life who was hemorrhaging after losing her baby with a blood transfusion in an ambulance. (Further Reading) But, through no fault if hers, the required prescription for a blood transfusion had not been taken onto the ambulance with the patient. The nurse claims she has been the victim of bullying by senior NHS managers after she saved the life of the woman. She was unable to return to work at the trust's insistence for ten months, and resigned after she lost a disciplinary hearing. She had to find work outside the trust and is now practising elsewhere. <br /><br />
She was a finalist for 2020 Florence Nightingale Nurse of the Year after raising </span><span face="arial, sans-serif" style="background-color: white; color: #5f6368;">£</span><span style="font-family: arial;">100,000 to buy iPads for Covid patients isolated from loved ones. Four years later the Nursing and Midwifery Council concluded the nurse undoubtedly acted in the best interests of the patient and has 'no case to answer'. In some ways this case reminds me of the Bawa-Garba case in UK where a pediatric trainee was convicted of gross negligence manslaughter. (Further Reading)<br /><br />
In addition to this case, <span style="background-color: #fff2cc;">harassment and bullying of medical students</span> has been in the news in several nations for a few years. And in my province of Alberta, Canada, in 2016 a noose was hung outside a Black Dr's operating room in Grande Prairie. It was reported almost immediately to hospital administrators by startled bystanders. Yet, according to multiple doctors who wrote complaints, nothing was done to discipline the perpetrator, a white surgeon whom colleagues say still held leadership positions after the incident. (Further Reading)<br /><br />
The blog's title derives from a 1961 song by Ben E. King featured in the 1986 move of the same name.<br /><br /><b><span style="color: #0b5394;">
PERSONAL ANECDOTES</span></b><br />
The University of Alberta where I once taught has explicit, well defined Employment Equity and Human Rights Definitions and <span style="background-color: #fff2cc;">policies on bullying and discrimination</span>. Yet I'm certain both still exist. The guidelines are followed by all faculties, including the Faculty of Medicine & Dentistry. (Further Reading) It covers pretty much every kind of discrimination, whether direct or indirect: any act or omission based on race, religious beliefs, colour, gender, physical disability, mental disability, marital status, age, ancestry, place of origin, family status, source of income, sexual orientation or political belief, when that act or omission results in loss of or limit on opportunities to work or to fully participate in campus life or offends the dignity of the person. <br /><br />
As a patient I've seen bullying by a Dr. against a trainee and at scientific conventions. As a patient the male Dr. presumably wanted the female trainee (intern or resident) to suffer abuse as a rite of passage that would toughen her up. Few likely report it as the Dr. is all powerful and they fear being judged as troublemakers that could affect their career progression. <br /><br />
At Canadian transfusion medicine conferences I've also witnessed bullying, again by a male Dr. (a 'biggie') against a female Dr. who had presented and was taking comments from the audience. She held her own but his comments were dismissive and abusive and it likely cost her much stress. I wondered why at the time and since and, frankly, suspect he'd not have done that to a male colleague in the same way. <br /><br />
As always, comments are most welcome. Would appreciate hearing about discrimination or bullying you've experienced or witnessed, You can do so by name or anonymously.<br /><br /><b><span style="color: #0b5394;">
FOR FUN</span></b><br />
Chose this song because we all need to stand by colleagues in any field when they experience bullying, discrimination, harassment of any kind. Sad to report as items in Further Reading report, the <span style="background-color: #fff2cc;">incidence of bullying in medicine remains quite high</span>.<br /></span></span></p><ul style="text-align: left;"><li><span style="font-family: arial;"><span><span style="font-family: arial;"><span style="font-family: arial;"><a href="https://youtu.be/FX--7gFHkU0">Stand By Me</a> (Ben E. King with stars and clips from the film)</span></span></span></span></li></ul><span style="font-family: arial;"><span><span style="font-family: arial;"><span style="color: #0b5394;"><b>FURTHER READING</b></span><br /><a href="https://bbcgossip.com/scandal-to-shake-your-faith-in-our-wonderful-nhs/">
Nurse who faced being struck off after she saved a woman's life with a blood transfusion has been cleared by an official inquiry</a> (20 Apr. 2021) | Related:<br /></span><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px; text-align: left;"><span style="font-family: arial;"><a href="https://assets.publishing.service.gov.uk/media/5db84c39ed915d1d0c3b7ea9/Mrs_L_Harris_v_East_Lancashire_Hospitals_NHS_Trust_-_2410190_2018_-_Reasons_judgment.pdf">Employment Tribunal of Leona Harris</a> (18 Oct. 2019) | <i>The complaint of unfair dismissal is not well-founded and is dismissed.</i></span></blockquote><span style="font-family: arial;"><br />
University of Alberta: <a href="https://www.ualberta.ca/medicine/about/social-accountability/diversity/definitions.html">Employment Equity and Human Rights Definitions</a><br /><a eudora="autourl" href="https://www.ualberta.ca/medicine/about/social-accountability/diversity/definitions.html"><br />
</a>Taylor-Robinson SD, De Sousa Lopes PA, Zdravkov J, Harrison R. A. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882792/">Personal perspective: is bullying still a problem in medicine?</a> Adv Med Educ Pract. 2021 Feb 10;12:141-5. (Free full text)<br /><br /><a href="https://www.cma.ca/physician-wellness-hub/content/bullying-in-the-workplace">Bullying in the workplace</a> (1 Sept. 2020, CMA) | <i>What bullying in health care looks like, why it persists and how to eliminate it from the culture of medicine.<br /></i><a href="https://www.macleans.ca/opinion/medicines-bigotry-and-bullying-problem/"><br />Medicine's bigotry and bullying problem</a> (Oped in Canada's Macleans magazine, 8 July 2020)<br /><a eudora="autourl" href="https://www.macleans.ca/opinion/medicines-bigotry-and-bullying-problem/"><br />
</a>Colenbrander L, Causer L, Haire B. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092452/">'If you can't make it, you're not tough enough to do medicine': a qualitative study of Sydney-based medical students' experiences of bullying and harassment in clinical settings.</a> BMC Med Educ. 2020 Mar 24;20(1):86. (Free full text)<br /><a eudora="autourl" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092452/"><br />
</a>Australia: <a href="https://www.abc.net.au/news/health/2020-02-10/bullying-harassment-medicine-doctors/11949748">Culture of bullying, harassment and discrimination in medicine still widespread, survey suggests</a> (9 Feb. 2020)<a eudora="autourl" href="https://www.abc.net.au/news/health/2020-02-10/bullying-harassment-medicine-doctors/11949748"><br /><br />
</a><a href="https://blogs.bmj.com/bmj/2019/05/09/jenny-vaughan-the-bawa-garba-case-should-usher-in-a-fairer-culture-in-healthcare/">The Bawa-Garba case should usher in a fairer culture in healthcare</a> (9 May 2019)<br /></span></span></span><p></p>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-63443141511126204722021-04-01T14:17:00.008-06:002021-04-06T16:34:31.805-06:00Simply the best (Musing on healthcare educators during COVID-19) <span style="color: #0b5394; font-family: arial;"><b>INTRODUCTION</b></span><br /><span style="font-family: arial;">
I've meant to write this blog for awhile. I'm privileged to look after the mailing lists for University of Alberta's Medical Laboratory Science. As such, even though I no longer teach in the division, I get all messages to students and staff plus more. The blog will focus on medical laboratory education but I suspect it rings true for other health professionals. Had help with ideas for the blog from a former student of mine, who I won't identify at this time. <br /><br />
The blog's title is based on a ditty written by Holly Knight and Mike Chapman, but best known by Tina Turner's recording of it. <br /><br /><b><span style="color: #0b5394;">
HOW EDUCATORS ADAPTED DURING PANDEMIC</span></b><br />
Where to start. I'll need to speak in generalities because it differs depending on the prevalence of COVID-19 in educators' areas. Sample list of key adaptations heath profession educators had to make:<br /><b>
1. </b>Managing the chaos of <span style="background-color: #fff2cc;">ever-changing information</span>. Suspect most people know how hard this is as regulations and policies regularly change as new evidence becomes available. Good example is the changing advice on the AstraZeneca COVID-19 vaccine as research and real world evidence become available.<br /><br /><b>
2.</b> <span style="background-color: #fff2cc;">Online learning</span>. This was a major transition, involving putting course material online. Much harder for instructors who didn't use Powerpoints regularly, instead had in-class activities. <br />
Not all students enjoy online learning as much as face-to-face interaction with classmates and instructors, nor do the assignments, required pre-reading, etc. That's true for in person classes too but worse with online learning. Plus it's much easier to be distracted when text messages arrive as today's students pretty much have their cell phones on at all times. <br /><br />
Online learning also put much stress on university, community college, and technical institute IT departments. <br /><br /><b>
3.</b> In <span style="background-color: #fff2cc;">introductory courses</span>, depending on when the pandemic was declared, students had a <span style="background-color: #fff2cc;">different laboratory experience</span> than in prior years when all routine labs and a final exam were performed before entering the clinical year. Similarly, for other pre-clinical experiences such as phlebotomy visits to outpatient labs, etc. <br /><br />
Ultimately, some in-person introductory lab courses resumed, but required many adaptations in student labs. Examples: Fewer students in each lab space (e.g., one lab becomes two), shower curtains erected for students facing each other on the same bench, between labs sanitizing high touch areas (door knobs, bench areas, reagent bottles). <br /><br />
4. In the <span style="background-color: #fff2cc;">clinical year</span>, depending on when the pandemic was declared, students were<span style="background-color: #fff2cc;"> pulled from the sites until safety precautions</span> could be put in place. This required re-scheduling. <br /><br />
5. Depending on how many institutions, healthcare organizations are involved, <span style="background-color: #fff2cc;">processes and procedures could differ, requiring educators to meet the needs of each</span>. <br /><br /><b><span style="color: #0b5394;">
LEARNING POINT</span></b><br />
To me all healthcare educators deserve a loud round of applause for how they've had to adapt during the COVID-19 pandemic to constantly changing regulations and policies. In some ways I'm glad I retired decades ago as I would have found this difficult even then. <br /><br /><b><span style="color: #0b5394;">
FOR FUN</span></b><br />
Chose this song because to me healthcare educators have been simply the best during COVID-19 pandemic. To me they're heroes similar to those on the frontlines. <br /></span><ul style="text-align: left;"><li><span style="font-family: arial;"><span style="font-family: arial;"><a href="https://youtu.be/Ob6RRcw3V3A">Simply the best</a> (Tina Turner, Barcelona, 1990)</span></span></li></ul><span style="font-family: arial;">
As always, comments are most welcome (you can do so anonymously or by name below) and there are some.<br /></span><p></p>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com4tag:blogger.com,1999:blog-8729772.post-80563539828269870822021-02-28T17:52:00.019-07:002021-03-01T15:34:09.314-07:00I will remember you (Musings on healthcare heroes during COVID-19 pandemic)<p style="text-align: center;"><span style="font-family: arial;"> <i>Updated</i>: <span style="background-color: #fff2cc;">1 March 2021</span></span></p><p><span style="font-family: arial;">February's blog is about healthcare workers who have been infected and died from COVID-19 worldwide, and who have made many sacrifices for us all.</span></p><span style="font-family: arial;"><b><span style="color: #0b5394;">INTRODUCTION</span></b><br />
The idea for the blog was stimulated by a series of news items posted in TraQ's Feb. newsletter (Further Reading). Also by the fact that so many healthcare professionals have put their duty to patients above the safety of themselves and their families. COVID has also highlighted invisible health professionals such as medical laboratory technologists/biomedical scientists who have shone with dedicated work to test for COVID-19 infection. Plus</span><div><span style="font-family: arial;">Emergency Medical Services (EMS) emergency medical technicians </span><span style="font-family: arial;">Also those who work for low wages in long term care facilities, often immigrants who need several jobs to make a go of it, and personal care workers. </span></div><div><div style="text-align: left;"><span style="font-family: arial;"><br />
I could also focus on many non-healthcare heroic workers during the COVID-19 pandemic. If I've missed any, please send a comment. Examples (Some in Further Reading): <br /><ul style="text-align: left;"><li><span style="font-family: arial;">Hospital cleaners and maintenance staff</span></li><li><span style="font-family: arial;">Daycare workers</span></li><li>Teachers, teachers' aides, school janitors</li><li>Apartment housekeeping & maintenance staff</li><li>Meat plant workers (often immigrants) who are often housed in close contact with other workers</li><li>Grocery and food retail workers</li><li>Food delivery drivers</li><li><span style="background-color: #fff2cc;">NEW</span>: Transit workers who transport essential workers to and from work (Thanks, Penny)</li></ul>
The blog's title derives from a 1995 Sarah McLachlan song.<br /><br /><b><span style="color: #0b5394;">
THE EVIDENCE</span></b><br />
Folks, there is overwhelming evidence that health professionals and many others have stepped up to the plate during the coronavirus pandemic. I do not need to belabour the point. The aim of this blog is to celebrate their contributions around the globe at great personal cost to themselves not just dying but also anxiety and depression.</span></div><div style="text-align: left;"><ul style="text-align: left;"><li><span style="font-family: arial;">While the numbers of those dead due to COVID-19 are overwhelming, it's key to remember that each of these folks are individuals, someone's 'significant other', child, mother, father, brother, sister, aunt, uncle, cousin, friend. </span></li><li><span style="font-family: arial;">As of 12:39 pm Central European Time, 1 March 2021, there have been 113,695,296 confirmed cases of COVID-19, including 2,526,007 deaths, reported to WHO. (Further Reading) </span></li><li><span style="font-family: arial;">See stories of some folks who have died from COVID-19 (</span><span style="font-family: arial;">Further Reading)</span><span style="font-family: arial;">. </span></li><li><span style="font-family: arial;">Note that people of colour are more likely to get COVID-19. (Further Reading) </span></li></ul></div><div style="text-align: left;"><span style="font-family: arial;">
I encourage you read the items in Further Reading to gain a perspective on what we owe these heroes. Also to see affected people as individuals.<br /><br />
</span></div><div style="text-align: left;"><span style="font-family: arial;">As always, comments are most welcome and there are some below.<br /><br /><b><span style="color: #0b5394;">
FOR FUN</span></b><br />
Chose this song because I hope we will all remember the heroes who put their lives at risk during the COVID-19 pandemic. I certainly will, as my husband with a serious lung disease went to the Emergency Dept. by ambulance in Dec. 2020 & spent a week in hospital.<br /><ul style="text-align: left;"><li><span style="font-family: arial;"><a href="https://youtu.be/uHooH4464dQ">I will remember you</a> (by Canada's Sarah McLachlan)</span></li></ul><b><span style="color: #0b5394;">FURTHER READING</span></b><br /><ul style="text-align: left;"><li><span style="font-family: arial;"><a href="https://covid19.who.int/">WHO Coronavirus Disease (COVID-19) Dashboard</a></span></li></ul><ul style="text-align: left;"><li><a href="https://www.bbc.com/news/uk-52676411">Remembering coronavirus victims</a> (UK) </li></ul><ul style="text-align: left;"><li><a href="https://www.boston.com/news/coronavirus/2021/01/14/faces-of-covid">Sharing stories of people who’ve died from COVID-19</a> (USA)</li></ul><ul style="text-align: left;"><li><a href="https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/coronavirus-infection-by-race/faq-20488802">Why are people of color more at risk of coronavirus complications?</a> </li></ul><ul style="text-align: left;"><li><a href="https://www.bbc.com/news/health-54907473">Black people 'twice as likely to catch coronavirus'</a> (12 Nov. 2020)</li></ul><ul style="text-align: left;"><li><span style="font-family: arial;">Salari N, Khazaie H, Hosseinian-Far A, et al. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745176/">The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression</a>. Hum Resour Health. 2020 Dec 17;18(1):100.</span></li></ul><ul style="text-align: left;"><li><span style="font-family: arial;">Bandyopadhyay S, Baticulon RE, Kadhum M, et al. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722361/">Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review.</a> BMJ Glob Health. 2020 Dec;5(12):e003097.</span></li></ul><ul style="text-align: left;"><li><span style="font-family: arial;"><a href="https://www.forbes.com/sites/williamhaseltine/2020/11/17/the-infection-of-hundreds-of-thousands-of-healthcare-workers-worldwide-poses-a-threat-to-national-health-systems/">Nearly 300,000 healthcare workers have been infected with Covid-19 worldwide, threatening health systems</a> (17 Nov. 2020) | Related:</span></li><ul><li><span style="font-family: arial;">Erdem H, Lucey DR. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598357/">Healthcare worker infections and deaths due to COVID-19: A survey from 37 nations and a call for WHO to post national data on their website.</a> Int J Infect Dis. 2021 Jan;102:239-41. Epub 2020 Oct 29.</span></li></ul></ul><a eudora="autourl" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598357/"></a><ul style="text-align: left;"><a eudora="autourl" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598357/"></a><li><a eudora="autourl" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598357/"><span style="font-family: arial;">In memoriam: </span></a><span style="font-family: arial;"><a href="https://nursesunions.ca/covid-memoriam/">Canada's health workers who have died of COVID-19</a> (19 Feb. 2021)</span></li></ul><ul style="text-align: left;"><li><a href="https://www.icn.ch/news/icn-confirms-1500-nurses-have-died-covid-19-44-countries-and-estimates-healthcare-worker-covid">ICN confirms 1,500 nurses have died from COVID-19 in 44 countries and estimates that healthcare worker COVID-19 fatalities worldwide could be more than 20,000</a> (28 Oct. 2020)</li></ul><ul style="text-align: left;"><a eudora="autourl" href="https://www.icn.ch/news/icn-confirms-1500-nurses-have-died-covid-19-44-countries-and-estimates-healthcare-worker-covid"></a><li><span style="font-family: arial;"><a href="https://www.thespec.com/opinion/contributors/2020/07/06/medical-lab-staff-working-in-the-shadows-to-help-defeat-covid-19.html">Canada's medical lab staff working in the shadows to help defeat COVID-19</a> (6 July 2020)</span></li></ul>
</span></div></div><span style="font-family: arial;"><ul style="text-align: left;"><li><span style="font-family: arial;"><a href="https://www.bbc.com/news/world-us-canada-52359101">Are hospital cleaners forgotten heroes in this crisis?</a> (20 Apr. 2020)</span></li></ul><ul style="text-align: left;"><li>Canada: <a href="https://www.cbc.ca/news/canada/calgary/red-deer-olymel-outbreak-1.5914137">Alberta slaughterhouse to close temporarily amid growing COVID-19 outbreak that has claimed one life</a> (15 Feb. 2021) | Related:</li><ul><li><a href="https://www.rcinet.ca/en/2020/04/29/labour-leaders-want-action-on-covid-19-outbreaks-at-alberta-meat-plants/">Labour leaders want action on COVID-19 outbreaks at Alberta meat plants</a> (29 Apr. 2020)</li></ul></ul><ul style="text-align: left;"><li><span style="font-family: arial;">USA: </span><a eudora="autourl" href="https://www.rcinet.ca/en/2020/04/29/labour-leaders-want-action-on-covid-19-outbreaks-at-alberta-meat-plants/">About 20% of grocery store workers had Covid-19, and most didn't have symptoms, study found (29 Oct. 2020)</a></li></ul></span>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-22484569763258565622021-01-08T15:46:00.009-07:002021-04-01T14:44:31.506-06:00I will remember you (Musings on a 1991 graduation speech) <p style="text-align: center;"><span style="font-family: arial;"><i>Revised</i>: <span style="background-color: #fff2cc;">31 Jan. 2021</span></span></p><p><span style="font-family: arial;">Folks, recently I was cleaning out a file cabinet and came across a typed copy of a speech I'd given to MLS graduates in 1991, nearly 30 years ago. Yes, I'm a lifelong packrat who now must cope with its consequences. F</span><span style="font-family: arial;">ortunate to have been asked to give a few graduation speeches to MLS grads decades ago. </span></p><p><span style="font-family: arial;">On the upside it made me realize that my December blog - <a href="https://traq.blogspot.com/2020/12/sweet-dreams-musings-on-benefits-of.html">Sweet Dreams</a> (</span><span style="font-family: arial;"><i>Musings on the benefits of a well-rounded education</i></span><span style="font-family: Arial; font-size: small;"><i>)</i> - </span><span style="font-family: arial;">had its origins decades ago. So what I did was to scan the speech pages into my computer, convert each .jpg photo to PDF using Adobe Acrobat Pro DC, then export as Word doc so I could copy each page into this blog.</span></p><p><span style="font-family: arial;">Yes, I realize that some parts of the speech won't make sense to non-MLS grads or to non-medical laboratory technologists/biomedical scientists. Yet I hope that the blog's <span style="background-color: #fff2cc;">main theme</span> will resonate with all health professionals. See the tidbits under 'What You Learned' and 'Personal Development' below. </span></p><span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #0b5394;"><span style="font-family: arial;"><b>SPEECH TO 1991 MLS GRAD<span style="font-size: x-small;">S</span></b></span></span><br style="background-color: white; color: #333333; font-family: arial; font-size: 11.05px;" /><span style="font-family: arial;">Thanks very much Terry [Terry the MC, was a fellow MLS instructor] for your generous introduction. I am really glad to have this time because there are a few things I still need to cover with this class.</span><div><p><span style="font-family: arial;">First, I thought we would have a spot quiz. I should point out that some of the answers will only make sense to the graduates. So let's begin, then, starting with a test of your long-term memory.</span></p><span style="background-color: white; font-family: arial;"><span style="color: #0b5394;"><b>SPOT QUIZ</b></span></span><br font-size:="" style="background-color: white; color: #333333; font-family: arial;" x-small="" /><span style="font-family: arial;"><b>Question #1</b>: </span><span style="font-family: arial;">How many First Year MLS students does it take to change a lightbulb? <i>Answer</i>: Five: </span><span style="font-family: arial;">One to change it and four to set up Kohler illumination.</span><p></p><p><span style="font-family: arial;"><b>Question #2</b>: </span><span style="font-family: arial;">How many Second Year students does it take to change a lightbulb? <i>Answer</i>: None. At least not in my class. You see, they were all asleep and the light would only have disturbed them.</span></p><p><span style="font-family: arial;"><b>Question #3</b>: </span><span style="font-family: arial;">How many Third Year students does it take to change a lightbulb? <i>Answer</i>: The whole class. </span><span style="font-family: arial;">One student to change it and the rest to complain that their friends in other faculties had all summer off to do it. </span></p><p><span style="font-family: arial;"><b>Question #4</b>: </span><span style="font-family: arial;">This one is a test of your short term memory. How many Fourth Year students does it take to change a lightbulb? <i>Answer</i>: Again, the whole class. One to change it and the rest to complain that it should be deleted from Path 401 [Course at the time, perhaps no longer exists?] </span></p><p><span style="font-family: arial;">Before turning to the last question, could I prevail upon John S. to come to the podium. Well, this is something you have waited a long time for. Could we have the Gingerbread Lady please. Ladies and Gentlemen - I should explain that the Gingerbread Lady, our very own Rosemarie Cunningham [hematology instructor], always brings students gingerbread men at the end of Second Year. John pulled an Oliver Twist and said, “more please’, during third year. Well, better late than never. Let’s have a hand for this cookie monster. [Rosemarie gave him a gingerbread cookie]</span></p><p><span style="font-family: arial;"><b>Question 5</b>: And now, so the instructors won't be left out, here's the last question. </span><span style="font-family: arial;">How many MLS instructors does it take to change a lightbulb? <i>Answer</i>: Ten. One to change it and nine to evaluate whether it was done right.</span></p><span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #0b5394;"><b><span style="font-family: arial;">AMBASSADORS</span></b></span><div><span style="font-family: arial;">Now that the spot quiz is over there are a few things that I would like to talk to you about in a more serious vein. A few weeks ago I went to the Ambassador Awards at the Convention Centre. It was attended by people from all walks of life who belonged to associations like the CSLT [now CSMLS] that can bring conventions to the city. The organizers gave out awards and asked all of us to act as ambassadors by promoting Edmonton as a convention site.</span><div><p><span style="font-family: arial;">The thought occurred to me that in one way or another we all act as ambassadors. For example, when we are tourists in a foreign country, or when we interact with visitors to our city.</span></p><p><span style="font-family: arial;">So I would like to talk tonight about the idea that all of you - the MLS graduates of 1991 - are going to be <span style="background-color: #fff2cc;">ambassadors </span>for MLS whether you realize it or not. No matter what the future holds for each of you, all of the people you will meet will be gaining impressions of MLS through you, your actions, and attitudes.</span></p><p><span style="font-family: arial;">Now before you say, "Good grief! I can't handle the pressure - MLSers for life" - 1 want to tell you that I have great faith in each and every one of you. As an MLS instructor I have been privileged to share a part of your life for the past three years or so. Let me explain why I think that you will be great ambassadors. In a way I feel like mosquito in a nudist colony. I don’t know where to start.</span></p><span style="background-color: white; font-family: arial;"><b><span style="color: #0b5394;">WHAT YOU LEARNED</span></b></span><br style="background-color: white; color: #333333; font-family: arial; font-size: 11.05px;" /><span style="font-family: arial;">To begin with, there are all of the things you have learned while in MLS. And I'm not talking about the information and technical skills you have assimilated, although these are important. You have learned so much that what you have forgotten would fill a library. No, I'm talking about skills that you will find useful all your lives.</span><p><span style="font-family: arial;">For example, you have learned how to be <span style="background-color: #fff2cc;">good listeners</span>. Goodness knows you have had enough practice being listeners during your time here. As you begin your careers, remember the words of a wise person who once said, "good listeners are not only popular everywhere, but after a while they know something."</span></p><p><span style="font-family: arial;">You have also learned how to <span style="background-color: #fff2cc;">communicate clearly</span>, both orally and in writing. Who can ever forget their first teaching assignment? I should explain that our students give at least three presentations to classmates and instructors beginning with teaching assignments during the Third Year.</span></p><p><span style="font-family: arial;">I'm sure that some of you think that teaching assignments were cruel and unusual punishment, both for the student and the audience. But, boy, do they ever pay off! The progress you made was really shown during presentation of your research projects. Your instructors and supervisors were very impressed. This will be a real plus for you in any career. I tell you this because I have seen many technologists, scientists, and doctors who have not had the advantage that teaching assignments provide, namely to express ideas clearly and concisely.</span></p><p><span style="font-family: arial;">There are many other intellectual skills you have learned, such as your grasp of the<span style="background-color: #fff2cc;"> scientific method</span> and all that entails. You have developed the ability to be <span style="background-color: #fff2cc;">skeptical</span> about so-called established knowledge, and to be <span style="background-color: #fff2cc;">open-minded </span>about issues. You know that it is okay to say, "Gee, I don't know, but I will find out." You know how to learn. You will draw on these skills over and over again, especially because medical laboratory science is evolving so rapidly.</span></p><p><span style="color: #0b5394; font-family: arial;"><b>PERSONAL DEVELOPMENT</b><br style="background-color: white; color: #333333; font-size: 11.05px;" /></span><span style="font-family: arial;">I would like to shift for awhile to some of the ways you have all grown in your personal development. Those of you who entered MLS lacking self-confidence have seen your belief in your abilities increase. </span><span style="background-color: #fff2cc; font-family: arial;">Self-confidence</span><span style="font-family: arial;"> is essential because no one will believe in you if you don't believe in yourself. I'm not talking about being over-confident and self-important, but rather about the quiet self-assurance of people who are competent and know it.</span></p><p><span style="font-family: arial;">Conversely, if you came with a fair degree of self-confidence, if you were like me at 18 (and trust me, I was18 once - and thought I pretty much knew everything) - then your experiences in MLS have added to your growth by teaching you <span style="background-color: #fff2cc;">humility</span>.</span></p><p><span style="font-family: arial;">Your entire Third Year was an exercise in discovering your strengths and weaknesses, coming to terms with them, and <span style="background-color: #fff2cc;">accepting both praise and criticism gracefully</span>. It was hard to be evaluated each and every day of your hospital rotation; it was hard to accept feedback that you may or may not have felt was justified. </span></p><p><span style="font-family: arial;">But you all did it, and because of this you will have a big advantage in the workplace, as well as in life. Having a <span style="background-color: #fff2cc;">positive approach to learning</span> will always serve you well. You know that imperfection is only human. The important thing is that we all try to do better. And keep in mind that misery is optional.</span></p><p><span style="font-family: arial;">You have also learned what <span style="background-color: #fff2cc;">friendship </span>means. In the years ahead, you will remember your friends very fondly. One definition of a friend is "a friend is one who dislikes the same people that you dislike." There is a lot of truth in this, but a better way to think of friendship is to realize that the only way to have a friend is to be one. You have all done that during your university days.</span></p><p><span style="font-family: arial;"> Thank you very much asking me to speak and for listening.</span></p>
<span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: #fff2cc;">/////////////////////////////////////////////////////////////////</span></span></div></div></div><p><span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white;">As always, comments are most welcome. Now that you've read the graduation speech, please see an earlier blog closely related to this one: </span></span><span style="font-family: arial;"><a href="https://traq.blogspot.com/2020/12/sweet-dreams-musings-on-benefits-of.html">Sweet Dreams</a> (</span><span style="font-family: arial;"><i>Musings on the benefits of a well-rounded education</i>).</span></p><p><span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #0b5394;"><b>FOR FUN </b></span><br style="background-color: white; color: #333333;" /></span><span style="font-family: arial;">This song</span><span style="font-family: arial;"> by Canada's Sarah McLachlan seemed right for a speech given 30 years ago. Fact is, I remember all my 'kids' (those I taught decades ago) with a great deal of affection.</span></p><p></p><ul style="text-align: left;"><li><span style="font-family: arial;"><a href="https://youtu.be/uHooH4464dQ">I will remember you </a></span></li></ul><p></p>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-11498759363720912982020-12-29T17:22:00.046-07:002022-09-11T14:40:56.157-06:00Sweet Dreams (Musings on the benefits of a well-rounded education)<p style="text-align: center;"><span style="font-family: arial;"><i>Updated</i>: <span style="background-color: #fff2cc;"><span> 1 May </span></span><span><span style="background-color: #fff2cc;">2022</span></span><span style="background-color: white;"> (Added full names to <a href="#grads">MLS grads</a>)</span></span></p><p><span style="font-family: arial;">No blog for a few months but wanted to write one for the end of 2020 and specifically the holiday season. December’s blog will discuss the benefits of a well-rounded medical laboratory science education. But I hope that the blog’s theme rings true for all transfusion medicine professionals.</span></p><p><span style="font-family: arial;">The idea for the blog was stimulated by a message I wrote last year for an alumni reception of the <a href="https://www.ualberta.ca/medicine/programs/mls/index.html ">MLS</a> program I once taught in. As I couldn’t attend the Director asked me to send a greeting that she would read out. I’ve adapted it to a blog format and omitted some personal memories and the names of those MLS grads I mentioned.</span></p><p><span style="font-family: arial;"><b style="background-color: #fff2cc;">NOTE</b>: Often MLS grads from the 1990s could not find jobs due to Alberta's Conservative government cutting </span><span style="font-family: arial;">clinical lab funding by </span><span style="font-family: arial;">40%. (See Further Reading) Many were forced to seek work in the USA and overseas. Some decided to change careers. In both cases they had the soft skills needed to succeed: love of learning, </span><span style="font-family: arial;">communication skills, and the ability and skills to be lifelong learners.</span></p><p><span style="font-family: arial;">The blog's title derives from a song co-written by Annie Lennox and originally released by the Eurythmics in 1983.</span></p><p><span style="color: #0b5394; font-family: arial;"><b>INTRODUCTION</b></span></p><p><span style="font-family: arial;">Greeting to all Med Lab Science grads, no matter when you graduated. The oldster has two messages for all of you. First, I must tell you a bit about myself, but only so that you will appreciate - once you hear my messages - that I know what I'm talking about. In brief, I know the international scene in medical lab science well. Some examples (I excluded several others):</span></p><p></p><ul style="text-align: left;"><li><span style="font-family: arial;">Founded a mailing list in 1994, MEDLAB-L, which became the world's largest English language mailing list for med lab professionals in all disciplines: 2400+ subscribers in 50 countries.</span></li><li><span style="font-family: arial;">Still a list manager, albeit a silent one in the background, for CLSEDUC-L, the mailing list of U.S. clin lab science educators in all disciplines. All the leading educators are members, including textbook authors.</span></li><li><span style="font-family: arial;">For decades I’ve been the webmaster for the TraQ website of the <a href="https://www.pbco.ca/">BC Provincial Blood Coordinating Office</a> which distributes a monthly newsletter to 1000s of transfusion professionals all over the world. </span></li></ul><p></p><p><span style="color: #0b5394; font-family: arial;"><b>ANECDOTES </b></span></p><p><span style="font-family: arial;">1. In the 1990s medical laboratory technologist positions became scarce in Alberta due to severe government cutbacks. Many MLS grads went to work in the U.S. as they had written ASCP (MT) examinations when they graduated. I know from my extensive contacts there that MLS grads were highly valued and considered excellent. One reason of several was their long internship in clinical labs. The clinical rotation is shorter now, pretty much everywhere.</span></p><p><span style="font-family: arial;">2. Several also worked in NZ for its national Blood Transfusion Service. To facilitate that adventure, I sent copies of the MLS curriculum to the NZ registration body. The <a href="https://www.nzblood.co.nz/ ">NZBS</a> runs blood centres and also pretransfusion testing laboratories. </span></p><p><span style="font-family: arial;">3. In the 1990s out-of-the-blue I was contacted by a company (Wyndgate Technologies, now part of Haemonetics) in Sacramento, California who made software for transfusion labs. The company had given a demonstration of their LIS software to staff in Hamilton, NZ for the New Zealand Blood Service. They were so impressed by the 5 MLS grads working there that they wanted to know if MLS had any more like that. </span></p><p><span style="font-family: arial;">Turns out two grads were game and worked for the company for many years, travelling all over the U.S. demonstrating the software for new clients. One was a NAIT graduate, who took MLS’s degree-completion program for technologists with general certification from <a href="https://www.csmls.org/">CSMLS</a>. </span></p><p><span style="color: #0b5394; font-family: arial;"><b>WHERE LIFE TAKES US</b></span></p><p><span style="font-family: arial;">In <a href="https://www.ualberta.ca/medicine/programs/mls/index.html">MLS </a>you obtained 3 main skills:</span></p><p></p><ol style="text-align: left;"><li><span style="font-family: arial;">Extensive knowledge in all MLS disciplines; </span></li><li><span style="font-family: arial;">Sound practical training in clinical labs;</span></li><li><span style="font-family: arial;">Priceless so-called 'soft skills' that are transferable to many occupations, especially communication skills and the ability to be a lifelong learner.</span></li></ol><p></p><p><span style="font-family: arial;">To me it's always been the third that's most valuable because we never know where life will take us. Most MLS grads went on to long careers in clinical labs, where many became supervisors and managers. Some rose to high positions in healthcare organizations.</span></p><p><span style="font-family: arial;">Other MLS grads followed different paths. Some got post-secondary Masters or PhDs and became researchers, Deans in technical institutes and universities. Several became MDs and rose to high positions in healthcare. Others became lawyers, nurses, dentists, physical therapists, investment brokers, real estate agents, sales representatives, information system specialists.</span></p><p><span style="font-family: arial;">I’ll highlight but one MLS grad: Susan Wong was born in AB to immigrant parents and when she entered grade one she spoke only Chinese. She worked in her parents’ modest restaurant, as did her sisters. After working as a med lab technologist Susan became a lawyer and progressed to be a tax specialist who was the Regional Director at the Department of Justice Canada in Vancouver. Susan was appointed a judge of the Tax Court of Canada by Canada’s Governor General and now has the title Honorable as part of her name. Hope to add Susan to the grads below.</span></p><p><span style="color: #0b5394; font-family: arial;"><b>LEARNING POINTS</b></span></p><p><span style="font-family: arial;"><b>#1: </b>As an MLS graduate be aware that your hard work has resulted in graduating from one of the world's top medical lab science programs. Not just top Canadian MLS program, but one of the world's finest MLS programs. As someone active on the international scene for decades, I can attest to this. </span></p><p><span style="font-family: arial;">Concrete Evidence: In 1998 MLS won a worldwide competition to put on a 5-day seminar in Saudi Arabia for the healthcare division of Saudi Aramco (Saudi Arabia's national oil company). </span></p><p><span style="font-family: arial;"><b>#2: </b>With an MLS degree you can become anything. You can work as a med lab technologist in Canada, the USA, and beyond or get further education in any field. </span></p><p><span style="font-family: arial;">Indeed, most of my 'kids' work as medical lab technologists in labs across Canada, not just in Alberta but literally from coast to coast to coast, including New Brunswick in the east, BC in the west, and Whitehorse, Yukon. As such they make important contributions to Canada's healthcare system. Yes, I'm incredibly proud of all my 'kids'. </span></p><p><span style="font-family: arial;">But if you want to, with an MLS BSc - and being skilled lifelong learners - you can take further education and enter any profession. The sky's the limit. </span><span style="font-family: arial;">You have the education to be FUTURE LEADERS in wherever life takes you. </span><span style="font-family: arial;">Never forget it.</span></p><p><span style="color: #0b5394; font-family: arial;"><b>SECRET TO SUCCESS</b></span></p><p><span style="font-family: arial;">Regardless of the health profession it’s the so-called 'soft skills' that are transferable to many occupations, especially communication skills and the ability to be a lifelong learner. Not all the facts you have learned, though they are important to being a competent health practitioner.</span></p><p><span style="font-family: arial;"><b style="color: #0b5394;"><a name="grads"></a>PHOTOS OF SOME OF MY MLS 'KIDS'</b><span> (Many taken by me)</span></span></p><p></p><ul style="text-align: left;"><li><span style="font-family: arial;">Still hope to include more MLS grads in the future.</span></li><li><span style="font-family: arial;"><span><b>Liz </b><span style="background-color: white;"><b>McBride</b>,</span><span style="background-color: white; font-size: 14px;"><span style="color: #5f6368;"> </span></span> BSc (MLS), MLT, LQM, ASQ CQA</span> </span></li></ul><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEjeCnvdMjuRDoiIDAJdQAYz67Ss6rXa96EngSvEsAsPYOtUNEoYt7bKhH7X3j1A_2OOzSlLN1X0BY3s-FM8EaYSOw-phLY8_5foU6M4QyeGFz2NM_jak_zjkM72B27KjSCW_uSiNXxkcQv3_l_c6lA7DxxVV8-urauTIWrTF0mrti6RWSlJnw=s400" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: arial;"><img border="0" data-original-height="400" data-original-width="400" height="320" src="https://blogger.googleusercontent.com/img/a/AVvXsEjeCnvdMjuRDoiIDAJdQAYz67Ss6rXa96EngSvEsAsPYOtUNEoYt7bKhH7X3j1A_2OOzSlLN1X0BY3s-FM8EaYSOw-phLY8_5foU6M4QyeGFz2NM_jak_zjkM72B27KjSCW_uSiNXxkcQv3_l_c6lA7DxxVV8-urauTIWrTF0mrti6RWSlJnw=s320" width="320" /></span></a></div></div><ul style="text-align: left;"><ul><li><span style="font-family: arial;">Director of Accreditation, <a href="https://cpsa.ca/">CPSA</a> (until retired)</span></li><li><span style="font-family: arial;">Program Manager, Laboratory Accreditation Services,CPSA (Managed the accreditation of over 160 diagnostic medical laboratories in AB)</span></li><li><span style="font-family: arial;">Team Leader, Western Canada Diagnostic Accreditation Alliance (<a href="https://cpsa.ca/resources/western-canada-diagnostic-accreditation-alliance-wcdaa/">WCDAA</a>) </span></li><li><span style="font-family: arial;">Laboratory Data Centre Supervisor - Client Response Services (CRS)/Specimen Control Capital Health Authority - <a href="https://www.albertahealthservices.ca/uah/uah.aspx">University of Alberta Hospital</a> (UAH)</span></li><li><span style="font-family: arial;">Technologist I/ Technologist II, Dept. of Laboratory Medicine, UAH</span></li></ul><li><span style="font-family: arial;"> Many volunteering experiences, including with
</span></li><ul><li><span style="font-family: arial;"><a href="https://www.scc.ca/">Standards Council of Canada</a> </span></li><li><span style="font-family: arial;"><a href="https://clsi.org/">Clinical & Laboratory Standards Institute</a> </span></li><li><span style="font-family: arial;">Member Diagnostic Laboratory Programs Advisory Committee, <a href="https://www.nait.ca/nait/home">NAIT </a></span></li><li><span style="font-family: arial;">Chair, Combined Laboratory & X-Ray Technology Program Advisory Committee, NAIT </span></li></ul><div><span style="font-family: arial;"><br /></span></div><li><span style="font-family: arial;"><span style="background-color: white; color: #5f6368;"><b>Dr. Carol Ewanowich</b></span>, BSc (MLS), PhD (medical microbiology) & MD (anatomic pathologist), RAH at Edmonton Pride Parade <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjgLzaPz1rlBiLcaXW0LzMe7dJSZjuLuAMJdszliQpqhpPMlMhrurHmXWD30y_3Z5pGQoaF7I1Hq8EktAa_dIH-QmIxSsYx0qMMHWgqJVXYby70yfQUB1gOzrgpqaeHCsCj-qr/s568/carol.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="568" data-original-width="392" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjgLzaPz1rlBiLcaXW0LzMe7dJSZjuLuAMJdszliQpqhpPMlMhrurHmXWD30y_3Z5pGQoaF7I1Hq8EktAa_dIH-QmIxSsYx0qMMHWgqJVXYby70yfQUB1gOzrgpqaeHCsCj-qr/s320/carol.jpg" /></a></div><br /></span></li><li><span style="font-family: arial;"><b>Colleen Young</b>, BSc (MLS),worked for <a href="https://www.blood.ca">CBS</a> for years, & currently Macopharma marketing Manager in Lille, France <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVQW1tD-X_etqTRrkheiS3uRJwlG0f3_h-0mQ8zzaX4D2xjlLCrtjDSWM-5BF9uHxntjTd6pmB_v1QaA32ueiFz1vyZnA5Qux1qbO5TpMLpTXFH_UGJXURbZY27dEs-hAQSdjG/s399/colleen.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="399" data-original-width="278" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVQW1tD-X_etqTRrkheiS3uRJwlG0f3_h-0mQ8zzaX4D2xjlLCrtjDSWM-5BF9uHxntjTd6pmB_v1QaA32ueiFz1vyZnA5Qux1qbO5TpMLpTXFH_UGJXURbZY27dEs-hAQSdjG/s320/colleen.jpg" /></a></div><br /></span></li><li><span style="font-family: arial;"><b>Brenda Moltzan</b>, BSc (MLS),</span><span style="font-family: arial;">longtime medical lab technologist, <a href="https://www.albertahealthservices.ca/uah/uah.aspx">University of Alberta Hospital</a> </span></li><li><span style="font-family: arial;"><b>Francene Starko</b>, BSc (MLS) longtime medical lab technologist (Dynalife)</span></li><li><span style="font-family: arial; text-align: center;"><b>Liz McBride</b>, BSc (MLS), medical lab technologist,UAH, who became Director of Accreditation at <a href="http://www.cpsa.ca/">College of Physicians and Surgeons of Alberta</a> & more.</span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-wg7hjH-kqxPVGq5NYwpu0ORCT1XbxDUzKJJQVa-WAu20UIi9R-FQULahINm7OXUJrItekcikWbqJSTNJn3bJw70D6DfykfpbTPLEVYeSK22VEdb8oPA_GR10YnABk1ZgLtMy/s645/brendafran-liz.jpg" style="font-family: arial; margin-left: 1em; margin-right: 1em; text-align: center;"><img border="0" data-original-height="524" data-original-width="645" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-wg7hjH-kqxPVGq5NYwpu0ORCT1XbxDUzKJJQVa-WAu20UIi9R-FQULahINm7OXUJrItekcikWbqJSTNJn3bJw70D6DfykfpbTPLEVYeSK22VEdb8oPA_GR10YnABk1ZgLtMy/s320/brendafran-liz.jpg" width="320" /></a></li></ul><ul style="text-align: left;"><li><span style="font-family: arial;"><span><b>Sonja Chamberlin</b>,</span> <span>BSc (MLS), MEd (Post-secondary Studies), clinical instructor in MLS, now Dean, School of Health and Public Safety at <a href="https://www.sait.ca/">SAIT</a></span></span></li><li><span style="font-family: arial;"><b>Chris Ward</b>, BSc (MLS), MEd, now Associate Professor, Faculty of Medicine & Dentistry, Dept. Lab Med & Pathol, Division of MLS, who teaches multiple transfusion science and immunology courses, plus is involved in a multidisciplinary UAlberta course. Earlier he worked in multi-discipline 'core lab' then got my job and volunteered for CSMLS on exam panel when that was allowed.<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5FsYTMDUXO_8J5A9vLFjVmcAE_fmDXkbq9R9wYartD8AxE493IlDMLVpKFscfwdTx_D27H5F35d6USdTVZdu3vIx_U8orQ2_ls6F6eluHaqzZPwbexiObjYEk0UiqHyATCVWv/s488/ET_OPZtUEAAoJHr.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="325" data-original-width="488" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5FsYTMDUXO_8J5A9vLFjVmcAE_fmDXkbq9R9wYartD8AxE493IlDMLVpKFscfwdTx_D27H5F35d6USdTVZdu3vIx_U8orQ2_ls6F6eluHaqzZPwbexiObjYEk0UiqHyATCVWv/s320/ET_OPZtUEAAoJHr.jpg" width="320" /></a></div><br /></span></li><li><span style="font-family: arial;"><b>Lisa Denesiuk</b>, BSc (MLS), ART(<a href="https://www.csmls.org/">CSMLS</a>), MT (ASCP) SBB, </span><span style="font-family: arial;">Learning management specialist at <a href="https://www.dynalife.ca/">DynaLIFE Medical Labs</a> <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqqUIV58iGT_p4L5g1jIXR0pyGFuotC1ll1Rinz2ywM5egglhAYT1EGO0O-Pc59wpzWMQ50G1haHsDWLIhZ5bQqmsWi2DDd24C4hQPfvvWT4aa5Q961AEL326L-1qHeTMJ9GAS/s336/lisaD.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="336" data-original-width="322" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqqUIV58iGT_p4L5g1jIXR0pyGFuotC1ll1Rinz2ywM5egglhAYT1EGO0O-Pc59wpzWMQ50G1haHsDWLIhZ5bQqmsWi2DDd24C4hQPfvvWT4aa5Q961AEL326L-1qHeTMJ9GAS/s320/lisaD.jpg" /></a></div><br /></span></li><li><span style="font-family: arial;"><b>Judy Wong</b>, BSc (MLS), longtime medical technologist at CBS (photo of me & Judy) Judy was one of the grads who went to work for the NZ Blood Service in the 1990s.<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7vK7SGnN7t7y7n5jFMLcfamDeZIVyp-Xa6cSzL87w7kAIicoQmuKO4J-iV3cAJCOQRbPFA5g7Yj4-nc5nvpj_sn3ginFTeNYL0k5gKP1exfSU4p5MWgajCkE03hwKow6YwM7Y/s4896/me-judyWong90.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="3672" data-original-width="4896" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7vK7SGnN7t7y7n5jFMLcfamDeZIVyp-Xa6cSzL87w7kAIicoQmuKO4J-iV3cAJCOQRbPFA5g7Yj4-nc5nvpj_sn3ginFTeNYL0k5gKP1exfSU4p5MWgajCkE03hwKow6YwM7Y/s320/me-judyWong90.jpg" width="320" /></a></div><br /></span></li><li><span style="font-family: arial;"><b>Lisa Purdy,</b> BSc (MLS), MSc (medical microbiology & immunolgy)</span></li><ul><li><span style="font-family: arial;">First non-physician, non-PhD Director of MLS;</span></li><li><span style="font-family: arial;">Assistant Dean, Graduate Student Affairs, Office of Advocacy & Wellbeing at University of Alberta<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-4ljADikayXRGgCPy1JySBtrf5nmrU5IwK6hLkZqCVtSRda11SozxfVnW6Ip3IuFC83wv5cGoHiSUbvH6wdKHBVgicxpoz6PyHMDe-ZJbHOwEnBp_KLv07H6J_4ls6pbLZWz/s4896/lisaPurdy93.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="4896" data-original-width="3672" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-4ljADikayXRGgCPy1JySBtrf5nmrU5IwK6hLkZqCVtSRda11SozxfVnW6Ip3IuFC83wv5cGoHiSUbvH6wdKHBVgicxpoz6PyHMDe-ZJbHOwEnBp_KLv07H6J_4ls6pbLZWz/s320/lisaPurdy93.JPG" /></a></div></span></li></ul></ul><span style="font-family: arial;"><b><br /></b></span><ul style="text-align: left;"><li><span style="font-family: arial;"><span><a name="halpin"><b>Anne Halpin</b></span>, BSc (MLS), MT (ASCP), MSc, Trinity College, Dublin, (Community Health/Public Health), PhD candidate UAlberta (transplant immunology);</span></li></ul><ul><li><span style="font-family: arial;">2018 Outstanding Technologist Award by the <a href="https://www.ashi-hla.org/">American Society for Histocompatibility and Immunogenetics</a></span></li><li><span style="font-family: arial;"><a href="https://utswmed.org/">UTSW Medical Center</a> (Dallas, Tx), Senior Medical Technologist</span></li><li><span style="font-family: arial;">Current position: Laboratory Scientist II, Alberta Health Services<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN7yT4QEGopWqnz9rjF1bBcphFG1c5naW3MF6iI24aajMP7Zk-A4W-hd70O6qSH3f2ds147xZal9oqyYPX_vBTQySpJQWcZn1Y6vYwosCJi5vMI7g3kqpFD98QiH1mhhco5uCK/s399/halpingal-dance.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="399" data-original-width="110" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN7yT4QEGopWqnz9rjF1bBcphFG1c5naW3MF6iI24aajMP7Zk-A4W-hd70O6qSH3f2ds147xZal9oqyYPX_vBTQySpJQWcZn1Y6vYwosCJi5vMI7g3kqpFD98QiH1mhhco5uCK/s320/halpingal-dance.jpg" /></a></div><br /> </span></li></ul><li><span style="font-family: arial;"><b>Dr. Craig Kuziemsky</b>, BSc (MLS), Bachelor of Commerce (Management Information Systems), PhD (Health Information Science); </span></li><ul><li><span style="font-family: arial;">University Research Chair in Healthcare Innovation, UOttawa; </span></li></ul><li><span style="font-family: arial;"><span>Current position: Associate Vice-President, Research, </span><a href="https://www.macewan.ca/wcm/index.htm">MacEwan University</a></span><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial;"><a href="https://www.macewan.ca/wcm/index.htm"></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi111c1wzbXdakYGkW6Nbhvlw_znW5rARWFDKJSR6bdFohnnh-9c2Ln5YDRcjAcNe2-gcmoxyMm72PmfZeGEeXij2Pcq_weRSNt_n70VdsuzV8MVTdf3KPCDC6lQJ3hXt7oGB5h/s504/craig.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="504" data-original-width="211" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi111c1wzbXdakYGkW6Nbhvlw_znW5rARWFDKJSR6bdFohnnh-9c2Ln5YDRcjAcNe2-gcmoxyMm72PmfZeGEeXij2Pcq_weRSNt_n70VdsuzV8MVTdf3KPCDC6lQJ3hXt7oGB5h/s320/craig.jpg" /></a></span></div></li><li><span style="font-family: arial;"><b>Dr. Susan Nahirniak</b>, BSc (MLS), MD +Hematopathology certification, University of Alberta; </span></li><ul><li><span style="font-family: arial;">2020 Physician of the Year for Edmonton Zone Medical Staff Association; </span></li><li><span style="font-family: arial;">Medical Director, Transfusion Medicine at Alberta Health Services;</span></li><li><span style="font-family: arial;">Section Chief/ Divisional Director for the AHS Edmonton Zone Transfusion Medicine Service;</span></li><li><span style="font-family: arial;">Deputy Clinical Department Head for Laboratory Medicine and Pathology</span></li><li><span style="font-family: arial;">Member of the Alberta Blood Office Collaborative (ABOC)</span></li><li><span style="font-family: arial;">Canada's National Advisory Committee on Blood and Blood Products (NAC) </span></li><li><span style="font-family: arial;">International Collaborative for Transfusion Medicine Guidelines (ICTMG).</span></li></ul><li><span style="font-family: arial;"><span>Photo of me & Susan </span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiV5vs0NP666_4MWV4OuQwoXjrCtjOnocs4ik5uk_S_CHiqpX1fNCS94nQEX07Um7J3ykCx2WQ5rjkzSGRZ5b74sI9U4_rQViNHQn0e5wHNHtCg4Oxqd9URtN09sAAGAe-OS23D/s342/susan-me.jpg" style="margin-left: 1em; margin-right: 1em; text-align: center;"><img border="0" data-original-height="342" data-original-width="322" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiV5vs0NP666_4MWV4OuQwoXjrCtjOnocs4ik5uk_S_CHiqpX1fNCS94nQEX07Um7J3ykCx2WQ5rjkzSGRZ5b74sI9U4_rQViNHQn0e5wHNHtCg4Oxqd9URtN09sAAGAe-OS23D/s320/susan-me.jpg" /></a></span></li><span style="font-family: arial;"><br /></span><li><span style="font-family: arial;"><b>Jodi McDonald</b>, BSc (MLS); </span></li><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><li style="text-align: left;"><span style="font-family: arial;">Quality Control Manager, <a href="https://innotechalberta.ca/">Alberta Research Council</a></span></li></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><li style="text-align: left;"><span style="font-family: arial;">Quality Control Analyst, KS Avicenna Inc.</span></li></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><li style="text-align: left;"><span style="font-family: arial;">Founder & President of <a href="https://keystonelabs.ca/">Keystone Labs Inc.</a> (2005-present) </span></li></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px; text-align: left;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7cDXpCV2UlYxYDYoadmJU_b6vCvHw9upvp12f9k1S7gyrBAGlKdutXZK4i8Rk2e4h6L66R5d-AVvGPJhDqaFrHmACY35_kpSNYrBcjsTgStvpNmkcYVm2rXr69VXGrZa9qS17/s930/jodi-mcdonald.jpg" style="margin-left: 1em; margin-right: 1em; text-align: center;"><span style="font-family: arial;"><span> </span><span> </span><span> </span><span> </span><span> </span><span> </span><span> </span><img border="0" data-original-height="930" data-original-width="491" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7cDXpCV2UlYxYDYoadmJU_b6vCvHw9upvp12f9k1S7gyrBAGlKdutXZK4i8Rk2e4h6L66R5d-AVvGPJhDqaFrHmACY35_kpSNYrBcjsTgStvpNmkcYVm2rXr69VXGrZa9qS17/s320/jodi-mcdonald.jpg" /></span></a></blockquote><div><span style="font-family: arial;"><br /></span></div><div><span style="font-family: arial;"><br /></span></div><ul style="text-align: left;"><li><span style="font-family: arial;"><b>Shelly Chamaschuk</b>, BSc (MLS), LL.B, admitted to the Alberta Bar;</span></li><li><span style="font-family: arial;">Current position: Partner at <a href="https://www.rmrf.com/">Reynolds Mirth Richards & Farmer LLP</a></span></li><li><span style="font-family: arial;">Volunteer and leadership experience:</span></li><ul><li><span style="font-family: arial;">Past President, Youth Empowerment and Support Services (YESS) Board of Directors (2003 - 2012);</span></li><li><span style="font-family: arial;">Presenter, Edmonton Community Foundation;</span></li><li><span style="font-family: arial;">Lecturer, Legal Education Society of Alberta;</span></li><li><span style="font-family: arial;">Past Presenter, Metro Continuing Education, Edmonton Public Schools.</span></li></ul><li><span style="font-family: arial;">Prior work experience:</span></li><ul><li><span style="font-family: arial;">Regional Coordinator for Edmonton's then Capital Health Authority, Department of Laboratory Medicine;</span></li><li><span style="font-family: arial;">Worked as a medical laboratory technologist in Saudi Arabia;</span></li><li><span style="font-family: arial;">Worked with a humanitarian aid project (Osvita medical project) in Kyiv, Ukraine. </span></li></ul><li><span style="font-family: arial;">Photo of me and group of Canadian medical technologists in Oslo, 1996 for a world congress. Shelly is third from the right, next to my spouse. <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifAHxr8QSb62ef-7q2zlR-0XlK1shLP9lCi1vCwURre2Xov8riMKSEfkqNqh5UslZnto9vRRK6_JCVAIuAhIJUYtJsWmtBEWuAxw6feFqPxAw5YGROE8qyb0iQWInxJNCHRN3h/s399/shellyc-oslo.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="347" data-original-width="399" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifAHxr8QSb62ef-7q2zlR-0XlK1shLP9lCi1vCwURre2Xov8riMKSEfkqNqh5UslZnto9vRRK6_JCVAIuAhIJUYtJsWmtBEWuAxw6feFqPxAw5YGROE8qyb0iQWInxJNCHRN3h/s320/shellyc-oslo.jpg" width="320" /></a></div><br /></span></li><li><span style="font-family: arial;"><span style="background-color: white;"><b>Dr. Gordon Chan</b>, BSc (MLS), PhD (medical biochemistry);</span></span></li><ul><li><span style="font-family: arial;"><span style="background-color: white;">Post-doc fellow, Fox Chase Cancer Center, Philadelphia, PA; </span></span></li><li><span style="font-family: arial;"><span style="background-color: white;">Research scientist, Cross Cancer Institute, Edmonton (2002-present);</span></span></li><li><span style="font-family: arial;"><span style="background-color: white;">Associate professor, <a href="https://www.ualberta.ca/index.html">University of Alberta</a> (2002-present)</span></span></li><li><span style="font-family: arial;"><span style="background-color: white;"><a href="http://www.graduate-studies-in-cancer-research.org/chanlab/ChanLab.htm">Chan laboratory website</a> </span></span></li></ul></ul><span style="font-family: arial;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNWrgmmhDRdkJNX79A7f8SIDUZo_pB6yyvnzBuH3Du0VFzhb-r4TwkBHBzQ9sJvRGw8p092EhdfdmIljTtQH8GLJuoWmPljgnPI-wr16OMF4tSzds1dbdkPTJATbXZkenilHrA/s427/gordon-chan.jpg" style="background-color: white; margin-left: 1em; margin-right: 1em; text-align: center;"><img border="0" data-original-height="427" data-original-width="227" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNWrgmmhDRdkJNX79A7f8SIDUZo_pB6yyvnzBuH3Du0VFzhb-r4TwkBHBzQ9sJvRGw8p092EhdfdmIljTtQH8GLJuoWmPljgnPI-wr16OMF4tSzds1dbdkPTJATbXZkenilHrA/s320/gordon-chan.jpg" /></a><br /><span><div style="text-align: left;"><ul li="" style="text-align: left;"><li><b>Roberta Martindale</b>, BSc (MLS), MT(ASCP), MEd (Adult education) Work history:</li><ul><li>Clinical Labs of Hawaii</li><li>University of Alberta, Faculty of Medicine & Dentistry, Dept. Lab Med
& Pathol, Division of MLS - MLS instructor (Clinical Chemistry)</li><li>Current positions: Associate Professor and MLS Program Coordinator, University of Alberta, Division
of MLS </li><ul><li>Instructing in Histology, Foundations of Instrumentation and Laboratory
Management</li></ul></ul></ul><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjM0K0L9oEP5oBLSuc4tVaLU58hNyEXFFwGOcFr_I-Rv3hJtzNVfba09Qt4wfT6_uOxyigaRgVzJVD0RGklKovzQ-0e-nDkDhK9e0FNuQpElA1UwtuKGNYMmAhlHE_V0_xgN2nm/s432/roberta-teaching.jpg" style="margin-left: 1em; margin-right: 1em; text-align: center;"><span> </span><span> </span><span> </span><span> <span> </span><span> </span><span> </span><span> </span><span> </span><span> </span><span> </span></span><img border="0" data-original-height="415" data-original-width="432" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjM0K0L9oEP5oBLSuc4tVaLU58hNyEXFFwGOcFr_I-Rv3hJtzNVfba09Qt4wfT6_uOxyigaRgVzJVD0RGklKovzQ-0e-nDkDhK9e0FNuQpElA1UwtuKGNYMmAhlHE_V0_xgN2nm/s320/roberta-teaching.jpg" width="320" /></a></div></span><span><b><br /></b></span></span><li><span style="background-color: white; font-family: arial;"><b>Darcy Fortier</b>, BSc (MLS), MT (ASCP) Work history: </span></li><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><li style="text-align: left;"><span style="font-family: arial;">Medical Technologist, Associated Pathologist Laboratories </span></li></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><li style="text-align: left;"><span style="font-family: arial;">Implementation Specialist, Sunquest Information Systems</span></li></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><li style="text-align: left;"><span style="font-family: arial;">Implementation Specialist, Misys Healthcare Systems</span></li></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><li style="text-align: left;"><span style="font-family: arial;">Business Systems Advisor, Dell Services/NTT DATA Services </span></li></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><li style="text-align: left;"><span style="font-family: arial;">Current position: Sr. Business Analyst - LIS at Verity Health System</span></li><li style="text-align: left;"><span style="font-family: arial;"><span style="background-color: white;">Enterprise Application Administrator III, MultiCare Health System</span> </span></li></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"></blockquote><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px;"><blockquote style="border: none; margin: 0px 0px 0px 40px; padding: 0px; text-align: center;"><span style="font-family: arial;"><span style="background-color: white;"> </span><img border="0" data-original-height="511" data-original-width="512" height="149" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiA2FOM3cBVVyufkaA1SE0ADDoF-RDWfymY4sYkGuWWdM6CqaVNdwgCCKNBPUC_KPa1bx541OKab9XOWjlvwYYOxisbUFMcN5wA8Yhyaf1Mz2apHpY3-0JJF1uk58OUhIRbUVJi/w150-h149/darcy-f.jpg" style="background-color: white; text-align: center;" width="150" /></span></blockquote></blockquote></blockquote><div><span style="background-color: white; font-family: arial;"><br /></span></div><span style="background-color: white; font-family: arial;"><div><span style="font-family: arial;"><br /></span></div>Stay tuned</span><span style="font-family: arial;">...more graduates to come.</span><div><p><span style="font-family: arial;">As always comments are most welcome and there are some.</span></p><p><span style="font-family: arial;"><b>Addendum</b>: Please see my latest blog, which is related to this one: <a href="https://traq.blogspot.com/2021/01/i-will-remember-you-musings-on-1991.html">I will remember you</a> (Musings on a 1991 graduation speech)</span></p><p><span style="color: #0b5394; font-family: arial;"><b>FOR FUN</b></span></p><p></p><ul style="text-align: left;"><li><span style="font-family: arial;"><a href="https://youtu.be/1-7yeVQFegE">Sweet dreams are made of this</a> (Annie Lennox, Hyde Park, London: Live 8, 2005)</span></li></ul><div><b style="color: #0b5394;"><span style="font-family: arial;">FURTHER READING</span></b></div><div><ul style="text-align: left;"><li><span class="css-901oao css-16my406 r-poiln3 r-bcqeeo r-qvutc0" style="background-color: rgba(0, 0, 0, 0.03); border: 0px solid black; box-sizing: border-box; color: #0f1419; display: inline; font-family: arial; font-size: 15px; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: inherit; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><a href="http://patletendre.com/orighealthcare">Lab restructuring</a></span></li><li><span style="font-family: arial;"><span class="css-901oao css-16my406 r-poiln3 r-bcqeeo r-qvutc0" face="-apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Helvetica, Arial, sans-serif" style="background-color: rgba(0, 0, 0, 0.03); border: 0px solid black; box-sizing: border-box; color: #0f1419; display: inline; font-size: 15px; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: inherit; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span><a href="http://patletendre.com/healthnews.html">General HC restructuring</a> under Premier <span class="css-901oao css-16my406 r-poiln3 r-b88u0q r-bcqeeo r-qvutc0" style="border: 0px solid black; box-sizing: border-box; display: inline; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: inherit; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px;">Klein</span></span><span class="css-901oao css-16my406 r-poiln3 r-bcqeeo r-qvutc0" style="border: 0px solid black; box-sizing: border-box; display: inline; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: inherit; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px;">
</span>
</span><a class="css-4rbku5 css-18t94o4 css-901oao css-16my406 r-1n1174f r-1loqt21 r-poiln3 r-bcqeeo r-qvutc0" data-focusable="true" dir="ltr" href="https://t.co/ifmahdSvGt?amp=1" rel="noopener noreferrer" role="link" style="background-color: rgba(0, 0, 0, 0.03); border: 0px solid black; box-sizing: border-box; color: #1b95e0; cursor: pointer; display: inline; font-size: 15px; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: inherit; list-style: none; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; text-decoration-line: none; white-space: pre-wrap;" target="_blank"><span aria-hidden="true" class="css-901oao css-16my406 r-poiln3 r-hiw28u r-bcqeeo r-qvutc0" color="inherit" style="border: 0px solid black; box-sizing: border-box; display: inline; font-size: 0px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: inherit;">.html</span></a></span></li></ul></div><p></p></div>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com6tag:blogger.com,1999:blog-8729772.post-83332515947615607382020-08-31T17:33:00.006-06:002020-09-03T11:03:54.803-06:00Revolution (More musings on using artificial intelligence in transfusion medicine)<p style="text-align: center;"><span style="font-family: arial;"><i>Updated</i>:<span style="background-color: #fff2cc;"> 3 Sept. 2020 </span>(Added to Learning Point)</span></p><p><span style="font-family: arial;">August's blog will discuss the issue of artificial intelligence (AI) & 'big data' in medicine and health.</span></p><p><span style="font-family: arial;">The idea for the blog was stimulated by a fascinating article in The Economist of June 13-19 as part of its Technology Quarterly: 'Driverless cars illustrate the limits of today's AI.' (Further Reading)</span></p><p><span style="font-family: arial;">The blog's title derives from a 1968 ditty by the Beatles written by John Lennon</span></p><p><span style="color: #0b5394; font-family: arial;"><b>LIMITATIONS OF AI</b></span></p><span style="font-family: arial;">According to The Economist article, the following are some of AI's current limitations that I've chosen to highlight. Yes they relate to self-driving cars but most have broad applicability relevant to medicine:</span><p><span style="font-family: arial;">1. Self-driving cars work similar to other applications of machine learning. Computers crunch huge piles of data to extract general rules, and in theory the more data, the better the systems perform. </span></p><p><span style="font-family: arial;">But deep-learning is statistical, linking inputs to outputs in ways specified by training data. That leaves them unable to cope with “edge cases” unusual circumstances that are not common in those training data.</span></p><p></p><ul style="text-align: left;"><li><span style="font-family: arial;">You can imagine if this applies to driving cars how much it can apply to the complexities of human beings, their health, symptoms, medical needs, etc. Humans can cope with oddities much better than AI, which in some ways works with only half a brain. </span></li></ul><p></p><p><span style="font-family: arial;">2. Google’s “Translate” often does a decent job at translating between languages. But in 2018 researchers noticed that, when asked to translate 18 repetitions of the word “dog” into a language spoken in parts of Nigeria and Benin and back into English, it came up with the following hilarious translations:</span></p><p></p><ul style="text-align: left;"><li><span style="font-family: arial;">“Doomsday Clock is at three minutes to twelve. We are experiencing characters and dramatic developments in the world, which indicate that we are increasingly approaching the end times and Jesus’ return.” </span></li><li><span style="font-family: arial;">Fact: Google’s system doesn't understand language because concepts like verbs and nouns are alien. It's constructed using statistical rules linking strings of letters in one language with strings of letters in another and is baffled by questions a toddler would find trivial. </span></li></ul><p></p><p><span style="font-family: arial;">3. Richard Sutton, AI researcher at the University of Alberta and DeepMind, published “The Bitter Lesson” (Further Reading) arguing that AI history shows that attempts to build human understanding into computers rarely work. The “bitter lesson” is that “the actual contents of [human] minds are tremendously, irredeemably complex…They are not what should be built in [to machines].” </span></p><p><span style="font-family: arial;">Christopher Manning of Stanford University’s AI Lab notes that biological brains learn from far richer data-sets than machines. </span></p><p><span style="font-family: arial;">4. About Big Data, which makes AI possible, see 'Big Data in Healthcare' (Further Reading). The conclusion: 'While big data provides great potential for improving healthcare delivery, it is essential that we consider the individual, social and organizational contexts of data use when implementing big data solutions.' Personal note: </span></p><p><span style="font-family: arial;">* <a href="https://www.researchgate.net/profile/Craig_Kuziemsky/" target="_blank">The lead author</a> </span><span style="font-family: arial;">is one of my UAlberta Med Lab Science 'kids'. </span></p><p><span style="color: #0b5394; font-family: arial;"><b>LEARNING POINT</b></span></p><p><span style="font-family: arial;">AI has a long way to go before it can be safely used in self-driven cars. Despite the hype, AI has an even longer road to travel before it's as safe and reliable as human health care professionals. Feel free to disagree. </span></p><p><span style="font-family: arial;">The entire Technical Quarterly in </span><span style="font-family: arial;">The Economist, June 13-19, 2020 deals with AI and its limits. As its many proponents hype AI and Big Data, it's prudent to show their limitations too. Included articles:</span></p><p></p><ol style="text-align: left;"><li><span style="font-family: arial;">Reality check: </span><i style="font-family: arial;">After yrs of hype,an understanding of AI's limitations is beginning to set in</i></li><li><span style="font-family: arial;">Data - Not So Big: <i>Data can be scarcer than you think and full of traps</i></span></li><li><span style="font-family: arial;">Brain Scan | An AI for an eye: <i>Pioneering ophthalmologist highlights the potential, and the pitfalls, of medical AI</i></span></li><li><span style="font-family: arial;">Computing Hardware | Machine Learning: <i>The cost of training machines is becoming a problem</i></span></li><li><span style="font-family: arial;">Road Block: <i>Driverless cars illustrate the limits of today's AI</i></span></li><li><span style="font-family: arial;">The Future | Autumn is coming: <i>As AI's limits become apparent, humans will add more</i></span></li></ol><p></p><p><span style="font-family: arial;"><b style="background-color: #fff2cc;">Note</b>: If you don't subscribe to The Economist, perhaps take a trial one? Or check if your hospital is affiliated with a university, college (or perhaps the public library) has it available.</span></p><p><span style="font-family: arial;">As always, comments are most welcome. And there are some.</span></p><p><span style="color: #0b5394; font-family: arial;"><b>FOR FUN</b></span></p><p><span style="font-family: arial;">I chose this song because pretty much everyone has hopped on Big Data and AI bandwagons as if they're a revolution that's going to sweep traditional medicine aside. Maybe but I suspect not for years.</span></p><p></p><ul style="text-align: left;"><li><span style="font-family: arial;"><a href="https://youtu.be/BGLGzRXY5Bw">Revolution</a> (by the Beatles)</span></li></ul><p></p><p><span style="color: #0b5394; font-family: arial;"><b>FURTHER READING</b></span></p><p><span style="font-family: arial;"><a href="https://www.economist.com/technology-quarterly/2020/06/11/driverless-cars-show-the-limits-of-todays-ai " target="_blank">Driverless cars illustrate the limits of today's AI</a> - They, and many other such systems, still struggle to handle the unexpected (The Economist, June 13-19, 2020) </span></p><p><span style="font-family: arial;">Prior AI blog (30 Nov. 2019): <a href="https://traq.blogspot.com/2019/11/i-can-see-clearly-now-musings-on-using.html " target="_blank">I can see clearly now</a> (Musings on using artificial intelligence in transfusion medicine)</span></p><p><span style="font-family: arial;"><a href="http://www.incompleteideas.net/IncIdeas/BitterLesson.html " target="_blank">The Bitter Lesson</a> by Rich Sutton (19 Mar. 2019)</span></p><p><span style="font-family: arial;"><a href="https://apps.ualberta.ca/directory/person/rsutton " target="_blank">Rich Sutton, University of Alberta</a> | </span><span style="font-family: arial;">Also see this <a href="http://incompleteideas.net/ " target="_blank">bio</a></span></p><p><span style="font-family: arial;">Kuziemsky CE, Monkman H, Petersen C, et al. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287094/ " target="_blank">Big Data in Healthcare</a> - Defining the digital persona through user contexts from the micro to the macro. Contribution of the IMIA Organizational and Social Issues WG. Yearb Med Inform. 2014;9(1):82-9. Published 2014 Aug 15. </span></p>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-83515532324318050412020-07-31T18:21:00.002-06:002020-09-26T14:33:02.858-06:00I heard it through the grapevine-2 (Musings on the value of Twitter)<span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif">In 2019 I wrote a blog promoting Twitter for TM professionals and for July's blog, I'll do a second one.</span><br />
<span face=""arial" , "helvetica" , sans-serif">The blog's title derives from</span><span face=""arial" , "helvetica" , sans-serif"> 1966 ditty recorded by Marvin Gaye and later Creedence Clearwater Revival. </span><br />
<span face=""arial" , "helvetica" , sans-serif"><br /></span>
<span face=""arial" , "helvetica" , sans-serif" style="color: #0b5394;"><b>INTRODUCTION</b></span><br />
<span face=""arial" , "helvetica" , sans-serif">To me far too few transfusion professionals are on Twitter, including medical laboratory technologists, nurses, and physicians. Many reasons, including Facebook preceded Twitter and Twitter tends to have a poor reputation in general. Today Facebook has an even worse reputation but if you're on it, you may value how it keeps you in touch with pals and family. </span><br />
<span face=""arial" , "helvetica" , sans-serif"><br /></span>
<span face=""arial" , "helvetica" , sans-serif">In my experience TM folks on Twitter are a different breed. They want to share resources and expertise and, if you want to engage in continuing professionals education, Twitter is a wonderful free resource. Questions can be asked and answered by experts. Also Twitter is international. Based on my <oldbloodbanker> Twitter account (Further Reading), experts from Australia, Canada, UK, USA, and professionals from many nations in Africa and Asia participate. Glad to report that some Canadian medical laboratory technologists are on Twitter.</oldbloodbanker></span><br />
<span face=""arial" , "helvetica" , sans-serif"><b><span style="color: #0b5394;"><br /></span></b></span>
<span face=""arial" , "helvetica" , sans-serif"><b><span style="color: #0b5394;">UNDERSTANDING TWITTER</span></b> (from earlier blog)</span><br />
<span face=""arial" , "helvetica" , sans-serif">First, <a href="https://help.twitter.com/en/using-twitter/create-twitter-account">Signing up on Twitter is easy </a></span><br />
<span face=""arial" , "helvetica" , sans-serif"><b>Tidbits </b>(Twitter 101)<b>:</b></span><br />
</span><ul>
<li><span style="font-family: arial;">Language: Twitter is the software platform. You are a tweep. When you post a message, it's called a tweet. </span></li>
<li><span style="font-family: arial;">If not on Twitter when accessing a tweet and asked to join, just click on another part of the screen and you can see direct tweets. </span></li>
<li><span style="font-family: arial;">Be aware you don't need to tweet. Just as on mailing lists, you can lurk. </span></li>
<li><span style="font-family: arial;">By being on Twitter you can see the replies given by tweeps to other tweeps. If not, you can see only their direct tweets (not replies). </span></li>
<li><span style="font-family: arial;">Twitter gives you quicker access to important professional events and issues, allows you to share resources with colleagues. </span></li>
<li><span style="font-family: arial;">As a citizen Twitter is the place to be because you get news about anything well before it appears on mainstream media, e.g., disasters, latest weather, political events. All media and reporters are on Twitter.</span></li>
<li><span style="font-family: arial;">Twitter hashtags are key (Further Reading) For example, they can be used to identify who to follow. And you can also see who others follow for more suggestions.</span></li>
</ul>
<span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif"><b>Learning Point</b>: If you are a transfusion professional in any capacity, please consider joining Twitter. You won't be disappointed. Look at my account to see who I follow, many transfusion experts from all over the world, well known experts.</span><br />
<span face=""arial" , "helvetica" , sans-serif"><br /></span>
<span face=""arial" , "helvetica" , sans-serif">As always, comments are most welcome.</span><br />
<span face=""arial" , "helvetica" , sans-serif"><br /></span><span face=""arial" , "helvetica" , sans-serif"><b style="color: #0b5394;">FOR FUN</b></span><br />
<span face=""arial" , "helvetica" , sans-serif">Chose this ditty because Twitter is a good grapevine to keep up with the latest transfusion medicine news.</span><br />
</span><ul>
<li><span style="font-family: arial;"><a href="https://www.youtube.com/watch?v=wCCfc2vAuDU">I Heard it Through The Grapevine</a> (CCR)</span></li>
<li><span style="font-family: arial;"><a href="https://youtu.be/Y7dGdrP3pms?t=104">I Heard it through the Grapevine</a> (Marvin Gaye, live at Montreux) </span></li>
</ul>
<span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="color: #0b5394;"><b>FURTHER READING</b></span></span><ul>
<li><span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #333333;">Gardner JM, McKee PH. </span><a href="https://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2018-0431-ED" style="background-color: white; color: maroon;">Social media use for pathologists of all ages</a><span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #333333;">. Arch Pathol Lab Med. 2019 Mar;143(3):282-6.</span></span></li><li><span style="font-family: arial;"><a href="https://help.twitter.com/en/using-twitter/how-to-use-hashtags">Twitter hashtags</a><span face=""arial" , "helvetica" , sans-serif"> (one pertinent to this blog is #transfusion)</span></span></li>
<li><span style="font-family: arial;">My current transfusion-related Twitter account:<a href="https://twitter.com/oldbloodbanker"> @oldbloodbanker </a></span></li>
</ul>
Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-46295742420231961872020-06-30T19:15:00.001-06:002020-09-05T12:44:27.190-06:00You never give me your money (Musings on paying to develop COVID-19 vaccine)<div style="text-align: center;">
<span face=""><i>Updated</i>: <span style="background-color: #fff2cc;">1 July 2020</span></span></div>
<span face="">What to blog about when COVID-19 dominates the news, whether it's research funding, impact on blood supplies, paid plasma proponents, testing, treatments, vaccines? Plus, of course, government guidelines and measures to prevent the spread of coronavirus while opening up the economy. <br /><br />
Finally decided that June's blog should discuss the question of who pays to develop COVID-19 vaccine and who gets priority once it exists, including which countries worldwide and, within countries like the USA without universal healthcare, will all be able to afford it.<br /><br />
The blog's title derives from a 1969 ditty by the Beatles.<br /><br /><b><span style="color: #0b5394;">
INTRODUCTION</span></b><br />
Governments worldwide have invested billions into developing a coronavirus vaccine, some given to university researchers, some to Big Pharma. There are reports that if a vaccine is developed inside a nation, that country will have priority access to the vaccine. <br /><br />
If COVID-19 has taught us anything it's that supply chains for crucial medical equipment like food, PPE and drugs must be secured and the best way is to produce them in the country, if possible. There are even reports of France and Germany accusing USA of diverting medical supplies like masks and that president Trump asked mask maker 3M not to supply masks and more to Canada and Latin America. Trump also bought up almost all stocks of Remdesivir, a drug used to treat coronavirus. (Further Reading)<br /><br />
Plus the world is experiencing infighting and global politics at its worst: <br />
At G20 meeting of health ministers the intent was to strengthen WHO's mandate to coordinate fight against COVID-19 with a major focus on the process of crafting international agreements on any drugs or vaccines that successfully treat COVID-19. U.S. was the only country opposed to a statement that offered a framework for a united approach to fighting the pandemic and stopped funding WHO. (Further Reading)<br /><br /><b><span style="color: #0b5394;">
HISTORY</span></b><br />
The past has shown that poor developing nations don't have access to drugs that we in the industrialized world take for granted. Examples:</span><br />
<blockquote class="tr_bq">
<span face="">
For the vast majority of the 325 million people living with hepatitis B or C, accessing testing and treatment remains beyond reach (Further Reading).</span></blockquote>
<blockquote class="tr_bq">
<span face="">Without charitable donations by Big Pharma, for ages more than 75% of folks in developing world with hemophilia had little or no access to diagnosis and treatment. Those with severe hemophilia often did not survive to adulthood or, if they did, faced a life of severe disability and chronic pain (Further Reading).</span></blockquote>
<span face=""><b>
Learning Points</b>: If history repeats itself, COVID-19 will follow similar path. Folks in poor nations will be last to get the vaccine and treatments. And nations like USA whose POTUS puts America first, will try to gobble up most, leading to worldwide inequality in life-saving treatments. All at a time when the world needs to come together to fight a pandemic. </span><div><span face=""><br /></span></div><div><span face="">As always, comments are most welcome and there are some.<br /><br /><b><span style="color: #0b5394;">
FOR FUN</span></b><br />
First song I chose for the blog:</span><br />
<ul><span face="">
<li><span face=""><a href="https://youtu.be/BpndGZ71yww">You never give me your money</a> (1969 song by the Beatles)</span></li>
</span></ul>
<span face="">
Back-up song you may enjoy is 'Money' from 1972's Cabaret film.</span><br />
<ul>
<li><span face=""><a href="https://youtu.be/I8P80A8vy9I">Money </a>(by Lisa Minneli & Joel Grey)</span></li>
</ul>
<span face=""><b><span style="color: #0b5394;">FURTHER READING</span></b><br /><i>
Listed by date of news report</i><br /><br /><a href="https://www.huffingtonpost.in/entry/remdesivir-donald-trump-buys-up-almost-all-stocks_in_5efc990cc5b6acab2849b8a9">Trump buys up almost all stocks of Remdesivir, a drug used to treat coronavirus</a> (1 July 2020)</span><br />
<span face=""><br /></span>
<span face=""><a href="https://www.marketwatch.com/story/big-pharma-is-taking-big-money-from-us-taxpayers-to-find-a-coronavirus-vaccine-and-charge-whatever-they-want-for-it-2020-06-24">Big pharma is taking big money from U.S. taxpayers to find a coronavirus vaccine and charge whatever they want for it</a> (24 June 2020)<br /><br /><a href="https://www.dw.com/en/will-coronavirus-pandemic-change-big-pharmas-long-term-focus/a-53807139">Will coronavirus pandemic change Big Pharma's long-term focus?</a> (15 June 2020) <br /><br /><a href="https://stockhouse.com/news/press-releases/2020/06/14/sanofi-and-sobi-donate-up-to-500-million-additional-ius-of-clotting-factor-to">Sanofi and Sobi donate up to 500 million additional IUs of clotting factor to WFH Humanitarian Aid Program</a> (14 June 2020)<br /><br /><a href="https://www.mercurynews.com/2020/04/23/editorial-vaccine-production/">U.S. must stop blocking global effort to fight COVID-19</a> (23 Apr. 2020)<br /><br /><a href="https://www.fiercebiotech.com/biotech/big-pharma-want-billions-more-for-covid-19-pot-remind-gov-t-not-to-forget-them-post">Big Pharma wants billions more for COVID-19 funding pot</a> (21 Apr. 2020)<br /><br /><a href="https://www.npr.org/2020/04/04/827321294/german-french-officials-accuse-u-s-of-diverting-supplies">German, French officials accuse U.S. of diverting supplies</a> (4 Apr. 2020)<br /><br /><a href="https://www.who.int/news-room/detail/26-07-2019-who-urges-countries-to-invest-in-eliminating-hepatitis">WHO urges countries to invest in eliminating hepatitis</a> (26 July 2019)</span></div>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-70922745474839372802020-05-31T17:32:00.000-06:002020-05-31T18:03:27.642-06:00For the times they are a-changing (Musings on COVID-19 global news)<div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;">Stay tuned: Revisions are sure to come</span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;">What to write about during COVID-19? It initially stumped me. Possibilities I considered include how coronavirus has impacted the blood supply worldwide and increased pressure from paid plasma advocates to promote paying for all plasma and other body tissues. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Finally settled on a mini-survey of coronavirus news featured in May's TraQ's newsletter to see what, if anything, that might reveal..</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The blog's title is based on a 1965 ditty by Bob Dylan, and yes, it can be read many ways given the news.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>INTRODUCTION</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">The mini-survey is based on news items I selectively collated for TraQ's newsletter during March, April, and May 2020. As past blogs will show, the blogs are mine alone and reflect my personal biases. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">For May's blog I arbitrarily organized COVID-19 news items into four topics, which have some overlap:</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">General (Information, industry news, search for treatments and vaccines)</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Blood supply (Risk of shortages)</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Convalescent plasma</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Journal articles</span></li>
</ul>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>SUMMARY </b></span><br />
<span style="font-family: "arial" , "helveti ca" , sans-serif;"><span style="font-family: "arial" , "helvetica" , sans-serif;">R</span>esults of TraQ's March to May survey:</span><br />
<table border="1" style="width: 60%;">
<tbody>
<tr>
<td style="text-align: center;"><div style="text-align: center;">
<div style="text-align: left;">
<span style="font-family: "arial" , "helvetica" , sans-serif; text-align: start;">TOPIC </span><span style="font-family: "arial" , "helvetica" , sans-serif; white-space: pre;"> </span></div>
</div>
</td>
<td style="text-align: center;"><div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif; text-align: start;">MAR.</span></div>
</td>
<td style="text-align: center;"><div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif; text-align: start;">APR.</span></div>
</td>
<td style="text-align: center;"><div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif; text-align: start;">APR.</span></div>
</td>
<td style="text-align: center;">TOTAL</td>
</tr>
<tr>
<td style="text-align: center;"><div style="text-align: center;">
<div style="text-align: left;">
<span style="font-family: "arial" , "helvetica" , sans-serif; text-align: start;">General </span><span style="font-family: "arial" , "helvetica" , sans-serif; white-space: pre;"> </span></div>
</div>
</td>
<td style="text-align: center;">0</td>
<td style="text-align: center;"><div style="text-align: center;">
13</div>
</td>
<td style="text-align: center;"><div style="text-align: center;">
8</div>
</td>
<td style="text-align: center;"><div style="text-align: center;">
21</div>
</td>
</tr>
<tr>
<td style="text-align: center;"><div style="text-align: center;">
<div style="text-align: left;">
<span style="font-family: "arial" , "helvetica" , sans-serif;">Blood supply</span></div>
</div>
</td>
<td style="text-align: center;">6</td>
<td style="text-align: center;">3</td>
<td style="text-align: center;">4</td>
<td style="text-align: center;">13</td>
</tr>
<tr>
<td style="text-align: center;"><div style="text-align: center;">
<div style="text-align: left;">
<span style="font-family: "arial" , "helvetica" , sans-serif;">Convalescent plasma</span><span style="font-family: "arial" , "helvetica" , sans-serif; white-space: pre;"> </span></div>
</div>
</td>
<td style="text-align: center;">6</td>
<td style="text-align: center;">14</td>
<td style="text-align: center;">7</td>
<td style="text-align: center;">27</td>
</tr>
<tr>
<td style="text-align: center;"><div style="text-align: center;">
<div style="text-align: left;">
<span style="font-family: "arial" , "helvetica" , sans-serif;">Journal articles</span></div>
</div>
</td>
<td style="text-align: center;">0</td>
<td style="text-align: center;">23</td>
<td style="text-align: center;">15</td><td style="text-align: center;">38</td>
</tr>
</tbody></table>
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>Limitations</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">I could have calculated results incorrectly. My search alerts may not have identified all possible news items in each category. Also, in May the number of convalescent plasma news items soared and I decided not to include many in the newsletter, as they often involved only a few people and were repetitive of earlier news. It's possible I haven't yet been alerted to the existence of more COVID-19 research articles published in May. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>LEARNING POINTS</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">So, as I recall from the 1966 film Alfie, it's time to ask, 'What's it all about Alfie?' Or as I once told my Med Lab Sci students, you should try to identify the 'so what' message of research papers. So too should blogs have a point. </span><span style="font-family: "arial" , "helvetica" , sans-serif;">My biased musings on the results</span>:<br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">So much money is being poured into research for a vaccine and improved COVID-19 testing. It's a race to get there first among nations, including to have the vaccine manufactured in a country, as presumably that would give priority access to its citizens. </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Seems a rush to strike gold first. Potential for industrialized nation to get priority access and developing nations to be left out as often is the case. Think of recombinant FVIII being unavailable for ages in developing nations. Also countries like India where blood banks still use ELISA to test for HIV, Hepatitis B and C, rather than NAT.</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Convalescent plasma is the flavour of the year of COVID-19. Results look promising but final results not in yet. More troubling is the notion that having antibodies allows you to return to work as you are protected. But scientists don't know yet whether people who've been exposed will be immune for life, as for measles, or if COVID-19 can return again and again, like the common cold. </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Big Pharma wants mega-money up front to fund COVID-19 research (Further Reading). Quote from article:</span></li>
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><i>Particular concern over poorer countries’ access to medical supplies was highlighted by G20 health ministers’ failure at the weekend to issue a declaration of solidarity after this was blocked by the US</i>. </span></li>
</ul>
</ul>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FOR FUN</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">I chose this Bob Dylan song as it reflects what's called the 'new normal' during COVID-19 and also reflects the current protests happening in the USA over the killing of a black man by a police officer. Somehow I suspect, with zero evidence, that the protests may be stronger and more widespread because of the coronavirus lockdown. Or perhaps because murder of black people by police has become all too common in America?</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Chose Joan Baez to sing it for several reasons, the most important being she has a much better voice than Dylan. Also this version has the song's lyrics. Tidbit: Joan and Bob were once an item (Further Reading).</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://youtu.be/n8xJ43QtfSY">For the times they are a-changing</a> (Joan Baez)</span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">As always comments are most welcome.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FURTHER READING</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">TraQ's newsletters</span><br />
<ul>
<li><a href="https://www.traqprogram.ca/index.php/news/monthly-newsletter/790-monthly-newsletter-march-2020" style="font-family: Arial, Helvetica, sans-serif;">March</a></li>
<li><a href="https://www.traqprogram.ca/index.php/news/monthly-newsletter/793-monthly-newsletter-april-2020"><span style="font-family: "arial" , "helvetica" , sans-serif;">April</span></a></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.traqprogram.ca/index.php/news/monthly-newsletter/796-monthly-newsletter-may-2020">May</a></span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.ft.com/content/000a129e-780e-11ea-bd25-7fd923850377" style="background-color: white; color: maroon; text-decoration-line: none;">Big Pharma calls for ‘billions’ in upfront coronavirus funding</a><span style="background-color: white; color: #333333;"> (20 Apr. 2020)</span></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: white; color: #333333; font-family: "helvetica neue" , "helvetica" , "arial" , sans-serif; font-size: 14px;"><br /></span></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.thestar.com/entertainment/movies/2009/09/21/joan_baez_gets_her_apology.html">Joan Baez finally gets her public apology from Dylan</a> (21 Sept. 2009)</span>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-71825951219758429542020-04-30T15:55:00.002-06:002020-09-08T14:21:01.384-06:00Could I have this dance (Musings on a love affair with transfusion medicine for NMLW)<div style="text-align: center;">
<span face="" style="font-family: arial;"><i>Updated</i>: 3<span style="background-color: #fff2cc;"> May 2020</span><span style="background-color: white;"> (Fixed typos) </span></span></div>
<span style="font-family: arial;"><span face=""><br /></span>
<span face="" style="color: #0b5394;"><b style="background-color: #fff2cc;">INTRODUCTION</b></span><br />
<span face="">Because it's National Medical Laboratory Week, for April's blog I'll share brief anecdotes from the labs of the blood suppliers and transfusion services I've worked for, including when an educator. These are the personal anecdotes of an oldster and I hope that some of them give a chuckle, albeit a wry one.</span><br />
<span face=""><br /></span>
<span face="">Keep in mind that I last had a real job working in a clinical laboratory 20 years ago. But I taught many students who still work and we keep in touch. Plus I manage a transfusion mailing list for the <a href="http://www.transfusion.ca/">Canadian Society for Transfusion Medicine</a> and an educational transfusion website, so keep up-to-date in the field.</span><br />
<br />
<span face="">The blog's title is based on a 1980 ditty by Canada's Anne Murray, and yes, it's an allegory for what I want to convey in this blog.</span><br />
<span face=""><br /></span>
<span face=""><b><span style="color: #0b5394;">1. CRC-BTS </span></b>[Canadian Red Cross Blood Transfusion Service] </span><br />
<span face="">CRC-BTS in Winnipeg, MB, Canada is where I began my career in 1964. It was a combined blood donor centre and central transfusion service for the city and outlying areas of Manitoba and northwest Ontario. In those days Winnipeg hospitals did not have blood banks per se but functioned merely as distribution centres of blood, whose 'blood banks' were managed by hospital RNs. </span><br />
<span face=""><br /></span>
<span face="">As I've written before, today I would never be hired as I had a general BSc (not when hired, though), and no med lab training. My knowledge of blood was close to nil. Nonetheless, CRC-BTS became my family for 13 years and I thrived. <span style="background-color: #fff2cc;">Fact is, I loved coming to work each day as I never knew what it would entail and what else I'd learn.</span></span><br />
<span face=""><br /></span>
<span face="">I decided to read the current immunohematology bibles (textbooks and journals) and eventually wrote the <a href="https://www.csmls.org/">CSMLS </a>(then CSLT) subject exam in immunohematology (now transfusion science), which no longer exists as a subject exam. </span><br />
<span face=""><br /></span>
<span face="">Tidbit: As a subject blood banker, I'm a dinosaur who no longer exists in Canada. At one point I took offense when the then CSLT President said those with subject certification were only good for chopping liver. Think I wrote a letter to the Society's newsletter in rebuttal. </span><br />
<span face=""><br /></span>
<span face="">Then I became the clinical instructor for med lab students from Red River Community College (now Red River College), new CRC-BTS lab staff, and any trainee physicians who wanted to learn about the transfusion service. </span><br />
<span face=""><br /></span>
<span face="">Teaching was a natural as after the science faculty, I took a short session in the Faculty of Education and taught high school in rural Manitoba for a year. Yes, the school I taught in was so desperate for teachers they took someone without a BSc and 3 months education training. Main subjects taught were chemistry and maths but many more as it was a 4-room high school. </span><br />
<span face=""><br /></span>
<span face="">Same with CRC-BTS, they hired me without a BSc (I'd goofed off and failed physics in my first year). Eventually after 3 years, management pressed me to get the BSc and I obliged with a night course in what I recall as the 'new algebra'. </span><br />
<span face=""><br /></span>
<span face=""><b>Anecdote #1 </b></span><br />
<span face="">There were no SOPs at CRC-BTS, and before I became the clinical instructor, what students and new hires learned depended on which technologist trained them on-the-job. You can imagine what fun that was for trainees. Today, med lab training is based on competencies and students are evaluated daily, but not then. </span><br />
<span face=""><br /></span>
<span face="">Finally, I decided to write SOPs for the transfusion service (TS) part of the operation on my holidays at a local lakeside cabin. Whatever possessed me? This was before I became the clinical instructor. <span style="background-color: #d9ead3;">So why did I do it?</span> Lo and behold, the crossmatch lab used the SOPs I'd written. The SOPs weren't validated, we were in a wild west world where anything goes. </span><br />
<span face=""><br /></span>
<span face=""><b>Anecdote #2</b></span><br />
<span face="">At one point a new hire with a general BSc had a disability that included having deformed hands. She could do all laboratory tasks well (TS wasn't automated and everything was done by manually pipetting) but when it came to her compulsory medical done a few months into the job, the physician said she could not do the job and should be let go. </span><br />
<span face=""><br /></span>
<span face="">After I spoke to other medical lab technologists, we unanimously agreed that we should all sign a letter to management saying she could do the job and we did. <span style="background-color: #d9ead3;">So why did we do it? </span>Bottom line: She was kept on and stayed in the job for decades, eventually becoming a supervisor/manager. </span><br />
<span face=""><br /></span>
<span face=""><b><span style="color: #0b5394;">2. MLS</span></b> [Medical Laboratory Science, University of Alberta]</span><br />
<span face="">In late 1977 I was hired as an MLS instructor to teach introductory transfusion science, with a joint appointment as the clinical instructor for the University of Alberta Hospital transfusion service (UAH-TS). I was sad to leave my pals and family in Winnipeg but excited to move to Edmonton and meet the challenge of teaching at a university.<span style="background-color: #fff2cc;"> Yes, in MLS I loved coming to work each day as you never knew what it would entail, students being students, and what else I'd learn.</span></span><br />
<span face=""><br /></span>
<span face=""><b>Anecdote #3</b></span><br />
<span face="">As the prior transfusion instructor had unexpectedly left after attending an AABB conference and meeting a young man 😂, the position was temporarily filled by an experienced med lab technologist from the UAH-TS. Indeed, she had applied for the job but did not get it as she lacked a BSc.</span><br />
<span face=""><br /></span>
<span face="">This technologist became a dear, close friend, showed me the ropes, how to navigate the hospital, and introduced me to the local blood bank community, which became my new family. She also got me involved in the CSMLS in several ways, including recommending me for the Certification Board, a 3-year appointment. <span style="background-color: #d9ead3;">So why did she do it? </span></span><br />
<span face=""><br /></span>
<span face=""><b>Anecdote #4</b></span><br />
<span face="">As mentioned earlier, I lacked education and training in medical laboratory science and managed to learn transfusion in-depth through reading and broad practical experience in a busy joint blood centre and transfusion service. In MLS most colleagues were graduates of MLS and they too befriended me, put up with my many deficiencies, became my family, and generously taught me the key things I needed to know in other clinical lab disciplines. I'm forever grateful. <span style="background-color: #d9ead3;">So why did they do it? </span></span><br />
<span face=""><br /></span>
<span face=""><b>3. CBS</b> (Canadian Blood Services, Edmonton)</span><br />
<span face="">After MLS, I was lured to take a job at CBS as an assistant lab manager, where I was in charge of the patient services laboratory (PS lab): pretransfusion testing, prenatal testing. Not quite the job I expected, as it was promoted as having a significant teaching component. I refer to it as my 'assman' job as that's how the QA dept. addressed my correspondence. <span style="background-color: #fff2cc;">Again, I loved coming to work each day as I never knew what it would entail, more specifically what new knowledge and skills I'd learn. </span></span><br />
<span face=""><br /></span>
<span face=""><b>Anecdote #5</b></span><br />
<span face="">The person who had been running the lab on a temporary basis was in the first MLS class I taught all the way through, one of my 'kids' as I call them. She was an assistant to the person in the manager job prior to me. She should have gotten the job I now had, but nonetheless, she kindly showed me the CBS ropes and performed any function I asked her to do. <span style="background-color: #d9ead3;">So why did she do it? </span></span><br />
<span face=""><br /></span>
<span face=""><b>Anecdote #6</b></span><br />
<span face="">All of the PS lab staff (supervisors, technologists, lab assistants, clerical) generously welcomed me, a rank outsider. One of the big projects we had was being the Canadian pilot site for a new CBS computer system (Mak Progesa). In conjunction with the new lab information system, I decided to change most of the PS lab's serological and policy SOPs to update them, including instituting the electronic crossmatch. </span><br />
<span face=""><br /></span>
<span face="">Despite what must have been stressful, all staff pitched in, performed above and beyond, and did so as a team with great camaraderie. In retrospect, I suspect we had a lot of fun meeting the training challenges. <span style="background-color: #d9ead3;">So why did they do it?</span></span><br />
<span face=""><br /></span>
<span face=""><b>4. PLC</b> [Consulting career]</span><br />
<span face="">I won't go into the many adventures I had in a consulting career as that's another blog. </span><br />
<span face=""><br /></span>
<span face="" style="color: #134f5c;"><b style="background-color: #fff2cc;">SUMMARY</b></span><br />
<span face="">So the questions above ask why did I, she, they do it? The answer is the same for all. </span><br />
<span face=""><br /></span>
<span face="">My experience is that medical lab technologists (biomedical scientists) who work in transfusion, and I suspect all clinical laboratories, are a close-knit <span style="background-color: #d9ead3;">family </span>dedicated to protecting patient safety. Why do I say family? Because just like a biological family, the medical laboratory family has little to nil to do with ancestors and genes and everything to do with love, compassion, and support for members of the team. </span><br />
<span face=""><br /></span>
<span face="">Perhaps transfusion is even more so a family, because we are a comparatively small group. For example, when I was active in the profession I knew many med lab technologists in blood centres and transfusion services across Canada. When the Internet made international mailing lists possible, the family grew to include lab professionals from around the world. </span><br />
<span face=""><br /></span>
<span face="">For all the positions I held throughout a long career, members of the family became lifelong pals. <span style="background-color: #d9ead3;">I think of my career and those of my colleagues as a</span><span style="background-color: #fff2cc;"> long love affair </span><span style="background-color: #d9ead3;">with transfusion medicine and laboratory medicine that's never ended.</span> I hope that those who work as med lab professionals in any discipline are lucky enough to feel the same, indeed, workers in any field. That I lucked out with my career is an understatement and I'm sure many of my transfusion colleagues over the years feel the same way.</span><br />
<span face=""><br /></span>
<span face="">Happy National Medical Laboratory Week (April 26 to May 2, 2020 in Canada). Though largely hidden from the public and working behind the scenes, we in clinical laboratories play a crucial role in diagnosing and treating diseases. </span><br />
<span face=""><br /></span>
<span face="" style="color: #0b5394;"><b style="background-color: #fff2cc;">FOR FUN</b></span><br />
<span face="">I chose this song as a allegory for how so many medical laboratory technologists (biomedical scientists) feel about transfusion, myself included. </span><br />
</span><ul>
<li><span face="" style="font-family: arial;"><a href="https://www.youtube.com/watch?v=iE3z-6XO2Ds&feature=emb_logo">Could I have this danc</a>e (Anne Murray)</span></li>
</ul>
<span style="font-family: arial;"><span face="">Could I have this dance for the rest of my life?</span><br />
<span face="">Would you be my partner every night?</span><br />
<span face="">When we're together it feels so right</span><br />
<span face="">Could I have this dance for the rest of my life? </span><br />
<span face=""><br /></span>
<span face="">As always, comments are most welcome and appreciated. See some below.</span></span>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com5tag:blogger.com,1999:blog-8729772.post-91016164170141496412020-03-31T16:02:00.000-06:002020-03-31T16:16:40.756-06:00We are the world (Musings on COVID-19's impact on the world's blood supply)<div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>Stay tuned</i>: Revisions are sure to occur</span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;">March's blog derives from the ongoing worldwide shortage of blood due to the coronavirus (COVID-19). Of course, because this is a transfusion medicine blog, I'm preaching to the converted. But I hope it gets wider distribution among all healthcare colleagues and the public beyond. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Specifically, I ask all transfusion heath professionals to speak to colleagues, family, friends, neighbours about the ongoing need for blood donation, made even more crucial because of the COVID-19 pandemic. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The blog's title is based on a 1985 song written by Michael Jackson and Lionel Richie for 'USA for Africa.' </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>BLOOD SHORTAGES</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">For TraQ's newsletter, I've collated some of the ongoing blood shortages across the globe (Further Reading). Fact is, the need for blood transfusion is ongoing despite the COVID-19 pandemic. Yet blood donation has dropped off significantly in many nations for numerous reasons explained in the news items in Further Reading. </span><br />
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b><br /></b></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>TRANSFUSION NEEDS</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Despite the ongoing efforts of the Transfusing Wisely initiative (Further Reading), implemented in many nations, regular need for transfusions still exits for many patients. Transfusing Wisely's general goals: Reduce the rate of unnecessary blood transfusions with the goals of lowering the risk of complications for patients and supporting the judicious use of valuable resources. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">For the general public, just some of the ongoing needs for blood transfusion include the following (not all inclusive):</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>Patients who need blood transfusions</b></span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Mothers who incur significant bleeding during delivery, including those with <a href="https://medlineplus.gov/ency/article/000900.htm">placenta previa</a></span></li>
</ul>
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Gastrointestinal bleeding (if massive can be life threatening) with many causes such as hemorrhoids, peptic ulcers, tears or inflammation in the esophagus, diverticulosis and diverticulitis, ulcerative colitis and Crohn's disease, colonic polyps, or cancer in the colon, stomach or esophagus </span></li>
</ul>
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Kidney disease, sometimes secondary to type 1 diabetes, that requires dialysis</span></li>
</ul>
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Any surgery that involves significant blood loss</span></li>
</ul>
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Trauma patients including those in car accidents who experience blood loss and victims of knife attacks or gun shot wounds</span></li>
</ul>
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Blood disorders, including</span></li>
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://medlineplus.gov/ency/article/000587.htm">Thalassemia major</a> patients need regular red blood cell transfusions to raise their hemoglobin level and deliver oxygen to body tissues</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&v%3Asources=medlineplus-bundle&query=Sickle+cell+disease&_ga=2.254358539.241135477.1585684728-787935382.1585684728">Sickle cell disease</a> patients need regular red blood cell transfusions to provide normal red blood cells, lessen anemia and reduce the blood's viscosity, allowing it to flow more freely and ease disease symptoms and prevent complications</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://medlineplus.gov/leukemia.html">Leukemia</a> patients who develop thrombocytopenia need platelet transfusions to control bleeding </span></li>
</ul>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The need is real and ongoing. Please encourage colleagues, family, friends, and neighbours to donate blood and save a life. It's one thing folks can do during the pandemic. Further Reading includes questions about donating in Canada and blood systems in all nations have similar information. </span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"></span><br />
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FOR FUN</b></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Naturally, I chose We Are The World, originally written for 'USA for Africa' in 1985 by Michael Jackson and Lionel Richie, produced by Quincy Jones and Michael Omartian, and sung by many fabulous American artists. </span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.youtube.com/watch?v=9AjkUyX0rVw">We Are The World</a> </span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>We are the world</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>We are the children</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>We are the ones who make a brighter day</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>So let's start giving...</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">As always, comments are most welcome and appreciated.</span><br />
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FURTHER READING</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>Australia</b>: <a href="https://www.bodyandsoul.com.au/health/health-news/the-most-powerful-way-help-during-the-coronavirus-crisis-is-to-donate-blood/news-story/7e68cc0a8d0804b4bda0a0fc6407b160">In the face of coronavirus pandemic, Australian Red Cross Lifeblood’s stocks are threatened</a> (24 Mar. 2020)</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>Canada</b>: <a href="https://ipolitics.ca/2020/03/17/countrys-top-doc-says-canada-still-needs-people-to-give-blood-amidst-social-distancing/">Top doc says Canada still needs people to give blood amidst social distancing</a> (17 Mar. 2020)</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"> Canadian Blood Services:</span><a href="https://blood.ca/en" style="font-family: Arial, Helvetica, sans-serif;"> Message by CEO Dr. Graham Sher</a><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"> <a href="https://blood.ca/en/covid19#safe">CBS answers COVID-19 blood donation questions</a></span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>Pakistan</b>:<a href="https://www.thenews.com.pk/print/632583-experts-urge-volunteers-to-donate-blood-as-thalassaemia-patients-face-shortage"> Experts urge volunteers to donate blood as thalassaemia patients face shortage</a> (22 Mar. 2020)</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>Spain</b>: <a href="https://www.theolivepress.es/spain-news/2020/03/18/covid-19-blood-donations-needed-on-spains-costa-del-sol-as-malagas-transfusion-centre-pleas-for-help-heres-how-to-donate/">In COVID-19 emergency blood bank stocks in Costa Del Sol hospitals are alarmingly low</a> (18 Mar. 2020)</span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>UK</b>: <a href="https://www.bbc.com/news/health-51999480">Blood donors needed after 15% drop, says NHS</a> (23 Mar. 2020)</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>USA</b>: <a href="https://thehill.com/changing-america/well-being/prevention-cures/487285-coronavirus-fears-threaten-the-nations-blood">Coronavirus fears threaten America's blood supply</a> (12 Mar. 2020)</span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://choosingwiselycanada.org/transfusion-medicine/">Transfusing Wisely Canada</a></span>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-1380837248807891552020-02-29T17:30:00.003-07:002020-03-01T07:30:11.529-07:00You don't own me (Musings on questioning Dr. orders) <div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;"> </span><span style="font-family: "arial" , "helvetica" , sans-serif;"><i>Updated</i>: <span style="background-color: #fff2cc;">March 1, 2020</span></span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;">February's blog derives from another TraQ case study from decades ago that discusses a topic not often included in online transfusion medicine cases but is still relevant. This case was based on a case study used to teach nurses at the McGill University Health Centre (<a href="https://muhc.ca/">MUHC</a>) in Montréal, Québec. Because of this blog, I've revised the case to update all links. </span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">The blog's title derives from a 1963 ditty first recorded by Lesley Gore.</span></li>
</ul>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>Case Study O6: Transfusion Reaction Coincidental with Failure to Disobey Physician Orders</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">This case was suggested by an RN and, because I'm not a nurse, several helped me with the case, also medical laboratory technologist pals from Hamilton and a physician (whom I taught when she was in Medical Laboratory Science at the University of Alberta). </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>CASE SUMMARY</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">This case study presents a scenario in which a nurse did not follow several key transfusion protocols and procedures, including adhering to the time limit for transfusing blood, monitoring vital signs throughout a transfusion, and questioning orders that contradicted hospital policies and procedures.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">It began when the nurse called the attending physician to explain the situation and charted the conversation as follows:</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">The Dr. was made aware; he ordered to continue transfusion even if it takes all day.</span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">What happened to the patient? Based on laboratory results and a multidisciplinary discussion, staff concluded that a febrile non-hemolytic reaction had likely occurred after the second PRBC and had triggered subsequent events:</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Increased temperature and chills increased intracranial pressure (the drain had been closed the previous day), leading to</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Seizure and convulsions (treated by medication, induced coma, and intubation)</span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Analysis of the incident revealed that the nurse in question required remedial training related to resolving slow running transfusions and critical thinking in general, and also required re-training for how to monitor and document transfusions.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">A more systemic problem was identified regarding the responsibilities and related skills of health professionals to provide checks for patient safety as part of the healthcare team. In other words, she should have questioned the physician's orders and taken it further, though that would be difficult.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Further analysis resulted in individual re-training and a system-wide education program on responsibilities and skills for providing interdisciplinary checks to ensure patient safety.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>Key learning points include:</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">1. Clinical staff who administer transfusions must be trained and assessed in blood administration.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">2. Monitoring and documenting vital signs must be done for each blood component transfused before, during, and after transfusion according to established policies and procedures.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">3. Scopes of practice ensure that health professionals have the required education, training, and professional qualifications to perform their duties competently and safely.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">4. Within their respective scopes of practice, members of the health care team collaborate in providing patient care.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">5. Perceived loss of autonomy is considered to be a major obstacle to collaboration and open questioning within health teams.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">6. Nurses and allied health care professionals such as medical laboratory technologists have a duty to question physician orders that are inappropriate or unclear.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FOR FUN </b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Yes, I'm being facetious with the title and song, having some fun, but I couldn't resist. Decided to use the version with Bette Midler, Goldie Hawn & Diane Keaton as in the 1996 film, The First Wives Club. Yep, love these actors.</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.youtube.com/watch?v=Q_oFL_b719g">You Don't Own Me</a> (Bette Midler, Goldie Hawn & Diane Keaton)</span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">As always, comments are most welcome.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FURTHER READING</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Case Study O6: <a href="https://www.traqprogram.ca/index.php/case-studies/case-studies-o/case-o6">Transfusion Reaction Coincidental with Failure to Disobey Physician Orders</a> (Links are fixed) </span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Davies C. G<a href="https://www.bmj.com/content/320/7241/1021">etting doctors and nurses to work together</a>. BMJ 2000 Apr 15;320:1021-2. [Changed title]</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Mancini ME. P<a href="https://www.archivesofpathology.org/doi/10.1043/0003-9985(1999)123%3C0496:PIITM%3E2.0.CO;2?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed">erformance improvement in transfusion medicine. What do nurses need and want?</a> Arch Pathol Lab Med 1999;123(6):496-502.</span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Poerto G, Lauve R. <a href="https://www.psqh.com/julaug06/disruptive.html">Disruptive Clinician Behavior: A Persistent Threat to Patient Safety</a> (July /August 2006, Patient Safety & Quality Healthcare)</span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Salvage J, Smith R. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117926/pdf/1019.pdf">Doctors and nurses: doing it differently. The time is ripe for a major reconstruction</a>. BMJ. 2000 April 15; 320(7241): 1019-20.</span>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-38514012801377666032020-01-31T16:13:00.001-07:002020-02-01T15:14:30.979-07:00Stand by me (Musings on transfusion medicine errors)<div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>Updated</i>: <span style="background-color: #fff2cc;">1 Feb. 2020</span><span style="background-color: white;"> (Learning pt. 5, Further Reading)</span></span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;">To begin the new decade, I'll muse on a TraQ case study from decades ago that discusses a topic not often discussed by educators in class or included in online cases* but is still relevant and merits airing. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">*Online transfusion cases often involve antibody identification or making a diagnosis using lab and other diagnostic tests, in other words, cases with clear evidence-based results: yes and no answers that require factual knowledge and experience but not much reflective thinking. You may disagree, that's okay too. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">This blog's case study involves a student whose error resulted in a patient dying prematurely but, given another patient, could easily have been THE cause of death. Frankly, I shudder to think what the headlines may have been if local media had gotten hold of the story and were anything like the UK's tabloid press. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The blog's title derives from a 1961 ditty by Ben. E. King.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>CASE A8: Severe Hemolytic Transfusion Reaction Involving a Student</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">This case involved me directly as I was the clinical instructor of the student and transfusion service (TS) involved. As the clinical instructor I taught the student in a 2-week student lab (involving wet laboratories and small group tutorials) followed by a 4-week internship in the clinical transfusion lab where students were supervised by medical laboratory technologists. All the details of the case are in Further Reading. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>CASE SUMMARY</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">The student was supervised by an experienced, respected technologist who was also responsible for working on the bench and processing routine work. The TS laboratory performs antibody screens using gel technology followed by an electronic crossmatch for patients who lack clinically significant antibodies.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The lab's policy is to initially supervise students very closely and then, depending on performance (which is documented daily), to gradually allow students to perform with less supervision. Regardless of the intensity of supervision, the policy requires that supervising technologists always read the results of student tests.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The student did gel antibody screens on a batch of 5 patients in the late afternoon.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">One of the 5 patients had a positive (3+) antibody screen ("Patient A") but, because blood was not ordered and unlikely to be required for the type of surgery, the patient specimen was set aside for antibody identification the next day.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">One of the 4 patients with a negative antibody screen ("Patient B" - an 70-year old male scheduled for liver resection for metastatic colorectal cancer) had an electronic crossmatch performed for 3 units of RBC.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Early the next morning Patient "B" was transfused with 2 units of RBC.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">When the morning shift began in the laboratory, an antibody identification panel on Patient A was unexpectedly negative, as was the repeat antibody screen. Antibody screens were then repeated for all patients in the batch and one (Patient B) was positive. Patient B was later found to have an anti-Fy<sup>a</sup> and anti-c.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Immediately upon discovering the mix-up and positive antibody screen on patient B, the ward was contacted to stop any transfusion in progress, to inquire about Patient B's condition, and to monitor him for signs of a possible hemolytic transfusion reaction (HTR). Subsequently, Patient B was found to be experiencing a severe HTR and the TS medical director was consulted to help manage it. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The student and supervising technologist were questioned in private, both individually and together, by the medical director and laboratory supervisor. The student could not recall making an error and thought that patient plasma had been pipetted correctly for each patient. The supervising technologist recalled not seeing the student actually pipette patient plasma into the gel cards but did read the results of all indirect antiglobulin tests (IATS) in the batch.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">By chance, staff were able to retrieve gel cards from the biohazard garbage and identify that Patient B had less volume than usual in the antibody screen tests, consistent with no plasma having been added. The conclusion was that there was a pipetting error in which Patient B's plasma was not added to Patient B's gel antibody screen cards but rather to Patient A's tests.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: #fff2cc;">Patient B died the day following transfusion</span>.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The hospital's Risk Management Office was contacted and the chief counsel discussed the case with the TS medical director and Patient B's physician.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">A series of group meetings were held by the lawyer from Risk Management with the TS laboratory supervisor, student, supervising technologist, and TS clinical instructor (me) all being present.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span><span style="font-family: "arial" , "helvetica" , sans-serif;">The Chief Medical Examiner was notified and investigated the death.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The TS medical director openly disclosed and explained what had happened to the patient's family. We waited for 2 years suing limitation but the family never decided to sue. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The supervising medical technologist left the lab and began a career in a related field.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b style="background-color: #fff2cc;">My personal learning points from the case:</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">1. When medical technologists in a busy lab supervise students, they can't watch every student move. Student errors may happen and supervising technologists are devastated, as in this case. Suspect this may be true for other health professionals supervising students who make serious errors too. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">2. The group sessions with the hospital's Risk Management lawyer were enlightening to me. She stressed that anything said in our meetings couldn't be used in court because of attorney-client privilege.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">3. Our TS medical director was exemplary in her transparency to disclose the error to the patient's family. Perhaps ahead of her time?</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">4. I suspect many lab errors are <span style="background-color: #fff2cc;">latent errors</span> (aka <span style="background-color: #fff2cc;">systems errors</span> as well documented by UK's SHOT) caused by flaws in the system, i.e., errors that lead to human (operator) errors and whose effects typically lie dormant in the system. (Further Reading) </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span><span style="font-family: "arial" , "helvetica" , sans-serif;">5.The student in Case 8 thought she'd added drops to the antibody screens correctly. Many times in the student lab when students get incorrect results they'd almost always say, 'But I did it right. I know I did.' Then I'd gently remind them that it was, of course, normal to think that.If they knew they were adding the wrong drops, following the wrong procedure, they'd not have done it. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Being human we make all sometimes make mistakes.What's key is to learn from them and realize the clinical laboratory has a culture of no blame that enhances patient safety. The worst thing would be for them to be spooked and frightened of making mistakes in the clinical lab (self-fulfilling prophesy) where patient safety is at risk. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">6. Reminds me of the reality that transfusion med lab technologists / scientists are often the last barrier between a patients and possible death. The transfusion service is different from many other med lab departments (not all) where unusual results are often repeated before reporting. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">I knew this as early in my career I'd crossmatched group AB blood for a patient who died because she was group O and had a wrong group AB sample sent to the off-site transfusion service where I worked. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">As always comments are most welcome. </span><br />
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FOR FUN</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Chose this song because I think all health professionals need to stand by colleagues and students when human or systematic errors occur because there, but for the grace of gawd, go I. </span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.youtube.com/watch?v=dTd2ylacYNU">Stand by me</a> (Ben. E. King) </span></span></li>
</ul>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FURTHER READING</b></span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Case A8: <a href="https://www.traqprogram.ca/index.php/case-studies/case-studies-a/case-a8">Severe Hemolytic Transfusion Reaction Involving a Student</a></span></li>
<li><a href="https://www.aacc.org/-/media/Files/CLN/Astion-Patient-Safety-Articles-CLN/Latent-Errors-CLN-2009.pdf" style="font-family: arial, helvetica, sans-serif;">Latent errors</a></li>
<li><a href="https://www.shotuk.org/" style="font-family: arial, helvetica, sans-serif;">UK SHOT</a></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Farinre B. <a href="https://thepathologist.com/inside-the-lab/mistakes-happen">Mistakes happen. Alleviating the emotional impact of medical errors on healthcare staff</a>. (oped) The Pathologist, 18 Dec. 2019.</span></li>
<li><a href="https://www.ismp-canada.org/download/safetyBulletins/2018/ISMPCSB2018-02-MIA-Student-Incidents.pdf" style="font-family: arial, helvetica, sans-serif;">Students have a key role in a culture of safety:a multi-incident analysis of student-associated medication incidents</a><span style="font-family: "arial" , "helvetica" , sans-serif;">. ISMP Canada Safety Bulletin 2018 Feb 28; 18(2):1-3. </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Beck JB, McGrath C, Toncray K, Rooholamini SN. <a href="https://pediatrics.aappublications.org/content/pediatrics/early/2018/02/12/peds.2017-4222.full.pdf">Failure is an option: using errors as teaching opportunities</a>. Pediatrics. 2018 Mar;141(3). pii: e20174222. Epub 2018 Feb 13.</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Disch J, Barnsteiner J, Connor S, Brogren F. <a href="https://www.ncsbn.org/Disch_Exploring_how_nsg_schools_handle_student_errors.pdf">Exploring how nursing schools handle student errors and near misses</a>. Am J Nurs. 2017 Oct;117(10):24-31.</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Barnsteiner J, Disch J. <a href="https://www.ncsbn.org/Barnsteiner_Creating_a_fair_and_just_culture_in_schools_of_nursing.pdf">Creating a fair and just culture in schools of nursing</a>. Am J Nurs. 2017 Nov;117(11):42-8. </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Elmqvist KO, Rigaudy MT, Vink JP. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982483/pdf/jmdh-9-345.pdf">Creating a no-blame culture through medical education: a UK perspective</a>. J Multidiscip Healthc. 2016 Aug 8;9:345-6. eCollection 2016.</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Hernandez JS. <a href="https://www.aacc.org/Publications/CLN/Articles/2012/october/Laboratory-Errors.aspx">Responding to laboratory errors. How not to lose your coo</a>l. Clin Lab News, 1 OCT. 2012</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.ismp.org/resources/error-prone-conditions-lead-student-nurse-related-errors">Error-prone conditions that lead to student nurse-related errors</a>. (ISMP, 18 Oct. 2007)</span></li>
</ul>
Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-27231328574408259232019-12-31T15:14:00.000-07:002020-02-20T08:26:23.758-07:00Bridge over troubled water (Musings on how to prevent burnout in transfusion professionals)<div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>Updated</i>: <span style="background-color: #fff2cc;">20 Feb. 2020</span> (<i>Fixed typos</i>)</span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;">As the decade comes to an end, some musings on how to be happier and prevent burnout. </span><span style="font-family: "arial" , "helvetica" , sans-serif;">The idea for December's blog began this morning with a CBC radio interview with its workplace columnist. She mentioned a study of physician burnout that showed enabling Drs. to devote 20% of their work activities to the part of their practice that is especially meaningful to them had a strong inverse relationship to their risk of burnout (Shanafelt TD,et al, Further Reading).</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Physician burnout is often in the news these days and spoken of as an epidemic. It made me wonder about other transfusion workers such as nurses and medical laboratory technologists/scientists. The blog's title derives from a 1970 Simon and Garfunkel ditty (changed the tune - this one fits better) .</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>INTRODUCTION</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Took a peek at some of the literature on physician burnout. Must be said up front that burnout varies by specialty (nice chart in Rothenberger DA, Further Reading), and many other factors including sex, specifically that women are more likely to experience burnout. (Further Reading)</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Factors that contribute to work burnout are nicely summarized in Rothenberger's paper (Table 2) and include</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Work overload </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Lack of control </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Insufficient reward </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Lack of fairness </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Breakdown of community </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Conflicting values between job requirements and personal values </span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Please consider which, if any, play a role in your workplace.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">See the Engagement column of Table 2 for ideas that lessen factors that contribute burnout. Think if these are possible in your workplace and, more importantly, which, if any, you can affect positively. (Click to enlarge)</span><br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6wsDPLaZOGbIu1k0zYh5ctb6PY-ASDeYw3EiD30xDdpU203mqPiqdweKAaz-RGc9qgOwwsagLBVBSZqALmYv9HKmGMBpnZqc0G6b-UKUK0yHrZ4cXnRTgRZPvD1kK-EN3LxFb/s1600/table2-burnout.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="398" data-original-width="1025" height="123" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6wsDPLaZOGbIu1k0zYh5ctb6PY-ASDeYw3EiD30xDdpU203mqPiqdweKAaz-RGc9qgOwwsagLBVBSZqALmYv9HKmGMBpnZqc0G6b-UKUK0yHrZ4cXnRTgRZPvD1kK-EN3LxFb/s320/table2-burnout.jpg" width="320" /></a></span></div>
<br />
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>WHAT IS BURNOUT?</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">One of several scales used to assess burnout is Maslach’s triad of emotional exhaustion, de-personalization or cynicism, and feelings of diminished personal competence and accomplishment at the work. (Further Reading)</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Recently, I saw burnout in a hospital where my spouse spent 33 days this summer. One of his nurses was clearly burned out. We know because my husband often talks to healthcare providers, asks them about themselves, etc. Many find this refreshing and tell him all kinds of personal things about their backgrounds. One evening one of his RNs opened up to him and mentioned that she was stressed and might leave the profession soon. That formed a bond between them. As a daily visitor, I noticed how under-staffed and over-worked nurses often were, literally run off their feet at times.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Much earlier I saw burnout among medical laboratory technologists (aka biomedical scientists) when restructuring occurred in Alberta combined with a massive laboratory budget cut. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The powers that be wouldn't come clean about what was happening and lab staff were left feeling totally out of control. Uncertainty ruled, unproductive incessant gossip ensued.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Those staff who remained had to compete for remaining positions, setting colleague against colleague, friend against friend. Often the process was viewed as unfair by losers and the winners felt guilty. Lose-lose all around, including the organization.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Fewer jobs existed, indeed lab jobs disappeared in Alberta and those who could had to uproot and find work in the USA, NZ, etc.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">With budget cuts, continuing education opportunities dried up and staff were left feeling unappreciated.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Today, more than 25 years later, something similar is happening in Alberta. The provincial government changed and what had been planned has once again been ditched. Local lab staff experienced so much change over the years and now uncertainty reigns once again. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">For transfusion labs an added factor includes automated testing, which lessens the hands-on factor many who gravitate to serology and immunohematology love. Plus the modern computerized, high-tech work environment makes patients seem more remote and e-mail is so overused, it numbs the mind. I know of lab staff whose mailboxes are full of 100s of messages, most of them irrelevant.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Have no idea how much of this currently relates to transfusion physicians, nurses and lab staff elsewhere, but I suspect some aspects must apply. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>NEW DAWNS</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">So....to steal from journalism, please consider the 5 Ws and one H on how to lessen burnout: </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>WHO needs to act? </b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">All of us. It we owe it to ourselves and colleagues in our transfusion family and most of all to our patients.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>WHEN should we act?</b> </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Now, the sooner the better. Make it a New Year's resolution, if you're into that and it motivates you. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>WHERE should we act?</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">In our workplaces dealing with patients; in staff meetings with colleagues; at lunch, coffee breaks, other outings; training students and new staff; collaborating with administrators and health professionals in other disciplines; representing our profession and ourselves at meeting; meeting with those we perceive as our bosses. Bottom line: Everywhere in work related roles.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>WHY should we act?</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Not just to retain health professionals so the number doesn't wane with possible shortages or to recruit successfully as aging professionals retire in increasing numbers. As important, if not more crucial, is we act to keep our mental health, which affects physical health. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Our health and attitudes affect all around us, including our family, colleagues, students, patients, and their health too. Face it, no person wants to be in the presence of negativity and with burnout we exude it. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>WHAT do we need to do?</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">This may seem the tough question but I see it as relatively simple. For ages I've realized that what we remember in life is a series of short interactions with others, perhaps only lasting seconds or minutes. <span style="background-color: #fff2cc;">First</span>, remember that every conversation you have, every word or phrase uttered, may be remembered by the recipient of the communication forever, and have an effect either as a positive force or, gawd forbid, life-defining in a negative way.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: #fff2cc;">Second</span>, respect yourself and your work (meaning do your best, especially when it's hard) because only when you feel good about yourself can you help others. It's similar to the Buddhist core concept of self-love, whereby you must love yourself before you can extend love to others.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: #fff2cc;">Third</span>, if in any position of power, do what you can to delegate to subordinates (under supervision remote or close depending on where they're at), which will increase their self-worth and confidence. Most every health professional has some power, e.g., in training and mentoring students and staff; in influencing colleagues to be their best by being a role model. One way is not to gossip maliciously, another is to be true to those who are absent, which builds trust in all present. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: #fff2cc;">Tidbits</span>: Genuine praise goes a long way for a job well done. If high up on the chain of command, remembering staff names is always appreciated. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: #fff2cc;">Corollary</span>: Take every opportunity to convince those above you of ways to make the workplace better because it's win-win for them, you, the staff, and patients. If unsuccessful as will inevitably occur at times, be creative and find work-arounds to improve your work environment tangibly or spiritually. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>HOW to do it?</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Have fun and be happy in your work as it's infectious and will spread to others. Give of yourself and others will pay it forward. Resolve to be the best you can according to your abilities. You owe it to yourself.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">As in the research paper, one way to decrease burnout is to spend 20% doing what you best love about your job. Must admit I was very fortunate because I loved ~99% of my job, what I've always said was the best job teaching transfusion science in the world. Students were a diverse group of delightful characters, smarter than I was, had more comprehensive knowledge, and kindly tolerated me calling them 'kids', something I do to this day. Also fortunate with colleagues, who generously helped me overcome my deficiencies. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">What did I least love? Staff meetings that were not needed, and when they were, hearing 'We tried that, it didn't work', thereby shutting down discussion. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b>Learning Points</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">If you love nil about your job, best to pack it in and try another career or retire. As someone who experiences the health system a lot, I see burnout in some health staff. Also as an educator, I've seen the rare colleague who became jaded and really needed to quit before doing more damage. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Doing more of what you love and enjoy makes sense and helps decrease burnout. When work is fun, we stick with it and create an environment where everyone improves, including patients. Just like when learning is fun, students tend to do much better.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FOR FUN</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Wavered between 2 songs, but in the end chose a very old ditty, many will think is dated:</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.youtube.com/watch?v=WrcwRt6J32o">Bridge Over Troubled Water</a> (Simon and Garfunkel, concert in Central Park 1981) </span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>When you're weary, feeling small,</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>When tears are in your eyes, I will dry them all.</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>I'm on your side. When times get rough</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>And friends just can't be found,</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>Like a bridge over troubled water</i></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="font-family: "arial" , "helvetica" , sans-serif;"><i>I will lay me down.</i></span></span><br />
<div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;">As always, comments are most appreciated. </span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FURTHER READING</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Shanafelt TD, et al. </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19468093" style="font-family: arial, helvetica, sans-serif;">Career fit and burnout among academic faculty</a><span style="font-family: "arial" , "helvetica" , sans-serif;">. Arch Intern Med. 2009 May 25;169(10):990-5. </span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Rothenberger DA. <a href="https://www.ncbi.nlm.nih.gov/pubmed/28481850">Physician burnout and well-being: a systematic review and framework for action</a>. Dis Colon Rectum. 2017 Jun;60(6):567-76.</span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">CBC Edmonton AM Workplace Column: <a href="https://www.cbc.ca/listen/live-radio/1-17-edmonton-am/clip/15753492-workplace-column-new-year-at-work">New Year at Work</a> (31 Dec. 2019 - 7:06 mins.)</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Berg S. <a href="https://www.ama-assn.org/practice-management/physician-health/why-women-physicians-are-more-likely-experience-burnout">Why women physicians are more likely to experience burnout</a> (9 Sept. 2019, AMA)</span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Templeton K, et al. <a href="https://nam.edu/gender-based-differences-in-burnout-issues-faced-by-women-physicians/">Gender-based differences in burnout: issues faced by women physicians </a>(30 May 2019, NAM)</span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Maslach C, Jackson SE. 1981. <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/job.4030020205">The measurement of experienced burnout</a>. Journal of Organization Behavior;2(2):99-113.</span><br />
<br />Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-56416125002933193862019-11-30T17:01:00.001-07:002019-12-01T12:17:41.995-07:00I can see clearly now (Musings on using artificial intelligence in transfusion medicine)<div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>Updated</i>: <span style="background-color: #fff2cc;">1 Dec. 2019</span><span style="background-color: white;"> [See <a href="http://traq.blogspot.com/2019/11/i-can-see-clearly-now-musings-on-using.html#addendum">Addendum</a> below.]</span></span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">November's blog, similar to all recent ones, is short. Perhaps the oldster (me) has finally learned that shorter is better or is it due to <a href="https://www.frontiersin.org/files/Articles/449901/fnmol-12-00132-HTML/image_m/fnmol-12-00132-g001.jpg">neuronal changes of normal aging</a>?<br /><br />
The idea for the blog was initially stimulated by an article (Artificial Intelligence: A Primer for the Laboratory Leader) in <a href="https://www.csmls.org/">CSMLS</a>'s LabBuzz, Nov. 22. (Further Reading). Naturally, this led me to read many more AI articles, some of which are included in Further Reading below. <br /><br />
The title derives from a ditty composed and sung by Johnny Nash. <br /><br /><b><span style="color: #0b5394;">
INTRODUCTION</span></b><br />
As someone whose career was marked by many dramatic changes, I'm interested in what the 'next big thing' is. One candidate is <span style="background-color: #fff2cc;">artificial intelligence</span> (AI). <br /><br />
I was particularly struck by the authors' (of </span><span style="font-family: "arial" , "helvetica" , sans-serif;">Artificial Intelligence: A Primer for the Laboratory Leader) </span><span style="font-family: "arial" , "helvetica" , sans-serif;">choice of six 'Roles of Laboratory Managers in the <span style="background-color: #fff2cc;">Post-AI</span> Laboratory' See the article for a description of the outcomes of each role or see the screen shot from the article:</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br />
</span><br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuGxG4SuRLzzs3SU1GvXaA97sLtR6tJcCc68p00qrLwQbqHihMLxpjfS98VoPwf2n0vLXY6SWguvj5mBdqBPB4oyApIdec0r0U6FbX2xMdtfFMKALvyLbjVlP6cUokKrkDRm9G/s1600/ai-roles-clin-lab.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="531" data-original-width="488" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuGxG4SuRLzzs3SU1GvXaA97sLtR6tJcCc68p00qrLwQbqHihMLxpjfS98VoPwf2n0vLXY6SWguvj5mBdqBPB4oyApIdec0r0U6FbX2xMdtfFMKALvyLbjVlP6cUokKrkDRm9G/s400/ai-roles-clin-lab.jpg" width="367" /></a></span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br />
To me, many of these roles exist in the <span style="background-color: #fff2cc;">pre-AI lab</span> and may be fulfilled by the lab manager or medical director, depending on the laboratory. The authors mention a quote attributed to the Greek Heraclitus, who lived ~500 BC:</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">"Change is the only constant in life." </span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">
They also mentioned the </span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif;">cliché </span><span style="font-family: "arial" , "helvetica" , sans-serif;">used by diagnostic reps who push automated clinical instruments: it's useful to remember that new technology eliminates old jobs, but it also creates new jobs. Clinical lab reps often phrase it as eliminating boring, mundane work to do the intellectually stimulating work med lab techs/scientists were educated and trained for. Except that clinical lab reps often promote automated instruments as a way to 'decrease head count', the euphemism for axing staff, especially highly educated, well paid staff. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br />
Authors' learning points: Welcome all change, it's inevitable and will take us to a better and brighter future. Think, 'Robots are coming to help us' not take our jobs.<br /><br />
Fair enough. Change is inevitable. Not sure it's always good, though, as many technological changes are a mixed bag of pros and cons. <br /><br /><span style="background-color: #fff2cc;">
Sidebar</span>: Must admit that the robot comment reminds me of Reagan's "I'm from the government and I'm here to help", a late-1970s </span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif;">cliché</span><span style="font-family: "arial" , "helvetica" , sans-serif;">. Reagan was the less-government POTUS who believed in trickle-down economics: tax breaks and benefits for corporations and the wealthy will trickle down to everyone else. Except the theory didn't work well. Reagan also opted to end federal funding for mental health programs to cut the budget. The consequences of Reagan's social policy? ~One-third of the USA's homeless suffer from severe mental illness, which puts a burden on police departments, hospitals and the penal system. <br /><br />
To me, a more apt </span><span style="background-color: white; color: #222222; font-family: "arial" , sans-serif;">cliché</span><span style="font-family: "arial" , "helvetica" , sans-serif;"> is one prevalent in the 1990s in Alberta, Canada when government health care cuts and restructuring decimated the laboratory and broader health system. They hired consultants to do the dirty work, then leave. Many in the lab community called them 'suits.' (See Further Reading) </span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="font-family: "arial" , "helvetica" , sans-serif;">
"I'm a consultant and I'm here to help."</span></span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b><span style="color: #0b5394;">
TRADITIONAL MANAGERIAL ROLES</span></b><br />
Managerial roles <span style="background-color: #fff2cc;">pre-AI</span> often include the manager performing the following functions:</span><br />
<ul><span style="font-family: "arial" , "helvetica" , sans-serif;">
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Assume leadership, which includes motivating staff to achieve a common goal and being a role model for key qualities like dedication and integrity; </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Communicate to lab staff and beyond the lab;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Delegate responsibilities to staff;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Manage projects and budgets;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Organise and chair meetings;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Comply with mandatory laboratory regulations;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Maintain current best practices;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Manage conflicts in the workplace;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Manage conflicting priorities;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Manage workplace diversity (inter-generational, ethnic,cultural); </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Problem solve issues from technical to human resources;</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">
Develop staff skills, including CE/CPD opportunities;</span></li>
<li>Recruit and retain talent;</li>
<li>Maintain a safe workplace. </li>
</span></ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">
<b><span style="color: #0b5394;">
BOTTOM LINE</span></b><br />
So can I assume that the six 'Post-AI Laboratory Roles' are just add-ons, more or less minor tweaks, to what today's managers already do versus a revolutionary change? Is artificial intelligence and machine learning that big a deal? Will it consume a manager's time as the be all and end all? Or is it just one of many changes that laboratory professionals have adapted to over the decades. Are AI roles more critical than traditional managerial roles? You tell me. <br /><br />
As always comments are most welcome. See below.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<b><a href="https://www.blogger.com/null" name="addendum"></a><span style="color: #0b5394;">Addendum</span></b><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">My reply to Anonymous's comment below, who writes, "A huge concern I have centres around the data chosen for algorithms used for AI decisions" and mentions two books:</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.researchgate.net/publication/334086134_Weapons_of_Math_Destruction_How_Big_Data_Increases_Inequality_and_Threatens_Democracy">Weapons of Math Destruction: How Big Data Increases Inequality and Threatens Democracy</a> by Cathy O’Neil (2016). I've linked it to a book review. The reviewer writes:</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">"The core theme of the book is to dispel a widely held <span style="background-color: #fff2cc;">misconception </span>of mathematical models and their results being fair, objective and <span style="background-color: white;">unbiased.</span>" </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">"She believes that these models are here to stay but they need to used with caution; appropriate regulation is required <span style="background-color: #fff2cc;">to ensure that humans are not treated simply as collateral damage for the sake of efficiency</span>."</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://youtu.be/gdCJYsKlX_Y?t=133">Talk by O'Neil on Weapons of Math Destruction and algorithms</a> (12:15 min. video) | I started it part way through.</span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">The second book that Anonymous mentions is <a href="https://www.theguardian.com/books/2019/apr/11/machines-like-me-by-ian-mcewan-review">Machines Like Me</a> by Ian McEwan (2019). The link is a review. The book gets a mixed review. A few quotes:</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">"The book touches on many themes:...artificial intelligence AI, ...but its real subject is <span style="background-color: #fff2cc;">moral choice</span>. </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">"The epigraph quotes Rudyard Kipling’s poem “The Secret of the Machines”, which presciently expresses the uncompromising quality of the machine mind. “<span style="background-color: #fff2cc;">We are not built to comprehend a lie</span>,” the poem goes. </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">"In Adam’s digital brain [he's a robot], there may be fuzzy logic, but there’s no fuzzy morality. This clarity gives him an <span style="background-color: #fff2cc;">inhuman icines</span>s." </span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Thanks, Anonymous, for much food for thought. Suspect algorithms come down to <a href="https://dictionary.cambridge.org/dictionary/english/gigo">GIGO</a>. Oh and they're highly susceptible to historical bias and... [Fill in the blank as you wish]. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /><b><span style="color: #0b5394;">
FOR FUN</span></b><br />
I chose a 1972 song by Johnny Nash (who often collaborated with Jamaica's Bob Marley) and admit it's somewhat tongue in cheek as I'm skeptical of AI's use in medicine, including laboratory medicine and transfusion. Admit it has much promise but has yet to deliver due to obstacles (See Artificial intelligence and digital pathology: challenges and opportunities, Further Reading). </span><br />
<ul><span style="font-family: "arial" , "helvetica" , sans-serif;">
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.youtube.com/watch?v=FscIgtDJFXg">I can see clearly now</a> (Johnny Nash)</span></li>
</span></ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">
<b><span style="color: #0b5394;">
FURTHER READING</span></b><br /><a href="https://www.clinicallabmanager.com/trends/ai-in-the-clinical-lab/artificial-intelligence--a-primer-for-the-laboratory-leader-405">Artificial intelligence: a primer for the laboratory leader</a> (18 Nov. 2019)<br /><br /><a href="https://www.clinicallabmanager.com/thought-leadership/ai-can-help-labs-manage-data-to-improve-stewardship-427">AI can help labs manage data to improve stewardship</a>. New artificial intelligence technologies improve patient care and lower laboratory costs (21 Nov. 2019)<br /><br /><a href="https://www.mynewlab.com/blog/8-management-skills-you-need-to-be-a-laboratory-manager/">8 Management skills you need to be a laboratory manager</a> (10 Mar. 2019)<br /><br />
For pathologists:<br />
Tizhoosh HR, Pantanowitz L. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289004/">Artificial intelligence and digital pathology: challenges and opportunities.</a> J Pathol Inform. 2018 Nov 14;9:38.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://blog.ucdmc.ucdavis.edu/pathology-chair/index.php/2018/02/01/making-artificial-intelligence-real-in-pathology-and-lab-medicine/">Making artificial intelligence real in pathology and lab medicine</a> (Pathology Chair's blog, Lydia Howell, MD, 1 Feb. 2018)</span>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-56406458284530883722019-10-30T18:25:00.005-06:002019-11-02T15:46:54.114-06:00I will remember you (Musings on gender in transfusion medicine) <br />
<div style="text-align: center;">
<span style="font-family: "arial" , "helvetica" , sans-serif;"><i>Updated</i>: 2<span style="background-color: #fff2cc;"> Nov. 2019</span></span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span><span style="font-family: "arial" , "helvetica" , sans-serif;">
October's blog is short. The idea was initially stimulated by two 'from the archives' papers in TraQ (Further Reading). The topic of the papers was perceived gender discrimination by healthcare professionals. The initial p</span><span style="font-family: "arial" , "helvetica" , sans-serif;">urpose of October's blog was to get readers to assess if they perceived gender discrimination exists in their disciplines and workplaces.</span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">After reflection, I decided to change the focus to highlighting how many great female physicians there are in transfusion medicine, many of whom I've been privileged to know personally. And, sad to report, one recently died. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span><span style="font-family: "arial" , "helvetica" , sans-serif;">
The title derives from a ditty sung by Canada's Sara McLachlan.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b><span style="color: #0b5394;">
BACKGROUND</span></b></span><span style="font-family: "arial" , "helvetica" , sans-serif;"> </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Historically, medicine has been male dominated, whereas both nursing and medical laboratory technology/science have been female dominated, at least in Canada. That's been my experience in transfusion medicine but it has changed significantly over the years, especially in transfusion medicine.<br /> </span><span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span><span style="font-family: "arial" , "helvetica" , sans-serif;"><b><span style="color: #0b5394;">
TIDBITS</span></b></span><span style="font-family: "arial" , "helvetica" , sans-serif;">
Since I moved to Edmonton in Nov. 1977 to teach in University of Alberta's <a href="https://www.ualberta.ca/medicine/programs/mls">Medical Laboratory Science</a> to the present, Oct. 2019 (42 years), top jobs have been held by men: Medical Directors of UAH's Dept. Lab Medicine and Chairs of the <a href="https://www.ualberta.ca/laboratory-medicine-and-pathology">Dept. of Lab Med and Pathol</a> (<a href="https://www.ualberta.ca/medicine">Faculty of Medicine and Dentistry</a>,<a href="https://www.ualberta.ca/"> University of Alberta</a>).<br /> </span><span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span><span style="font-family: "arial" , "helvetica" , sans-serif;">
Individual <a href="https://www.ualberta.ca/laboratory-medicine-and-pathology/about-the-department">UAH lab specialties have been held by women</a>, including I am especially pleased to say the transfusion service, which is currently headed by one of my Med Lab Sci 'kids', who also holds higher regional positions. Across Canada, many female physicians hold significant transfusion medicine positions. </span><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.ualberta.ca/laboratory-medicine-and-pathology/about-the-department"><br /></a> </span><span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span><span style="font-family: "arial" , "helvetica" , sans-serif;">
Nurses vs physicians remains an ongoing saga and perhaps sometimes it's just about power, not gender. Suspect it gets more dicey when scope of practice is involved, which also adds pharmacists to the mix.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Canada's blood suppliers are a mixed bag. <a href="https://www.blood.ca/en">CBS </a>had had a male CEO from the get-go, though many female physicians are CBS medical directors across Canada. <a href="https://www.hema-quebec.qc.ca/index.en.html">Héma-Québec</a> began with a female CEO. Parts of CBS are <a href="https://blood.ca/en/about-us/governance/executive-and-board-directors">male top-heavy</a>. </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Over the years I've seen female transfusion Drs. bullied by what I perceived as pompous male colleagues in rounds and at conferences. As the cliché goes, women must be way better than male colleagues to succeed. Is it still true?</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="color: #0b5394; font-family: "arial" , "helvetica" , sans-serif;"><b>FEMALE TRANSFUSION MEDICINE PHYSICIANS</b></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Transfusion medicine is blessed with many exemplary female physicians in top positions. Some examples of ones I've known personally and met F2F (alphabetical order):</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://blood.ca/en/research/our-research-activities/our-team/clarke-gwen-0">Dr. Gwen Clarke</a> (via <a href="https://www.ualberta.ca/medicine/programs/mls">Med Lab Sci</a>,<a href="https://www.albertahealthservices.ca/about/about.aspx"> Alberta Health Services</a>, <a href="https://blood.ca/en">CBS</a>)</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.hema-quebec.qc.ca/publications/communiques/archives/2011/communiques/fdecary.en.html">Francine Décary</a> (at conferences when CEO of <a href="https://www.hema-quebec.qc.ca/index.en.html">Héma-Québec</a>) </span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://sites.google.com/a/ualberta.ca/thehematopathologist/vox-alumni/dr-judith-l-hannon">Dr. Judith Hannon</a> (via <a href="https://blood.ca/en">CBS</a>)</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://blood.ca/en/research/our-research-stories/research-education-discovery/providing-safe-transfusions-developing">Dr. Heather Hume</a> (when at <a href="https://blood.ca/en">CBS</a> she directed me & <a href="http://www.transfusion.ca/Resources/CSTM-Blog/January-2016/I-will-remember-you-Kathy-Chambers">Kathy Chamber</a>s to create CBS's first<a href="http://www.patletendre.com/resume/images/tm.ca-site.jpg"> educational site</a>, now defunct)</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://blood.ca/en/research/our-research-activities/our-team/lane-debra">Dr. Debra Lane</a> (as resident at </span><a href="https://www.albertahealthservices.ca/about/about.aspx" style="font-family: arial, helvetica, sans-serif;">Alberta Health Services</a>, <span style="font-family: "arial" , "helvetica" , sans-serif;">at conferences when CBS medical director in Winnipeg)</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://ca.linkedin.com/in/susan-nahirniak-aaa37880">Dr. Susan Nahirniak</a> (via <a href="https://www.ualberta.ca/medicine/programs/mls">Med Lab Sci</a>, <a href="https://www.albertahealthservices.ca/about/about.aspx">Alberta Health Services</a>)</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.med.mun.ca/Medicine/Faculty/Whitman_Lucinda.aspx">Dr. Lucinda Whitman</a> (via <a href="https://blood.ca/en">CBS</a>, <a href="https://www.nacblood.ca/">National Advisory Committee on Blood and Blood Products</a> [NAC])</span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Interesting that so many of these Canadian female transfusion medicine docs have held major positions (as above) and won awards. To name a few: </span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">CSTM <a href="http://www.transfusion.ca/About-CSTM/Awards_Bursaries/Past-Award-Winners">Ortho award recipients</a>:</span></li>
<ul>
<li><span style="color: #333333; font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: white;"><span style="font-family: "arial" , "helvetica" , sans-serif;">2002, Francine Décary</span><span style="font-family: "arial" , "helvetica" , sans-serif;"> </span><span style="font-family: "arial" , "helvetica" , sans-serif;">(CEO of <a href="https://www.hema-quebec.qc.ca/index.en.html">H-Q</a>, </span></span></span><span style="font-family: "arial" , "helvetica" , sans-serif;">ISBT President 2004-6)</span></li>
<li><span style="color: #333333; font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: white;"><span style="font-family: "arial" , "helvetica" , sans-serif;">2007, Heather Hume </span><span style="font-family: "arial" , "helvetica" , sans-serif;">(</span></span></span><span style="font-family: "arial" , "helvetica" , sans-serif;">Executive medical director, CBS)</span></li>
<li><span style="color: #333333; font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: white;">2010, Susan Nahirniak (Chair of <a href="https://www.nacblood.ca/">NAC</a>)</span></span></li>
<li><span style="color: #333333; font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: white;">2013, Debra Lane, Medical Director of CBS's only joint transfusion service/ blood supplier in Canada)</span></span></li>
<li><span style="color: #333333; font-family: "arial" , "helvetica" , sans-serif;"><span style="background-color: white;"><span style="font-family: "arial" , "helvetica" , sans-serif;">2014, Lucinda Whitman</span><span style="font-family: "arial" , "helvetica" , sans-serif;"> </span></span></span><span style="font-family: "arial" , "helvetica" , sans-serif;">(Chair of <a href="https://www.nacblood.ca/">NAC</a>)</span></li>
</ul>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Of course, Canada has many outstanding female transfusion medicine Drs. I've never met F2F but know via social media like Twitter or via e-mail. Ex:</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://sunnybrook.ca/research/team/member.asp?t=10&m=39&page=527">Dr. Jeannie Callum </a>(who kindly contributed to <a href="http://www.transfusion.ca/Resources/CSTM-Blog/April-2018/I-will-remember-you-Ana-Lima-en">CSTM blog on Ana Lima</a> )</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="http://www.lmp.utoronto.ca/research/faculty-research-database/lin-yulia?demo1=gkjftiiphcuze">Dr. Yulia Lin</a>: CSTM Ortho award recipient, 2016; 2019 AABB President's Award, '</span>I<span style="font-family: "arial" , "helvetica" , sans-serif;">n recognition of her role as a master educator in the field of transfusion medicine, particularly through her contributions to the education of junior doctors through the Transfusion Camp program.'</span></li>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;">Dr. Elianna Saidenberg who died far too young on Oct. 20, 2019 (Further Reading) </span></li>
</ul>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Special note on Elianna Saidenberg, Never met her except via her tweets, and she kindly liked many of mine.Thought she was a wonderful human being as I suspect did all who knew her up close or from afar. Clearly, Dr. Saidenberg made a difference in her all too short time on planet earth. <a href="https://twitter.com/search?q=elianna%20saidenberg&src=typed_query">Twitter remembers Elianna</a>. </span><br />
<br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">So...what do you think? Does your country have many fabulous female transfusion medicine physicians as Canada does. Is gender an issue in transfusion medicine, whether related to physicians, nurses, medical laboratory technologists?</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><span style="color: #0b5394;"><b>
FOR FUN</b></span></span><span style="font-family: "arial" , "helvetica" , sans-serif;"> </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">I've chosen Canadian Sarah McLachlan's song for this blog, one I've used before:</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">I will remember you </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">will remember you, will you remember me? </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Don't let your life pass you by </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;">Weep not for the memories.</span><br />
<ul>
<li><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.youtube.com/watch?v=uHooH4464dQ">I will remember you</a> (Sara McLachlan)</span></li>
</ul>
<div>
<span style="font-family: "arial" , "helvetica" , sans-serif;">As always, comments are most welcome and there are several below you may enjoy. </span></div>
<div>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span></div>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><b><span style="color: #0b5394;">
FURTHER READING</span></b></span><span style="font-family: "arial" , "helvetica" , sans-serif;"> </span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://med.uottawa.ca/en/news/memoriam-elianna-saidenberg" style="background-color: white;">In Memoriam: Dr Elianna Saidenberg</a><span style="background-color: white; font-size: 14px;"> (21 Oct. 2019)</span></span><br />
<ul style="background-color: white; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; margin: 0px 0px 0px 25px; padding: 0px;">
<li style="line-height: 18px; overflow-wrap: break-word; padding: 2px;"><span style="color: black;"><a href="https://blood.ca/en/news-and-events/newsroom/acts-kindness-repair-world-canadian-blood-services-remembers-dr-elianna" style="text-decoration-line: none;">‘Acts of kindness to repair the world’: CBS remembers Dr. Elianna Saidenberg </a>(22 Oct. 2019)</span></li>
</ul>
<span style="color: #333333; font-family: "helvetica neue" , "helvetica" , "arial" , sans-serif;"><span style="font-size: 14px;"><br /></span></span><span style="font-family: "arial" , "helvetica" , sans-serif;">Blau G, Tatum D. <a href="https://www.researchgate.net/publication/227275962_Correlates_of_Perceived_Gender_Discrimination_For_Female_Versus_Male_Medical_Technologists">Correlates of perceived gender discrimination for female versus male medical technologists. </a>Sex roles 2000 Jul;43(1):105-18. | Related:<br /> </span><span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span><span style="font-family: "arial" , "helvetica" , sans-serif;">
Blau G, Tatum DS, Ward-Cook K, Dobria L, McCoy K. <a href="https://www.ncbi.nlm.nih.gov/pubmed/16252675">Testing for time-based correlates of perceived gender discrimination. </a>J Allied Health. 2005 Fall;34(3):130-7.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;">Shannon G, Jansen M, Williams K, Cáceres C, Motta A, Odhiambo A, et al. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33135-0/fulltext">Gender equality in science, medicine, and global health: where are we at and why does it matter?</a> Lancet. 2019 Feb 9; 393(10171):560-9.</span>Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com8tag:blogger.com,1999:blog-8729772.post-65346729515965974372019-10-01T17:56:00.000-06:002019-10-02T16:38:34.607-06:00Both sides now (Musings on humans vs technology in transfusion medicine)<div style="text-align: center;">
Stay tuned: Revisions are sure to occur</div>
<b><span style="color: #0b5394;"><br /></span></b>
<b><span style="color: #0b5394;">INTRODUCTION</span></b><br />
There's much transfusion news these days on artificial intelligence (AI), big data, drones, innovations, new technology, precision medicine. In a way this blog is a follow-up to the prior one, 'Get back' (Musings on transfusion medicine's future).<br />
<br />
September's blog (albeit published Oct. 1) was stimulated by a weekly feature ('Workplace column') on a local radio program I heard this morning (Further Reading). Also, because as an oldster I want a record of events I've experienced in the hope they will resonate with some and influence others to do similar. Otherwise when we oldsters croak, they're gone forever.<br />
<br />
The blog's title derives from a song by Canada's Joni Mitchell.<br />
<br />
As you read the blog, regardless of your health profession, please consider the challenges you faced if you have held a management position and, if not, think about the strengths and weaknesses of managers you have had. Also, consider the impact you as a manager have had on colleagues and the influence your managers have had on you and your career. <br />
<br />
Specifically, the radio column was on moving into management, generally viewed as a promotion with a higher salary. The columnist (<a href="https://twitter.com/sandbaryeg?lang=en">@sandbaryeg</a>) gave tips on becoming a manager for the first time. Her tips made me recall when I took a giant leap from a long career as a transfusion educator of medical laboratory technologists/biomedical scientists to become a lab manager at <a href="https://blood.ca/en">CBS</a> ('assman' as the centre's QA department addressed my mail). True, I'd been lab supervisor in my 13-yr job before teaching, but with none of the responsibility the 'assman' position entailed. <br />
<br />
Indeed, as I only learned later, although I managed the patient services lab at the blood centre, the position had been downgraded to 'assistant manager' in order for the centre (and perhaps head office?) to retain more control, especially over salaries. Also, I hadn't realized (bit stunned of me) that the person who had been an assistant to the prior manager and perhaps (just a guess) had applied for the job I was recruited for, and was the acting manager when I came. She was a prior student of mine, in fact in the first Med Lab Sci class that I taught all the way through, who I was and still am exceedingly fond and proud of.<br />
<br />
My take on the consultant's 5 tips for new managers. How to<br />
1. Run meetings, something many dread;<br />
2. Give effective feedback;<br />
3. Foster a team environment;<br />
4. Attract & recruit the staff you need vs filling an existing job;<br />
5. Manage your own time effectively.<br />
<br />
<b>
Promotion</b>: First, I'll note that in my experience (historical, I know, dating from 1960s-2000) often the folks who get promoted in the lab are ace technologists. If all factors are considered more or less equal, seniority may play a role. To me, that's not an effective process, but it's likely the easiest. <br />
<br />
How often do fabulous footie players (soccer in NA) or hockey players become great managers? Not many. Why? Because the skills needed are quite different. <br />
<br />
<b>Needed skills?</b> More recently, not only med lab techs/scientists but also physicians (perhaps nurses?) tend to get Masters of Business Administration (MBAs) as lab medicine and transfusion have become more and more a business. Presumably these degrees help in a new career as a 'suit' whose prime concern is the bottom line, though patient safety is always touted, given first place in communications.<br />
<br />
I'll discuss the 5 tips in various ways based on my experience.<br />
<br />
<b><span style="color: #0b5394;">
RUNNING MEETINGS</span></b><br />
Decades ago as an educator I'd experienced many ineffective meetings, including those run by MDs at the departmental (Lab Med & Path) & Faculty of Medicine levels. Some dept. meetings were info-only unneeded sessions. Few required active participation. And often the minutes were totally useless to anyone not attending.<br />
<ul>
<li>My experiences motivated me to write a resource for TraQ in 2009 on running meetings (Meetings as Time Wasters, Further Reading).</li>
</ul>
On running meetings in my brief career as 'assman' I was fortunate and smart to designate my prior student to run many meetings. She was experienced in the task and did it much better than I ever could. Only time I ran meetings was when it came to getting staff on board with changing almost all pretransfusion testing methods in the lab. That came easy as it was right up my alley as an educator. <br />
<br />
In a similar vein, I was glad I'd insisted on a whiteboard for my 'assman' office as it was well used when meeting with supervisors in the various sections of the patient services lab. <br />
<br />
<b><span style="color: #0b5394;">EFFECTIVE FEEDBACK</span></b><br />
As an educator I had to give feedback over decades and some was difficult. For example, telling foreign students (English as a second language), whose parents had struggled and worked hard to send them to Canada that they were not going to pass their clinical rotation. For such students it was a total disaster, an incredible loss of face and shame. Frankly, it broke my heart and I know that whatever I said to lesson the blow (e.g., they could have great success in another career) wasn't heard and didn't lesson their reality in any way.<br />
<br />
In giving more routine feedback, as a med lab technologist with an MEd, I knew the characteristics of effective feedback. On a personal level I believe that often what shapes us for good and bad in life are 15-60 second interactions with others. For example, I'll never forget the powerful effect of my Dad saying, 'Pat, don't be afraid to be different.'<br />
<br />
As a teacher of med lab students I always kept that in mind when giving feedback. Meant I treated struggling students the same as high achievers. And in retrospect I see that many of those who struggled have gone on to be high achievers, leaders in their field. Why? Suspect it's because success depends on many factors, not necessarily getting the highest grades.<br />
<br />
A good pal is a standardized patient at the <a href="https://www.ualberta.ca/">University of Alberta</a> and they have a particular take on feedback, called CORBS (Further Reading):<br />
<br />
CLEAR – Give information clearly and concisely<br />
OWNED – Offer feedback as your perception, not the ultimate truth. Talk about how something made you feel. Use terms such as “I find” or “I felt” and not “You are”<br />
REGULAR – Feedback is offered immediately, or as soon as possible after the event<br />
BALANCED – Offer a reasonable balance of negative and positive feedback. DO NOT overload with negative feedback.<br />
SPECIFIC – Feedback should be based on observable behavior and behaviors that can be modified.<br />
<br />
<b style="background-color: white;"><span style="color: #0b5394;">TEAM ENVIRONMENT</span></b><br />
Not much to say. Health care teams are similar to politicians kissing babies. Everybody does it as it's the reigning orthodoxy, the cliché of how we love to see ourselves. Again, University of Alberta has a course on it. INT D410 - <a href="https://catalogue.ualberta.ca/Course/Details?subjectCode=INT%20D&catalog=410">Interprofessional Health Team Development</a>.<br />
<br />
Like to think I've been a member of many teams in health care (my transfusion families over the years) but must admit that many who promote it most publicly do not walk the talk.<br />
<br />
<b><span style="background-color: white; color: #0b5394;">RECRUITING STAFF</span></b><br />
Will only speak to my recruitment to be 'assman' 21 years ago. Fact was the job was not quite as advertised. In retrospect I thought they portrayed part of the job almost as if it was what became <a href="https://blood.ca/en/hospital-services/customer-service/hospital-liaison-specialists">hospital liaison specialists</a>. I totally dug the part about the centre being the pilot site for a new information system and found it a worthwhile challenge.Our talented team of med lab professionals did a wonderful job in implementing the new IS.<br />
<br />
Similarly, I loved the opportunity to change outdated lab methods, though don't think they hired me for that. It was just my 'value added' to the job I held for all of 9 months. When I tendered resignation I explained why in exit interview. They understood more money wouldn't make a difference and admitted they could not change what I thought needed changing most (head office, though it's more complicated than that).<br />
<br />
So did CBS recruit the right person for the job? Yes and no. Yes, because I led the talented patient services lab team successfully through a difficult time of incredible change. No, because after years in academia at a university where dissent and free speech are cherished, I didn't fit in a national organization where adhering to head office directives was paramount. That's what made you a valued team member.<br />
<br />
<b><span style="color: #0b5394;">MANAGE YOUR TIME</span></b><br />
The radio consultant pointed out that managers need to prioritize their tasks and serve as role models for staff as they cannot work to 10 pm over the long term. I don't have much to say except that you obviously cannot help others if you're exhausted. See it as a Buddhist concept that you need to love yourself, be okay with who you are, in order to love and help others. Over my entire career I was often the first in and last out daily but that's another story.<br />
<br />
<b><span style="color: #0b5394;">CONCLUSION</span></b><br />
Are AI, big data,new technology, precision medicine all important to health care and more crucial than the qualities of people in leadership positions? Perhaps. But not to me. As a human being on plant earth, I'll always value the human condition over technology. See excerpt from 2001, a Space Odyssey (Further Reading).😁<br />
<br />
<b><span style="color: #0b5394;">FOR FUN</span></b><br />
Chose this song because I've lived long enough to see transfusion medicine evolve from being people-focused to technology-focused. As early adopter of technology (not a Luddite), I doubt we're on the right track (Further Reading). Also, admit that I love the songs of Canada's Joni Mitchell.<br />
<ul>
<li><a href="https://www.youtube.com/watch?v=bcrEqIpi6sg">Both sides now</a> (Joni Mitchell, live in concert, 1970)</li>
</ul>
<b><span style="color: #0b5394;">FURTHER READING</span></b><br />
<ul>
<li><a href="https://www.cbc.ca/listen/live-radio/1-17-edmonton-am/clip/15738970-workplace-column-moving-into-management">Moving into management </a>(5:41 mins)</li>
<li><a href="https://www.ualberta.ca/health-sciences-education-research/standardized-patients/become-a-sp/standardized-patient-tools/give-feedback-corbs">CORBS</a> (for Standardized Patients, University of Alberta) </li>
<li><a href="http://www.patletendre.com/letendre-traq-meetings-tips.pdf">Meetings as Time Wasters</a> (by Pat Letendre)</li>
<li><a href="http://www.lsoft.com/news/qa-autumn2004-us.asp">Early adopter of technology</a> (My interview in 'Listserv at work', 2004)</li>
<li><a href="https://www.youtube.com/watch?v=qDrDUmuUBTo">2001, a Space Odyssey</a> (1968)</li>
</ul>
<br />
<br />Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-43202159424963148052019-08-31T16:59:00.000-06:002019-09-02T17:12:31.705-06:00Get back (Musings on transfusion medicine's future)<div style="text-align: center;">
<i>Updated</i>: <span style="background-color: #fff2cc;">1 Sept. 2019</span> (<i>Learning pt 4, Further Reading</i>)</div>
August's blog was inspired by a blog I saw on the UK's <a href="https://www.bbts.org.uk/">BBTS</a> website: <br />
<ul>
<li>Transfusion 2024: What did we learn and where will we be? (Further Reading)</li>
</ul>
To me Dr. Nicholas Watkins' blog had 3 related themes:<br />
<ul>
<li>
How to replace retiring staff (and their experience) with new staff, including retaining them.</li>
<ul>
<li>Innovation and technology can help </li>
<li>As can big data (electronic donor and patient records)</li>
</ul>
</ul>
The blog's title comes from a 1969 Beatles ditty. <br />
<b><br /><span style="color: #0b5394;">
MY TAKE</span></b><br />
Be aware I've worked in transfusion for decades. My views are biased by long experience as are the opinions of everyone.<br />
<br />
<b>
Staffing</b><br />
In the 1990s I saw how regionalization and centralization of hospital transfusion service laboratories affected staffing, along with semi-automatic instruments. In Alberta, Canada (perhaps everywhere?) that meant many transfusion labs required fewer knowledgeable specialists and could get by with mostly medical technologists who were generalists, plus lab assistants. Another factor was an AB conservative government that removed 40% of the province's lab budget to decrease a budgetary deficit. <br />
<br />
Similar changes across Canada resulted in all medical lab educational programs closing in Western Canada except for the two in Edmonton, NAIT and the University of Alberta's <a href="https://www.ualberta.ca/medicine/programs/mls">MLS</a>. I taught in MLS but as the University of Alberta Hospital's transfusion service clinical instructor I also taught <a href="https://www.nait.ca/programs/medical-laboratory-technology?term=2019-fall"> NAIT</a> med lab students.<br />
<br />
Automation came much earlier to blood supplier donor testing labs. In effect donor testing labs could be mostly staffed by technologists experienced in highly automated clinical chemistry labs. <br />
<br />
<span style="background-color: #fff2cc;">
Learning point #1</span>:<br />
To me, these events meant a huge loss of laboratory transfusion expertise in immunohematology. In Edmonton, Alberta, for example, experienced technologists had to compete for the few remaining jobs based on seniority and many left the field. Those with a BSc in Med Lab Science (who wrote ASCP exams) were able to move to USA (and overseas to countries such as NZ) and work for years. <br />
<br />
I don't see 'innovation and technology' as truly helping the loss of expertise except in the sense it means:<br />
<ul>
<li>
Med lab profession can be 'dumbed down.' With increasing technology no one needs much expertise to perform routine tasks. And I don't mean generalists and lab assistants are 'dumb', I respect them for their skills, just that their lack of transfusion expertise is the new normal in many labs. </li>
<li>We can only hope so long as serology survives, there's a safety net in all workplaces where the few knowledgeable staff catch any errors.</li>
</ul>
<span style="background-color: #fce5cd;">
Learning point #2</span>: <br />
Today the biggie is molecular testing, which means immunohematology expertise will eventually become passé<span style="background-color: white; color: #878787; font-family: "arial" , sans-serif; font-size: x-small;">.</span> <span style="background-color: white;">Presumably</span>, if biotech manufacturers succeed with marketing campaigns that promote matching blood donors and transfusion recipients for antigens with known genes, not just in multi-transfused patients but as the gold standard for ALL transfusion recipients, serologists will no longer be needed. <br />
<br />
Transfusion recipients will no longer develop alloantibodies from transfusion, except for ones the DNA PhD gurus haven't identified. But let's hype the hell out of <i>precision medicine</i> to increase profits of commercial interests.<br />
<br />
Sounds like a perfect world, no? Local med lab staff numbers shrink to a precious few. Their pesky staff benefits are greatly reduced as an employer cost. Instead of supporting a local economy, money is funneled to foreign biotech companies, who thrive by pleasing their shareholders who grow richer and richer.<br />
<br />
<b>
Big Data</b><br />
Yep, big data can provide insights and feed into artificial intelligence (AI) to further remove error-prone humans from healthcare decisions. The downsides include patient privacy and the reality that machines make mistakes. <a href="https://dictionary.cambridge.org/dictionary/english/gigo">GIGO</a> rules and AI is only as good as human input. <br />
<br />
<span style="background-color: #fff2cc;">
Learning point #3</span>: Privacy is big data's greatest challenge and if it fails (as is likely), big data will become just another failed trend. As to AI, I suspect it's decades away from filling the skilled worker shortage in the transfusion world. But it's already got niche roles in medicine (Further Reading).<br />
<br />
<span style="background-color: #fff2cc;">Learning point #4</span>: Presumably one day in the distant future AI, automation, and robotics will make human work passé. It's already started and not just on car manufacturing assembly lines. Have you seen the Android robots from Japan or those providing robotic nursing care? With an aging population and worker shortage, robots can fill the bill. (Further Reading)<br />
<br />
My vision for the future includes humans who cannot communicate with other humans by talking and have developed enormous thumbs for texting and perhaps sexting. 😉<br />
<br />
<b><span style="color: #0b5394;">
FOR FUN</span></b><br />
Choose this Beatles ditty for blog's title song<br />
<ul>
<li><a href="https://www.youtube.com/watch?time_continue=33&v=zauqejl1W78">Get back</a> (Paul McCartney, Live in Lisbon 2004)</li>
</ul>
It's my attempt at a joke as we can never get back to the days where oldsters like me once belonged. 😄<br />
<br />
As always, comments are most welcome. And there are some - see below.<br />
<br />
<b><span style="color: #0b5394;">
FURTHER READING</span></b><br />
<ul>
<li><a href="https://www.bbts.org.uk/blog/transfusion2024_what_did_we_learn_and_where_will_we_be_/">Transfusion 2024: What did we learn and where will we be?</a></li>
<li><a href="https://www.youtube.com/watch?v=hlHrvQ7D5OU">Android robots</a> (3:07 min. video)</li>
<li><a href="https://www.latimes.com/world-nation/story/2019-07-25/desperate-for-workers-aging-japan-turns-to-robots-for-healthcare">Desperate for workers aging Japan turns to robotic nursing care</a> (25 July 2019)</li>
<li><a href="http://sitn.hms.harvard.edu/flash/2019/artificial-intelligence-in-medicine-applications-implications-and-limitations/">Artificial Intelligence in Medicine: Applications, implications, and limitations</a> (19 June 2019)</li>
<li>Chen JH, Asch SM. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5953825/">Machine learning and prediction in medicine — beyond the peak of inflated expectations.</a> N Engl J Med. 2017 Jun 29; 376(26): 2507–9.</li>
</ul>
Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-13860704888011389942019-07-31T20:10:00.000-06:002019-07-31T22:43:11.669-06:00Look what they've done to my song Ma (Musings on invisible health professionals)July's blog, another short one, was stimulated by an editorial in the Archives of Pathology; Laboratory Medicine, August 2019: Emerging From the Basement: The Visible Pathologist. (Further Reading)<br />
<br />
The editorial reminded me that a hematopathologist I once worked with told me, "Pat, just like medical laboratory technologists/scientists (biomedical scientists in UK, Australia, NZ) feel invisible, at the bottom of the health professional pecking order, so do pathologists of all specialties." <br />
<br />
Also on the local scene in Alberta, Canada, a new provincial government just cancelled a needed planned hub lab in Edmonton, with the new government implying they wanted to concentrate on patient care (as if clinical laboratories didn't affect patients) and the centralized superlab/ hub lab was a waste of money best spent elsewhere. The new Premier Jason Kenny argued the changes (new consolidated hub lab) would do nothing to improve patient services. <br />
<br />
The blog's title derives by a 1970 song by Melanie Safka.<br />
<br />
<b><span style="color: #0b5394;">
INTRODUCTION</span></b><br />
My take has always been that most folk don't have a clue what medical laboratory technologists/ biomedical scientists do. Suspect they assume we are merely the vampires/blood suckers who draw their blood samples for lab tests. Generally, folks do not realize we are highly educated and trained professionals who play an critical role in assisting physicians to diagnose and treat patients. <br />
<b><span style="color: #0b5394;"><br />
PROMOTING THE PROFESSION </span></b><br />
Fact is med lab science and clinical labs need to be more visible to the public. In this section I'm going to include tweets of colleagues and former students (my beloved 'kids') who are using Twitter to promote med lab science and make the case for why clinical labs merit respect as playing an as important in patient care. <br />
<b><br /><span style="color: #0b5394;">
Tweets and News</span></b><br />
Folks you can see tweets without being on Twitter. If you are asked to join, just ignore the dialogue box asking you to join and click on the tweet off the dialogue box. All tweets are short, please read them. <br />
<br />
1. <a href="https://twitter.com/Tee_Know/status/1154014039111946245">Thanks to all who came out to the CSMLS open forum last night </a><br />
<br />
2. <a href="https://twitter.com/bogeywheels/status/1149813081318445056">AHS Newborn Metabolic Screening program </a><br />
<br />
3. <a href="https://twitter.com/Halpingal/status/1146462931439116289">Cancelling superlab undermines foundation of patient care</a><br />
<br />
4. <a href="https://twitter.com/RobinStocks2/status/1154982580678094850">Finally - someone took a look at what's going on</a><br />
<br />
5. <a href="https://threadreaderapp.com/thread/1154450071427198977.html">Short-sighted decision to halt ongoing construction of the Edmonton Clinical Lab Hub</a><br />
<br />
6. <a href="https://twitter.com/ShawnaGofABPoli/status/1154398757863038976">Yet another example of the importance of lab medicine</a><br />
<br />
7. <a href="https://twitter.com/thefirstjoel/status/1150899869394984960">Pictured here are very passionate medical lab professionals seeking to educate Albertans of the critical role med lab plays in quality patient care</a> <br />
<br />
8. <a href="https://twitter.com/Halpingal/status/1150544574248472576">Clinical labs save lives</a>. We have no space & aging equipment. Cancellation of Northern AB Hub Lab leaves us wondering how will this crisis be addressed? <br />
<br />
9. <a href="https://twitter.com/thefirstjoel/status/1146896146742145025">Thank you for helping champion the voice of the medical lab profession and its critical role in effective quality patient care</a>. <br />
<br />
<b><span style="color: #0b5394;">
FOR FUN</span></b><br />
I chose this song because I'm disappointed that medical lab technologists (biomedical scientists) still have to fight to be visible to the public, including some politicians, after all these years. I came to the med lab science field by a non-traditional route 55years ago and still we face the same challenges. <br />
<ul>
<li><a href="https://www.youtube.com/watch?v=Cqg3kcwAgso">Look what they done to my song Ma (</a>Melanie Safka)</li>
</ul>
Look what they've done to my song, Ma<br />
Look what they've done to my song<br />
Well, it's the only thing I could do half right<br />
And it's turning out all wrong, Ma<br />
Look what they've done to my song <br />
<br />
<b><span style="color: #0b5394;">
FURTHER READING</span></b><br />
Harrold IM, Bean SM, Williams NC. <a href="https://www.archivesofpathology.org/doi/full/10.5858/arpa.2019-0020-ED">Emerging from the basement: the visible pathologist.</a> Arch Pathol Lab Med. 2019 Aug;143(8):917-8.<br />
<br />
Health Quality Council of Alberta: <a href="https://www.hqca.ca/wp-content/uploads/2018/05/Provincial_Plan_for_Integrated_Laboratory_Services_in_Alberta_FINAL_.pdf">Provincial Plan for Laboratory Services in Alberta</a> (February 2017)<br />
<br />
<a href="https://www.ualberta.ca/medicine/news/2019/june/leaning-into-the-challenge-of-medical-science">Leaning into the challenge of medical science</a> (4 June 2019)<br />
<br />
<a href="https://www.thestar.com/edmonton/2019/07/24/time-is-ticking-national-group-wants-united-conservatives-to-come-up-with-solutions-after-cancellation-of-edmonton-superlab.html">The UCP government scrapped Edmonton's 'superlab'</a>. Medical experts say Alberta needs an alternative and fast (24 July 2019)<br />
<br />
<a href="https://globalnews.ca/news/5677728/medical-lab-group-alberta-ucp-cancel-superlab-dynalife/">Medical lab group pushing Alberta government to address gaps after cancelling superlab</a> (24 July 2019)<br />
<br />
<a href="https://globalnews.ca/news/5413687/edmonton-medical-superlab-cancelled/">Alberta government keeps promise to cancel construction of medical superlab</a> (20 June 2019)<br />
<br />
<a href="https://labtestsonline.org/">Lab Tests Online</a>: For anyone interested in what medical lab professionals do and information on your lab tests resultsBluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-9507343315528456542019-06-30T17:06:00.001-06:002019-07-01T12:45:01.357-06:00I will remember you (Musings on Marion Lewis, an extraordinary Canadian)On June 27 Julie Payette, Governor General of Canada, announced new appointments to the Order of Canada. Included in the honours was Marion Lewis of Winnipeg, who at age 93 was named an Officer of the Order of Canada (<i>Further Reading</i>).<br />
<br />
As my early career was in Winnipeg I was well familiar with Marion Lewis and Dr. Bruce Chown. In 1944, she and Dr. Bruce Chown opened the Rh Laboratory to study and eradicate Rh hemolytic disease of the fetus and newborn (HDFN).<br />
<br />
The blog's title is based on a 1995 ditty by Sarah McLachlan.<br />
<br />
<b><span style="color: #0b5394;">FROM HUMBLE BEGINNINGS</span></b><br />
In 1943 Marion Lewis graduated from high school and trained as a 'medical technician' at Winnipeg General Hospital (now Health Science Centre). In those days there were no post-secondary institutions training what today we call medical laboratory technologists/scientists ('biomedical scientists' in UK and Down Under). As noted, only a year later she was at Winnipeg's Rh Laboratory with Dr. Bruce Chown.<br />
<br />
With a Bachelor of Arts degree she became a Full Professor in the Dept of Pediatrics and 2 years later a Professor in Dept. of Human Genetics. Normally that's reserved for those with MD or PhD degrees. In 1971 Marion shared <a href="http://www.aabb.org/">AABB</a>'s Karl Landsteiner Memorial Award with Dr. Bruce Chown in 1971. To me, it's AABB's most prestigious award. And it's not the only AABB award she received.<br />
<ul>
<li><a href="http://www.aabb.org/about/awards/Pages/descriptions.aspx#landsteiner">Karl Landsteiner Award</a></li>
<li><a href="http://www.aabb.org/about/awards/Pages/recipientspast.aspx">Past recipients</a> (Check these TM giants out: Levine, Wiener, Race, Sanger, Morgan, Watkins, Mollison, Dausset, Blumberg, Crookston<span style="font-family: "arial" , "helvetica" , sans-serif;">, Bowman, Issitt, <span style="background-color: white;">Gallo, </span><span style="background-color: white;">Montagnier, </span></span>et al.)</li>
</ul>
<b><span style="color: #0b5394;">TIDBITS</span></b><br />
It's fascinating that in 1950-51 Marion Lewis needed a break and spent four months at an Italian university studying Italy's language and culture. Then she spent another three months studying in London with Dr. Robert Race and Dr. Ruth Sanger of 'Blood Groups in Man' fame. In 1951 Marion returned to Winnipeg and the Rh Lab. And the rest is history (See her University of Manitoba biography in <i>Further Reading</i>).<br />
<br />
Please read <i>Further Reading</i> for Marion's unique career.<br />
<br />
Of course, I knew Dr. Jack Bowman of Winnipeg's Rh Lab well as he was the Medical Director of Winnipeg's Can. Red Cross BTS while I still worked there. Wrote a blog when he died in 2005 (<i>Further Reading</i>).<br />
<br />
<b><span style="color: #0b5394;">FOR FUN</span></b><br />
Chose this Sarah McLachlan song because I will always remember transfusion medicine giants and especially folks like Marion Lewis who rose from humble beginnings to great accomplishments on the strength of intellect, skills, and hard work.<br />
<ul>
<li><a href="https://www.youtube.com/watch?v=uHooH4464dQ">I will remember you</a> (Canada's Sarah McLachlan)</li>
</ul>
<div>
As always, comments are most welcome.</div>
<div>
<br /></div>
<b><span style="color: #0b5394;">FURTHER READING</span></b><br />
<ul>
<li><a href="https://www.gg.ca/en/media/news/2019/governor-general-announces-83-new-appointments-order-canada">Governor General's announcement on appointments to the Order of Canada</a> (27 June 2019)</li>
<li>University of Manitoba: <a href="http://umanitoba.ca/libraries/units/archives/collections/complete_holdings/ead/html/M.Lewis2.shtml#tag_bioghist">Marin Lewis biography</a></li>
<li>CBC news: <a href="https://www.cbc.ca/news/canada/manitoba/order-of-canada-winnipeg-manitoba-marion-lewis-1.5193354?__vfz=medium%3Dsharebar">Marion Lewis's Order of Canada</a> (27 June 2019)</li>
<li><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=lewis+M%5Bau%5D+chown+b%5Bau%5D">Lewis and Chown</a> - PubMed papers</li>
<li><a href="https://traq.blogspot.com/2005/06/dr-jack-bowman-in-memoriam.html">Dr. Jack Bowman (In memoriam)</a> - 2005 blog</li>
</ul>
Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-47660303770982788682019-06-01T18:53:00.000-06:002019-06-03T07:55:08.625-06:00We can work it out (Musings on transfusion association annual meetings)<div style="text-align: center;">
<i>Last revised</i>: <span style="background-color: #fff2cc;">2 June 2019 </span><span style="background-color: white;"> (See <a href="http://traq.blogspot.com/2019/06/we-can-work-it-out-musings-on.html#addendum">ADDENDUM </a>below)</span></div>
<br />
<b><span style="color: #0b5394;">INTRODUCTION</span></b><br />
As the CSTM annual conjoint meeting with CBS and <span style="background-color: white; font-family: "arial" , sans-serif;"><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Héma</span></span></span><span style="background-color: white; font-family: "arial" , sans-serif; vertical-align: inherit;"><span style="vertical-align: inherit;">-</span></span><span style="background-color: white; font-family: "arial" , sans-serif;"><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Québec</span></span></span> is now on May 29 to June 2, I thought I'd muse on annual meetings in general. As readers of this blog will know, I've had a long career in transfusion starting at the bottom without qualifications but being incredibly fortunate in my employers.<br />
<br />
I'm an outlier of sorts with atypical views and being an oldster gives me the freedom to say things that colleagues likely would not. Perhaps many may disagree with me on this blog's points. That's okay too as I'd be concerned if all, even most, agreed with me. Included are tidbits I think contribute to quality presentations at meetings.<br />
<br />
Professional associations exist to serve and represent the interests of their members, which applies to the three associations I belonged to during my long career as a medical lab technologist turned educator: <a href="http://www.aabb.org/">AABB</a>, <a href="http://csmls.org/">CSMLS </a>(includes <a href="http://www.ifbls.org/">IFBLS </a>membership), <a href="http://www.transfusion.ca/">CSTM</a>. The latter two are Canadian organizations, the first American but AABB has branched out to become international, though its headquarters remains in the USA as does its primary focus.<br />
<br />
The blog's title is based on a 1965 Beatles ditty, We Can Work It Out.<br />
<br />
<b><span style="color: #0b5394;">LESSONS LEARNED</span></b><br />
Over the years I've attended many meetings, aka conventions and congresses. With a few exceptions most of all those attended were held in Canada by CSMLS or CSTM. One memorable one (IFBLS) was held in Oslo in 1996. Why memorable? Most of all it was because I met a Norwegian med lab technologist who worked in transfusion and we've been good pals ever since.<br />
<br />
To me, that's Lesson #1 of what's important at annual meetings. It's not so much the scientific presentations you hear and what, if anything, you learn from them (commit to long-term memory). Face it, if you read professional journals you're pretty up-to-date on the latest and greatest. During my career the AABB journal <i>Transfusion </i>and similar were kept in the bathroom as a welcome distraction or read while basking outside in Canada's all too short spring, summer, fall.<br />
<br />
Of course, I suspect not many transfusion technologists and nurses in the trenches regularly read journals. Take a peak at the <a href="https://onlinelibrary.wiley.com/toc/15372995/2019/59/5">index of <i>Transfusion </i></a>2019;59(5). How many articles would you read let alone understand?<br />
<br />
Today, keeping current also applies to those on social media platforms like Twitter where journals and associations alert folks to the latest developments. But how many of you use Twitter?<br />
<br />
<span style="background-color: #fff2cc;">LESSON #1</span>: The most valuable benefits of meetings are the interactions with peers, sharing experiences and knowledge that's not in journals or textbooks, including the friendships made. Often such interchanges are shared during a night-out over a meal or glass of wine/beer. Typically, chitchat involves practical and <a href="https://dictionary.cambridge.org/dictionary/english/tacit-knowledge">tacit knowledge</a> only gained from experience.<br />
<div style="text-align: center;">
~~~~~~~~~~~~~~~~</div>
Pretty certain that Lesson #2 will be familiar to medical lab technologists/scientists world-wide, at least those lucky enough to attend meetings:<br />
<ul>
<li>So many of the presentations at transfusion association meetings are by physicians and researchers, though it's slowly changing. </li>
</ul>
What this means is the information and research presented, though significant, is often not particularly meaningful nor of immediate use to those in the trenches, whether transfusion med lab techs, nurses, physicians without university appointments. And being able to use new meaningful learning right away is important to busy adult learners. In continuing education and professional development courses it's critical because 'adults vote with their feet' as the cliché goes.<br />
<br />
Indeed, I wonder in the age of the smart phone how many meeting attendees during presentations spend most of the time checking e-mail, texting and browsing. Suspect it's far too many. Best take is they're live tweeting but no, that's not it.<br />
<br />
Reality is that much transfusion research is esoteric, of interest mainly to those involved in similar, narrow research. Kudos to CSTM for its full day of workshops relevant to front-line professionals.<br />
<br />
<span style="background-color: #fff2cc;">LESSON #2:</span> Many presentations at scientific meeting are of minimal value to attendees, especially those who work in the trenches on the front-lines of transfusion, those in the lab and those on the wards. If you're a PhD or MD/PhD researcher and the topic coincides with your interests, the talks are no doubt fascinating.<br />
<div style="text-align: center;">
~~~~~~~~~~~~~~~~</div>
Lesson #3 relates to a sad fact of life for many in the trenches. Years ago funding for CE/CPD was scaled back significantly. The result is fewer and fewer attend national meetings (unless local), let alone international ones. Today the cost of airfare and hotels is increasingly exorbitant.<br />
<br />
Who can afford it? My guess includes<br />
<ul>
<li>Physicians and researchers who get funding support or earn large salaries, along with those in senior positions. </li>
<ul>
<li>Bench technologists and front-line transfusion nurses not so much. </li>
</ul>
<li>Educators and those in health profession unions who get discretionary funds to use for CE/CPD but the funding wouldn't come close covering travel and hotel costs to attend meetings outside their locale. </li>
<li>Some associations fund invited presenters, but not all.</li>
<li>An association's board of directors, whose members are volunteers and put in much dedicated time and a tiny perk is funding to attend meetings.</li>
</ul>
Many transfusion associations/organizations now offer local CE/CPD events across the country or provincially, including CSTM's Education Days. And thanks to the Internet, technology makes webcasts and podcasts possible.<br />
<br />
<span style="background-color: #fff2cc;">LESSON #3:</span> To what extent have annual meetings become a place for the 'elites' to meet and interact? By elites, I mean those professionals fortunate to have funding or be wealthy enough to attend if the meeting is not in their locale and schmooze with other elites? It's a question to which I do not have an evidence-based answer, yet suspect it may be true.<br />
<div style="text-align: center;">
<span style="text-align: center;">~~~~~~~~~~~~~~~~</span></div>
Lesson #4 has been a pet peeve of mine for ages and relates to the quality of presentations at meetings by the biggies, the so-called '<a href="https://dictionary.cambridge.org/dictionary/english/thought-leader">thought leaders</a>' of a profession. My experience is presentation quality is often awful, bordering on pathetic.<br />
<br />
It's one reason I'm so glad that <a href="https://www.ualberta.ca/medicine/programs/mls">Medical Laboratory Science</a> at the University of Alberta has a communications course that includes how to give presentations and gives students opportunities to practice the skills, including presenting their research projects.<br />
<br />
Wish all MSc/PhD graduate and medical education programs included such a course. About physicians, my experience is, if a communication course or any professional development program, is not given by a physician, they devalue it. Apparently only physicians can teach physicians.😞<br />
<br />
To me the biggest, common presentation failures include NOT doing the following, relevant to physicians, especially. BTW, the points are basic, equivalent to <i>Presentation 101</i> courses.<br />
<ul>
<li>Begin with a personal anecdote to grab audience attention immediately and get them to appreciate your authenticity, that you've 'been there, done that,' and dig their professional realities.</li>
<li>Explain up-front why the talk is relevant to the audience.</li>
<ul>
<li>For gawd sake, don't keep it a secret.</li>
</ul>
<li>Briefly outline what the talk is about, perhaps even say, if that's not what you expected, feel free to exit now. </li>
<ul>
<li>Shows you respect the needs of audience.</li>
</ul>
<li>Mention there will be time at the end for questions, if the person who introduced you did not.</li>
<li>Distribute handouts at the end and say that up front. </li>
<ul>
<li>Include your speaker notes in handouts so the audience has something substantive to take away.</li>
<li>In the early days of Powerpoint I don't know how many handouts I brought home from meetings, including making notes on each slide myself, that were all but useless and eventually tossed in a trash can.</li>
<li>Fact: If you distribute handouts at the start of a talk, the audience will concentrate on them, not what you are saying.</li>
</ul>
<li>Use mostly graphics in the presentation vs bullet points. It's a way to get folks to listen to what you say.</li>
<ul>
<li>If you use a few slides with bullets, do NOT use complete sentences and, regardless, NEVER read the points word for word unless you want to put the audience to sleep.</li>
</ul>
<li>Forget about using any busy slides you have where the writing is minuscule and unreadable.</li>
<ul>
<li>Just don't, no matter what.</li>
<li>Saves you the trouble of cynically apologizing for it being busy.</li>
<li>Because obviously you included the slide anyway, thus disrespecting your audience's intelligence. </li>
</ul>
<li>Throughout the talk refer to the experiences of colleagues and audience members you recognize, and sprinkle the presentation with their work.</li>
<ul>
<li>It's not all about you, it's about those who helped you succeed.</li>
<li><a href="https://dictionary.cambridge.org/dictionary/english/self-deprecating">Self-deprecating</a> humour, if sincere, is appreciated by listeners.</li>
</ul>
<li>Focus on key points only.</li>
<ul>
<li>Though tempting, do not succumb to presenting all your data and conclusions.</li>
<li>Few viewers are as obsessed with the topic as you are.</li>
<li>The fewer key learning points, the more they will be remembered because of info overload.</li>
</ul>
<li>At talk's end, briefly tell the audience what you told them and reinforce why it's significant and relevant to them. </li>
<li>Thank the audience for their attention and thank conference organizers for inviting you.</li>
<li>With questions at the talk's end, even if you get snarky questions (yep, there are always all-about-me colleagues), try to be gracious, realizing that to most in the audience, the asker is showing themselves in a bad light and you are better than them.</li>
<ul>
<li>Taking the high road always wins.</li>
</ul>
</ul>
<span style="background-color: #fff2cc;">LESSON #4:</span><span style="background-color: white;"> P</span>hysicians and researchers, at least try to learn how to present well. I realize you could care less as you've gotten away with pathetic presentations forever and have zero motivation to change. But please try to be better because it has many rewards, adds to your reputation.<br />
<div style="text-align: center;">
<div style="text-align: center;">
~~~~~~~~~~~~~~~</div>
<div style="text-align: left;">
<a href="https://www.blogger.com/null" name="addendum"></a><b><span style="color: #0b5394;">ADDENDUM</span></b></div>
<div style="text-align: left;">
First a <span style="background-color: #fff2cc;">disclosure</span>. Folks, for most of my career I was one of the fortunate 'elites' I referenced earlier, mainly by virtue of volunteer positions for professional associations, being an invited speaker at conferences where organizers funded travel and hotel costs, or as a perk of being an educator at a university. </div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
One thing I noticed in those days of yore versus today's national meetings is that now there seem to be <span style="background-color: #fff2cc;">fewer young attendees</span>. Perhaps it's my imagination or just that all professions are aging and those in senior positions are older than before. Or maybe not.</div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
While I hesitate to mention this, one reason could be that younger med lab technologists/scientists may not be as keen as we were in what I call the 'golden age of immunohematology.' Perhaps when considering annual fees, younger folks and many older ones too, wonder if it's worth it, questioning the benefits of membership. That is, they first ask </div>
<div style="text-align: left;">
</div>
<ul>
<li style="text-align: left;"><span style="background-color: #fff2cc;">What will the association and being a member do for me?</span> <span style="background-color: #e06666;">vs</span></li>
<ul>
<li style="text-align: left;"><span style="background-color: #fff2cc;">What can I do for my association?</span></li>
<li style="text-align: left;"><span style="background-color: #fff2cc;">How can I give back to my profession?</span></li>
</ul>
</ul>
<div style="text-align: left;">
Or it could be that membership for some has become a financial burden. For example, in Canada registration with provincial regulatory colleges is compulsory for med lab techs,e.g. <a href="http://www.cmlto.com/index.php?option=com_content&view=article&id=1274&Itemid=675">CMLTO annual fees.</a> In contrast, membership in professional associations is voluntary and annual fees are a bargain in my opinion, e.g., CSTM $120 and CSMLS $167. But if you worked in Ontario and belonged to all three, the total would be $671.20. To me, that's just a tiny percentage of annual salaries and the benefits are many. </div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
Which brings me Julie Hendry's presentation. Julie is this year's recipient of the CSTM's Buchanan Award, who included this slide at the end of her talk (<span style="background-color: #fff2cc;">click to enlarge</span> - Julie's slide was tweeted by Geraldine Walsh and Clare O'Reilly on Twitter): </div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhup9bJ4UH5NFI8lLH9-YwEvHE66FgPUnSWKDEtq13Vsg60BUUOTxaAyg6FP9ghVDLRET3CJyCbAWq70RHGevLUHBxtxDCt4-jckct0FtQjxRNU9BpWIp1aXnA_1SG6O8eBSBCZ/s1600/julie-slide-cstm.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="376" data-original-width="693" height="173" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhup9bJ4UH5NFI8lLH9-YwEvHE66FgPUnSWKDEtq13Vsg60BUUOTxaAyg6FP9ghVDLRET3CJyCbAWq70RHGevLUHBxtxDCt4-jckct0FtQjxRNU9BpWIp1aXnA_1SG6O8eBSBCZ/s320/julie-slide-cstm.jpg" width="320" /></a></div>
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
Julie's challenge is a great one for CSTM members and members of all professions. We in the health professions are so lucky. </div>
<div style="text-align: left;">
<br /></div>
</div>
<span style="color: #0b5394;"><b>FOR FUN</b></span><br />
I chose this Beatles song because its lyrics fit the blog's content.<br />
<ul>
<li><a href="https://www.youtube.com/watch?v=Qyclqo_AV2M">We can work it out</a></li>
</ul>
As always, comment are most welcome (and there are some below).Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2tag:blogger.com,1999:blog-8729772.post-2707591005028712032019-04-30T18:34:00.000-06:002019-09-28T11:26:03.347-06:00The thing called love (Musings on folks who work in medical labs)<div style="text-align: center;">
<i>Last updated</i>: <span style="background-color: #fff2cc;">May 3, 2019</span> (See <a href="http://traq.blogspot.com/2019/04/the-thing-called-love-musings-on-folks.html#addendum"> ADDENDUM</a> below)</div>
Another short blog, this one about National Medical Laboratory Week (NMLW), April 21-27, 2019. My story is one that's hardly ever told because oldsters like me don't normally write blogs,<br />
<br />
Folks, I came to work in a clinical lab by an atypical route. To test myself, as an individual who was terrified of being asked a question in high school, I followed some of my pals into unusual UManitoba teacher training. We were to spend several summers in Faculty of Education and get BEd. <br />
<br />
My most vivid memory was the Dean telling me I'd never be a good teacher because my handwriting was poor. Hard to believe but the dude said it to my face. Regardless, after the first 3-month summer session I was hired by a HS in Baldur, MB. That experience was wonderful and I'll never forget it. Many students were older than 20-yr-old me and their parents totally supported teachers.<br />
<br />
However, when the opportunity arose to move back to Winnipeg and be near to my family, I took it. The opportunity came from a university pal who told me that Canadian Red Cross Blood Transfusion Services (CRC-BTS) hired BSc grads. In retrospect that was crazy as folks like me knew nil about blood and laboratory medicine. <br />
<br />
Note: Winnipeg's CRC-BTS was unique in Canada, a combined blood centre and transfusion service for Winnipeg and the province of Manitoba and beyond into northern Ontario. BSc grads were hired because training for med lab technologists in Winnipeg was poor. CRC-BTS was the only show in town and the training community college students received was inadequate. Most were afraid to work in transfusion labs. Hence they hired untrained innocents like me. <br />
<br />
Fact: When hired in 1964, I well recall asking CRC-BTS colleagues what the yellow stuff was after the whole blood donation had settled. My knowledge was NIL. Today I would never be hired and that's a good thing.<br />
<br />
<b><a href="https://www.blogger.com/null" name="addendum"></a><span style="color: #0b5394;">ADDENDUM</span></b><br />
To flesh out the above tale of my start at CRC-BTS an excerpt from a 2014 blog, <a href="https://traq.blogspot.com/2014/10/bridge-over-troubled-waters-musings-on.html">Bridge over troubled water</a> (<i>Musings on what to be thankful for as TM professionals</i>):<br />
<blockquote class="tr_bq">
The reason Canadian Red Cross Blood Transfusion Service hired BSc grads because most med lab tech grads from Red River Community College (RRCC) were afraid to work there.' I later learned the fear was largely because the clinical rotation was pathetic. Students spending most time labelling tubes and similar <a href="http://www.merriam-webster.com/dictionary/scut%20work">scut work</a> in between being told by technologists to get the ABO group right or they could kill a patient. Did I mention the clinical rotation was only 2 weeks then? </blockquote>
<blockquote class="tr_bq">
Soon I started work in a large combined blood centre and transfusion lab, the latter doing compatibility testing for all city hospitals and beyond, plus prenatal testing for northwestern Ontario. At first, I did not even know what the yellow stuff was when the red cells settled. </blockquote>
<blockquote class="tr_bq">
I'm so <b>thankful </b>for the <b>mentoring </b>of generous colleagues. And for <b style="background-color: #fff2cc; color: #333333;">wanting and </b><span style="background-color: #fff2cc; color: #333333;"><b>needing to read the 'bibles' of TM</b></span> from front to back (every word). The books were penned by such icons as Issitt and Mollison, and included the AABB Technical Manual and a 'little red book' written for Red Cross staff by <a href="https://www.legacy.com/obituaries/thestar/obituary.aspx?n=bpl-moore-paddy&pid=154929290&fhid=12298">Dr. B.P.L. (Paddy) Moore</a><span style="background-color: white; color: #333333;"> (and others), National Director of the Red Cross Blood Group Reference Laboratory, who died in 2011. I wrote about Dr. Moore in a 2007 blog, '</span><a href="http://traq.blogspot.ca/2007_03_01_archive.html">My life as a blood eater</a>.' </blockquote>
<blockquote class="tr_bq">
I worked in Winnipeg for 13 years, got Subject certification in Transfusion Science (no longer offered) from what is now <a href="http://www.csmls.org/">CSMLS</a>. My last 3 years were as the clinical instructor for new laboratory staff, RRCC students, and medical residents doing a transfusion medicine rotation in the only show in town. How crazy is that?</blockquote>
<blockquote class="tr_bq">
Looking back, I'm <b>thankful </b>that I worked in a <b>busy laboratory</b> where you <b>never knew what to expect</b>. Besides the routine of pretransfusion testing for scheduled surgery and anemic patients, at any time 24/7 patients might need massive amounts of blood in a hurry from a ruptured aneurysm to a GI bleed to a placenta previa during delivery. Often the lab was chaotic but it was organized chaos, even if that's an oxymoron.</blockquote>
<blockquote class="tr_bq">
Moreover, <b>I'm thankful </b>that in those days work was mostly <b>hands-on</b> and issues arose daily that required <b>problem solving</b>. For example, I worked with <a href="https://passages.winnipegfreepress.com/passage-details/id-96654">Dr. John Bowman</a> when he did the first trials of antenatal Rh immune globulin and was involved in the work that led to this paper (I'm the Pat mentioned in the paper):<br />
<ul>
<li>Lewis M, Kaita H, Anderson C, Chown B. <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.1971.tb04406.x/abstract" style="color: maroon;">Independence of Colton blood group</a>. Transfusion. 1971 Jul-Aug;11(4):223-4.</li>
</ul>
</blockquote>
Which is why I'm so privileged to have worked in transfusion for more than 50 years. Why I love my kind Med Lab Sci colleagues at the University of Alberta who overlooked my weaknesses and generously taught me what I didn't know. Why I love my students, who were smarter and more knowledgeable than I was, who tolerated me calling them 'kids.' And so many went on to become leaders in many areas. <br />
<br />
<b><span style="color: #0b5394;">FOR FUN</span></b><br />
Chose Bonnie Raitt ditty because I'm a fan and it's how I feel about medical labs, especially transfusion services.<br />
<ul>
<li><a href="https://www.youtube.com/watch?time_continue=42&v=shnHm8D-XRk">The thing called love</a> (Bonnie Raitt and Bruce Hornsby) </li>
</ul>
As always, comments are most welcome. See some below.Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com4tag:blogger.com,1999:blog-8729772.post-6293989670545176412019-03-31T17:20:00.001-06:002020-09-26T14:25:27.431-06:00I heard it through the grapevine (Musings on value of Twitter)<span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="color: #333333;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white;">The idea for March's blog was stimulated by 'Social media use for pathologists of all ages' (Further Reading). The article begins as follows:</span></span><br />
</span><blockquote class="tr_bq">
<span face=""arial" , "helvetica" , sans-serif" style="color: #333333;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white; font-family: arial;"><i>Pathologists have shown an increasing acceptance of professional social media use in recent years. There are currently more than 4700 pathologists and pathology-related accounts on Twitter per an online list maintained by one of the authors.</i></span></span></blockquote>
<span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="color: #333333;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white;">Based on personal experience, my guess is that few medical laboratory technologists are on Twitter, especially those working in transfusion. Perhaps because it came after Facebook (founded 2004), Twitter (founded 2006) is a mystery to many. Find that sad but understand why. Blogged on Twitter before (Further Reading). </span></span><br />
<span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #333333;"><br /></span>
<span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #333333;">Back in 1994 I founded a mailing list (</span><a href="http://www.lsoft.com/news/qa-autumn2004-us.asp">MEDLAB-L</a><span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #333333;">),early social media. Delighted that many med lab technologists and physicians from all over the globe subscribed. </span><br />
<span face=""arial" , "helvetica" , sans-serif"><span style="background-color: white; color: #333333;">Blog's title derives from 1966 ditty recorded by Marvin Gaye and later </span><span face=""arial" , "helvetica" , sans-serif" style="color: #333333;">Creedence Clearwater Revival. </span></span><br />
<span face=""arial" , "helvetica" , sans-serif"><span face=""arial" , "helvetica" , sans-serif" style="color: #0b5394;"><span style="background-color: white;"><b><br /></b></span></span></span>
<span face=""arial" , "helvetica" , sans-serif"><span face=""arial" , "helvetica" , sans-serif" style="color: #0b5394;"><span style="background-color: white;"><b>UNDERSTANDING TWITTER</b></span></span></span><br />
<a href="https://help.twitter.com/en/using-twitter/create-twitter-account">Signing up on Twitter is easy.</a><span face=""arial" , "helvetica" , sans-serif" style="background-color: white; color: #333333;"> Tidbits:</span><br />
</span><ul>
<li><span face="arial, helvetica, sans-serif" style="background-color: white; color: #333333; font-family: arial;">Language: Twitter is the software platform. You are a tweep. When you post a message, it's a tweet. </span></li>
</ul>
<ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">If not on Twitter when accessing a tweet and asked to join, just click on another part of the screen and you can see direct tweets. </span></li>
</ul>
<ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">Be aware you don't need to tweet. Just as on earlier mailing lists, you can lurk. </span></li>
</ul>
<ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">By being on Twitter you can see the replies given by tweeps to other tweeps. If not, you can see only their direct tweets (not replies). </span></li>
</ul>
<ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">Twitter gives you quicker access to important professional events and issues, allows you to share resources with colleagues. </span></li>
</ul>
<ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">As a citizen Twitter is the place to be because you get news about anything well before it appears on mainstream media, e.g., disasters, latest weather, political events. All media and reporters are on Twitter.</span></li>
</ul>
<ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">Twitter hashtags are key (Further Reading) For example, they can be used to identify who to follow. And you can also see who others follow for more suggestions.</span></li>
</ul>
<span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="color: #333333;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white;">As always, comments are most welcome.</span></span><br />
<b style="color: #0b5394;"><span face=""arial" , "helvetica" , sans-serif"><br /></span></b>
<b style="color: #0b5394;"><span face=""arial" , "helvetica" , sans-serif">FOR FUN</span></b><br />
<span face=""arial" , "helvetica" , sans-serif"><span face=""arial" , "helvetica" , sans-serif" style="color: #444444;">Chose this ditty because Twitter is a good grapevine,</span></span><br />
</span><ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="color: #444444; font-family: arial;"><a href="https://www.youtube.com/watch?v=wCCfc2vAuDU">I Heard it Through The Grapevine</a> (CCR)</span></li>
</ul>
<ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="color: #444444; font-family: arial;"><a href="https://www.youtube.com/watch?v=Y7dGdrP3pms">I Heard it through the Grapevine</a> (Marvin Gaye, live at Montreux) </span></li>
</ul>
<span style="font-family: arial;"><span face=""arial" , "helvetica" , sans-serif" style="color: #0b5394;"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white;"><b>FURTHER READING</b></span></span><br />
<span face=""arial" , "helvetica" , sans-serif">Gardner JM, McKee PH. </span><a href="https://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2018-0431-ED">Social media use for pathologists of all ages</a><span face=""arial" , "helvetica" , sans-serif">. Arch Pathol Lab Med. 2019 Mar;143(3):282-6.</span><br />
<span face=""arial" , "helvetica" , sans-serif"><br /></span>
<span face=""arial" , "helvetica" , sans-serif" style="color: #333333;"><a href="https://help.twitter.com/en/using-twitter/how-to-use-hashtags">Twitter hashtags</a> | </span><a href="https://twitter.com/search?q=%23transfusion&src=typd">Transfusion hashtag</a><br /><br />
<span face=""arial" , "helvetica" , sans-serif">My Twitter accounts</span><br />
</span><ul>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">Transfusion: <a href="https://twitter.com/oldbloodbanker">oldbloodbanker</a></span></li>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">Politics: <a href="https://twitter.com/bogeywheels">bogeywheels</a> </span></li>
<li><span face=""arial" , "helvetica" , sans-serif" style="font-family: arial;">Footie (soccer): <a href="https://twitter.com/eurofutball">eurofutball</a></span></li>
</ul>
Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com0tag:blogger.com,1999:blog-8729772.post-53178088233196716222019-02-26T18:09:00.003-07:002019-02-27T11:18:26.703-07:00Always on my mind (Musings on infected blood inquiries)<div style="text-align: center;">
<i>Stay tuned - Updates likely to occur</i></div>
<br />
The idea for this blog has roots in the <a href="https://www.infectedbloodinquiry.org.uk/">UK Infected Blood Inquiry</a> now in the news and the CBC's <a href="https://www.cbc.ca/mediacentre/program/unspeakable1">Unspeakable</a>, an 8-part television series (Jan. 9-Feb. 27) about Canada's 'tainted blood scandal' of the 1980s-90s.<br />
<br />
I will not go into too much detail as some topics discussed are emotional minefields for folks, eliciting strong opinions. The purpose is to offer food for thought and leave it to you, the reader, to think about the issues, according to your background and experience.<br />
<br />
The title derives from a 1969 ditty that Willie Nelson covered with much success in 1982.<br />
<br />
As you read,<span style="background-color: #fff2cc;"> please monitor your reactions</span>, since what we think and how we react to events largely depends on the emotional baggage we each carry. As one example of many, my reaction to blood inquiries is shaped by having worked for Canada's first blood supplier (Canadian Red Cross) for 13 years and for decades as a transfusion science educator. Also my views are shaped by being a bit of a contrarian who tends to challenge orthodox opinions of transfusion medicine's 'biggies' (thought leaders).<br />
<br />
<b><span style="color: #0b5394;">PURPOSE/PRINCIPLES OF INQUIRIES</span></b><br />
First, inquiries into infected blood tragedies are not concerned with criminal or civil liability. Supreme Court Decision of Canada (Attorney General) v. Canada (Commission of Inquiry on the Blood System) specifies<br />
<ul>
<li><a href="https://t.co/6mHs6q942U">Intent of the Krever Inquiry</a> (Hearings1993-5; Report1997)</li>
</ul>
Second, the same Supreme Court decision specifies<br />
<ul>
<li><a href="https://t.co/XpW8CKdxgp">Principles applicable to inquiries ~Krever's</a> </li>
</ul>
Note that inquiries can make findings of misconduct if they fall within the inquiry's terms of reference. If the same is true for the UK's inquiry, then folks looking for criminal and civil blame to be assigned will be disappointed. But misconduct that occurred or actions that failed standards of conduct will be identified and open to further investigation by the justice system.<br />
<br />
Given that memories fail and records disappear over time, especially sensitive ones, and self-interest makes few reveal their errors, based on Canada's experience, criminal prosecution is next to impossible. But civil suits, requiring a lower standard of proof beyond a reasonable doubt, may succeed.<br />
<br />
As in most legal matters, credibility of witnesses is crucial where no hard evidence exists. It's complicated because of self-interest. Few,if any, admit, 'I screwed up and made a bad decision, I'm partly to blame. Forgive me.' Those involved are far more likely to say, ' I did the best I could under difficult conditions. I didn't know all the facts or what would happen. No one did. Hindsight is 20-20.'<br />
<br />
From Canada's experience, an added key factor is that so many different players are involved, sometimes operating in silos, with no one ultimately responsible, that it's easy to claim, 'Not my responsibility.' All very convenient and I suspect Canada's blood system still has this fatal flaw despite its transmogrification, post-Krever.<br />
<br />
<b><span style="color: #0b5394;">PURPOSE/PRINCIPLES OF CRIMINAL JUSTICE SYSTEM</span></b><br />
Not being a lawyer, I hesitate to include this section but include it as food for thought. Here's how I see Canada's justice system, its purpose and principles. Note: My opinions may well differ with those of many Canadians, particularly regarding incarceration and punishment.<br />
<ul>
<li><span style="background-color: #fff2cc;">Ensures public safety</span> by protecting society from those who violate the law. Defines unacceptable behaviours and the nature and severity of punishment for a given offence. </li>
</ul>
<ul>
<li><span style="background-color: #fff2cc;">Presumes innocent until proven guilty</span> and those charged have the right to legal representation and a fair trial. Burden of proof is on the prosecution and defendant must be proven guilty beyond a reasonable doubt. </li>
</ul>
<ul>
<li><span style="background-color: #fff2cc;">Acts as a deterrent</span> to criminals, with incarceration being the last resort, reserved for the most serious offenses and where mitigating factors do not exist.</li>
</ul>
<ul>
<li><span style="background-color: #fff2cc;">Purpose is not to punish offenders</span> but to act with compassion and rehabilitate, if possible. Fact: Most people who come in contact with criminal justice system are vulnerable or marginalized individuals who struggle with mental health and addiction issues, poverty, homelessness, and prior victimization. (See 'What we heard - Transforming Canada's criminal justice system,' Further Reading)</li>
</ul>
<b style="background-color: #fce5cd;">TIDBIT</b>: When I read news items or information on the UK Blood Inquiry, it's my impression, rightly or wrongly, that, as in Canada, many victims and their families are out for blood so to speak. They clearly want those whose professional misconduct and negligence - unproven but it's how they see it - led to loved ones being infected brought to justice and punished. In other words, the NHS and its medical professionals and officials seem to have been prejudged as guilty. (Further Reading)<br />
<br />
<b><span style="color: #0b5394;">ANALOGIES</span></b><br />
Analogies are offered to stimulate thought.<br />
<br />
<b>#1. Tragic Humboldt bus crash </b>(Further Reading)<br />
On April 6, 2018 sixteen people were killed and thirteen injured when a bus carrying members of the Humboldt Broncos, a Canadian junior hockey team, struck a semi-trailer truck. The driver passed four signs warning about the upcoming intersection yet the semi-trailer went through a large stop sign with a flashing red light.<br />
<br />
The driver of the semi-trailer, 29-year-old Jaskirat Singh Sidhu was charged with 16 counts of dangerous operation of a motor vehicle causing death and 13 counts of dangerous operation of a motor vehicle causing bodily injury.On January 8, 2019, Sidhu pleaded guilty to all charges.<br />
<br />
The Crown is asking for a sentence of 10 years with a 10-year driving prohibition. Sentencing is March 22, 2019. It's possible Sidhu could be deported after serving his sentence.<br />
<br />
Sidhu followed his girlfriend to Canada in 2013 and is now a permanent resident. He's a newlywed who grew up on a farm in India and earned a commerce degree. He worked at a Calgary liquor store before he started driving a truck. He started work at a small trucking company only three weeks before the crash, after undergoing a week of training and spent two weeks driving a double-trailer with the owner before driving on his own.<br />
<br />
Canada and its provinces, except for Ontario, have no compulsory training for new 'class 1' truck drivers and no mandatory training standards.<br />
<br />
<b style="background-color: #fff2cc;">TIDBIT</b>: Sad but it seems Sidhu will take the full blame for his horrific error, despite mitigating circumstances, namely the entire trucking driver safety system failed. Trucking companies and governments now say they'll do better, but they suffer no consequences, only the ill-trained driver of the truck. Sidhu is the scapegoat.<br />
<br />
Reminds me that Canadian Red Cross was the scapegoat of Canada's 'tainted blood tragedy.' The newly created CBC and Héma-Québec operated with many of the same transfusion professionals because you cannot educate and train new experts overnight.<br />
<br />
Truck companies can save money by offering minimal training and put unsafe drivers of large semi-trailers behind the wheel. Only one provincial government required mandatory training or considered standardized training. Of course, now some provincial governments have but it will be a pathetic patchwork, ignoring that semis regularly drive across provincial borders.<br />
<br />
Did the justice system provide a deterrent to prevent a tragedy like the Humboldt bus crash from happening? If a similar tragedy occurs, will it all fall on the driver again? Will the justice system rehabilitate the dysfunction system that played a key role in the crash?<br />
<br />
<b>#2. Sexual abuse by Roman Catholic clergy</b> (Further Reading)<br />
Happened globally in 20th and 21st centuries, and likely for centuries before that. Scandal is so well exposed it needs no documentation, though see Further Reading. Clearly a systemic problem, yet who is held accountable?<br />
<br />
Bishops transferred known offending priests to other jurisdictions to abuse more children. Everyone in the Church worked to protect the Church at the expense of children, and now it turns out, even nuns were abused.<br />
<br />
Who is ever held accountable other than the odd defrocked clergyman? Who in the Catholic Church's patriarchal hierarchy should be held accountable and what would justice for victims, providing a deterrent to future crimes, and making the public and society safe entail?<br />
<br />
Does 'We did the best we could in difficult circumstances, wanting to protect both the perpetrators and victims equally' cut it, because there's good people on both sides (to use a Trumpism)?<br />
<br />
<b><span style="color: #0b5394;">BLAME GAME</span></b><br />
Healthcare, including transfusion medicine, supposedly has adopted a quality system that promotes a <span style="background-color: #fff2cc;">blame-free culture</span> where individuals are able to report errors or near misses without fear of reprimand or punishment. (Further Reading, Culture of Safety)<br />
<blockquote class="tr_bq">
"The culture of individual blame still dominant and traditional in health care undoubtedly impairs the advancement of a safety culture. One issue is that, while "no blame" is the appropriate stance for many errors, certain errors do seem blameworthy and demand accountability. In an effort to reconcile the twin needs for no-blame and appropriate accountability, the concept of just culture is now widely used. </blockquote>
<blockquote class="tr_bq">
A just culture focuses on identifying and addressing systems issues that lead individuals to engage in unsafe behaviors, while maintaining individual accountability by establishing zero tolerance for reckless behavior. It distinguishes between human error (e.g., slips), at-risk behavior (e.g., taking shortcuts), and reckless behavior (e.g., ignoring required safety steps), in contrast to an overarching "no-blame" approach still favored by some. " </blockquote>
Yet the blame game still exists in medicine, as exemplified by the Dr. Bawa Garba case in the UK (Further Reading), although the injustice was ultimately rectified.<br />
<br />
A key part of human nature is to want to know and understand why things happen. Humans (we <i>Homo sapiens</i>) have done it since we emerged as Great Apes, along with orangutans, gorillas, and chimpanzees. Later in our history it's one reason astrology emerged.<br />
<br />
If bad things happen, it's natural to assign blame. Take footie (soccer in NA). If a team loses 1-0 because of a goal from a penalty kick due to the referee penalizing our player, many fans see it as the refs fault, it wasn't a penalty, the opponent dived. Definitely not that our club couldn't score even one goal.<br />
<br />
And it's much more satisfying and easy to grasp if we can assign blame to fellow humans as opposed to some amorphous system failure. Another factor at play: if we look for something, we often find it. For example, can be as simple as being a new VW Beetle owner and suddenly noticing them everywhere. Or more relevantly, if I suspect that a person is a misogynist, I may interpret their perhaps innocent words and actions as misogynistic.<br />
<br />
<b><span style="color: #0b5394;">REVENGE </span></b><br />
When I told a good pal that I considered writing this blog, she encouraged me (as she always does) and suggested I include what a desire for revenge does to a person.<br />
<br />
Good example exists in the CBC's Unspeakable series, in the character <a href="https://www.cbc.ca/unspeakable/characters/ben-landry">Ben Landry</a>, to me a fictionalized version of one of two book authors (along with Krever Report) the series is based on: Vic Parson, who wrote Bad Blood: The Tragedy of the Canadian Tainted Blood Scandal. In the fictionalized version, Landry's behaviour drives away his wife and son with hemophilia and misses out on celebrating the birth of his grandson.<br />
<br />
It's a given that hatred and the desire for revenge eats away at people and can destroy their lives if left unchecked. Know this from personal experience of a relative who physically abused his wife and sexually abused many children. Revenge seldom, if ever, gives the solace we need.<br />
<br />
<b style="color: #0b5394;">LEARNING POINTS</b><br />
Just want folks to think about what would constitute justice for victims of infected blood scandals around the globe. Are thousands of deaths from HIV and HCV the fault of no one, just a system failure that no one could prevent? No one can be faulted for decisions because they didn't know enough? If preventable errors were made, what does justice look like?<br />
<b><span style="color: #0b5394;"><br /></span></b>
<b><span style="color: #0b5394;">FOR FUN</span></b><br />
Chose this ditty because it fits how I feel about the blog's issue. To me, transfusion professionals always had patient well-being on their minds yet they failed them, as the lover admits in this song:<br />
<ul>
<li><a href="https://www.youtube.com/watch?v=R7f189Z0v0Y">Always on my mind</a> (Willie Nelson)</li>
<li>In particular, <a href="https://youtu.be/R7f189Z0v0Y?t=117">note these words</a> </li>
</ul>
<b>COMMENTS</b>: As always, your comments are appreciated and welcome. See below.<br />
<b><span style="color: #0b5394;"><br /></span></b>
<b><span style="color: #0b5394;">FURTHER READING</span></b><br />
<b>Canada's blood scandal </b><br />
If you view only one resource, make it this one. From Canada's blood tragedy: <a href="https://www.cbc.ca/archives/entry/the-tragedy-of-factor-viii-concentrate">Tragedy of Factor VIII concentrate</a> (19:14 mins. well worth watching. See Randy Conners words at 18 min. mark)<br />
<ul>
<li><a href="https://www.cbc.ca/news/canada/nova-scotia/acquittal-in-tainted-blood-scandal-outrages-survivor-1.641964">Acquittal in tainted blood scandal outrages survivor</a></li>
<li><a href="https://www.cbc.ca/archives/entry/nova-scotia-compensates-victims-for-tainted-blood">Nova Scotia compensates victims for 'tainted blood'</a></li>
</ul>
<b>Criminal Justice System Purpose</b><br />
<ul>
<li><a href="https://www.justice.gc.ca/eng/rp-pr/other-autre/tcjs-tsjp/p1.html">Transforming Canada's criminal justice system</a></li>
</ul>
<b>UK Infected Blood Inquiry News </b><br />
<ul>
<li><a href="https://www.traqprogram.ca/index.php/news/international#infected">Latest here</a></li>
</ul>
<b>Humboldt Broncos bus crash</b><br />
<ul>
<li><i>Included more links as case may be unfamiliar to many outside Canada</i></li>
<li><a href="https://globalnews.ca/news/4143655/humboldt-broncos-bus-crash-truck-driving-regulations-canada/">Only Ontario requires truck driver training, but Humboldt crash could change that</a></li>
<li><a href="https://www.sootoday.com/national-news/semi-driver-in-humboldt-broncos-crash-a-newlywed-with-business-education-1222701">Semi-driver in Humboldt Broncos crash a newlywed with business education</a></li>
<li><a href="https://www.ctvnews.ca/canada/crown-wants-truck-driver-sentenced-to-10-years-in-broncos-crash-1.4277076">Crown wants truck driver sentenced to 10 years in Broncos crash</a></li>
<li><a href="https://www.cbc.ca/news/canada/saskatoon/jaskirat-singh-sidhu-humboldt-broncos-deportation-1.5002167">Semi-driver in Humboldt Broncos crash will likely be deported, says immigration lawyer</a></li>
<li><a href="https://globalnews.ca/news/4910631/sentencing-arguments-humboldt-broncos-bus-crash-sidhu/">Sidhu apologizes to families as Crown asks for 10-year sentence in Humboldt Broncos bus crash</a></li>
<li><a href="https://globalnews.ca/news/4901778/semi-driver-in-humboldt-broncos-bus-crash-had-70-regulation-violations/">Semi-driver in Humboldt Broncos bus crash had 70 regulation violations</a></li>
</ul>
<b>Catholic Church Sexual Abuse</b><br />
<ul>
<li><a href="https://www.americamagazine.org/faith/2018/08/23/sexual-abuse-and-culture-clericalism">Sexual abuse and the culture of clericalism</a></li>
<li><a href="https://en.wikipedia.org/wiki/Catholic_Church_sexual_abuse_cases">Sexual abuse cases</a></li>
</ul>
<b>No Blame Culture</b><br />
<ul>
<li><a href="https://psnet.ahrq.gov/primers/primer/5/Culture-of-Safety">Culture of Safety</a></li>
</ul>
<b>Bawa-Garba Case</b><br />
<ul>
<li><a href="https://www.theguardian.com/uk-news/2018/aug/13/dr-hadiza-bawa-garba-wins-appeal-against-decision-to-strike-her-off">Dr Hadiza Bawa-Garba wins appeal against being struck off </a>(13 Aug. 2018)</li>
</ul>
Bluthttp://www.blogger.com/profile/06234734730501396268noreply@blogger.com2