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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3777_Библиотеки_им_академика_М_И_Перельмана
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CHAPTER 1 The Student’s Role in the Classroom
https://t.me/med1917
23
incompetent or illegal actions are observed. Failure to report an incident
may lead to termination of employment or even exposure to personal
liability for malpractice.
Fear of negative peer pressure or of making the accused angry may
make the phlebotomist apprehensive about reporting on a colleague.
However, reporting inappropriate behavior can be carried out successfully
if it is done in a systematic manner. The following process should be followed when reporting any illegal or incompetent behavior of a coworker:
1. Gather information. Complete an incident report.
2. Report the incident to the appropriate person, according to the
employer’s chain of command.
3. Maintain a record of efforts to report the incident through
appropriate channels.
4. After a reasonable duration, determine whether the problem has
been corrected.
5. If the problem still exists, report the incident to the person at
the next level of command.
An incident report may be used to report other types of problems as
well. An incident is an event that is inconsistent with ordinary procedure.
For instance, any injury to a patient would require an incident report.
Incident reports may also be used to document patient complaints, errors,
and injuries to professionals and visitors. Phlebotomists have a legal duty
to report any incident of which they have rsthand knowledge. Incident
reports serve three purposes:
1. To inform administrators, so that patterns and trends can be
monitored. This is called risk management. The goal is to
prevent future similar incidents.
2. To alert administrators to possible liability claims.
o provide a means of documenting, in a factual manner, infor-
3. T
mation that may be used for detecting possible future problems.
Most employers make incident report forms available to professionals.
Forms vary with each facility. However, they usually require the following
information:
The identities of the persons involved and any witnesses
•
What happened•
Consequences to the person(s) involved•
Date and time of incident•
Location of incident•
Signature of person making report•
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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PART 1 Student Success in Phlebotomy
Incident report forms should be completed in an objective, factual manner. Incident reports should not include the following types of
statements:
•
Emotional descriptions of what happened
Opinions (such as what you think may happen because of the •
incident)
Assumptions (what you think caused the incident)
•
Finger pointing (who you think was responsible for the incident)•
If an incident results from the phlebotomist’s own error, the phlebotomist still has the responsibility to
le an incident report. It is possible
that the phlebotomist’s supervisor will take corrective action because of
the incident, but a reprimand is likely to be less severe in this case than
if the phlebotomist does not report the incident or attempts to cover up
the error.
Immediate, factual, and accurate reporting are essential for risk
management and quality assurance. In fact, risk management and
quality assurance are closely related. Both activities are important
for the protection of the patient, the employer, and the health care
professional. Phlebotomists need to understand the concepts of risk
management and quality assurance so that they may contribute to the
well-being of the patient and the employer. Risk management and quality assurance both make use of the information gathered through the
reporting system and use the information in the same way, applying the
same methodology:
•
Identifying a risk or problem
Monitoring•
Identifying trends•
Summarizing•
Prescribing corrective action•
Evaluating the effectiveness of the correction•
The difference between the two areas is that risk management is
involved with nancial liability issues, while quality assurance seeks to
eliminate or reduce patient case problems. The goal of risk management
is to avoid risks that could cause nancial loss. Quality assurance uses most
of the same processes as risk management to assure quality care. Quality assurance is not nancially oriented. Both activities are geared toward
protection, however. They are intended to protect the patient, the health
care worker, and the health care institution through the elimination or
reduction of risk.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
CHAPTER 1 The Student’s Role in the Classroom
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25
HEALTH CARE FACILITIES THAT UTILIZE
PHLEBOTOMISTS
Phlebotomists have the opportunity to work in a variety of health care
facilities. Hospitals, clinics, physician of ces, nursing homes, blood donor
centers, insurance companies, and commercial laboratories all employ
phlebotomists. Job duties may vary greatly, but the primary job duty is to
collect blood samples.
Hospitals vary in size, the type of care and services provided, and the
type of ownership. The size of a hospital is usually described by the number of patient beds in the facility. For instance, a large hospital such as
Cedar-Sinai Medical Center in Los Angeles, California, had 952 beds and
55,486 inpatient admissions in 2007. A medium-sized hospital like Baptist
Health South Florida in Miami, Florida, had 680 beds and 31,792 admissions in 2008. Penrose-St. Francis Hospital in Colorado Springs, Colorado,
also a medium-sized hospital, had 522 beds and 23,258 admissions in 2008.
A smaller hospital like Seattle Children’s Hospital in Seattle, Washington,
had 250 beds with a huge number of outpatient visits (176,608) in 2007.
A phlebotomist may deduce that a large hospital will need a larger
phlebotomy staff for inpatient laboratory collections. However, a small
hospital such as Seattle Children’s Hospital requires a larger staff due not
to the size of the hospital but to the number of outpatient visits. Hospitals
offer a large variety of services and specialties. Services may include birth
centers, cancer centers, critical care, emergency/trauma, pediatric care,
rehabilitation services, surgical services, imaging/radiology, cardiovascular
programs, neurological services, and many other specialties. For instance,
Bellevue Hospital Center in New York City is the oldest public hospital in
the United States with 809 beds. It has long been identi ed with treating
mental illness. The University of Texas M.D. Anderson Cancer Center is
well known for outstanding cancer treatment and is a 521-bed hospital.
Hospitals are also categorized by their type of ownership. Private hospitals are owned by a corporation and are expected to produce a pro t
from delivering health services. The pro t is returned to the owner or
stockholders. A nonprofit hospital may make money, but the money is
returned to the organization. Nonpro t hospitals are normally run by a
board of directors. Hospitals may also be owned by a state, county, or city
government. Taxpayer dollars help fund the operation of the hospital.
Commercial diagnostic laboratories are another type of facility that
employs phlebotomists. Commercial laboratories offer testing services
for patients referred by their physician. Commercial laboratories such a
LabCorp and Quest Diagnostics have large testing facilities with several
off-site blood collection stations.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
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PART 1 Student Success in Phlebotomy
Insurance companies and nursing homes employ phlebotomists who
often perform other duties in addition to blood collection. Insurance companies send the phlebotomist to the homes of potential patients to collect
blood samples as part of the required health physical. Nursing homes utilize certi ed nursing assistants with phlebotomy skills to provide care to
patients and collect blood specimens for laboratory testing.
CLINICAL LABORATORY
DEPARTMENTS
Phlebotomy students assigned to a medical laboratory to complete an internship should have a basic knowledge of the departments that comprise
the laboratory. Medical laboratory testing plays a crucial role in the detection, diagnosis, and treatment of disease. The laboratory may be divided
into two areas of testing: clinical pathology and anatomic pathology. The
anatomic pathology laboratory may include histopathology, cytopathology, electron microscopy, and surgical pathology. The clinical pathology
laboratory may include chemistry, blood bank, hematology, microbiology,
toxicology, immunology, serology, and phlebotomy. The division of departments varies from one facility to another. The pathology laboratory designs
the testing departments based upon several factors such as workload, type
of tests offered, and other miscellaneous factors. Brief descriptions of the
department within the pathology laboratory are as follows:
Chemistry.• May use serum, whole blood, or plasma for testing.
The department tests for chemicals present in blood. Lipids, blood
sugar, enzymes, and hormones are tested.
Hematology.
• Requires whole blood for most tests. Complete blood
counts are the most common test. Please refer to Figure 1-4.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Delmar/Cengage Learning
Figure 1-4 Hematologist at work.
CHAPTER 1 The Student’s Role in the Classroom
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Microbiology.• May use almost any specimen type including feces,
urine, blood, sputum, swabs, cerebrospinal uid, synovial uid,
and tissue. The primary concerns cultures to look for pathogens.
Once the pathogen has been determined, a sensitivity test is run to
determine the appropriate medication for killing the organism.
• Requires citrated blood. The department is respon-
Coagulation.
sible for determining clotting times and coagulation factors.
Blood Bank.
• Uses primarily serum and anticoagulated whole blood
for testing. The purpose of the department is to provide transfusion
medicine. It performs ABO blood Rh typing; prepares blood components, derivatives, and products for transfusion; and may include
a section for communication and contact for blood donations.
• Examines urine for many analytes. The department
Urinalysis.
may be an independent laboratory, or it may be combined with
hematology or chemistry.
Histopathology• . Processes solid tissue for evaluation at the
microscopic level. It requires a variety of staining techniques.
Cytopathology• . Examines smears of cells (such as from the cervix)
for possible in ammation, cancer, and other conditions. Cells in
urine or sputum may be placed in a preservative for examination.
• Uses blood and tissue for DNA analysis.
Cytogenetics.
Surgical Pathology.
• Examines organs, tumors, fetuses, and other
tissues biopsied in surgery.
Phlebotomy.• Consists of specimen collection, specimen process-
ing, point-of-care testing, and clerical functions. Please refer to
Figure 1-5 and Figure 1-6.
27
Figure 1-5 Phlebotomist performing specimen
processing duties.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Delmar/Cengage Learning
Delmar/Cengage Learning
Figure 1-6 Phlebotomist assigned to
specimen collection duties.
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PART 1 Student Success in Phlebotomy
STUDY SKILLS
Good study skills are a very important element in becoming a successful student in the classroom. Adult students may nd themselves entering a very exciting and stimulating environment. However, the feelings of
excitement and joy may also be accompanied with feelings of anxiety, fear,
and stress. Some students may be returning to the classroom after spending years as a stay-at-home mom, or after working many years in a career
that has been abruptly ended by downsizing at the company, or even loss
of a job due to the company closing its doors. The fear and anxiety comes
from the unknown. Will I be able to learn the material? Will I be able to
get acceptable grades on exams? Will I be able to compete with other
students? Am I too old, too young, too inexperienced? And on and on it
goes with the self-doubt and insecurities. The answer to the unknown is
to take away as much of the unknown as possible, and put a controlled
environment into place. The student should set up an organized, planned
study routine that is strictly practiced on a daily basis.
Before the Classroom
The time to begin learning starts with researching schools and career goals.
Phlebotomy students should research lab technician/phlebotomy requirements. There are many ne community colleges that offer certi cate programs in phlebotomy. There are also many good private schools that offer
phlebotomy training. Research the schools that would be available to you.
Check courses offered, costs, and time elements that will suit your individual needs. Check job opportunities for phlebotomists and lab technicians,
potential pay, and any other factors of concern to you. Once you have decided upon a school, complete a school application. Completing a school
application is not dif cult and relatively inexpensive. When you have been
accepted to the school, make an appointment with a school advisor. The
advisor will help you plan courses and schedule any other school requirements. Obtain a school catalogue and read everything about the school as
well as your certi cate or degree pathway. The more you learn about your
school, the more you will be comfortable in your new environment. You will
not be faced with the unknown and unpleasant surprises.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
The Classroom
Once the student has enrolled in a program, it is very important to prepare
for the classroom. The following offers suggestions that will lead to success:
Have reading and homework assignments completed. Before •
leaving home for class, take a moment to check for school
CHAPTER 1 The Student’s Role in the Classroom
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supplies. Pencils, pens, notebooks, folders, and so on should be in
your possession before you enter the classroom. Have your reading assignments completed so that you can participate in class
discussions. Highlight important sections in your textbook. Make
notes of questions that you may have. Complete all homework
assignments. Don’t wait until late the evening before class to
complete assignments. Unexpected events may prevent you
from completing your assignments. Allow yourself time if you
have computer or printer malfunctions. Instructors always hear
unfortunate stories about “My printer ran out of ink,” “My computer was acting up,” or “My children were ill.” Plan and prepare
ahead of class time.
•
Be on time for class. Arriving late to class is disruptive. It is disrespectful to your instructor and to your fellow classmates. Arrive
slightly early and select a seat that is close to the front. Y
hear the instructor better, see the visual aids better
instructor to get to know you, especially in a large class. Don’t sit
next to someone who is a distraction. You have paid for the class.
Get your money’s worth!
•
Take notes. Listen to the instructor and outline the lecture as it
is presented. Be alert for key ideas and statements. If it is dif-
cult for you to take notes, ask the instructor if you can record
the lecture. Review your notes and revise them the same day
Waiting longer to review your notes may result in not knowing
what you wrote. A good technique is to put your notes on index
cards with different categories. Or type your notes into your
computer with categories. Take time to spell key terms correctly.
Correct spelling is important in health care. Medical terms may
be dif cult to spell, but you need to take time to learn them
correctly.
•
Ask good questions in class. Don’t interrupt the instructor. Wait
until the instructor asks for questions. It is very disruptive to the
class to constantly interject comments or ask questions at inappropriate times. When addressing the instructor or class, speak
up so that the entire class can hear your comments and questions.
Participate in class discussions. Sitting silently is like a good book
sitting on the shelf. If it is not read, it has no value.
•
Respect your instructor’s time and space. When the instructor
arrives in the classroom, give her time to get her personal
belongings settled. Ask if this is a good time to talk. Or ask if
you could schedule a time to meet. Don’
29
ou can
, and allow the
.
t send your instructor
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
30
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PART 1 Student Success in Phlebotomy
unnecessary e-mails or phone calls. There are many students
requesting attention. Be considerate and ask necessary questions
that cannot be saved until class time.
•
Do not bring food and drink to the classroom, unless your
instructor has given permission. Rustling snack bags is very disruptive and disrespectful to the instructor and the class. Eating
during lecture time is distracting to you. You are not focusing on
the lecture if you are eating. Throw away your drink containers
and trash. Leaving them on your desk turns your instructor into a
housekeeper.
•
Review your class syllabus regularly. Be prepared for the topic of
the day as well as for future classes.
•
Check out your school’
ties have study centers where you can get help. T
of all the services your school has to offer
•
Prepare yourself mentally for a good class. Put aside worries,
s study center. Most higher education facili-
ake full advantage
.
problems, and so on and allow yourself to enjoy your class time.
This is time for you. Be positive and happy, and you will get more
out of your class.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Preparing for Exams
Examinations may be a time of anxiety for many students. The following
tips for exam preparation may help you to perform at an optimal level
when taking an exam.
Preparing for an exam should begin at the beginning of a
•
course. Review your notes and handouts regularly. Review your
reading assignments immediately after reading. Study dif cult
material until you feel comfortable with it. Do not wait until the
day before an exam to study. You will have a dif cult time absorbing the material.
Study in blocks of 30–60 minutes. Take short breaks. Study with-
•
out distractions, in a quiet place. Television and music will not
allow you to focus.
•
Plan a schedule. Block out speci
family members not to disturb you during your scheduled study
time. Be disciplined. Don’t look for excuses to delay your study
time.
c time for studying. Ask
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31
Taking the Exam
Once you have prepared for the exam, the following tips will help in taking it:
Get suf cient sleep. Do not stay up late cramming. Eat a light
•
breakfast or snack.
Arrive on time. Arriving late for an exam decreases your exam
•
time, and causes you to be unfocused.
Make sure you have all necessary supplies such as pens, pencils,
•
paper, and so on.
Look over the exam and have a basic plan for how much time
•
to spend on each section. Answer the easier sections rst.
the dif
cult sections for last so that you have more time to
focus.
•
Put your name and date on the exam. It is not unusual for students
to forget to place this information on the exam. Place all notebooks,
textbooks, and paper off of your desk.
Read the questions thoroughly and carefully. Do not assume anything. •
Ask for clari cation, if necessary.
If you are unsure of an answer
•
, do not leave the question unan-
swered. Make a good guess.
atch the clock. Do not allow yourself to run out of time.
•
W
When you have completed the exam, review it. Make sure you •
have answered all questions. Turn your exam in to the instructor
and do not disrupt other students.
Save
,
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
CLINICAL ASSIGNMENT EXPECTATIONS
Many phlebotomy training programs involve a lecture section combined
with an internship section. The internship is basically an on-the-job training period that allows the student to apply skills learned in the classroom
to real life situations involving patients and medical staff. The clinical internship allows for many opportunities in networking with medical professionals, learning an appreciation of the stresses and rewards of the medical
eld, and building lifelong memories and knowledge. The rewards come
with several responsibilities:
•
Arrive on time at your assigned health care facility. One of the
most important aspects of a phlebotomist’s duties is to draw
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PART 1 Student Success in Phlebotomy
specimens in a timely manner. Stat, ASAP, and timed collections
must be drawn at the appropriate time.
• morning rounds
Maintain a professional appearance. Early
may start as early as 3:00 A.M. Go to bed early enough the previous evening so that you are rested and energized. Allow yourself
enough time to be well groomed for the performance of your
duties. Look your best every day. Follow the health care facility’s
dress code. A good
appearance will give you con dence and
increase your self-esteem.
•
Maintain a well-stocked and organized phlebotomy collection tray.
Your tray or cart represents your work area, and is a re ection of
the quality of your work.
Ensure appropriate, timely, and professional communication •
with patients, staff, and physicians. Y
our attention should be on
the patient and your assigned duties. Do not discuss personal
issues such as nancial concerns, family problems, your opinions
about medical care, etc., with the patient. Do not have disagreements or arguments with staff in front of the patient. Be courteous and respectful at all times with everyone in the internship
environment.
•
Ask good questions and show a keen interest in your work. Do
not challenge the health care staff about the correctness of procedures. If you see something that seems wrong or inappropriate,
direct your concerns to your instructor. Remember that you are a
guest at the facility. Thank the staff for the information and help
that has been given to you.
Introduce yourself to supervisors and other staff. Y
•
ou may wish to
seek employment with the facility after your internship. The job
market is very competitive, and forming a favorable impression
with health care professionals at your internship site may be very
helpful in your job search.
Copyright 2010 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
SUMMARY
The role of the student carries with it both responsibilities and rewards.
As you begin to learn your role, keep the following thoughts in mind:
Learn the procedures and protocols of your profession accurately. •
Interact with all members of your health care team in a positive •
and professional manner.
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