Thoughts please
To all,
(This was posted on the AACC listerver also if you subscribe to both.)
I apologize for the long post but I need some thoughts.
Due to circumstances, I have a new boss. This boss is a good egg...knows little about POCT but is totally willing to learn and has my back when that is needed. We have reached an impasse. (Not a swords drawn, guns at 10 paces impasse) ...but a head scratching "Where do we go now?"
Background:
- I have 6 hospitals inspected by CAP for non-waived and TJC for waived. Close to 1M glucose and probably about 80-100K ISTAT cartridges. 235 meters in production and about 85 ISTAT. 12 AVOX.
- I have responsibility for all RT areas also-though that is more of a surveillance thing. Through the time I have been here, I have taught them what they need to know and now they do as I ask. It did take a few years.
- The interfaces are one pipeline for all hospitals. Only two people have day to day responsibility for the meter software. (me and the 32 hour person in one hospital)
- In POCT, there are only 3 FTE. Mine as a fulltime FTE and the other two scattered throughout the labs with their first responsibility being bench work. They may get 8 hours a month to "do" POCT. ( In a system the size and volume of ours, usually there is a full time POCC for each hospital.)
- I do not have Educational Resources backup for anything but glucose teaching when I am on vacation. I do all of the teaching for both ISTAT and glucose. AVOX is taught in the Cath Labs using my training guides.
- I do most of the direct demonstration comps with Experts in ER and RT areas. There are about 600 operators not including the labs. I drive to them including weekends. This is much appreciated by nursing.
- POCC in the labs do the lab ISTAT comps and initial teaching.
- I do "wet work" QC etc. only in an emergency.
This works pretty well. I am busy, but seldom frantic unless there is a new instrument install or a computer issue. Regulatory is standardized also. I can even cover for RT directors for the blood gases portion of the job for a short time. (as I am doing now for one hospital due to a job promotion)
Impasse: What the new boss wants is the lab to be "Self-sufficient" for POCT if I am gone. What I do not know is what does that mean?
As POCC, our job can be different every day. One day comps and computer issues, the next day planning meetings with IT and nursing director issues for various things, the next day contract reviews and new unit openings. Or maybe all of those in the same day. J
Your thoughts:
What does self-sufficient mean for a lab with POCT? Keep things going only or be able to everything I do....or somewhere in between?
I can ask the lab directors, but they are going to ask me to tell them what it means.
(Caveat: I am not willing to give up the comps or the majority of the teaching or have all of them in the meter software to rectify on a daily basis. Some of them would not be able to rectify it due to time-meaning errors are more difficult to correct days later. Not all of the POCC are on day shift either. As all of you know, middleware is the life blood of a POCT program. If someone alters things, I may not be able to defend items for regulatory questions.)
Give me your thoughts....All thoughts are welcome. It is seldom in this job that I do not have an answer but this is one of those times.
Feel free to call me if you want to discuss.
Thanks.
Deanna Bogner M.T. (ASCP)
Regional POCT Coordinator
Baptist Health System
730 North Main, Suite 808
San Antonio, Texas 78205
(p) 210-297-9657
(f) 210-297-0845
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So we are similarly sized and we have 3 full time ftes devoted to poct I would ask for that plus nurse educators train people so kudos to everything you do. I don’t know how you have time to do it all.
For your question about fully functional I would not think that should include training people or educational responsibilities. I would think that should just be making sure results are flowing smoothly. The prior poct person (prior to expanding the department) had one lab person that knew the ins and outs of the computer plus a job aid for the rest of us to try to fumble around with while she was gone on a vacation. If they want education to be included they need to get you more help with another full time person to keep things running.
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My inclination would be to have the other two POCC positions cover for you. They may need additional training to get them to your level of knowledge and they would need to be removed from benchwork while covering for you.
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My interpretation of "self-sufficient" is maintaining a level of service that keeps POCT operations running without additional immediate risk to patient safety. Your boss probably is seeing how much you do for POCT, and recognizes a certain level of risk should you get sick, go on vacation, or LOA.
As Michelle pointed out, it probably would be best to have the other POCT coordinators trained to cover for you. It would be good if they were highly competent on your middleware applications, and troubleshooting analyzers, for which there is no readily available back-up/loaner. Training and competency assessment can usually wait a week, so that's really up to your discretion.
Additionally, if your boss really is feeling concerned about POCT operations in your absence, it might be a great opportunity to negotiate a few more hours/days for your POCT coordinators. Hope this helps.