POC postions

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All,
In light of no applicants for an open POC position for almost a year now, I am starting to think outside the box- at least for my facility.

Does anyone have a non-technical POC position? If so, what POC duties does this person perform?

If could create this type position for POC, what duties would you have for this position?

Thanks for your thoughts.
Leighea
Leighea Triplett
Supervisor
(601) 968-3070x1379

10 Replies

Hello Leighea,

I currently hold a QA Specialist/ POC Coordinator position at my hospital. We are accredited by CAP and based on my education, I fall into the testing personnel category. I can sign off on anything waved and I can implement new test platforms, review QC..ect BUT my laboratory manager has to over-sign everything on top of me. I essentially do all of the work and her signature confirms its acceptable. 

Hi Leighea, 
   My clients all over the US are struggling to fill all types of positions within the lab, especially MLS/MLT positions, so it's not a surprise that a POC MLS/MLT position would be hard to fill, particularly if the pay isn't as good as they might get on the bench.  This may hurt some people's ears, but it is a fact - a large portion of what a POCC does does not require an MLS/MLT. This could be a Laboratory Assistant position and could include nearly everything except for signing off competency assessments for moderate complexity. Additionally, what I am seeing trending now is delegating all competency assessment to nursing/clinical educators with a Bachelor Degree plus 2 years experience with that test system. The POC MLS does their training and competencies, then those RN Educators perform the direct obs for everyone on their respective unit.  My recommendation is to sit down and list out all of the POC duties at your location, then designate which of those require an MLS. A Lab Assistant can do all supply QC and stocking, quality rounds, instrument maintenance and troubleshooting, pulling reports out of the data manager and compiling data for monthly QA reviews, training waived testing, to name a few of the biggies. At my last place of employment we had a very smart specimen processor that was mid-way through her bachelor degree with plans to attend medical school after graduation so I recruited her for the POC team and she was fabulous.
Silka

Leighea,

We have kicked around the idea of hiring a part time lab assistant to help take care of all non-technical items. By non-technical we are referring to some education and training, all paperwork, monitoring and ordering of supplies, communications; monitoring facility temp logs, documenting corrective actions; etc.
Im intrested in seeing what o9thers are saying.

I'm a respiratory therapist and I'm the POC Coordinator for the pulmonary lab at my hospital. I handle anything blood gas related. I oversee QC testing, proficiency testing, new testing, and blood gas equipment. I do have to have our Medical Director to sign off on everything, but I the one that is responsible for keeping the lab up to CAP standards.

Hmm, my first thought is, if potential POCC applicants are choosing bench tech positions with likely, off-shift, weekend and holiday obligations over a M-F, no-holiday, daytime only POCC position, I would seriously reevaluate the POCC starting salary offer?  My personal opinion, but I do not think reducing the actual POCC position to largely clerical-type tasks, while delegating the all-important competency assessment task to non-laboratory personnel does your POC program any favors.  However, I do understand that sometimes you have to do what you have to do.

Hi everyone,
Thanks for your input into the question. Just to clarify for a couple of comments about pay. At my facility, since POC is a department in the laboratory the starting salary is the same as for bench techs- which in Mississippi is not great!

What we are seeing, especially from new grads is a hesitancy to come to POC because they don't want to teach or have direct interaction with non-laboratory staff. Yes, I know they interact with nursing when relaying laboratory results, but as most POC staffers know this is a different type of interaction. They also are hesitant to give up being a generalist to focusing on limited POC testing methods. Although the POC technical staff do work one weekend a month, they are again limited in the area they are assigned to work for the weekend. We also are not seeing a lot of the "older" technical staff changing jobs in our area.

My director was not especially keen on giving up a technical position for a non-technical position, so I needed some reassurance for him that other facilities have gone this route to alleviate the shortage of technical applications. I had already provided him a list of duties I felt this non-technical position could handle, which included all aspects of waived POC testing and assisting with correlation, calibration/verification for the moderately complex procedures. I did not include teaching and competency for the moderately complex procedures, so this aligned with other suggestions.

Again, thanks for your thoughts and input.
Leighea
________________________________

Related to the very large volume of waived testing and # of testing sites we have to cover, my boss decided to hire a Certified Medical Assistant in a 'coordinator' role but the title is not 'POC Coordinator'. We selected a clinic employee who had done a fantastic job with 'local POC oversight' within her care team role in a clinic. She went beyond performing POCT well, enjoyed troubleshooting (other MAs would call her to walk though through problems), volunteered to be trained to review & sign off on logs, did all the new hire WT training and handled annual competencies for her supervisor, and had consistent '100%' POC compliance audits. Oh, and because she worked with patients, she has fantastic customer service ethics.
The employee absolutely loves working in this role. She got a promotion, sorta is a role model for MAs to do better with their local testing & POC compliance.
I would not hesitate to put this CMA into helping with nonwaived stuff that wasn't tied to/limited by her lack of educational degree but there is already too much on her plate.

Peggy, I agree! Just love those engaged clinical team members. They are gems when you find them! Especially in clinic and POL land, where they are living in a totally different world than the hospitals.
Leighea,  another way I've seen labs get creative - Especially when those critical technical FTE positions were fought for in the past, I completely understand your lab director wanting to keep that on the books, so a few thoughts: A) use the technical FTE for the lab, then use the next open phleb/LA position for POC instead, or B) hire a bench tech for that technical FTE position, however with the caveat that it is 0.5 POC and 0.5 lab, or C) hire a technical FTE and add a bench to the lab called POC and all techs rotate through that bench just as they would every other generalist bench because after all, you're not a true generalist until you've also done POCT ;) 

Silka
What about the new CLIA guidelines coming out that may not recognize RN's as a TC anymore? This will hurt us as we do use some RN's to do competency for fern testing and iSTAT for OR.   I agree that there is room in a POC program for a lab assistant, but we do need to maintain some staff with technical background in the department, especially when you have heavy moderate complexity testing. 

Thats a good question Kim! I understood the potential changes coming to CLIA TC qualifications to mean that an RN degree would not meet the requirement automatically, but there may be room to look at actual science credits towards the degree (hopefully!) so that there may be still a number of nursing educators that would qualify. I can tell you when I reviewed the transcripts of all ICU nurses in our hospital system back when we temporarily had to designate our glucometers as High Complexity in the ICU, about 90% of those transcripts I reviewed had more than enough science classes to qualify for High Complexity testing personnel. So there is hope the same would be true for TC.
100% agree that you need a MLS leading the POC program - but desperate times lead to desperate measures and I was just pointing out some of the ways I've seen my clients solve a staffing challenge in that department. There are absolutely tasks that must be done or signed off by an MLS or above, but there are also tasks that don't. This is also true in the lab - how many waived tests are your highest paid MLS's performing still? :) Urine pregs? Rapid Streps? etc. etc.

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leighea triplett
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