Drs. Alexandra Danakas (PGY-2) and Tamera Paczos have co-authored an article that has been published in an online continuing education OB/GYN curriculum produced by the University.
The article entitled Understanding Basic Maternal and Fetal Laboratory Measures was published in Perifacts on October 1. It describes the specific ways in which changes in physiology in pregnant patients can yield laboratory reference values that may seem abnormal in patients who are not pregnant.
These differences can sometimes be misinterpreted by physicians who use them to diagnose a disease outside of pregnancy. Physicians can be better equipped to manage such patients by better understanding the ways in which fluctuations in hormones and changes to maternal physiology affect the major organ systems.
The article includes a chart listing some of the most common reference ranges, comparing a non-pregnant patient with patients in their first, second, or third trimester.
On Monday, Aug. 28 UR Medicine Labs and the Department of Pathology and Laboratory Medicine were pleased to welcome 12 new graduate students who are taking the first step toward a professional laboratory career.
The program is sponsored in the Department of Pathology and Laboratory Medicine. The class of 2018 is the first group to complete all of their training at the University of Rochester.
After passing a state licensure exam in the spring, those who complete the 2-semester program will be qualified to work as certified Clinical Laboratory Technologists, commonly referred to as medical technologists or “med techs.”
Many of the trainees have bachelor’s degrees in biology or related scientific field. They come from area colleges including SUNY Brockport, RIT, UR, SUNY Geneseo, University of Buffalo, and St. John Fisher College.
Cheryl Gardner is one of the students who, like many of her classmates, is going back to school after her career path took some unexpected turns. She was laid off from her software job in 2015 and decided to use the opportunity to finish her bachelor’s degree in biology.
After graduating, however, she soon learned that many jobs in her chosen area of study required advanced degrees or job experience. She then learned about the new program at URMC – which thankfully offered both. For her, the prospect of having a license to practice in the clinical laboratory offered the chance to finally have a stable future.
“This is my fourth career,” said Gardner. “I have worn many hats, but I look forward to spending the rest of my career in a lab.”
The U of R Clinical Laboratory Technology program has a comprehensive curriculum including both classroom education and real world practical lab experience.
Since 2006, it has been more difficult for clinical laboratories across New York State to fill vacancies due to changing requirements. Instead of just needing a bachelor’s degree in an applicable major, employees were required to have 1-2 years’ worth of additional education and pass a certification exam.
The med tech program offers the opportunity to become certified and land a job fairly soon, said Scott Kirkley, M.D., Vice Chair of Pathology Education.
He explained that having just a biology or biotechnology degree does not guarantee that you’ll find a job in the medical field.
“Not everyone goes on to get a PhD or goes to med school, so we need alternatives.” said Kirkley. “This job (as a medical technologist) is in demand and it is a satisfying career with many opportunities for advancement."
Read more about the program here: UR to Launch New Clinical/Medical Technology Program
Current institution: Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth
Lives in: Hanover, NH
Family: Husband, Raymond, son, Michael, and daughter, Joycelyn
Originally from: Tianjin, China. She came to the U.S. to pursue her Ph.D. in microbiology
Specialties: Gastrointestinal, liver and pancreatic pathology, genitourinary pathology
MD: West China University of Medical Sciences (1995),
PhD: University of Alabama (2003)
AP/CP Residency: University of Rochester (2010-2014)
Fellowships: Surgical and Oncologic Pathology at Memorial Sloan-Kettering Cancer Center, Gastrointestinal and liver Pathology at University of Pittsburgh Medical Center.
How did you first become interested in pathology?
My interest in pathology started in medical school when I took histology and pathology courses. With a basic and translational research background, I know pathology is the right choice for me because it allows me to work on both basic and molecular mechanism and clinical management of diseases.
What kind of research are you interested in?
My research is focused on the gastrointestinal and pancreatic pathology, especially in colon cancer.
How would you describe your job to someone who’s never heard of it before?
I examine human tissue under a microscope to tell whether it is normal or abnormal. If it is abnormal, I diagnose and interpret the pathologic changes and underlying causes.
What’s one piece of advice you would give to pathology students or trainees?
A good pathologist does not only issue correct diagnoses. As pathologists, our role is to help clinicians treat and manage patients. It's important to be aware of how your diagnosis will affect treatment. Communicating with clinicians and frequently attending the tumor board conferences will help you stay up to date on current clinical practice.
How do you like to spend your free time?
Hanover has plenty of opportunities for outdoor activities. I like hiking, biking, swimming and skiing with my family. I also enjoying reading and cooking with my children.
Each day, phlebotomists are tasked with putting patients at ease during a blood draw. This can be especially challenging when it comes to pediatric patients.
Sue McAnany, MT, phlebotomy education coordinator at URMC, says her trainees are instructed to give special care to younger patients and involve the parents and caregivers to make the draw go as smoothly as possible.
McAnany oversees the 12-week training for all newly hired phlebotomists at URMC. During this time, the employees must perform a minimum of 50 venipunctures (and members of the inpatient vascular access team must perform twice that many). Within the first few weeks of training, phlebotomists perform draws on pediatric patients of different ages.
“It’s very important that they feel comfortable with the procedure on adults before we move on to pediatrics,” she said.
The University of Rochester Medical Center and Golisano Children’s Hospital have adapted concepts from the Poke and Procedure Program which was originally developed at the University of Michigan Health System. This plan outlines specific ways parents and caregivers can be helpful during pediatric blood draws – asking them to fill out a form describing their child’s experiences with needle-stick procedures and what type of distraction techniques or comfort positions they prefer.
Communication is vitally important in each step of the process, explains McAnany. When the patient arrives for treatment, it’s important for the phlebotomist performing the draw to clearly delegate responsibility to the adults present. This helps minimize potential anxiety for the child.
“If you have more than one person trying to hold the patient, it’s very overwhelming for the child to have everybody talking at the same time,” she said. “One person in the room should be the speaker.”
Sometimes, if there is just one phlebotomist on site and a caregiver is not present in the room, he or she must hold the patient while making the draw.
Most lab locations that frequently have pediatric patients are stocked with photos, bubbles, and other distraction tools that can help divert the child’s attention before or during the needle stick. These tools often include a “Buzzy,” which is a small cold pack shaped like a bumblebee that can vibrate and help numb the area. No matter what tools a phlebotomist chooses, communication is an important part of any draw.
“For a patient who’s never had blood drawn, you need to explain what’s going to happen (saying, It’s going to be a little bit of a pinch),” said McAnany. “If you distract them just by asking the patient about themselves, they won’t concentrate on the blood draw.”
Each patient is different when it comes to pain or discomfort, and having your blood drawn differs from getting a shot or vaccine because it is drawing the specimen out of the body rather than injecting something into the body. Still, some of the bravest patients often shed tears during or after the “pinch,” but phlebotomists are trained to give words of encouragement and praise.
“I always tell them that it’s OK to cry, but really try to hold still,” said McAnany. “You really have to get a good rapport with them and be soft-spoken.”
At the end of the day, she says the quality of these interactions will shape a patient’s overall experience. While needle-sticks can be challenging for patients at any age, following the right protocol and tuning in to the patient’s needs is absolutely essential.
Establishing a good relationship with a patient often results in them asking for a certain phlebotomist for future visits, even when it means waiting longer.
“Even some adults follow the tech from site to site just because they’ve had a good experience,” said McAnany.
Read more on this topic: CAP Today: Helping phlebotomists ease pediatric patient anxiety
Laboratory personnel were recently recognized at Strong Memorial Hospital at an event celebrating the launch of the new nucleic acid testing (NAT) laboratory.
The new FDA-approved lab, which officially opened in February, performs serologic testing to screen for HIV, Hepatitis B and Hepatitis C. These results must be obtained before a consenting donor’s organ can legally be transplanted into a recipient.
Prior to the launch, the closest FDA lab that did this testing was located in Philadelphia. Establishing the new lab has significantly reduced the amount of turnaround time for these lifesaving procedures.
Representatives from URMC, the Finger Lakes Donor Recovery Network (FLDRN) and regional organ procurement organizations came together on July 26 to recognize and thank the laboratory personnel who are on call 24/7 to perform this testing when needed.
“Bringing NAT testing here to Rochester really shortens the time, which helps donor organs to be more viable and more appropriate for the recipients, so we really are quite thankful that this team was able to make this testing possible,” said Kathy Parrinello, Chief Operating Officer of URMC.
Since it first opened, the lab has processed tests for 44 donors. It services Rochester, Buffalo, and Albany with hopes to expand this service area in the future.
“We do this because we in the laboratory are uniquely qualified to do this little piece of transplant testing,” said Dr. Dwight Hardy, Director of Clinical Microbiology at URMC. “We do it to be responsible members of the medical center community and Finger Lakes community, to see that organs that are to be potentially transplanted in patients are safe.”
Surgeons like Dr. Roberto Hernandez Alejandro, Chief of Transplantation Surgery at URMC, see many benefits to having NAT testing under the same roof.
“There was a huge push for doing this in a short period of time because families were requesting it,” said Hernandez Alejandro. “For those (surgeons) that are saving organs for transplantations, this is a great benefit.”
He explained that although this testing happens behind the scenes, no transplant can occur without it.
“It’s a huge part of transplantation,” he said. “Helping just one donor and saving one life is huge.”
Read more about the NAT Lab
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