Haematology / Transfusion Science Associate Practitioner

Question 1

Do you have any experience in Haematology / Transfusion Science?

Answer 1

1. My educational background has provided me with a bit of experience in Haematology & Transfusion Science. I studied Haematology in quite some detail, and did some associated practicals like looking at cell morphology, performing full blood counts, and determining blood groups (Anti-A antibody makes Type A blood cells clump together).
2. In a medical laboratory setting, I believe there is quite some overlap between POCT and Blood Sciences. We have many devices that are blood based. We have glucometers, INR devices, TEG6, which can measure blood clot formation, haemostasis, and platelet function. We also do rapid tests, measuring D-Dimer levels and blood gases, pH, and electrolyte concentrations. Recently we’ve got a device that measures inflammatory bio-markers in the blood to determine if an infection is bacterial or viral.
3. I also feel quite suited for this role; I regularly and competently perform the duties entailed in this role. We: receive and sort samples; we have to determine its suitability for testing; book it onto the LIMS, scan and sort request forms; manipulate the samples and run them on analysers; repair equipment; handle and store specimens properly; inventory control; QCs and EQAs; Monitoring and repair of POCT devices (especially).

Question 2

Why is it important to cross-match blood? What are the possible clinical impacts of transfusion reactions. What happens in terms of antigen-antibody complexes?

Answer 2

1. Cross-matching is when the donor’s blood is mixed with the recipient’s plasma. This is to ensure there are no adverse reactions of the blood transfer.
2. If the blood types are incompatible, you can get haemolysis which can cause significantly painful symptoms.
3. The host’s immune system views the donor’s blood antigens as foreign. As a result, the immune response is activated and you ultimately get the destruction of these foreign blood cells.

Question 3

What is the major haemorrhage protocol?

Answer 3

1. The major haemorrhage protocol starts when a patient is losing life-threatening amounts of blood.
2. We may have to urgently cross-check the blood to see what donations are adequate for their transfusion.
3. We will also be required to then supply the blood components such as RBCs and platelets.
4. The patient may then be monitored afterwards using the TEG.

Question 4

What is the NHSBT and why is it important for this role?

Answer 4

1. The NHS Blood and Transplant organisation manages the donation, testing, and supply of blood and blood components.
2. I may have to test blood, or cross-match blood to ensure the right products are given to the right patients.
3. The NHSBT also has its own guidelines and framework for handling these blood products and performing tests on them, and instructions and protocols for emergencies like the major haemorrhage protocol.
4. The NHSBT also communicates with laboratories to ensure sufficient supplies of stock.
5. This is important because it ensures the work in the lab is of the highest quality, adhering to national guidelines, and increases the confidence and trust of our service users.

Question 5

What is the MHRA and why is it important for this role?

Answer 5

1. The Medicines and and Healthcare products Regulatory Agency is a body that regulates medicine, medical devices, and blood components involved in transfusion.
2. They have many regulations such as how blood is stored, how cross-matching is performed, how quality control procedures are performed, operation and maintenance of analysers, health and safety, and quality management.
3. This is important because it ensures the work in the lab is of the highest quality, adhering to national guidelines, and increases the confidence and trust of our service users.

Question 6

What is traceability in Haematology & Transfusion Science?

Answer 6

1. Traceability is the ability to track blood products, samples, and results, from the moment it was donated, to its final destination.
2. If there is a problem with the transfusion, the donor’s blood needs to be identified. A record of their details and health records must be kept.
3. If the blood is split into components like platelets and plasma, these all need to be properly labelled and stored so that any one of these components can be tracked back to the donor in case of emergency.
4. Even when testing samples in the laboratory, having traceability means the sample can be tracked from start to finish.
5. If there are any errors, the donor can be contacted. It may be that there is a problem with his blood and he needs a checkup, or it may be to work out compatibility of his blood with another patient.
6. It is also a requirement of the MHRA.

Question 7

What do you know about the cold chain system?

Answer 7

1. Blood and blood products need to be kept at a certain temperature. The cold transport chain allows them to be stored and transported safely, whilst keeping the samples integral.
2. RBCs are kept refrigerated in blood banks.
3. Platelets can be left at room temperature but need to be slightly agitated to prevent clumping.
4. Plasma can be frozen for up to a year.
5. We use cold boxes, insulated materials, and alarmed fridges and freezers to maintain these temperatures.
6. If left outside of the optimal temperatures, their structure of function might change, they might be degraded, and this will have no positive, or even adverse, effects on the patient.
7. The NHSBT and MHRA have regulations on this.

Question 8

Someone calls you asking for a relative’s results. How would you proceed?

Answer 8

1. I would politely and empathetically tell the relative that I am only allowed to deliver the result to authorised healthcare professionals. This is in accordance with data protection laws and NHS guidelines on information governance.
2. If the patient was still in the hospital, I’d direct the relative to the appropriate ward / healthcare team looking after them. Maybe they’d be able to allow a visit upon confirming the relatives identity, and explain a bit about the care being given. The result may even be given if the patient doesn’t have the mental or physical capacity to understand it.
3. If this was a retrospective visit, it may be possible for the relative to contact their local healthcare provider and request a copy of their medical records, which would need written consent from the patient.

Question 9

A patient asks you for their test results. How would you proceed?

Answer 9

1. I would politely and empathetically tell the patient that I am only allowed to deliver the result to authorised healthcare professionals. This is in accordance with data protection laws and NHS guidelines on information governance.
2. If the patient was still in the hospital, I’d direct the relative to the appropriate ward / healthcare team looking after them. Maybe they’d be able to discuss their results and treatment in detail with the patient.
3. If this was a retrospective visit, I would advise the patient to contact their local healthcare provider, or check the NHS app.

Question 10

You observe someone using their phone in a lab setting. What do you do?

Answer 10

1. I would, in a polite and friendly manner, remind that person we are not allowed to use mobile phones, because as well as being distracting, it could potentially be a contaminant in the laboratory, which could have an affect on the patient. It could be that they simply didn’t know. Reminding them of the value to “put patients first” might encourage them not to use their phone.
2. If it was something that was happening multiple times, I might politely and empathetically ask the person if everything is okay. The phone use might be a sign of an underlying problem, or urgent matter. I would insist that they take a break out the lab, and I would be happy to cover for them. This way, they can get the problem resolved without compromising the safety of the environment.
3. If it was a repeated issue, or the person had a complete lack of regard for the lab (e.g. playing video games), then I would report it to a senior member of staff or the line manager. This isn’t to really get them in trouble or anything like that, but it’s just having their well-being and the safety and efficiency of the lab in mind. In a lot of cases, the line manager can resolve problems. It could be that the person was going through a tough time, or was struggling with the shifts, and the line manager may offer time off or flexible hours to alleviate the issue.

Question 11

You are running late to a meeting. However, a patient comes to you seeking your assistance. What do you do?

Answer 11

1. The patient always comes first, so my immediate priority will be to help them. If there is something I can help them with directly, like directions to a ward, I would happily help.
2. If the patient needed help with something out of my scope of practice, I would refer them to the appropriate team or healthcare professional and stay with them until they can be helped. For example, I was coming out the Hot Lab and somebody asked for some painkillers for her daughter. I reported it to the Urgent Treatment desk who went on his way with the painkillers.
3. I’d send a quick message to the meeting participants or organiser, if possible. When I arrive to the meeting, I would apologise and explain why I was late. As we are like-minded colleagues, we should share the same value of “putting the patient first” and I would hope they don’t mind, and continue with the meeting.

Question 12

Tell me about a time you were challenged. How did you overcome it?

Answer 12

1. After the May Bank Holiday, we were very short-staffed due to sickness. I was required to do my normal core shift, and also cover the late shift until 10pm. (S)
2. We received a LIAT test. These usually come after 6pm, and they are very rare. I had started my competency in it, and I was aware of it, but hadn’t been signed off and did not feel comfortable running it at all. (T)
3. I first checked the SOP for this particular test and viewed the sample storage instructions. It could remain in the fridge for 6 hours before being tested. I put it in the fridge and notified my colleague when he got in, to prioritise that sample. I also rang the ward to explain the situation and to offer an alternative test that I could perform. Fortunately, the patient was already being isolated, and so the test was not urgent. (A)
4. The patient test got processed and resulted relatively quickly, when my colleague got in, and was delivered to the ward. It also identified the need for me to complete this competency; the supervisors allowed me to shadow a week of late shifts where I had the opportunity to practise performing this test myself, which I am now competent in. (R)

Question 13

Tell me about a time you dealt with a coworker that wasn’t doing their work.

Answer 13

1. The Blackburn Foodbank was very busy during the Harvest period. We were receiving a huge amount of donations from local schools and community centres. (S)
2. A fellow volunteer wasn’t really working hard, and had a bit of a disruptive attitude. This had a knock-on effect because the pantry team and client services team were also being delayed in their duties. (T)
3. I politely and empathetically approached the coworker, and reminded them of our values and goals, which is serve the community and have a profound impact on people’s day-to-day lives. I also asked if there was anything they didn’t particularly enjoy. After speaking with the individual, I managed to delegate a different set of slightly more stimulating tasks, which they seemed to enjoy a lot more. (A)
4. The overall workflow in the Foodbank improved massively, delays were cleared, and a positive work environment was fostered. Ultimately, the service users benefitted from receiving timely food parcels and services. (R)

Question 14

Tell me about a time you did quality control.

Answer 14

1. We often perform quality control tests to ensure that the results we get are accurate. If the QC results are not within range, we can troubleshoot and repair the device or analyser before it has an impact on patient results.
2. We perform IQC every day of the week, or when a new device or delivery of reagents arrives.
3. We also perform EQA monthly/quarterly, where we get blind samples from an external distributor, and submit our results to them.
4. We perform regular audits in POCT, from devices like glucometers, to chairs and display screen equipment.
5. For example, we received a new delivery of Covid/Flu strips, which were a different batch to the previous. To ensure these were working properly with the devices, I performed a QC test with the new strip, and ensured the positive and negative controls passed before transporting them to the stock room.

Question 15

Tell me about a time you helped a sad coworker.

Answer 15

1. In my final semester of university, I was attending university every day, from 8am-6pm, almost like a full-time job. It was a research-based laboratory, and most of us will know that things don’t always go to plan, even if you perform everything correctly. (S)
2. My colleague was a pHd student, and was feeling a bit upset because her recent set of cell culture experiments hadn’t gone to plan. (T)
3. I talked to my colleague and politely and empathetically asked if everything was okay. We agreed that she could take some time away from the lab and repeat the experiments a little while later. As I had some down time, I made the cell culture media for her, so she was ready to begin her experiments when she returned. I also started and completed some SDS-PAGE runs. (A)
4. My colleague was a lot happier as a lot of pressure was removed, and was ready to restart her experiments. I also managed to get a lot more experience in the laboratory, performing these experiments with minimal supervision. (R)

Question 16

Tell me about a time you made a mistake and how you dealt with it.

Answer 16

1. We receive EQA samples for the glucometers each month. We get many samples, as there are numerous meters around the hospital and also at local health centres. (S)
2. We were required to print out specific forms with the glucometer serial number, testing instructions, with a matching envelope, and mailing them a sample. I was working through it until my shift was over, after which I placed the remaining samples in the fridge near the other EQAs. The next morning, my colleague on the early shifts took the same EQA samples from the TOP of the fridge, and continued packing samples. (T)
3. We received quite varied results. We also were returned the samples, on which we noticed the month/distribution was different. I backtracked my steps and knew exactly which ones I had done, and liaised with the other colleague. We called and apologised to the affected wards, informed them of the error, and sent them the new correct sample to test again. I also made the supervisors and line manager aware of the situation. (A)
4. The EQA results being returned were a lot more concordant. We also made some changes as a department to prevent this error from reoccurring. We now message on Teams and WhatsApp, with a photo of where the EQA has been stored (top drawer). All the previous months’ stay at the bottom, though we double-check the samples before distributing.

Question 17

Tell me about a time you showed compassion to someone.

Answer 17

1. In my final semester of university, I was attending university every day, from 8am-6pm, almost like a full-time job. It was a research-based laboratory, and most of us will know that things don’t always go to plan, even if you perform everything correctly. (S)
2. My colleague was a pHd student, and was feeling a bit upset because her recent set of cell culture experiments hadn’t gone to plan. (T)
3. I talked to my colleague and politely and empathetically asked if everything was okay. We agreed that she could take some time away from the lab and repeat the experiments a little while later. As I had some down time, I made the cell culture media for her, so she was ready to begin her experiments when she returned. I also started and completed some SDS-PAGE runs. (A)
4. My colleague was a lot happier as a lot of pressure was removed, and was ready to restart her experiments. I also managed to get a lot more experience in the laboratory, performing these experiments with minimal supervision. (R)
5. Even on a regular basis, I swap shifts with the rota staff if they have events or other commitments.

Question 18

Tell me about a time you worked as a team.

Answer 18

1. When I was working at the Blackburn Foodbank, teamwork was essential. There was a clear sort of chain, with parcels coming in to the warehouse, stock from the warehouse to the pantries, and finally to the client.
2. Even now, in my current role, teamwork is so embedded. We share tasks, let each other know the status of tests, book on and perform tests - it’s very seamless and efficient.
3. I’ll use the Blood Gas EQA as an example. We have 5 analysers in Chorley. The sample degrades quite quickly, so we want to test it on many analysers as quickly as possible to get the best results. (S, T)
4. I used a trolly to collect 2 analysers from different wards and bring them to a central location in ED. At the same time, my colleague printed off EQA labels and prepared the samples. I changed the analyser parameters, my colleague inserted the samples, and I labelled it straight away. One of us inputted it and the other checked it. (A)
5. We got good results and input them onto the EQA scheme timely, accurately, and efficiently. This method also saved us opening new samples, which could be used in case of an emergency. (R)

Question 19

Tell me about a time you’ve dealt with conflict?

Answer 19

1. People come to the Hot Lab or Pathology to collect swabs. Admission areas are allowed to collect rectal swabs, whereas ward areas need to gain authorisation from IPC. (S)
2. A particular ward wanted to collect a swab. I checked with my colleagues, and nothing had been authorised. I told the ward they would need authorisation before I could give the swab. However, the ward called back very unhappily, demanding that they are an admission area. (T)
3. I acknowledged that they wanted the best for their patients. However, I reminded them that this system was set up in place by IPC and Microbiology, and was out of my jurisdiction. I also informed my supervisor and line manager, who forwarded me an email from IPC and Microbiology confirming their decision. I showed it to them, and politely asked them to call IPC to request the test. (A)
4. They apologised and followed protocol, ringing IPC for authorisation. Shortly after, IPC authorised the test; I gave them the swab and we tested the patient for them. (R)

Question 20

Tell me about a time you’ve had to prioritise your workload.

Answer 20

1. You have to prioritise your workload all the time in POCT & Rapid Testing, it is a very dynamic department. The duties are also quite broad and varied, so it is important to order them by priority.
2. I was lone working an early 12-hour shift on Saturday. (S)
3. I had a range of tasks to complete, including: testing, making up solutions, updating devices, scanning forms, checking EQA results, and changing consumables on an analyser. (T)
4. I made a list, from most to least important. At the forefront, was testing, followed by device maintenance, and admin work. (A)
5. This helped me to keep sight of what tasks needed doing, and could be completed in my downtime. Ultimately, I managed smooth and efficient running of the Rapid Testing service, resulting patient tests as quickly as possible, whilst also attending to other service users. (R)

Question 21

Tell me about a time you were lone working and solved a problem.

Answer 21

1. After the May Bank Holiday, we were very short-staffed due to sickness. I was required to do my normal core shift, and also cover the late shift until 10pm. (S)
2. We received a LIAT test. These usually come after 6pm, and they are very rare. I had started my competency in it, and I was aware of it, but hadn’t been signed off and did not feel comfortable running it at all. (T)
3. I first checked the SOP for this particular test and viewed the sample storage instructions. It could remain in the fridge for 6 hours before being tested. I put it in the fridge and notified my colleague when he got in, to prioritise that sample. I also rang the ward to explain the situation and to offer an alternative test that I could perform. Fortunately, the patient was already being isolated, and so the test was not urgent. (A)
4. The patient test got processed and resulted relatively quickly, when my colleague got in, and was delivered to the ward. It also identified the need for me to complete this competency; the supervisors allowed me to shadow a week of late shifts where I had the opportunity to practise performing this test myself, which I am now competent in. (R)

Question 22

What would you do if you saw a colleague being bullied?

Answer 22

1. If there was a physical altercation, I would intervene and separate the employees to de-escalate the situation immediately.
2. If it was verbal, I may observe a little longer from a distance, as what I perceive to be bullying could be humour between friends. If needs be, I would speak to the colleague(s) privately to clarify and ensure everything is okay.
3. In either case, I would make a written record of what I observed, the time, location, any actions I took, ready to report it to a senior member of staff.
4. If the colleague was being bullied and felt very anxious, I’d speak to them and let them know I would be there for them. I may even urge them to use some services like the Safeguarding Team, where I would be happy to be a witness.
5. Leading up to the resolution, and following the resolution, I would regularly check up on the colleague to ensure everything is okay.

Question 23

What do you know about health and safety in the laboratory?

Answer 23

1. Health and safety is of paramount importance in the laboratory, to protect both staff and patients from chemical and biological risks.
2. Comprehensive risk assessments are carried out for all procedures performed and equipment used. This informs us of what protective measures should be taken.
3. We look at which chemicals and reagents we will be using, and adhere to COSHH guidelines to inform us how to safely handle the substance, and dispose of it.
4. We work in a safe manner, utilising aseptic techniques to minimise biological risk. All experiments are performed under safety cabinets, sterile equipment and methods are used, surfaces and regularly cleaned and disinfected, and samples disposed of correctly as per SOPs.
5. Depending on what is outlined in the risk assessment/SOP, we will wear PPE including a lab coat, gloves, and if necessary, safety goggles. These must be worn at all times in the lab and not leave the lab.
6. We also look at physical safety, using DSE and sharp equipment. We perform regular audits on chairs and DSE surveys to reduce MSK issues, for example.
7. We receive regular training and seminars about general health and safety - biological/chemical spills, fire alarms, moving and handling.
8. In any case, any accidents of any kind, or near-misses, should urgently be reported to senior staff members, and a report made on your quality management system.

Question 24

What do you know about information governance?

Answer 24

1. Information governance is informed by several laws, and acts as a framework for handling sensitive patient data. It ensures the data is obtained fairly, looked after securely, and only used ethically.
2. Confidential patient information is only to be accessed by and shared with authorised healthcare professionals. For example, I am only allowed to deliver test results to the staff in charge of the patient. I am also only allowed to use Flex to access records that help me with my role, like checking for authorisation and Microbiology notes.
3. We scan all request forms on the Trust’s SharePoint, and discard paper copies in confidential waste after 7 days.
4. It is important because if a patient feels more confident in their data being protected, they are more likely to discuss and confide in their healthcare providers more, which allows them to receive the best treatment possible.

Question 25

What do you know about our Trust values?

Answer 25

1. We put patients first: This agrees with my own values and beliefs. The patient is at the heart of everything we do. Hence, working at the highest quality to provide accurate and timely diagnostics that will further their care. 2. Respecting the individual: This applies to all staff, service users, and patients. Embracing diversity and ensuring that no one is treated differently based on race, religion, sexual orientation, disability, etc. 3. We act with integrity: This refers to having strong moral principles and following an ethical code of conduct. Again, not discriminating against patients, only using patient data responsibly, and declaring any conflicts of interest. 4. We serve the community: We have specialised services across Blackburn and Burnley Hospitals, but we also work with other Hospitals to provide the best care to patients. 5: We promote positive change: Especially in Biomedical Science, it's a very dynamic, evolving, field, and using CPD to stay at the forefront of scientific advancements allows us to provide the best care for the patient.

Question 26

What do you think this job role involves?

Answer 26

1. I think this job role involves a lot of what I currently do. 2. Samples are received and have to be sorted by urgency. Some might be for testing, some might be for storage, some may be transported to other sites. 3. The samples have to be tested for adequacy to run on analysers and booked on LIMS if/if not the case. 4. The samples are run on automated analysers, but manual methods may also be required. 5. Test results are rung out to authorised staff, we may also need to communicate details about testing procedures, turnaround times, etc. 6. Request forms are scanned and securely stored and uploaded online. 7. Quality control checks, EQA, maintenance, troubleshooting, and repair of analysers and equipment. 8. Ordering of stock, batch checking and storage of new deliveries, rotating the stock in fridges, cold rooms, and cupboards. 9. Monitoring POCT devices and troubleshooting them if necessary.

Question 27

What skills from your current role can you bring to this role?

Answer 27

1. Technical competence and manual dexterity, including attention to detail and ability to concentrate for long periods: I carry out many of the duties listed in the job description on a daily basis. I also do as many as 100 tests a day, and have not yet made an error inputting patient details, manipulating patient samples, loading cartridges into analysers. Particularly the POCT-based duties, I feel I can confidently do many of these duties. 2: Eager to learn and continuously improve: Most pathology departments are very dynamic and always evolving, we always change procedures and get new devices which requires new training. I am confident that I will get to competently learn many procedures as I enjoy learning. 3. Flexibility: My current rota looks like a rainbow because of how many shifts I cover. I reliably cover shifts, not just out of necessity, but also to make it easier on my colleagues. So hopefully I can be a collaborative team member that they can rely on.

Question 28

What would you do if an issue arises in the lab, by your own fault or others?

Answer 28

1. Easier said than done, but stay calm and level-headed, and think of a rational solution. I feel acting in haste could potentially have adverse effects. 2. It doesn't matter how the mistake arose, but it is important to alert the supervisors and line manager. You can ask for advice, as they will have the experience to know what to do, or you can simply keep them in the loop. 3. Try and rectify the result. This could be rerunning a test, reinputting results, calling a ward about their patient, cleaning up a spill, etc. 4. Once it has been resolved, the team can reflect on the issue. This is only to see if any changes and improvements can be implemented to prevent this error from happening again. It may be that some more education is required, or a flaw in the working system is allowing errors to occur often. No one gets in trouble or anything; it is just a genuine opportunity for the department to learn from and improve. 5. E.g. I received a correctly labelled and stained sample from a ward, so I processed it and ran it as usual, and delivered the result. However, I was called back by the ward telling me the patient hadn't been swabbed. I reported it to senior staff straight away, requested IT to delete the result, and told the ward that they would need to request new tests if they were querying this patient (or the suspected wrong patient) again.

Question 29

What would you do if you were working alone and there was a pool of liquid behind the analyser?

Answer 29

1. I would treat the liquid as unknown in origin and therefore potentially harmful. I would wear full PPE before approaching it. 2. I'd try and identify the liquid. It could be that the lid on a disinfectant wasn't properly sealed, or a QC spilled. I could also check the analyser logs to see if there were any error messages. 3. If the analyser is still running, I'd pause/cancel the tests, because the results could be invalidated. If necessary, I'd contact the wards to explain the situation. 4. I'd get the biological and chemical spill kits, put tissue and absorbent mats/pads over it with disinfectant, and collect everything and dispose of it in a yellow waste bag for incineration. 5. I'd repeat the tests on a different analyser, or try the same analyser to see if the error reoccurs. 6. I'd record the incident, and any steps I took to correct it, and report it to my supervisors and line manager.

Question 30

Where would you dispose of the following:? 1. Pipette Tips 2. Glass QC Bottles 3. Sample Tubes 4. Hand Towels

Answer 30

NB. I would always refer to SOPs and risk assessments to determine where to dispose of particular items or reagents. 1. During my research project, we would dispose of pipette tips in a Virkon beaker, which were subsequently collected and disposed of. In a medical laboratory, especially when handling bloods, I would dispose of the tips in a biohazard sharps bin. 2. We currently dispose of our glass QC bottles in the same sharps bin. I think some labs have designated glass bins. 3. We double bag sample tubes and throw them away in the yellow clinical waste bins (also double-lined with bags). 4. If the hand towel was contaminated, we would also dispose of that in the clinical waste bins. Otherwise, we would use the domestic waste bin, if just washing hands or similar.

Question 31

Why are priorities important in the workplace?

Answer 31

1. Priorities are important because it creates some form of order, and allows for more efficient workflow. Without it, we might spend too much time doing the wrong tasks. 2. It helps increase efficiency by having a list of goals or tasks that need to be completed. You work your way down, with patient testing always being at the top. 3. It is important for testing too. We get a range of samples. Some expire after 1 hour, and some after 5 hours. Prioritising the quickly diminishing samples means you can run all the samples in an appropriate timeframe. 4. It is important to note that priorities need to be dynamic. If a fridge or analyser broke, or we got an urgent sample, we have to be able to shift these priorities to give the best service possible to patients and service users.

Question 32

Why do you want to work in this department?

Answer 32

1. My ultimate goal has always been to have an impact on patient care, preferably utilising my passion for Biomedical Science. I feel like this department allows me to achieve that goal because I'm helping with diagnostics that would then inform treatment or clinical decisions on that patient, and you can see the impact you're having on a daily basis. 2. Following on from that, blood is a fascinating diagnostic tool. You can look at red blood cells, white blood cells, cell number, shape, and size, platelets, clotting, haemostasis, electrolytes, gas pressure, etc. This appeals to me as someone who really enjoys diagnostic work because there are so many things I can work on in this department. 3. There are many applications following this huge repertoire of diagnostic markers. It is obviously important for people having transfusions, people who have suffered major trauma, people undergoing surgery, and even to determine infection.

Question 33

Why is it impossible to create a daily worklist?

Answer 33

1. Pathology is a very dynamic department - you can go from testing 100s of samples a day, down to only 2 or 3. Whilst you can always prioritise patient tests, it's hard to predict how long you will be spending on testing them. 2. There may be urgent unforeseen events that cause you to reorder your priorities. For example, a ward came to me with a broken device that wasn't able to test until an electronic simulation was completed. Therefore, that was my new priority as not to disrupt further tests needed on this machine. 3. It's largely dependent on staff and colleagues. On a day that my co-worker is sick, I may have to change my worklist and stay in the laboratory all day. However, if both of us were present, one could stay in the lab whilst the other performs EQA testing.