Thread by @sobzay

Today's shift has been a rollacoaster of emotions which ended in a very sombre yet stark reminder of the importance of team work,effective communication & most importantly the value of life.#biomedicalscientist #pathology #NHS #Haematology #transfusion @IBMScience

A LONG THREAD:

I started my late shift today at 12pm, I am a Biomedical scientist and I work in the haematology and transfusion laboratories at a busy urban general hospital. I started in the haem dept helping process full blood counts, reviewing results & running countless add on tests.

This is normal for a busy large hospital. I was then asked to pop into the transfusion lab to review my training for manual crossmatches which has now been approved to carry out on analysers. I get as far as starting my crossmatch at 2.15pm, where upon I get a call from

Cardiac theatres. They have a patient in theatre & require more blood, octoplex and albumin. They inform me that the porter is on the way and could I get the products ready as soon as. No problem. I check the form and notice a request for all products plus fibrinogen conc. except

Octoplex which is prothrombin concentrate, I then ring round each theatre to locate patient, finally finding them,I ask the clinician to confirm request. Confusion cleared they need blood, albumin, PCC and fibrinogen therefore sending request form down. I issue what I can but

I'm still waiting for another request form for Octoplex. 2.45pm and I'm told I must take a break now because I have been asked to cover the coagulation lab when I get back.
Notice I haven't finished my test crossmatch.
After a break I'm the only worker in coagulation lab,

I get a call chasing up factor 8 & factor 9 results on 5 patients from another hospital, samples for testing from another hospital, authorising my own samples from clinics &splitting of lupus, protein c & s, factor 5 Leiden tests and answering telephone queries.
Phew all done...

As I pass the transfusion lab to collect my pending test list from the printer, I'm pulled back into transfusion to 'quickly' finish my crossmatch. I talk through my training rather than physically doing it, as I am aware I need to get back to coagulation.

I get the thumbs up and all clear from my senior biomedical scientist, now I need to repeat the process on a actual patient and I'm good to go. This is dedication of training and maintaining flow of work as a Biomedical scientist we must do everyday.

Back to coagulation and all queries dealt with and it's 4.25pm and I'm called back into haematology lab to do batch testing for a new kit of sickle screening tests as we're running extremely low on current lot. New testing done but I must put results on the pc. But first I need

Lunch. It's 5.05pm I must go now as day staff leave at 5.30pm which leaves 3 staff, 1 for each department. 5.30pm I'm back, we're all in a good mood. It's very busy but we're just about on top of it as we help each other out by answering phone calls, centrifuging samples & cover

Eachother.. 8pm, malaria screen received and IM screen received from A&E, check any missed tests, and films to make. I ask other colleague to go on her break as she is pregnant and will be by herself after 9pm for an hour til night shift comes in. We're down to 2 staff now.

8.20pm - bleeps go off, there's a patient with major haemorrhage somewhere in the hospital. My colleague decides to take it while I hold the fort in the background to deliver the service for all departments to the rest of the hospital. Adrenaline has kicked in.

Major haemorrhage pt in cardiac theatres, request for blood, platelets, cryoprecipitate and albumin. Luckily today the patient is known to bloodbank so we have some history to go by. 3rd colleague back from break and has been roped into helping issue products for said patient.

I have taken the 2nd phone for transfusion lab, coagulation telephone and my own haematology phone so my 2 colleagues are not disturbed at all. 1 of my phone's go off, it's a theatre doctor regarding the bleeder he desperately wants fibrinogen ASAP, I ask him to send the form.

I begin to get out products and pass the message on to my colleagues while I return to manage the labs. Haematologist rings at 8.40pm to confirm concentration for blood product, again I write this word for word & pass on to colleagues. I start my malaria and sickle tests for pts

I am aware my shift is nearing the end at 9pm so I swiftly clear all pending tests in haematology and coagulation, and make sure I authorise all results so there is nothing outstanding for my colleagues as they are still busy with the major haemorrhage pt.

8.55pm - one of my phones ring.Consultant haematologist on the line,steps down all major protocols regarding major haemorrhage.
Patient has died.
Patient.has.died.
I thank her for informing me & I will pass onto my colleagues who are dealing with it. We take a moment to breathe.

She thanks me and my colleagues for our input between herself, theatres and porters.
I inform my colleagues to stop processing products. We are shocked; collectively it's our first bleeder who died tonight.

10 minutes later a staff member from theatres personally comes to the labs & hands me unused blood products and thanks me profusely for the swift action of me and my colleagues tonight. I mumble a thank you as I don't know what else to say.

I couldn't help but think how we went from an emergency bleeding patient to dead in 35minutes.

We are staff that are hidden but we play a major role in patients care. We are affected by the outcome of a patient's journey too. I tell colleague to go home who took the lead for

Major haemorrhage pt. I stay behind to help clear things up and make sure we're upto date. I leave work at 9.25pm.

Exhausted as the adrenaline wears off.

12.07am as I write this.

Reflecting.

Tonight a whole team came together to save a patient, despite lack of funding, staff shortages, & distances from department to department whilst maintaining the gold standard of care expected by all. This is the NHS that I wish to save.

We do our complete best despite the challenges we are faced with.

We are dedicated. Caring. Passionate. Smart. Always learning. Determined.

We are the NHS.
.
.
.
.
.
Now to set my alarm.....to do it all again tomorrow, hopefully with a happy ending.