by Dennis Ernst • August 15, 2014
You were hired to help your employer market your facility's services to patients who need healthcare. Patients use your marketing message to make their decision on where to obtain the healthcare services your employer provides, often through you. How well do you represent your employer, department, and manager to those who you encounter every day? When you interact with a patient, what do your actions, speech, appearance, and personality say about your employer? Whatever it is, that's your marketing message.
Whether or not you loathe the concept of patients being referred to as "customers," they are. Customers are those consumers your employer recruits to purchase a service your employer provides. You were hired to help your employer provide those services. Customers have choices from where to obtain them, and when enough of them choose your employer, you get to keep your job. When enough of them go elsewhere because they don't like your marketing message, you get to lose your job. That's how a free-market economy works.
Your marketing message is delivered at least four ways.
Skill---nobody buys a car that konks out on the test drive. In fact, not only will a customer not buy the car, he's not likely to buy any car from that dealer. After all, why buy a car from someone who thought the one you just drove was worthy of his lot? Surely the others passed no greater scrutiny. Likewise, few patients will come back and let the same phlebotomist stick them who disappointed them the last time. They're not even likely to come back to the same lab, thinking all the cars on the lot must be the same.
Appearance---When a mechanic crawls out from under a vehicle covered in grease, dirt and sweat, his marketing message is "I'm not afraid to get a little dirty if that's what it takes to fix your car." When a patient comes to you for a blood test and sees your scrubs clean and tidy, your nails trimmed, your appearance well groomed and a smile on your face, your marketing message is "When I'm not cleaning my hands and nails, I'm thinking about how to make you glad you came here for your lab work."
When patients see you, they must see clean. Actually, they want to see sterile, but at least show them clean. You can't trust a dirty healthcare professional anymore that you can trust a clean mechanic.
Speech---Even the tidiest phlebotomist can scare off customers if she doesn't speak plainly, knowledgeably, sincerely and with polish. Do you answer patient questions with genuine authority or do you use speculation presented as fact? Do you answer in terms that are either beyond his understanding or insulting his intelligence? All of these are delicate differentiations that are best when simplified. All patients want to know is 1) you're glad to see them; 2) you know your subject, 3) you're honest, and 4) you care.
Personality---No marketing message is complete, or genuine, until it's wrapped in personality. This is where you separate yourself from a robot. Robots can be technically flawless, impeccably clean and tidy, and be programmed to articulate clearly and intelligently. Your personality is what makes you human, unique, endearing, and alive. It's also what makes your marketing message effective. Patients won't return for more attitude, indifference, complaints about your employer, or negativism.They will return for your enthusiasm, confidence, and the way you exude how much you enjoy your work.
Take a personal inventory of the degree to which your marketing message is delivered in each of these four ways. Ask yourself if you are effectively selling your employer's services, or discouraging repeat visits.
Deep down, you probably don't feel like a sales person; you may not even want to be one. You're a healthcare professional, and you delivery a high-quality product: your expertise. Your expertise is why you were hired; your marketing message is what keeps you there.
What's your marketing message?
Every month, Phlebotomy Today-STAT! reprints one of the prior month's posts to The Empowered Healthcare Manager blog, written by Dennis and Catherine Ernst.
Rhonda was a phlebotomist with baggage. So was Brittany.
Rhonda belittled her coworkers, considered policies to be suggestions, and found fault with everyone, patients and managers included. Her incessant gossip and bullying caused good workers to quit. Deep down she was unhappy.
Brittany was reserved, withdrawn, quiet, and a phenomenal employee. She didn't participate much in idle chatter, but engaged each patient with polished professionalism. She had very few recollects, rarely contaminated a blood culture, and never had a complaint lodged against her. Deep down, she was unhappy.
Rhonda's parents always minimized her accomplishments, and pointed out her flaws. She's been pointing out everyone else's flaws ever since.
Brittany survived the worst drunk driving accident in U.S. history. Twenty-seven of her friends were killed in Carrolton, Kentucky when a drunk crossed the expressway and struck the gas tank of her church bus. Few of her coworker ever knew. They just thought she was quiet.
Brittany suppressed her baggage before her shift and dealt with it on her own time. Rhonda let it play out 24/7.
Your staff has baggage. Some can handle it, some can't. As empowered healthcare managers, it's not ours to judge whose baggage is heavier, nor to remove it. It's ours to help them keep it from interfering with the reason we hired them.
It's not always the weight of the baggage, but the way it's carried.
Suscribe to The Empowered Healthcare Manager blog. It's not just for managers.
For the first time since being introduced in 2005, the most popular phlebotomy training videos on the market just got its price whacked. For a limited time only, any title in the Applied Phlebotomy video series is now 40% off. Titles include:
- Basic Venipuncture
- Preventing Preanalytical Errors
- Avoiding Phlebotomy-Related Lawsuits
- Skin Punctures & Newborn Screens
- Arterial Blood Gas Collection
Instead of $249/title, facilities that place their order before September 30, 2014 pay only $149.99, saving $100 each.
“We wanted to remove any obstacle facilities might have,” says Dennis J. Ernst MT(ASCP), Executive Director of the Center for Phlebotomy Education. “These are great DVDs, and in use around the world as the gold standard for phlebotomy training videos. Each title is current with the standards and OSHA guidelines. If price has ever been an obstacle, you no longer have an excuse.”
Education in the phlebotomy world I fear is sorely lacking. Ask any of the phlebotomists, old or new, a simple question like, shouldn’t patients pump their fist? or why is the order of draw the way it is? Some, will give you this deer-in-the-headlights look. They don’t know, and the saddest thing is they don’t care to know. It’s only those of us who take phlebotomy seriously and take the time to learn the ins and outs of the testing and the little details.
Let me give you a real life scenario. Not long ago, I went to get my blood drawn. The phlebotomist mentioned a teacher who I know has at least 2-inch fingernails. I mentioned how she should not be drawing blood. The response I got surprised me. She said, “oh well it’s different in every place, here we can have long finger nails.” When I replied, “not according to CAP regulations” she just stared at me and asked “what is CAP?” I don’t blame her or the company she works for. All of that should have been covered in the basic phlebotomy chapters at school, including the accreditation organizations and what each one is responsible for.
Today people are just satisfied to be able to stick a needle in the arm and get blood. They don’t care, and are taught not to care about anything else. They remain ignorant of some of the basic rules and courses of action that need to be taken. It’s very sad for those of us who want to know phlebotomy.
There is a funny little shirt going around that says “It’s just phlebotomy not brain surgery.” Yes phlebotomy is a basic invasive procedure, but if done wrong it can lead to lose of limb, temporary paralysis, and, in the worst case, the death of a patient.
If you are not getting your CEUs and not keeping up with the latest in your field by doing simple things like subscribing to a newsletter like this one, or even once in a while search in Google for phlebotomy articles and finding those that don’t conflict with CLSI standards or CAP requirements, you will be doing yourself a big favor. Share with your fellow phlebotomist and medical technicians what you find. We will advance phlebotomy education and get it out of the Stone Age and back into the 21st century.
Jeffery Silvas, RPT (AMT)
Do you have something you’d like to share? Phlebotomy Today-STAT! publishes passionate readers' opinions on any aspect of their work or profession as long as it has a phlebotomy connection. Rant if you want, but keep it clean. Vent if you need to, but don’t be cruel. Show frustration if it will help, but be articulate. (Preference will be given to submissions that don’t require heavy editing.) If you feel passionate about something, put it into 200-500 words and send it to [email protected] with your name, city, and state/province/country (no facility/organization names, please). By sending your comments, you agree to let us include them in future issues of Phlebotomy Today---STAT!. Your name, city and state/province/country will be included when published, so if you’re looking for a place to be anonymous, this isn’t it. We believe any comment worth sharing is worth owning.
Here’s what subscribers to Phlebotomy Today, the Center for Phlebotomy Education’s paid-subscription newsletter currently in its 15th year of publication, are reading about this month:
Anatomy of a Dysfunctional Team
On the Front Lines
Slapping a site to help find veins
Sticks, Staph, and Stuff
Fingernails in healthcare
The Empowered Manager
The ability to lead and transform
Pouring two tubes together
Hospital Saves Big Money Using Phlebotomy Team and Blood Culture Kits
(Institutional Version Only)
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It's a common, but expensive practice. You're drawing a CBC on an ED patient who is complaining to you of an abdominal cramp. The chances that you'll be back in fifteen minutes drawing preops or admission lab work from her is not unlikely. So you decide to draw a rainbow of colored-stopper tubes.
This practice has been reported to cost facilities over $200,000 per year. Whether or not that's worth the time saved is impossible to measure. What's easy to measure is how common this practice really is among Phlebotomy Today STAT! subscribers.
We asked "How often do you draw extra tubes of blood on patients just in case additional tests are ordered?
Fourteen percent said they always draw extras, twenty-two percent said they never did, and sixty-four percent said "sometimes."
Then we asked "In which of the following patient departments or situations do you draw extra tubes just in case?" Not surprisingly, the emergency department was the case for sixty-seven percent of respondents. What we did find surprising is that twenty-five percent of those responding draw extras on outpatients, the one category least likely to have tests added later that require a second draw. Other departments/situations:
- Obstetrics: 12.7%
- Surgery/recovery: 18.6%
- Emergency Dept.: 65.7%
- Acute care wards: 14.7%
- ICU/CCU: 25.5%
- NICU: 1.0%
- Psych wards: 3.9%
- Isolation patients: 14.7%
- Lockup rooms: 6.9%
Given fourteen percent said they always draw extra tubes, we wondered how many of those responding work in facilities that actually had a policy on drawing extras. Fifty-seven percent do not. That tells us the majority of facilities do not attempt to reduce the cost of drawing extra tubes. Forty-three percent do. Here are some comments:
I was trained to always draw extras especially when a heparin is ordered. I was taught to draw a green and lavender as well.
We may hold an extra tube for a couple of hours if the patient insists he needs certain test and we are unable to contact the doctor. If we don't hear from the doctor soon we discard the sample.
It's against our policy.
Our policy is the lab staff will not do this intentionally. If a wrong color tube is drawn accidentally or tests canceled, we will then order it up as an extra.
I currently work in a clinical setting so I do not draw extra tubes. When I worked in a hospital setting I always drew the rainbow when I was sent down to the ER. Also when drawing OB patients I always drew for a possible type and screen.
[I always do] in the Emergency Dept when able. Other areas only if I am aware of patients history and condition.
If a patient is hard to get or has compromised venous access, [I will]. Also if the patient typically gets a specific test and the order may have been missed.
I never draw extra tubes for any situation.
We draw JICs (just in case) on morning or first draw of the days.
On our cardio wing, nurses too often forget to order daily INR's.
[I do] when drawing on patients who are extremely hard draws and have a reasonable suspicion that add-ons are coming, as in changing status of patient.
Anticipated additional tests are a norm here and the doctors get angry if you have to redraw for a test they want to add.
There's no right or wrong to this question unless your facility has a policy. However, in today's healthcare climate, we expect more and more facilities to limit extra tubes as a cost-saving measure.
This month, we're asking our esteemed readers if they feel comfortable suggesting changes where they work, why or why not, what incentives or obstacles they have to suggesting changes where they work, and if they've ever had negative experiences suggesting change in the past.
What Should We Do? gives you the opportunity to ask our team of technical experts for advice on your most pressing phlebotomy challenges. Whether technical or management in nature, we’ll carefully consider solutions and suggestions based on the industry’s best practices so that you and those in other facilities with the same problem can benefit, all the while maintaining your facility’s anonymity. What Should We Do? is your opportunity to ask us for suggestions on the best way to handle your real-life dilemmas.
This month's case study: Using the phlebotomist as punishment
Just today I was in the admitting area of our hospital when a mother pointed to me & told her son he needed to behave or I would give him a shot. I looked at the boy & told him I had no needles. The mom proceeded to tell him that they were in my pocket & that I would use them for him. How do you properly respond to this type of threat? As a mother myself and health care worker I am appalled that a parent would use this as a discipline tool. I hate to see it done as it makes the kids afraid of healthcare professionals.
Our response: We understand how offensive that might have been. For a parent to suggest to her child that you are their accomplice in delivering punishment is profoundly inappropriate. It teaches the child that strangers can be easily recruited to dole out punishment, that healthcare professionals are to be feared, and that those who carry needles would gladly use them to make children behave. None of these are true, of course, but to the child, they may all seem to be entirely possible.
There are many ways to handle this situation. As you might imagine, the correct reaction is civilized and professional. Even though inside we might be tempted to be sharp, or at least snarky to the parent, the offense we take has to be muted. The mother and her child are guests in your workplace, and professionals aren't sharp or snarky to their guests.
It does no harm to ignore the comment and continue with your day. As much as you reject the mothers' attempt to use you to modify her child's behavior, no parent welcomes parenting advice from strangers no matter how sound the advice. Objecting to her tactic might make you feel better, but it won't likely change her modus operandi.
You might suggest to the child in a playful, sing-song voice that you're there to help people feel better, not worse. This would not only indicate to the child healthcare professionals are not ogres who punish other people's unruly children whenever invited, but would send a signal to the parent that you are not a reliable partner in disciplining her child. Either way, a good bit of tongue-biting is required.
Each month, our “What Should We Do?” panel of experts collaborates on a response to one of the many compelling problems submitted by our readers. Panelists include:
Email us your submission at [email protected] and you just might see it as a future case study. (Names and identifiers will be removed to assure anonymity.)
Each month on our home page,we post a "Tip of the Month" from our rich library of archived Tips from Phlebotomy Today.
This month's Tip: "Wanted!"
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