Thursday, October 29, 2009

Amazing Knowledge for November

I may be a two-bit, mediocre medical technologist, but my job affords me insight into amazing medical knowledge. Oh, people talk about Mayo's and Johns Hopkins, but those of us in the business know that the real innovations and advancements are taking place at small, rural, Indiana hospitals. Most the time when I'm in the lab, I just sit there with my eyes glazed over, mentally processing some new amazing thought. Other times I'm alert and actually paying attention to what I'm doing.

But before you become disproportionately impressed with me, let me get to this month's amazing medical knowledge:

Why We Wear Gloves

When I wear latex gloves I can't draw blood worth crap. I was trained pre-AIDS, and back then we donned gloves only when we were handling fecal specimens or when there was a possibility of getting something really icky on our fingers.

Fortunately, the only time I'm called upon to draw blood these days is when at least two other techs have already failed to acquire a blood specimen. These patients are referred to as "difficult sticks" and the hospital staff cares enough about its patients to look the other way when I perform my magic... ungloved.

By the time I enter the patient's hospital room, the patient is usually scared, upset, or thoroughly PO'd. I stroll in, sporting my best down-home demeanor, speaking slowly and relaxed like an airline pilot... And as I make a show of washing my hands, I use phrases like "You poor thing" and "We appreciate your patience." Then I generally say, "Let's just take our time and see what we can find." My aim is to make the patient confident both in my abilities, and the fact that I care about him.

But back to why we wear gloves...

When AIDS was brand-spanking new, the medical community erred on the side of caution in most instances, because it was not yet known how virulent the disease was, or how likely it could be spread in clinical situations.

Someone... I suspect someone sitting behind a desk, decided that lab personnel would be safer if they wore gloves when they performed venipunctures. The fallacy in that decision is obvious when you consider that 1) gloves make the tech less dexterous, more clumsy, and 2) latex gloves will not stop a needle. Therefore, in an effort to make us safer, the powers that be have surely increased our risk of infection with blood-borne pathogens, because gloves make it more likely that we will stick ourselves with a dirty needle... Especially those of us who did not begin our careers using gloves.

But what really tickles us is this: Most of our patients think that we are wearing gloves for their protection. In fact, patients have actually written letters to our hospital complaining that the tech drawing their blood did not wear gloves.

A couple of the techs that have been "turned in" have complained that, though I hardly ever wear gloves, I've never been turned in. I tell them, "The reason is simple, really... I'm Malott... And you're not."



Grammy said...

There's always our favorite "work around"...don the gloves with flourish and then quietly cut the essential fingers off after the patient resumes watching TV.

Malott said...

Ha! We just got lectured about that a couple lab meetings ago. We all smiled and nodded our heads. Surely it's a wink and a nod thing... Surely they want us to do our best work, regardless of the stupid rules.

Christina said...

You mentioned patients complaining about no gloves...I'm almost positive that there is a sign in every room in our local blood-sucking place that tells us to report those who don't wear gloves.

However, I never really thought about it being more for your protection than mine (though that makes perfect sense).

Oh, and I would be seeing a lot of you, as I am one of those "difficult sticks". I've learned to just tell the tech that I'm tough right off the bat. Most don't believe me...then they find out. A good "sticker" is worth his weight in gold.

Malott said...


So you are one of "them!" You've got to hate going to have your blood drawn.

I'm not going to tell my blood-sucking buddies about the signs. Some idiot might suggest that we post some.

Tsofah said...


Thank you! Having had worked in a big name medical school, I volunteered for some "studies" that included blood draws in the age of "pre-AIDS". Let me say this: when you sign up for such things and they find you have a high titer against meningitis or chicken pox for example; and/or let the Red Cross do a HLA-typing of you, expect to be called upon A LOT.

My work included working on grants from the CDC and NIH. There's a lot one can find out from such.

The only way I'd feel "safe" with a tech wearing gloves is 1) they were stuck by a needle used on an AIDS or TB patient; or 2) they were positive for AIDS themselves. Seriously, when tech's first began wearing gloves, I thought it was because they were positive for AIDS. And, I always asked for a different tech who didn't have to wear gloves.

With H1N1 being a concern now, it seems a LITTLE understandable that gloves and masks are worn around such patients.

Otherwise, I ask they take off the stinking gloves when doing a blood draw on me! Medical policies won't allow it, but I still ask. I also ask the dentist because the gloves taste ICKY.

Malott said...

We are all fit-tested for very efficient masks... In case of some sort of epidemic...
That might become important if the H1N1 mutates.

But for flu, the best prevention is good hand washing.

Oh, and I've never tasted my gloves.