ASCLS Today Volume 33, Number 2

Jean Bauer, MLS(ASCP)^CM, ASCLS Region V Director

Fresh talent brings in fresh views. It invigorates an organization. And in our current healthcare environment, the importance of developing laboratory leaders is vital to ensure we have a voice at the table when decisions are made about our profession.

The question is, how do we prepare new professionals to become leaders and take on roles within ASCLS and in the workplace? Many societies struggle to identify, prepare, and support new leaders. This results in some groups recycling leaders year after year. While this suffices for the short term, it is not good for the long term.

The ASCLS Leadership Academy, started more than a decade ago, was successful in recruiting and graduating a number of future leaders. But those numbers have decreased, due to a decline in applicants for the program. The Leadership Academy was recently updated and will debut with a new class for 2019-20. A few states and regions have also developed leadership academies to encourage those interested in seeking leader roles. All of these have had success, but we still fall short of the number of new leaders needed.

The Leadership Development Committee will prepare new modules that provide information on general leadership, as well as ASCLS-specific topics. For some individuals, this will be enough to give them the background and education to move forward. For others, however, a personal hand is needed to encourage and guide them. To meet this need, ASCLS has developed a mentorship program that pairs up mentors and mentees who have similar interests.

In spite of these ASCLS programs and structures, many laboratorians do not see the potential in themselves to become leaders. Therefore, it is incumbent upon current leaders to identify people with leadership potential. Those potential leaders should be encouraged to take part in the mentor/mentee program and/or volunteer for some opportunity within the organization. This starts with reaching out to our members individually and showing interest in them. Asking new people to get involved demonstrates that they are important to us and that we will stand by to help them succeed.

Leadership Development in Region V
In Region V, a leadership academy (LA) was started six years ago. Many of the graduates have gone on to lead committees and become officers in their local constituent societies, as well as participate or take on leadership roles at the regional and national levels within ASCLS. A number of instructors in the LA program have served as mentors to the participants during their program year and after graduation. Graduates themselves have also become mentors to others over the years.

In surveying the states in Region V, there is variation in how each is currently engaging and supporting new leaders:

• Wisconsin provides incoming leaders with an orientation packet. It is a basic guide that helps them learn what their role entails. Any mentoring that takes place is done on an informal basis.
• South Dakota has utilized mentoring and leadership succession planning in the past. However, its current process primarily consists of providing position descriptions to incoming leaders. A little more detail on how to complete tasks and associated timelines has been suggested to improve the success and transition for members into new roles.
• North Dakota provides informal mentoring to all incoming board members from past board members. A more formal mentoring process is on their agenda for their next board meeting.
• Minnesota has tried a formal mentoring process in the past but that has fallen by the wayside. However, in 2018, the Clinical Laboratory Collaborative (CLC) (state) Meeting Committee recognized that the chairs of various committees were mainly people that had been doing this work for years. The benefit of “recycled” leaders is that they need very little information to do the tasks of the committee, but these are also the seasoned professionals who are retired or are planning to retire in the next few years. Each committee chair, including the CLC Meeting co-chair, was charged with finding a new person to mentor into that role. Most of the committees engaged new people, resulting in new ideas and challenging the way things have been done in the past to improve the process. These new committee members are now participating in the 2019 planning process, with some taking on the chair role and their mentors acting as advisors.

In all of these states, basic information is being provided to people as they begin their new roles as leaders. There are many opportunities to augment the process via more focus on mentorship. When utilized, mentoring has proven to be rewarding for individuals on both sides of the relationship. For the mentee, it provides them with the support and tools to be successful leaders. And for the mentor, it is much like watching your children grow and learn to fly on their own.

In summary, we have a number of avenues to develop leaders:

• Identify potential leaders either by self-selection or by encouraging someone
• Education through ASCLS leadership academies, on-line modules, and/or sources outside ASCLS
• Practical experience in serving on a committee from local and state societies to regional and national committees
• Formal and/or informal mentorship

By utilizing these components as a complete package, we can provide the knowledge and ongoing support that will help these new leaders be successful. Let us cultivate the potential in others, develop laboratory leaders for the workplace and ASCLS, and ensure the future.

Jean Bauer is instructional designer/research assistant at the University of Minnesota in Minneapolis.

The ASCLS Nominations Committee is pleased to present the following candidates for office in the 2019-20 Society year. Candidates selected by the House of Delegates will take office at the 2019 ASCLS Annual Meeting in Charlotte, North Carolina.

Maddie Josephs, MS, MT(ASCP), ASCLS Region I Director

Catie recently completed the MLT program at the Community College of Rhode Island, which changed her life.

As an educator, I have an opportunity to meet a wide variety of students, from all walks of life, at various stages in their lives and many for whom life has had its challenges. I am always in awe of the student who works full or part time, cares for a family, and who further dedicates an abundance of time to his or her program of studies. I have the utmost respect for the student who prioritizes the many responsibilities of life and who always seems to make sure education is at the forefront. I can remember my college days and my subsequent year of clinical internship. The only responsibility I had was my program of studies … I was very lucky.

One student whose story really had an impact on me—and there have been so many—completed the MLT program last May. She passed the Board of Certification (BOC) exam and obtained employment immediately after completion of the program. I sat down with her to learn more about her journey to becoming a medical laboratory technician. When I asked to meet with her, she told me that she tells everyone how the MLT program changed her life. She also works hard to educate family, friends, and other healthcare professionals about this profession. Here is Catie’s story.

Maddie: What were you doing prior to entering the MLT program?

Catie: I was a phlebotomist. I went through the phlebotomy program because I needed a profession that provided better benefits. As a single mom of two children, it was important to find a job that I could rely on to provide for us. I always wanted to do something in the medical field, and this was a quicker path to where I wanted to be. My responsibilities eventually included becoming the reference lab coordinator, where I processed the send-out tests as well as planting in the microbiology lab.

Maddie: What made you decide to further your education?

Catie: The plan was always to further my education, but as I said, I needed a job with benefits. I really didn’t know what medical laboratory science was. While I was completing the clinical rotation component of my phlebotomy program, I met a student in the MLT program, also completing her clinical rotation at the same hospital. She is the one who told me that I needed to look into this field because she saw my interest and perhaps, she realized that I was capable of more. After securing a job as a phlebotomist and getting everything settled, I applied to the MLT program.

Maddie: What impact has the program had on you, your life, your family, etc.?

Catie: I know this sounds cliché, but it totally changed my life. I can support myself and my two children. I was so lucky to find a first shift position in microbiology, but I have the opportunity to work in the core lab as well, and my laboratory director wants me to also spend some time in blood bank. I feel so fortunate to have the support of my supervisors and my director. It is so gratifying to come into work and know that I make a difference.

Maddie: What gives you the most satisfaction as a medical laboratory technician?

Catie: I love that I am physically making a difference in patient care. Of course, no one really knows what we do and how important it is, including my family, so I love educating the public. I tell everyone what I do and what a difference this profession has made in my life. I sometimes work at an urgent care center with a physician’s assistant as well as a nurse practitioner. When I help to explain a test result, or when I explain the results of an antimicrobial susceptibility test, their minds are blown when they realize what I do and how much I know about laboratory diagnostics.

The other day, I was dropping my son off at his before-school program and his little friends asked him if I was a nurse because I was wearing scrubs. He said no, that I was a scientist. Well, that explanation was not good enough for everyone, and they continued to insist that his mom was a nurse. When I went to pick him up, the teacher explained that there was a lot of discussion related to my career and she asked that I explain to the students exactly what I do. I proceeded to tell them I was a laboratory scientist and that when the doctor ordered a blood test or a culture swab, that I was the one that tested that to let the doctor know what is wrong and what is making them sick.

Maddie: I love this story … it is never too early to start recruiting!

The MLT program was very rigorous, and you had so many responsibilities while you were going through the program. Given the choice, and knowing what you know now about the rigors of this education, would you go through it again?

Catie: Most definitely, in a heartbeat! I do wish I knew about the program before going through the phlebotomy program, but in the end, being a phlebotomist really helped. Starting as a phlebotomist and then becoming a tech is a great sequence. You understand all aspects of lab, from specimen collection on, including the effects of improper collection and handling, contamination, how to process reference lab tests, and so much more.

An Example for Us All
Catie became a member of ASCLS during her first year in the program. In addition to all her outside responsibilities, she was elected president of the MLT Club and impressively led her fellow students through several on- and off-campus fundraisers to benefit a scholarship to be awarded to a student in memory of an MLT program alumna.

Catie sacrificed a lot to complete her program of studies, and I’m sure it would have been so much easier for her to just continue in her phlebotomy career, but she persevered. Of course, there are hundreds, if not thousands, of stories just like Catie’s. And of course, many of us can relate to this story. However, what Catie is doing outside of her duties—educating the public, from a kindergartner to a physician’s assistant—is what we ALL need to be doing. We may just receive the professional recognition that we all strive for and deserve.

Maddie Josephs is professor/department chair at the Community College of Rhode Island in Lincoln, Rhode Island.

Joanna Ellis, MS, MLS(ASCP)^CM, CHWI

Future Peruvian laboratory professional with Professor Ellis at the microscope.

Francisco James and Jamie Vreeland perform anemia screening in Aco, Peru.

From left: Jennifer Pemp, Ashley Wells, Professor Ellis, Ashleigh Graham, and Idahlia Bland in Nicaragua.

Clinical Laboratory Science (CLS) professionals are underrepresented in study abroad (SA) programs, public health campaigns, and medical volunteer trips. As a clinical assistant professor of CLS at Texas State (TxSt) University, I set out to change that by creating a culturally-sensitive and ethically-responsible SA program for our students.

I helped create the first interprofessional service-learning SA program in the nation that included CLS students. I collaborated with faculty from the TxSt St. David’s School of Nursing, Respiratory Care, and Mass Communication programs to add interprofessional education to the existing nursing SA program in Nicaragua.

When I began exploring this opportunity, I consulted a lab professional that has extensive experience with health clinic labs in Haiti. I read many international volunteering resources, one of my favorites being When Healthcare Hurts, by Greg Seager. I learned how good intentions often fail to achieve positive outcomes in service abroad trips. Prior to the Nicaragua trip in 2017, I gave lectures on perceptions of poverty, monochronic vs polychronic societies, photography ethics, individualistic vs collectivist societies, health clinic best practices, and other topics to optimize positive results in the local community.

Interprofessional Study Abroad in Nicaragua
In Nicaragua, we conducted house visits where we collected public health information for the household and invited the families to our clinics. We enjoyed the learning experience, but due to the challenges of bringing lab equipment into Nicaragua, the CLS students were only able to conduct urine dipstick and pregnancy tests in these pop-up clinics.

We visited two Nicaraguan labs—one rural and one urban public hospital lab. In the rural lab, there were no computers. They washed and reused blood slides, pipette tips, and gloves. They performed red and white cell counts on a hemocytometer: tap, tap, tapping ALL DAY LONG. Patients submitted stool specimens in matchboxes.

The lab manager was an unflappable woman who described every step of their spectrophotometer chemistry tests and her unusual method for never missing “hard sticks.” She let us observe as she performed a painful skin scraping on a woman with a history of leishmaniosis.

The urban hospital lab had computer systems and automation much like a small rural lab in Texas might have. In the Microbiology Department, they had much of the same media that we use, but not an identification system. We noted that they had blood culture bottles, but not the detection system. They incubated the bottles and did a gram stain every few hours to detect positives.

At our evening debriefs, the four CLS students and I relayed all the interesting experiences we had in the labs and discussed what the healthcare team should know about lab science. One CLS student even taught a local physician and the nursing students about the potential to detect advanced testicular cancer with a pregnancy test. We created an interprofessional team that achieved the goal of learning the expertise of each of the different health professions, but there were opportunities for improvement in creating a program that effectively and sustainably promoted public health, continuity of care, and empowerment for the community.

The Path to Improvement
I was determined to learn how to achieve a truly mutually-beneficial SA program. I became a certified community health worker instructor (CHWI) through the Texas Department of State Health Services and earned a Certificate in Sustainable Community Development from Colorado State University. I learned more tips on how to avoid competing with local practitioners or businesses and creating dependency through paternalistic practices. I looked for a service provider with a sustained, year-round presence in their communities and a willingness to implement best practice procedures in all our events.

The Foundation for International Medical Relief of Children (FIMRC) fit the bill. In collaboration with FIMRC and following the guidance of The World Health Organization to promote education before medication, I worked with local physicians to determine appropriate lab testing and develop culturally-appropriate educational materials for a “Community Health Screening and Education through Laboratory Science Workshop” (CHS&E).

CLS Study Abroad in Peru
In June of 2018, I completed the first CLS-specific SA program in the 42-year history of the Texas State CLS program. Five senior-level students, my husband, and I spent two weeks learning about the healthcare system, lab services, and culture of Peru. We helped medical students detach skin from a cadaver, observed surgeries, and toured private and hospital labs in Huancayo, Peru.

The Carrion Hospital lab is enormous and quite advanced. The small private lab had compact CBC and Chem7 analyzers they were proud to demonstrate. We worked in an existing rural clinic to provide screening tests that the tiny lab could not offer routinely. We screened over 150 people. Using a hand-crank centrifuge, we detected two cases of syphilis, over 25 UTIs, and many anemic patients! We gave all abnormal results to a local physician for follow-up and treatment.

During our CHS&E through lab science workshop, we used the Lab-in-a-Suitcase^® to screen families for anemia and diabetes. We showed them Giardia in the microscope and discussed hygiene. Everyone loved the microscope!

We had interactive educational and craft stations where we demonstrated the plasma and cellular components of their microhematocrit, how sugar gets in urine, the effectiveness of their hand-hygiene, and some tests we use in diagnostics. They learned about the biological impact of their dietary choices in new and creative ways. As a bonus, they learned about the field of CLS!

I spoke about my novel CHS&E approach at the African Society for Laboratory Medicine 2018 Conference in Abuja, Nigeria. The workshop was lauded as “inspirational” and a “brilliant blend of clinical and public health services.” It’s time we take our CLS skills up, up, and abroad!

Joanna Ellis is clinical assistant professor and clinical coordinator at Texas State University in San Marcos, Texas.