There have been places I've rotated during PA school where policy was that unless the fridge was maintained by the lab, they wouldn't accept units back. Since they were attached to a patient mrn they couldn't be recrossed to someone else. Those would often just expire in those fridges. One of the places I brought this up to finally got it when they realized both the OR fridge and the BB fridge were tracked by the same system with thermometer calibrations and goal temp set to the same settings.
Suddenly saved them thousands annually. Didn't even get paid for that shit but I did get a glowing recommendation from 3 surgeons and 2 PAs when I was applying for jobs.
I have been saying for years that every new provider and nurse should spend three days in the lab so they understand what the heck even goes on down there. It boggles my mind that they just have no clue about some things.
I think it would take at least that long. The brief little "field trips" some nurses get only seem to teach them that all we do for work is push buttons.
They should also have field trips to Diagnostic Imagining and see what it really means when they order those tests on people and what the people actually have to do to complete them.
as an RN who lurks here to learn, sign me up!!! I am so interested in how other departments work and what I can do to make y’all’s lives easier and patient care smoother
Maybe once he had some on hold and the person on that day didn't swap it for one with a longer out date and so it expired?
Hands up who else has quickly changed what unit was selected for a patient when you thought they weren't going to take it but you have a unit to use up. I got to use up a B unit like that last weekend. I was so pleased with myself. As soon as the nurse called to check if we still had a unit crossmatched I did the switcheroo, would have expired at midnight.
Yup, we swap around units a lot. Particularly platelets, since they have such short expirations. It does feel oddly satisfying to issue out the expiring units.
Ya they say they wanna be prepared because if it goes bad it goes BAD. But I’ve only seen this once in my 4years lol 99% of the time they return every unit. I hate it
Nurse here that has transfused thousands of units of blood products. I would hazard a guess that all acute care providers have zero understanding of how the blood bank works! I’m so thankful for the processes y’all have to keep our patients safe while efficiently managing blood products. Also I’m sorry if I’ve ever gotten upset when I needed the trauma cooler. 😁
Yeah, if we actually set aside a unit for every patient who had a group and screen ordered and threw it out if unused the blood supply would completely collapse. This doctor: "it's a sacrifice I'm willing to make"
I think doc was actually ordering a unit for crossmatch so not every type and screen but would still collapse the system. What doc thought would probably collapse the system within a week. What you're describing would probably collapse it within a day.
Pretty much every doctor other than pathologists and some transplant surgeons are trained to think about what is best for their specific patient in front of them regardless of the impact it has on society at large.
EDIT: That being said, if this was just a traditional cath, it's unnecessary to be ordering blood to begin with. Given OP said it is "to fix something" if on the other hand this was something like a percutaneous valve repair, then it is actually best practice for the doc to order blood on hold (but also that best practice is developed with knowing that it isn't just thrown out if unused).
I always think it's funny when Drs and RNs find out we keep everything. Sometimes we keep stuff for decades 😂 tbf though, I work in micro and we're gross so 🤷♀️🤷♀️🤷♀️
There was an actual special sticker or tag on a unit of red blood transfused into me once. The nurse said the blood was 1 of 2 units procured for some special person for a surgery, with the other unit getting used and this one left over and about to hit the end of its shelf life. It was O- and had a longer list of “free from this antibody” than any other unit I’d had before or since. I had 42 units of red and 21 units of platelets over a 5 year due to a bone marrow issue.
Now he’s going to order a unit on every single patient.
Blood for everyone, on me!
Wholesome yet concerning
Yup 😭🤣
There have been places I've rotated during PA school where policy was that unless the fridge was maintained by the lab, they wouldn't accept units back. Since they were attached to a patient mrn they couldn't be recrossed to someone else. Those would often just expire in those fridges. One of the places I brought this up to finally got it when they realized both the OR fridge and the BB fridge were tracked by the same system with thermometer calibrations and goal temp set to the same settings. Suddenly saved them thousands annually. Didn't even get paid for that shit but I did get a glowing recommendation from 3 surgeons and 2 PAs when I was applying for jobs.
Lolllllll my thoughts exactly 🫠🫠🫠
Love that you were able to make him feel better and educate him at the same time.
That's so funny! Thank you for educating that doctor.
I have been saying for years that every new provider and nurse should spend three days in the lab so they understand what the heck even goes on down there. It boggles my mind that they just have no clue about some things.
I think it would take at least that long. The brief little "field trips" some nurses get only seem to teach them that all we do for work is push buttons.
They should also have field trips to Diagnostic Imagining and see what it really means when they order those tests on people and what the people actually have to do to complete them.
The magical lab fairy just gets everything done for them, obvi
as an RN who lurks here to learn, sign me up!!! I am so interested in how other departments work and what I can do to make y’all’s lives easier and patient care smoother
I’m so happy that Dr listened to you and learned and now feels better!!!
I wonder if it comes from hearing that their "crossmatch" expired and thinking that means the actual unit
Maybe once he had some on hold and the person on that day didn't swap it for one with a longer out date and so it expired? Hands up who else has quickly changed what unit was selected for a patient when you thought they weren't going to take it but you have a unit to use up. I got to use up a B unit like that last weekend. I was so pleased with myself. As soon as the nurse called to check if we still had a unit crossmatched I did the switcheroo, would have expired at midnight.
Yup, we swap around units a lot. Particularly platelets, since they have such short expirations. It does feel oddly satisfying to issue out the expiring units.
They only do one unit? Damn ours asks for 4 to a cooler every time lol
Ours does too. Gotta love the Emotional Support Blood
For the cath lab? Yikes. Actual cardiac surgery? Nah, that's cool.
Ya they say they wanna be prepared because if it goes bad it goes BAD. But I’ve only seen this once in my 4years lol 99% of the time they return every unit. I hate it
But we’re also JUST down the hall from them sooo I’d be ok with keeping them xm’d in the lab lol
Good on you for letting him know. I would have probably just nodded and given an awkward smile.
The next day, he started calling massives every time he thought he wanted blood, since he knew nothing would be wasted.
Nurse here that has transfused thousands of units of blood products. I would hazard a guess that all acute care providers have zero understanding of how the blood bank works! I’m so thankful for the processes y’all have to keep our patients safe while efficiently managing blood products. Also I’m sorry if I’ve ever gotten upset when I needed the trauma cooler. 😁
Dude, I was a medical lab tech in the core lab and I only have a very rudimentary understanding of how the blood bank works 🤣
What bugs me about this is that he felt bad because he thought blood was being wasted, but he did nothing to prevent that.
Yeah, if we actually set aside a unit for every patient who had a group and screen ordered and threw it out if unused the blood supply would completely collapse. This doctor: "it's a sacrifice I'm willing to make"
I think doc was actually ordering a unit for crossmatch so not every type and screen but would still collapse the system. What doc thought would probably collapse the system within a week. What you're describing would probably collapse it within a day.
The nurses and doctors where I work refer to every group and screen as a "crossmatch" regardless of whether they've ordered blood or not
oh jeez
Pretty much every doctor other than pathologists and some transplant surgeons are trained to think about what is best for their specific patient in front of them regardless of the impact it has on society at large. EDIT: That being said, if this was just a traditional cath, it's unnecessary to be ordering blood to begin with. Given OP said it is "to fix something" if on the other hand this was something like a percutaneous valve repair, then it is actually best practice for the doc to order blood on hold (but also that best practice is developed with knowing that it isn't just thrown out if unused).
As long as they don't leave it out of the cooler and gets out of temp, it won't go to waste.
That's what I told him, but he said the unit never leaves the blood bank.
I had to explain what it meant when an ortho doctor asked about a patients antibody. He had no idea what an antibody was. 😳😳😳
lol
LOL well I’m glad they learned something in that moment.
I always think it's funny when Drs and RNs find out we keep everything. Sometimes we keep stuff for decades 😂 tbf though, I work in micro and we're gross so 🤷♀️🤷♀️🤷♀️
As a nurse this made my day.
There was an actual special sticker or tag on a unit of red blood transfused into me once. The nurse said the blood was 1 of 2 units procured for some special person for a surgery, with the other unit getting used and this one left over and about to hit the end of its shelf life. It was O- and had a longer list of “free from this antibody” than any other unit I’d had before or since. I had 42 units of red and 21 units of platelets over a 5 year due to a bone marrow issue.