Nurses, Pathology Isn't Mad @You

Nurse: "Hi I'm calling about the unlabeled specimen."

Me: "Oh, yes, we need someone to come label it before we can process it."

Nurse: "Well I wasn't there when the specimen was taken so there is no way for me to know how to label it."

Me: "Do you know who might be able to?"

Nurse: "No and my manager says that if the specimen can't be labeled it should be thrown away, so you can discard it."

Me: "If we do that the patient won't get a diagnosis, could I speak with your manager?"

Nurse: "She's not here today."

Me: "Is there anyone else I can speak to?"

*Audible sigh*

Nurse: "Fine, I'll just come and do it."

Unlabeled specimens, mislabeled specimens, and improperly filled out requisition forms are extremely common errors. They happen at least 2-3 times a week in every hospital I've ever worked for. There's nothing shocking or surprising about it, not one bit. It's basically part of the pathology routine. Granted, it's the sort of thing that can be annoying because it delays specimen processing, but fortunately there's a simple fix.

Unfortunately, the nurses who are responsible for fixing these errors get flustered when asked to make corrections (usually they don't tell us to throw specimens away, that was a first. And no, we will not throw the specimen away). Rarely will the response be, "sure, we'll come fix it in a bit." Typically the response will involve snark, an attempt at an argument, or a transferred call. After convincing someone to come fix the error, we wait to hear one of these follow-up comments: "Why can't anyone do their job?" "No one around here does anything right" or "This isn't my responsibility." The responses are so predictable I'm thinking about getting a button that says "It wasn't my fault." when pressed.

These mistakes aren't serious. They're minor inconveniences to both parties, but no one gets written up or yelled at. It gets fixed and we move on with our day. I shudder to think what happens when there is a serious error. Based on the responses to these tiny, innocuous errors, there goes every hospital administrator's lofty mission statement about Just Culture, Environments of Safety, and Caring. These replies reflect an environment of Cover Your Ass and Everyone for Themselves. Toxic environments like those are the last thing we need right now, and the consultant who was paid a fortune to invent dreamy mottoes for the hospital isn't going to come back and make everything better.

We're in the middle of a pandemic where nurses are taking the brunt of the damage. Despite the above observations, I have a lot of respect for these providers. They're burnt out, stressed out, and quitting in unprecedented numbers. Nursing is a tough job that involves being disrespected by patients, doctors, and everyone in between, so it's understandable a culture of Cover Your Ass would be normalized. But it's not doing anyone any favors right now. To get through this mess, nurses need to band together. We need camaraderie because this is an all out war. Camaraderie is what gets soldiers through the hell of conflict. This is what is needed more than ever, more than the pointless, hollow encouragement emails from administration and "thank you healthcare heroes" signage. The sense of belonging to a team is what motivates people to go to work in hard times. Showing up for their team, their family, the people they would do anything for, even if it means correcting a minor error someone made...without complaining...too much. Let's encourage this type of behavior.

And for the record, if a nurse makes an error on a form or doesn't label a specimen, just know that pathology isn't mad and we've seen it before. We see you nurses, we know you're stressed out, and we understand that these things happen.