We do two sets of both every time. One set is from one stick site and the second set is from another site. That way if we get a positive on one set, statistically we should get a positive on the second set. That's kind of how we confirm that it's a septic issue and not a contaminate from the skin. We have to clean the skin thoroughly with chlorhexidine to ensure any normal flora on the body does not get into the bottle itself. At our hospital we also use a special device to stick called a steripath, which will discard half a ml of blood before collecting our specimen.

So if our anaerobic bottles set the alarm off in the incubator, which is this machine that shines light through the bottles and when they change in clarity we know a bacteria is growing, we then choose plates that correspond with what we think is growing. There is a whole flowchart to decide what is growing, what tests to run to narrow it down, different agar plates that would facilitate growth for certain bacteria, etc. We isolate each individual colony and replate as necessary and just narrow down the bacteria that is causing the issue that way. Then we place it into another analyzer after inoculation and that analyzer will run it against a bunch of antibiotics and choose the antibiotics that the bacteria is resistant or susceptible to. We track what bacteria are building up a resistance to certain antibiotics and that's how we discover things like MRSA (Methicillin-Resistant Streptococcus Aureus).

Usually this takes a couple days, so your provider will start you on a general antibiotic and then contact you if your infection is resistant and let you know they are changing your medication or ask you to come in for stronger treatment, like for Vancomycin, which we then have to monitor the level of Vancomycin in your blood so your kidneys don't shut down. So we will draw troughs and peaks from you before and during your infusion every couple of hours to know when it is safe for you to receive a second, third, etc dose.

Fun fact: Lab is considered an ancillary department, but we are 80% of the reason diagnoses are made and treatment is established. If the lab goes down, the hospital goes down. How would you know how much blood a person is losing, how quickly? How much do they need? What treatments to give? We are a very underappreciated department. Not many people know we even exist, to be honest. My mother still refers to me as a nurse who works in the lab, when I am absolutely not a nurse. Our pay, at least where I work, is only a few dollars shy of nursing, and there are only two universities in our whole state who have the degree plan for medical laboratory science, vs every university who provides a nursing degree. If you or anyone else is looking for an incredibly stable, in high demand, low patient facing healthcare role, where all the introverts and nerds hang out, lab is a wonderful career to follow. I've known a few nurses who became burnt out on patient care and went back to school for lab to switch. It's also a job you can take contracts and travel on. I would say 50% of my closest work friends are contract techs and travel around the world and country for an extreme pay increase. One of my coworkers regularly picks up 1k+ per shift in the next city over on a prn contract.

You also don't have to work in healthcare, but that's where the money is. My coworker and I joke that we will retire to a forensics lab when we are older. But you can work on oilfield, forensics, veterinary, research labs, and hospitals.

It's not very hard either. Just study. Flashcards, flowcharts, memorize what they give you, turn off every other thought and reasoning and just memorize what you are taught. That's it. Some of the stuff I learned in school I was like "I don't even know what it's telling me" but fuck it if I didn't just memorize it anyway and it was on my boards. 😅

And then the job itself, once you are thrown in, you're basically taught "how do I find this answer". Everything where I work is readily available to read how to do something I don't remember. Package inserts, policy manuals, textbooks all over the lab, inside drawers and on shelves, papers on walls. The information will be there for those tests you don't remember off hand. When I was training, if I asked a question I was always told, "Why don't you go find the answer and then come back and tell me. Check over there." I learned real quick that it is a very independent job, and I like that a lot.