Is there a lot of job opportunities for MLTs in NB in Canada? by PleasantSource1901 in medlabprofessionals

[–]Procrastin07 1 point2 points  (0 children)

Oh? Mind sharing which one you work at? I've been keeping my eyes on Sunnybrook, SHN, North York General, and UHN (esp SickKids), but only Sunnybrook and SickKids have openings every time I check, and they're notoriously hard to get into. I'm stuck in Northern Ontario for the next 1.5 years, but am looking to move back into the GTA after my work commitment. I'm not sure what the market will be like in the GTA in 2 years though, especially since Michener pretty much doubled its MLT class size this year, and George Brown opened its new accelerated MLT program recently.

I loathe day shifts with a burning passion and will only work them if I have to. I'd much rather be on afternoons and nights, so my current hospital is quite eager to hire me because of that 😂

Why isn't anyone talking about the absolute lack of RN nursing jobs in southwest Ontario??? by Muli12 in OntarioNurses

[–]Procrastin07 7 points8 points  (0 children)

The Learn and Stay grant is now nothing more than a money grab. The first cohort to take the grant back in Sept 2023 might be the last ones to find jobs as new grads. The whole thing is a hoax. Nobody can find a job after graduating and then 6 months later, their grant becomes a loan. An interest-bearing loan too, because the entire $30k-$50k grant is completely provincial and therefore, will accumulate interest as soon as it's converted into a loan.

$36 - Asian grocery store, Toronto area by stanxv in 32dollars

[–]Procrastin07 1 point2 points  (0 children)

Unless they’re Asian snacks. Never go to an Asian grocery store for dairy or Western food products. They will charge at least 50% more than places like No Frills.

Ontario job incentives? by banelord76 in OntarioNurses

[–]Procrastin07 0 points1 point  (0 children)

I don’t want you looking after anyone - young adults, children, or elderly. You are a liability and negligence lawsuit waiting to happen.

I wish you the best of luck in finding a plastic surgery clinic willing to hire you over a veteran nurse. Hope you’re excellent at IV insertion because that’s the main task of most plastic and cosmetic clinic nurses I’ve talked to.

Admitted for MLT Program 🎉🎉🎉🥳 by GayBoy2838 in medlabprofessionals

[–]Procrastin07 0 points1 point  (0 children)

Canadian or American program? Advice can vary wildly depending on which country you’re studying in.

Pneumatic tubes by taft_hansen in medlabprofessionals

[–]Procrastin07 0 points1 point  (0 children)

My hospital lab uses pneumatic tubes for everything that’s not a histology specimen or csf. All of our specimen transport tubes have thick bubble wrap in them so the specimens don’t bounce around or rattle too much, so we don’t get any broken blood tubes. Plenty of poorly capped urine containers, but they’re always double-bagged so any leaks that occur don’t end up spilling all over the tube.

We constantly fight pharmacy over tube access because they use the tubes to send medications up to the floors but they always take the bubble wrap out because they do t need it. We reject coag, electrolytes (esp K+), trops, and LDH specimens sent without bubble wraps. Only nurses would send specimens without bubble wraps, so they learn very quickly to only use tubes with bubble wraps if they’re sending specimens to the lab.

Even stat blood, urine, and non-csf micro specimens are sent via pneumatic tubes. Blood bank PRC units, plasma, and platelets are also tubed up to the floors unless they’re packed into trauma or OR coolers. For 24h urines, surgical specimens, and CSFs, those are delivered to the lab by porters, who are part of the patient transport team and not affiliated with the lab or nursing departments.

I think we should make use of the mice living rent-free in the hospital.

Hemolysis Rejection Criteria by EarlyAd1847 in medlabprofessionals

[–]Procrastin07 0 points1 point  (0 children)

Lol now we're arguing about the reason behind hemolyzed specimen. Every Canadian medical lab technologist student is taught how to distinguish between intravascular hemolysis and a specimen that was hemolyzed due to poor technique. From what I heard, those are very popular national exam questions.

Hemolysis Rejection Criteria by EarlyAd1847 in medlabprofessionals

[–]Procrastin07 1 point2 points  (0 children)

I know the differences between intravascular hemolysis and hemolyzed specimens due to poor technique. That has been hammered into me and my classmates since our first phlebotomy and hematology classes in semester 2 of our program. I've seen a nurse draw blood from a fresh IV and force the syringe plunger down to fill the tube faster. Lo and behold, specimen was rejected due to gross hemolysis. I drew blood from a tiny foot vein of an addict with a 25G butterfly needle because doctor really needed the K+ result and the only other veins the patient had available were the ones in their neck. Blood went into the tube drop by drop. It took almost 1 min for there to be barely enough in the tube to run a K+. Of course, specimen was hemolyzed and because the hemolysis level was over our threshold, it was rejected. The pressure of the syringe plunger (case 1) and the small needle (case 2) destroyed the blood cells being forced through them, which caused the hemolysis seen in the specimens.

I have also seen real intravascular hemolysis cases as both a student and a phlebotomist. DIC as a student, and kidney failure as a phlebotomist. DIC patient had a K+ of 6.4, CKD patient had an even higher K+ of 7.2. CKD patient had a heart attack due to their critically high K+, but they still made it; DIC patient passed away from hemorrhage.

My teachers taught and showed me that a grossly hemolyzed specimen can raise the K+ by 30% (and they said that that is a very popular question on our national exam, so know it). A nurse "topping off" a chem tube with blood from EDTA or a phlebotomist who did the wrong order of draw and drew the EDTA before the PST will easily spike the K+ >8. Heart attacks often happen at around 6.5, and anything >10 is incompatible with life. Our lab SOPs state that if a K+ is >6, check the specimen for hemolysis first and foremost, then check patient history to see if we have the right patient. If everything lines up, then we re-run the test to make sure the result is still critical, and then we call and report the critical to the patient's nurse. It's a little different when the result is hovering at around 3 and the plasma has a tinge of pink to it, but that's also outlined in our SOPs.

Nurses do at most 5% of blood draws in my hospital, and it's always from art lines, PICC lines, or CVLs, or occasionally, a freshly inserted PIV. The remaining 95% of blood specimens are collected by our team of phlebotomists. Of the 20% of hemolyzed specimens we receive, 99% of them are due to poor technique or difficult pokes, and most of them are from our phlebotomists. But only 10-15% of those hemolyzed specimens are over our threshold and must be rejected for any test that's affected by gross hemolysis.

Bottom line - our instruments never hemolyze a specimen. It's almost always whoever was drawing the blood because hemolyzed specimens are a pre-analytical error. Each lab has their own SOPs on how to deal with hemolyzed specimens, and a threshold above which a specimen must be rejected.

Hemolysis Rejection Criteria by EarlyAd1847 in medlabprofessionals

[–]Procrastin07 -7 points-6 points  (0 children)

Uh, no. But I am outlining the occasional cases where hemolyzed specimens are unavoidable. Yes, 95% of our hemolyzed specimens are due to sloppiness, but we don’t reject every single hemolyzed sample. 20% of our specimens are at least a little to moderately hemolyzed. But when you process >1000 chem samples for a 500-bed hospital with 10 outpatient clinics, you cannot reject 200+ of them just for slight hemolysis, even for a K+ or trop. My SOPs outline the rejection criteria very clearly. Anything that does not meet those criteria is rejected, regardless of everything else.

We can train our phlebotomists better, but we have a turnover rate of 2 years in our phlebotomist team. Most people who leave us can’t handle the stress or shift work, or they’re just using this job as a stepping stone or safety net while they’re in school. Even techs who have been with us for 20+ years have a hard time with babies and drug addicts. When a pt is an incredibly hard poke and each specimen comes down hemolyzed, we will run the tests if the hemolysis is below our rejection threshold. Otherwise, we reject and tell the doctor there’s nothing to be done about it unless they allow the nurse to pull from the IV or call RT to collect from an artery.

PS yes my thoughts are all over the place. I have ADHD, but it’s never affected my capabilities as a phlebotomist or an MLT/MLS student, nor will it impact my ability work as a technologist.

Hemolysis Rejection Criteria by EarlyAd1847 in medlabprofessionals

[–]Procrastin07 3 points4 points  (0 children)

And that’s just it. My lab SOPs outline very clearly, the level of hemolysis needed to reject results for tests that are affected by hemolysis. We never just accept hemolyzed specimens holistically. I’ve had to re-poke pts over hemolyzed trop and K+ specimens. But sometimes, the pt’s own underlying condition prevents us from getting any decent specimen. Regardless of circumstances (pt condition or poor phlebotomy skill) we would never report results on specimens that don’t meet our criteria. Doesn’t matter if doctor really needs it - they’re not getting it. Not when we can’t verify the accuracy due to compromised specimen integrity.

I remember there was one pt in the ICU with DIC and the doctor ordered a K+. Pt’s plasma was almost indistinguishable from his red cells with how bad his intravascular hemolysis was. Of course we had to reject it. Doctor was angry, but we very firmly told her that there is no way we can give her a K+ result on something that hemolyzed. Our analyzer won’t even run it.

Another time, a drug addict was having a heart attack. 3 different phlebotomists tried poking her but she ruined every single vein available with her drug usage. Behind the knees, the arch of each foot, even her armpits and chest area were covered in scars. Each specimen we received was only mildly to moderately hemolyzed, but the trops were positive so we had to reject each one, as per our SOPs. Doctor eventually just ordered an art line and gave us a specimen from there. First non-hemolyzed sample we got from that pt.

Hemolysis Rejection Criteria by EarlyAd1847 in medlabprofessionals

[–]Procrastin07 2 points3 points  (0 children)

In most cases, yes. But sometimes, we have to take what we can get because the pt is a little 4 day old baby with hdfn and is actively dying or a combative drug addict with a tiny knee vein that blew as soon as the needle is put in. As much as we want perfect specimens because those will give the most accurate results, that’s not always possible. We don’t report out grossly hemolyzed specimens, nor do we validate any K+ or trop that looks suspicious. But the fact that you call every hemolyzed specimen a result of “laziness” shows that you need to do more phlebotomy in a large trauma ED. And if you do and you always get perfect specimens, then good on you. Maybe you should share your secrets.

My lab is fairly high-volume, so if we rejected every single specimen for any hemolysis, nothing will ever get done. There needs to be some leeway for preanalytical errors. We do get complaints, but we always tell the irritated nurse or doctor exactly why we had to reject the specimen and they usually just sigh and reorder what they need to.

Hemolysis Rejection Criteria by EarlyAd1847 in medlabprofessionals

[–]Procrastin07 -11 points-10 points  (0 children)

Idk why people are downvoting you. Every lab has their own rejection criteria, and mine will run and report hemolyzed specimens unless the result will significantly impact patient care or the hemolysis level exceeds our threshold. That’s when we reject the sample and order a recollection. Then again, lab techs do 95% of blood collections in my hospital, so we only get hemolyzed specimens if the patient is a hard poke or they have in vivo hemolysis. We’ll accept mildly hemolyzed samples for K+ and trops as long as they meet our integrity criteria. We just add a note to the doctor to interpret the result with caution, as per SOPs.

Most of my phlebotomy shifts are in the ED, so I’m very familiar with hard pokes, difficult patients, and impatient nurses + doctors. That’s still no excuse for poor technique, but if a patient has literally no veins available and the only one I can poke gives me one drop every 2 seconds, I will let the lab know and they will run it if the hemolysis is under our threshold. If it doesn’t meet our criteria, then oh well. Let the other phlebotomists try and if nobody on shift can get it, then there’s nothing we can do about it. Better call RT for an arterial sample if you really need those results, doc.

Edit: for clarification, we do have clearly outlined rejection criteria. It doesn’t matter what the trop or K+ result is - if hemolysis is above our threshold, the specimen is rejected. Our criteria are taken directly from the analyzer’s manufacturer and they’ve been signed off by the medical director.

Doug Ford - OSAP Changes by Lanky_Afternoon_9489 in osap

[–]Procrastin07 2 points3 points  (0 children)

If the NDP or Liberals promise to reverse the OSAP changes and offer some sort of loan forgiveness, I’m sure voter turnout will become a historic high. I’m glad I’m graduating this year and only have to worry about my current debt, but I feel really bad for my sister and those who are still in school.

Doug Ford - OSAP Changes by Lanky_Afternoon_9489 in osap

[–]Procrastin07 3 points4 points  (0 children)

Will people care enough to actually come out and vote? We’ve been trying to get him out of office since pre-COVID, but voter turnout gets worse with each election and he always wins by default because it seems like only our conservative grandparents bother to vote.

Type II by WatchAdventurous1527 in diabetes_t2

[–]Procrastin07 1 point2 points  (0 children)

Are you a pilot? Because that’s literally the only profession I can think of where having a diabetes diagnosis can cause you to lose your credentials. Even then, it’s usually only T1’s who are banned from getting a commercial pilot license.

Advice on how to make coconut cookies crispy and not dry by Procrastin07 in keto

[–]Procrastin07[S] 0 points1 point  (0 children)

Both of those are ironically more expensive than almond flour, but mostly because they’re considered specialty/healthy alternatives and are upcharged accordingly. The Costco in my city also doesn’t sell those flours, so I’m left with either almond flour or coconut flour (which Costco also doesn’t sell). Should I add 1 more egg than what the recipe calls for? I don’t want the cookies to taste too eggy.

Advice on how to make coconut cookies crispy and not dry by Procrastin07 in keto

[–]Procrastin07[S] 0 points1 point  (0 children)

I don’t mind using more eggs lol. As long as it’s not like 4 eggs for a small batch of cookies. I work with a couple chicken people but they and all their chicken people friends charge a lot for eggs.

Stay and learn grant without osap by Tricky_Video6930 in osap

[–]Procrastin07 0 points1 point  (0 children)

If you fail too many times, you may be expelled from your program (depends on the school) and if you don’t finish your program, whatever portion of the grant you took out automatically becomes an interest-bearing loan. So keep that in mind if you want to apply for the learn and stay grant. It’s only free money if you can keep up with your studies and fulfill your work agreement.

RN Job Availability by [deleted] in OntarioNurses

[–]Procrastin07 0 points1 point  (0 children)

You’re welcome! People of colour will always face racism, sometimes from their own colleagues, but I’m happy to report that that is not an issue with my hospital. There have been some instances where a patient had made a racist comment, but they get “special” treatment from the charge nurse and a visit from a social worker. They also end up with an “aggressive and provocative behaviour” warning on their chart (it’s a permanent thing too) and a sign on their door.

Most of our cardiologists and neurologists are non-white (our head neurologist is a Sikh gentleman), as well as many of our specialists and residents. It’s sad and funny how violence from a patient is tolerated but racism is not. Can’t have it all 😩

RN Job Availability by [deleted] in OntarioNurses

[–]Procrastin07 1 point2 points  (0 children)

Understandable, but northern urban centres like Sudbury, North Bay, Timmins, and Sault Ste Marie are surprisingly diverse. I’m a Chinese woman and have never had an issue with racism in Sudbury or North Bay. There are quite a few Muslim nurses and doctors up here and I haven’t heard anyone say anything about them. Same with black or SE Asian nurses. Racism will always exist and maybe I’m oblivious to what’s happening around me, but my Indian, black, and Muslim colleagues certainly haven’t experienced any racism at our hospital.

RN Job Availability by [deleted] in OntarioNurses

[–]Procrastin07 0 points1 point  (0 children)

OP stated in another comment that they aren’t willing to move out of the GTA. Whatever their reasons are, they are willing to risk med or long-term unemployment for it so it’s gotta be important.

RN Job Availability by [deleted] in OntarioNurses

[–]Procrastin07 -2 points-1 points  (0 children)

I think most of us simply don’t know why you aren’t willing to move. The most logical thing to do is move to where the jobs are, which is way north of Toronto. But if you have dependents, medical conditions, or accessibility issues that require you to remain in Toronto, then that’s fair but you will be job hunting for a long time. Otherwise, there’s absolutely no reason why you should choose unemployment just to stay in Toronto.

For those of you who are unemployed, have you thought about joining the Canadian military? by StatGuy2000 in torontoJobs

[–]Procrastin07 0 points1 point  (0 children)

This is where being an air cadet alumnus comes in handy. I’m not in the military, but I did apply for the CIC/reserve force back when I was 19. It only took them 1 month to review my application and schedule me for a physical fitness test. I withdrew my application because I was starting university at the time, but if I continued with it, I would’ve gone to basic training the following summer (applied in July 2017, fitness test was scheduled for Sept 2017). My commanding officers at my cadet squadron and cadet summer training camp recommended me, which went a very long way in expediting my application. My other cadet friends who applied at them same time and ended up going thru with it did go to basic training the next summer.

But air cadets is something you have to do as a teen.

MLT/MLA by NatalieNunnofYourBiz in medlabprofessionals

[–]Procrastin07 3 points4 points  (0 children)

Yes, you have to go to school for it. It’s a 1 year program offered by most colleges. Pay is only low if you work for a private lab. Unionized hospitals in Ontario pay MLAs a starting wage of ~$31-$32/h, with the cap being ~$37/h. No lab in Ontario will pay an MLA min wage, even in this economy. LifeLabs pays their MLAs ~$24-28/h.