Health and Fitness : Medical Lab Professionals Week: VGH supervisor, techs discuss their job

The Beckman Coulter AU480 chemistry analyzer tests blood in a variety of ways.

Abbi Perkins demonstrates the Beckman Coulter AU480 chemistry analyzer.

Kay LaPointe analyzes blood samples in the VGH lab.

Abbi Perkins evaluates samples with the Beckman Coulter AU480 chemistry analyzer.

Sue Holst, Kay LaPointe, Steph Miller, Abbi Perkins, Carolyn Gavalas, Tracey Herink and Kim Smith.

Blood after it has been separated in the centrifuge.

The centrifuge that separates blood.

Kay LaPointe analyzes blood samples in the VGH lab.

VGH lab staff members are celebrating Medical Lab Professionals Week.

“Vampires.”

“Mosquitoes.”

Carolyn Gavalas and her techs and phlebotomists at the Virginia Gay Hospital lab have heard all of the humorous nicknames their friends and families use to describe members their profession.

But a virtually unknown annual commemoration this week gives Carolyn and her staff – along with the more than 300,000 other medical lab professionals in the U.S. – the chance to discuss how important their work is, especially in rural hospitals.

This week (April 22-26) is Medical Laboratory Professionals Week .

Few people know better what a medical lab professional does than Carolyn, who has spent 43 years in that vocation, the last 36 of them at VGH. She will retire next month. Tracey Herink, a 20-year VGH lab employee, will take over as supervisor of the seven lab techs and two phlebotomists, whose job it is to draw the patient’s blood for testing.

While patient interaction with lab staff usually ends after the blood draw, lab techs begin procedures that provide medical care for their patients in the processing of laboratory specimens.

There are no public celebrations of Medical Laboratory Professionals week planned at VGH, but Carolyn and her staff know very well how important their work is. In the past year, they have done more than 80,000 analyses of blood and urine samples to help doctors diagnose everything from the flu to heart attacks or strokes.

Their work is this important: About 70% of clinical decisions are affected by lab results, and those lab results constitute the bulk of information stored in a patient’s electronic health record (about 80-90 percent).

From her tiny office on the north end of hospital’s the lower level, Carolyn discusses the history of the VGH lab, and the changes she has seen since arriving in 1977.

But first, you should know when and why she chose this profession.

A teacher’s guidance

When asked how she chose her career, Carolyn responds with a question: “Do you remember Don Holmes?”

The long-time Vinton teacher and coach, who died a few weeks ago, is the reason Carolyn decided as a high school sophomore to do what she spent her life doing.

“Mr. Holmes asked me what I wanted to do with my life,” recalls Carolyn, who told him she wanted to be a hair stylist.

“No, you don’t,” replied the teacher.

Mr. Holmes, who taught biology and science, told Carolyn that she should consider a job in the science field.

“He then sat down with me and we went over some career options. He’s the reason I am doing this,” says Carolyn. “I need to thank him because he led me in the right direction.” Mr. Holmes, she said, did that for many other students, as well.

Carolyn went to the University of Iowa, where she earned a degree in science and medical technology. After interning for a year at Mercy Hospital, she then worked in the lab there for seven years. She took the job at VGH because she wanted to work and live in the same city.

Benefits of local service

The most significant benefit of having a complete lab in the hospital, says Carolyn, is that it offers the chance for doctors to see results much more quickly. In addition to serving the VGH hospital patients, the lab serves all of the VGH clinics as well as many of the care centers in the area.

The more quickly that lab results can provide specific information about a patient’s blood type, blood count, evidence of heart attack or stroke, the faster the physician can begin the best treatment.

Changes in policies, technology

“Blood-borne pathogen” was not part of the vocabulary in hospital labs when Carolyn began working at the lab in 1977. Her career began during an era when smoking was allowed in the hospital, even in the lab, and practices such as wearing masks of gloves had not yet been established.

“Those are obviously very good changes,” said Carolyn.

New technology

Technology, of course, is among the biggest changes – while Carolyn and her crew still use the microscope daily, current electronic analyzers make sampling quick and accurate.

“We use the microscopes for urine samples,” says Carolyn, who adds that if one of the electronic machines indicates something unusual, a lab tech may review the sample under a microscope. While most of the blood tests are fully analyzed at the lab, about 3,000 each year are sent to the Weland lab for more detailed analysis.

The new technology means that technicians and technologists are able to perform more tests using less blood, so the amount of blood drawn from a patient’s arm has decreased.

Yet, the use of needles is still part of blood testing, and the techs all understand first-hand the challenges of drawing blood as efficiently – and painlessly – as possible.

“It just takes experience,” says Carolyn, who adds that some ailments such as dehydration can make drawing blood very difficult.

Some patients who are sick when they come in think they will always be difficult to draw blood from, but later when they are well, they realize that normally, their veins will allow blood drawing more easily, says Carolyn.

Changes in regulations/insurance

When the lab moved into its new area approximately a decade ago, Carolyn’s office was located further down the hall.

“But my techs wanted my office to be closer to them,” she recalls. She now uses what used to be a changing room. The office is tiny – just big enough for her desk and another chair and a few other items.

“It’s small, but everything is within reach,” she says.

From that small office, Carolyn spends most of her day on the computer, receiving new information, guidelines and rules from both the government and insurance companies.

“Both Medicare and the insurance companies are changing what they will pay for, making us make sure that all of the tests we do are necessary,” says Carolyn.

Virtually every day, she receives new information affecting the policies and procedures of the VGH lab.

‘Great Crew’

Carolyn said people have asked how the staff will adapt when she leaves. But, she says,

“We have a great crew. They are good at what they do,” she says.

Some of the lab workers are defined as technicians, others as technologists. Yet, says Caroline, they all do the same work, taking turns in the different areas so they all stay proficient in each one.

At one station, the microscope allows the techs to view urine and blood cell samples. Across the room, next to the centrifuge that spins the tubes of blood at 3500 revolutions per minute until blood components separate for testing on the Beckman Coulter AU480 chemistry analyzer, the large machine which uses the principle of spectrophotometry to analyze proteins, cholesterol and many other compounds. Another instrument, the Beckman Coulter HMX, employs electrical impedance and other sophisticated methods that classify individual blood cells in a whole blood sample.

The techs are a close-knit bunch, enjoying each other’s company while analyzing an average of more than 1,500 blood samples each week. Lots of laughing, and jokes about the practice of “grazing” – eating throughout the day – abound.

The techs credit Carolyn with setting up the employee schedule that has two people covering weekends.

“She has made it possible for us to have a life outside of the lab,” says Tracey, who said she has been trying to learn more about the paperwork and computer duties before taking over for Carolyn next month.

In addition to using the equipment to evaluate blood samples, the techs are proficient at maintaining their instruments, replacing halogen lamps and electrodes, glass syringes that "insure precise serum and reagent volume measurements, and guaranteeing cuvette integrity for proper assays" (in other words making sure that miniature testing tubes are properly set up to allow accurate analysis). Each of the eight instruments requires maintenance procedures to assure proper analysis for patient samples.

The techs have also, at times, been called upon to help other hospital departments during emergencies. One tech held a mother’s leg during childbirth; others helped move patients to waiting helicopters.

'Time with family'

Now, after 36 years of working in the VGH lab, Carolyn is making plans to retire next month. She wants to travel, but also said she will be spending some time with her family, including her sister, and taking care of her great-grandnephew.