[Histonet] a question on ethics

[Amos Brooks]

Ron,
         When a ship is hitting a reef there is 2 options. First option: 
Bail out, hit the life rafts and get out of there before you go down with 
the ship. Second option is to get the ship off the reef and repair the 
damage. This sounds like a problematic situation and you may be in a good 
position to make drastic improvements to the system. The question you need 
to decide is which course you intend to take, and stick with it.
         If you decide to leave, do it cautiously as these problems could 
still be pinned on you as the guy that came in caused problems and left. (I 
know that's not the way it is but people often shift blame for problems on 
people that can't defend themselves). You still should mention in an exit 
interview (assuming you get one) about the issues, so that someone else can 
fix them when you are gone, and so it is documented that you were aware of 
the situation and not the cause.
         If you decide to fix the ship, expect some rough waters. Very 
often when you point out errors to people they start looking for things to 
complain about with you. You should proceed with caution and document, 
document, document! The root cause survey that was previously mentioned 
sounds like a good plan. Often people make errors that they can prevent 
just by a simple modification of their procedure. Establishing redundancy 
is a good way to prevent most of the errors you have described. For 
example, picking a block and a slide up and comparing them before they go 
into the microtome, then again after the slide is cut and finally comparing 
the block to the slides before sending them out. Time consuming, yes, but 
it is hard to make the same mistake 3 times. Similar redundancies can be 
established in most other situations too. Turn around time will probably 
suffer a bit, but if it keeps you from getting sued it's worth it.
Good luck which ever way you choose,
Amos Brooks

At 09:29 AM 8/13/2004, you wrote:
>Message: 9
>Date: Fri, 13 Aug 2004 04:27:14 -0500
>From: "Ron Martin" <pathrm35 <@t> adelphia.net>
>Subject: [Histonet] a question on ethics
>To: <histonet <@t> lists.utsouthwestern.edu>
>Message-ID: <002701c48117$b8cbc750$5dedeb44 <@t> Pathrm35>
>Content-Type: text/plain;       charset="iso-8859-1"
>
>Fellow techs,
>I am in a difficult situation and need some serious advice. I recently (4 
>months ago) accepted a technical supervisor position in a dermatology lab. 
>I went from a bench tech at my old job to this position. I also walked 
>away from a raise at my old position so I could step into a supervision 
>position. I took the new position because I was told by my manager that 
>she would teach me some supervision, management and financial skills that 
>I currently do not have as well as the growth potential of the 
>company.This position is not what I was told it would be. Part of my 
>"duties" include emptying the trash, clean the bathroom  (not happening) 
>and taking her personal and professional calls. The question on ethics is 
>the high volume of mistakes made by our technician, our offices and also 
>by my manager herself.
>I caught a mistake made by our tech a few weeks ago.She put the wrong 
>tissue on the wrong slides as she inverted the two cases. I caught her 
>mistake before it went out. One time she assigned the same number to two 
>different cases. She then sent the correct case out for a consult (which 
>wasn't needed) and put the wrong patient name on the slide. Every other 
>day there is something different.My manager will not terminate her as she 
>knows I am seeking employment elsewhere and she cannot afford to lose a tech.
>One day my manager gave three cases the same accession number.She caught 
>her mistake on one of the cases but I still ended up with two cases with 
>the same number. When I first started there my manager had a case in which 
>there " was no tissue in the container". She said that she notified the 
>office about the situation however up to six weeks later the office was 
>still calling looking for results.At that point she wrote up an incident 
>report and dated it six weeks prior to coincide with the surgery date.
>Our offices are not any better. One case came in with the wrong patient 
>information. It took about 7 weeks for the office to realize that they 
>sent the wrong patient information with the biopsy as the names were close 
>in spelling.  The offices continually send mistakes with incorrect 
>spelling of patients names and incorrect anatomical locations.
>  I have tired to document everything but there are too many mistakes and 
> I don't have enough time or energy to keep up with them.My manager wants 
> us to do our own "internal quality control". My interpretation of this is 
> that she doesn't want our physician and risk manager to know of these 
> mistakes. Are these becoming common problems or is it just my situation?
>I want to emphasize that I hope I am not being unethical myself for 
>revealing this information but I really need some advice and support.I 
>have very high standards and they are not being met in this current 
>situation. I am currently seeking a new position but I need employment and 
>cannot resign until another position becomes available. I would like to 
>stay in Florida and if anyone knows of any positions please inform me as I 
>am at my wits end. Thanks in advance.
>
>Ron