[Histonet] How many tissues an histo tech is suppose to cut per

[Thomas Jasper]

Hi Stella,

I would be more than happy let you take this response to your lab
management.  First of all, just a bit of background - I have been a
histologist for over 26 years.  I have an Associate Degree in
Histotechnology and a Bachelor's Degree in Applied Science.  I am a
registered HT (1986) ASCP certified #12664.  I have worked in;
university and VA clinical settings, pharmaceutical research, major
medical and now independent clinical service.  I have been in
supervision for over 10 years and function as a working supervisor. I
have been responsible for Cytology, Autopsy and Transcription as well as
Histology.  I served for a number of years as a safety officer.  I have
significant experience with immunohistochemistry from manual kits, using
concentrated antibodies in multiple species application to running the
latest in automated IHC.

Having said that, the notion that a single histotech should be able to
cut 100 blocks an hour is sheer lunacy!  Expecting anyone to even
attempt such an unrealistic goal is dangerous, irresponsible and
ridiculous.  I seriously question "their own research".  I'm sure you
couldn't sell it in a deli as it sounds like nothing more than bad
baloney.  According to my calculations, that would be 1 block every 36
seconds...let that sink in.  You mention you are dealing with med techs.
These med techs apparently have no concept about the realities of
Histology.  I am going to assume this is the case and you (Stella)
obviously know better.  I will lay out the basic problems and hope you
are able to drive home the point.

~ Volume - 100 blocks per hour equals 1 block every 36 seconds...really?
Can you make change for a dollar in 36 seconds, find your car keys and
start your car?  Now do this over and over and over again, hour after
hour.  Even 50 blocks an hour is insane.

~ Variety - Histologists cut blocks from every part of the human body
(or animal or plant).  The specimens can be big or small, thick or thin,
hard or soft.  They can be dry and brittle, full of sutures and staples,
under-fixed and poorly processed.  When sectioning you are subject to
humidity, air currents, quality of the knife edge and specimen
orientation (and you just gave me a whole 36 seconds).

~ Quality - This is the number one consideration in my lab and any lab
worth its salt.  Quality is not achieved in one block every 36 seconds.
I just mentioned a list of variables and out of that a histologist has
to produce a microscopic work of art, one slide at a time, every time.
Any pathologist worth his or her salt will tell you that.  If you aren't
giving a good picture to that doctor, he or she is not going to be
happy.  You will want to figure in some additional time beyond 36
seconds for all the rework you're going to get.

~ Patient Care - Every histologist knows that a specimen/block/slide is
a patient.  That patient could be your mom, dad, sister, brother or some
other loved one and must be treated as such (regardless of who it is).
Trying to force histology work through at an impossible rate is
practicing bad medicine.  Is that how you would want your biopsy
handled?  If there is nothing more important than the patient, I think
the patient is worth more than 36 seconds.

~ Safety - Safety is easy to practice and easy to ignore.  What are we
dealing with here...extremely sharp blades for one.  The occasional
histologist may be known to skirt a safety rule now and then.  Don't get
your fingers too close to the blade.  With automated microtomes there
are new and exciting technical features to consider from a safety
perspective.  Regardless of the situation, speed factors into safety.
Existing stress factors combined with new ones for unrealistic speed is
an accident waiting to happen.  And there are other mental health
considerations from undue stress.

~ Special Testing - Not only are quality sections required for standard
hematoxylin and eosin staining.  Quality sections are required for
straight chemical, special staining, immunohistochemistry and other
special procedure applications labs may run.  For example, some
pre-treatments or other protocol steps involved in IHC may be a bit
harsh.  To rush and produce less than desirable sections for any of
these various procedures, due to unrealistic quotas is a bad idea.  Once
again all of the above apply to special testing.

Well Stella, I don't want to write a book and I'm sure I've left out
some valuable information.  I used to have unionized techs working for
me at my previous position.  I don't know if that's the case for you.  I
can guarantee the union steward would've had a field day with this one.
Also, this is the type of thing that OSHA loves to get wind of, along
with any state agency that regulates labor.  Please contact me if you'd
like to speak about this further.  Not to sound extreme, but there are
other jobs and nice, reasonable people to work for.

Kind regards,
Tom Jasper

Thomas Jasper HT (ASCP) BAS
Histology Supervisor
Central Oregon Regional Pathology Services
Bend, Oregon 97701
541/693-2677
tjasper <@t> copc.net   

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Stella
Mireles
Sent: Tuesday, June 28, 2011 1:49 PM
To: Joanne
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] How many tissues an histo tech is suppose to cut
per

Joanne is not alone.

The lab I work at has informed us that due to their own research, a
single
histotech should be able to do 100 blocks an hour.
I'm not sure if they expect embedding, trimming, writing slides,
sectioning
and manual staining in this goal.

I am a seasoned histotech, and have tried to speak to my lab manager and
lab
supervisor, (both are med. techs and have very little insight into what
is
involved in producing a high quality slide), but their goal remains the
same.

I have an idea:  I feel like printing some of your responses to Joanne
question and showing them that their goal is unattainable as well.

Any other suggestions.
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