Order Entry

Hello! It's my turn to share what I've learnt during my first 2 weeks of internship(:

I'm attached to a clinical laboratory in a hospital. It's a really small and cosy laboratory so we have almost all the different discipline in the laboratory. The people here are really friendly, helpful and approachable. To me, it feels like one big family of medical technologists working together. Although it's a serious environment, we still manage to have lots of fun somehow(: We do our work seriously when dealing with patient's samples and have fun when there’s no sample for us to do. Enough of the fun-filled working environment and now to what I do there.

For the first 2 weeks of attachment, I'm assigned to do order entry. The doctors will order the test, then phlebotomist will take the blood from the patient and I will enter the tests and the rest of my colleagues will do the tests. I receive the test forms from the tubes via the pneumatic tube system. Initially, the sound of dropping pneumatic tubes was quite scary as it comes suddenly without warning. After awhile, I know when the pneumatic tubes are coming by hearing the different sounds made.

There are a lot of tests and there are different codes for different tests and I need to remember all of them in order to be efficient. But it's pretty easy to remember the tests codes because it's usually those few tests that you'll see many times a day and the test codes are very much related to the tests. It's okay if I cannot remember the rare ones too since there's a file with the different tests codes for me to refer to. Not only do different tests have different codes, it also varies for in-house tests, corporate screening tests and send-out tests. However, all that I need to know are in the files beside me so it's pretty easy doing order entry after awhile. For the first few days, I find it quite stressful as I don’t know when to order a separate section for the different tests and so a lot of modification needs to be done, which slows down the whole process a lot. For the urgent tests, time is important because we need to deliver the results within that short turnaround time.

Other than different test codes to remember, I also need to learn and remember the different blood tubes used for the different test. For this, we already learnt during clinical chemistry case studies and lectures that certain contents in the blood tubes can contaminate the blood depending on what tests we are doing. For example, blood is taken in an EDTA tube yet a potassium test is ordered. In this case, we need to call up the wards and ask them to send us another tube of blood and inform them that we need to reject the specimen. We also need to ask for the staff nurse whom we talk to regarding the wrong tube used so as to ensure traceability.

For order entry, it’s not just ordering of tests but also to place the send-out tests and histology or cytology specimens at the front desk area for the other order entry staff to do their work. Furthermore, if there’s blood banking forms, we need to order the tests and walk to the blood bank area to pass it to them to do their work. I also need to check the specimen received for corporate screening against the packing list and then sign and fax it back when I’m done. After ordering the test using the forms, I need to do counterchecking to ensure that what I’ve keyed in is correct and that I did not miss out any tests. Most of the time, I’ll need to stand and walk around to get the pneumatic tubes from the pneumatic system and pass the various forms to various people so it’s quite tiring. The only time I get to sit is when I’m the one doing the order entry. All these is what order entry is about.

Next, I’ll be talking about some tests that I’ve done on Friday at the urinalysis section although I’m not stationed there. I won’t be giving the full account of it but what I know from the limited time I have there.

One of my nice colleagues taught me how to identify microorganisms and the different cells present in the patient’s urine. I find it very interesting cause I didn’t manage to see all those in school during our clinical chemistry laboratory session. After which, he also taught me how to use arterial blood gases (ABG) test using the roche equipment. The ABG tests is done behind the order entry area, thus, I’ve seen it many times but didn’t get to try it until Friday. It looks really simple to mix the blood by rolling it between 2 hands. However, it wasn’t that easy for me probably because it was my first time and with others staring at me, it’s pretty nervous. Next, he taught me how to do the blood ketone test using the test kit, which is really easy since the reader will give you the result after you drop a drop of blood on the test strip. Lastly, I get to try doing the syphilis test, which is something like what we do in medical microbiology laboratory. It resembles the staphylococcus test kit. Add the reagent then the serum and spread it within the circle then use the rotator to rotate it for you for 8 minutes before observing for agglutination. Presence of agglutination means positive for syphilis and no agglutination means negative result.

That’s all from me for now(:

Goh Michelle
TG02