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Cross training techs from all different clinical backgrounds is essential to ensure quality productivity. Nearly every health system has made cross training a priority. In terms of long term sustainability, cross training is now a necessity. This issue cannot be ignored. With the known national shortage of laboratorians and the threat of many well respected senior techs planning on retirement, change must happen to keep our labs alive.
An evaluation of the situation can be explained from both a technical and management perspective. I have personally viewed this situation from both angles. The different strategies used in relation to departmental technician/technologist motivation, and the best outcomes in terms of success can be recognized by the viewpoint of both techs and managers respectfully. When the issue of cross training comes up, a general sense of distaste seems to always emerge. On deeper thought, it can be seen why this reaction exists and how barriers need to be lifted to ensure personal and professional laboratory satisfaction.
Laboratorians and Their Arguments
First and foremost, let us gain a general understanding of the wide variety of individual backgrounds found within the clinical laboratory. Through personal experience, I have come across those that have been in the field for decades. Such people have made the lab their life career and have been grandfathered into the field of medical technology. A large number of these laboratorians attended school while medical laboratory skill training was offered through individual hospitals.
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I was told in the beginning of my journey that those were the "good old days." Hospitals actually taught students in a hands-on learning environment throughout the entire program. As known today, such experience is only obtained through clinical rotations and more so training upon hire. There are then medical laboratory technicians (MLTs) who attend a 2-year college program to earn an associate's degree followed by a clinical rotation.
Clinical laboratory scientists (CLSs) attend a 4-year program earning a bachelor's degree along with clinical rotation. Each type of laboratorian is eligible for certification of his/her specialty. The mixture of people within the lab includes such a variety that it is difficult for those outside our department to obtain a clear understanding (or sometimes even care for that matter). The majority of us are just known as "techs" and even those aware of our jobs often confuse us with phlebotomists.
This is what we are faced with by those outside of our department. As for within the lab, a common complaint from all types is the fact that cross training is difficult to accomplish when several techs originally were hired to work in a specific department. This is still the case. More and more job postings state "Hematology MLT/CLS needed" or another quite common request "Generalist needed nights."
It seems as if the cross training has been an absolute on third shift is now influencing days and evenings as well. One thing is certain, among all types of techs, specialists still tend to dominate. From a personal perspective, larger health systems tend to maintain specialists in departments. The argument arises, when someone has been working in one area of the field for years any working knowledge of another area is long forgotten. You cannot help but to agree with this.
It is understandable why you would not trust yourself in a foreign section. It has been brought up repeatedly that lab workers are severely under recognized for their commitment. With this statement being true, now with cross training measures being introduced techs feel that are not being compensated for their extra devotion. Cross training has brought feelings of frustration due to lack of recognition within our own department. Cross training is also hard to accomplish when we work with limited staff. Overtime is not always permissible, and usually is not granted for merely learning purposes. As you can see, there are several rebuttals from the lab techs' point of view influenced by both internal and external sources on the issue of cross training.
A Management Standpoint
In order to have a fully functional department, numerous obligations must be met far beyond employee relations. Of course, your manager wants to have a smooth work flow for the department focusing on turnaround time, increase/decreases in specimen numbers, laboratory regulations, etc. The management needs the maximum productivity with the very least amount of error.
Every department head wants their employees to perform at the highest possible standard. This is not just a departmental goal, but a reflection on organizational strategy as well. We know this and are well aware of any consequences surrounding error. As far as cross training is concerned, integrated group work supports this goal. It is known that individuals within the laboratory are extremely independent. This is the nature of work. Group work requires more interaction to help motivate techs.
In reference back to individual tech's feelings on the lack of compensation offered for having to cross train and acquire more responsibility -- compensation is a short-term strategy for motivation. A raise does not positively affect a group of individuals for more than a brief period of time. Studies conclude that involvement of employees in group work act toward as long term motivational success. Cross training promotes group effort and serves as a type of encouragement.
This, in turn, gives the employee more sense of belonging within his department. For example, employees that cross train each other respect one another on a higher level. A greater trust is formed given that a fellow co-worker displays interest in you learning her section. A lot of this gratification has to do with the nature of work as well. We are healthcare employees and thrive to help patients.
We know that as healthcare workers, patient care is the No. 1 obligation. On another note, I have noticed that some managers fear that they will have employee turnover if strict guidelines including deadlines are implemented for cross training. The last occurrence that a manager wants is to lose good employees due to a perceived job threat. I have had many employees within my department threaten to resign due to strict cross training measures. I have also noticed that the lack of performance acknowledgement always comes up with this threat.
After all, who really wants to work only to have it be un-recognized just to take on even more work that will not be appreciated? Trust me; your manager knows this how you feel. Therefore, managers are careful not to rush this process, but at the same time identify any resistance which should be addressed.
Current and Future Outlook
Where we stand today is that there are still generalists and more so specialists. I have noticed that more recent graduates new to the field are cross trained in order to be flexible with more responsibilities. This seems to be the current and future trend. As more and more people retire in this field, new graduates will gain their experience through cross training. In general techs do agree that this is both helpful and a necessity for the future of the clinical laboratory. Then why still resistance? Is it that techs are just set in their ways? Is the general willingness to cross train ignored due to the lack of available help on the job? Will managers continue to press the issue with senior techs?
Many questions continue to be left unanswered. One answer is certain, it is clear that the future will hold more generalists than specialists as new generations enter the field.
Jenna Evans is a full-time PhD student.
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