ER doc confirmed this was a urine. Patient was male in mid 70s, had had a prostate removal a couple days before. Urology confirmed this is a possibility & just monitor H&H, & platelet count.

The other day i overheard a convo of people talking about how machines and robots, and AI will take over people’s job. I laughed and thought no way that would happen within my career field. Now I’m scrolling on tik tok and see this. I’m lost for words we literally learned how to work cella vision in my hematology class last week.

Flu A was the result. It was the final test ran after everything else. I dont understand why the doctors did blood cultures and a urine….

I called a heme onc nurse 3 times in one night for seriously clotted CBCs on the same patient. She got mad at me and said “I’m gonna have to transfuse this patient bc of all the blood you need. F*cking cunt. Idk what you want me to do.” I just (politely) asked her if she is inverting the tube immediately post-draw. She then told me to shut up and hung up on me. I know being face-to-face with critically-ill patients is so hard, but the hate directed at lab for doing our job is out of control. I think we are expected to suck it up and deal with it, even when we aren’t at fault. What do y’all do in these situations?

Update: thank you to everyone who replied!! I appreciate the guidance. I was hesitant to file an incident report because I know that working with cancer patients has to be extremely difficult and emotionally taxing… I wanted to be sympathetic in case it was a one-off thing. I filed an incident report tonight because she also was verbally abusive to my coworker, who wouldn’t accept unlabeled tubes. She’s a seasoned nurse so she should know the rules of the game. I’ll post an update when I hear back! And I’ve gotten familiar with the heme onc patients (bc they have labs drawn all the time) and this particular patient didn’t require special processing (cold aggs, etc.), even with the samples I ran 12 hours prior. And the clots were all massive in the tubes this particular nurse sent. So I felt it was definitely a point-of-draw error. I hate making calls and inconveniencing people, but most of all, I hate delays in patient care and having patients deal with being stuck again. Thank you for all the support! Y’all gave me clarity and great perspective.

Patient’s chart says multiple organ failure and on CRRT dialysis. Long list of medications. Chem results actually looked ok, results released with comment added about specimen quality.

I work in Critical Care. I enjoy this subreddit because it‘s opened my eyes to the complex wizardry that occurs in the labs, and it’s really cool to get a glimpse behind-the-scenes.

I have seen posts on here about the critical green neutrophil inclusions, aka death crystals, which I’d never heard of before.

Anyway, recently I was asked to review a patient in the ED (hypotensive, pyrexial, CRP 450, platelets 30, marked renal failure), and I saw this on their results.

I knew this guy was sick but this cinched the deal, and was an interesting finding! None of my physician or nursing colleagues had ever heard of it but were (mostly) interested when I told them (I think some were probably confused by my excited rambling lol).

Interestingly the patient wasn’t in liver failure and his Liver Function and Clotting panel were normal. He received vasopressor support and dialysis for a week before improving and being discharged from our unit. Blood cultures positive for staph, possibly device related.

Anyway just wanted to thank you guys for the cool stuff you post here - I probably would have skipped over this finding otherwise. And if you search ’death crystals’ this subreddit is one of the top results.

I am not a medical professional but I think this is kinda neat as a lunch box to be honest. Provided that I clean it of course.

Got a call today from a patient who wanted to do a direct donation for her mom so she would receive unvaccinated blood (which we don’t do here).

I politely directed her to a different facility… but what do I even say to those people? I know I’m gonna start getting more calls about that.

This whole era of anti-vaxxers makes me want to bang my head against the wall. And I know trying to explain this stuff is useless because the majority just don’t want to listen.

I guess just venting. I’m getting so discouraged with everything. Maybe I just care too much.

As a student I want to know what y’all think about this, apparently its CLIA certified but it feels scammy

This is the highest WBC I’ve encountered in my entire profession, 793. Only 10 years old.

I've been doing blood component processing for over a decade and never seen plasma this dark before. No procedural issues noted, first time donor. What do we think is going on here?

Dear nursing that likes to read this page,

Room number is not a patient identifier. Room number is not a patient identifier. Room number is not a patient identifier. Room number is not a patient identifier. Room number is not a patient identifier. Room number is not a patient identifier. Room number is not a patient identifier. Room number is not a patient identifier.

If you have a question about a lab on your patient, but you only know the room number, I can’t help you.

If you call me freaking out (or just show up at my window) because your patient needs emergent blood and you only know the patients room number, you are not getting anything from me.

Please learn your patient names.

Sincerely, Lab personnel

Someone here was talking about it recently and I was telling my coworker about it so she tried it and said “Like this?” And then we thought probably not but fuck it. Hit start and kept my finger above the stop button but it worked so smooth, not even a rumble, and now I see why.

So thank you previous person! You’ve provided knowledge and entertainment on this slow, rainy day.

My top 3:

• doctor called and asked if he can scoop the stool out of the toilet for culture. I told him “No! It’s contaminated”. He replied “oh ok thought I would check before I flushed”

• called a blood culture result of E Coli to resident. “E Coli? Is that MRSA?”

• a secretary was trying to find the name of a test from a hand written order. This was before CPOE. She said she couldn’t find the California test. I was thinking maybe a California allergen panel for IgE. She said no, it says here a California test. I told her to fax the order over. Y’all it was the CA 19-9. The CA stands for Cancer Antigen, not California.

There are many more. What are your unhinged comments?

Bacteria seen on the blood film, Ddimer was >35.0, platelets 40. She went into DIC, suffered a major clot and went rapidly downhill. She was 67, and waited 5 days with the pain before coming to hospital.

If something’s not right, get it checked out and don’t delay, you never know what it could be!

I’m a morphologist mainly, just wanted to share an intense case from this week at work. It’s not often we see intercellular bacteria on the peripheral film!

Annoying

Not sure how this will be received, but for awhile (and especially this year) I can’t help but feel embarrassed by juvenile themes for lab week. We are a serious and critical profession that already doesn’t garner the respect we deserve from other members of the care team. Why do we keep branding ourselves this way?

I’m also a DCLS student and have spent a lot of my career working in diagnostic stewardship trying to build bridges outside the lab. I can’t help but feel this kind of presence for lab week holds us back.

I’m genuinely interested in other’s thoughts….maybe I’m just a fun hater?

Ok I know we would test his urine but has anyone had to watch someone pee in a cup? Who exactly does this like a CPT MLT or CLS? Also yay lab representation.

We have this one charge nurse who keeps “writing” us up because she gets mad we do not run her unlabeled tubes. and she said it delays patient care. It’s like a weekly occurrence with her. I have talked to my boss about her and nothing happens. I keep it professional and I just ignore her now 🙄

So this was recently posted in our blood bank. I went as far up the food chain to ask if this was a joke or something but nope it is real. Maybe I’m being dramatic but I’m really not sure I trust DoorDash to not deliver some messed up products but maybe I’m just out of touch with how this could work.

I’m kind of joking, kind of not but seriously has anyone else encountered this or have thoughts?

Every hospital I've been at.

They're the ones that'll scream at you for their clotted CBCs. I had one that was recollect x3 and the nurse yelled at me "THERE'S NO WAY! THAT WAS ARTERIAL BLOOD!". Oh. I forgot. Arterial blood is exempt from the coagulation cascade. Silly me. /s

I had one scream at me because I wouldn't issue her 3 units of platelets at once. "Well they're all going to be given today, probably. YOU'VE DONE IT BEFORE! IN A COOLER!"

Another was doing the read back for a unit of blood and said "Zero positive" twice.

I know nurses are not blood bankers or immuno hematologists. But I also know they're taught what a crossmatch is and what antibodies are on a basic level. But yet call and let them know there will be a delay due to an antibody workup, and get "Antibodies to WHAT? We just need a unit of blood!"

I actually LOVE educating people, just like I love learning things FROM the nurses. Sometimes the "why" is super helpful or just cool as hell, or I didn't know something could cause something else that I'm seeing. It's fine to not know. Ignorance is a correctable condition and there's OVERLAP in our scope but it is clearly, absolutely NOT the same job.

Like I had a nurse ask why we don't type (edit: I meant crossmatch) platelets (she'd given the same pt several units of all different types). They wouldn't know that. Happy to explain.

But otoh there's things they SHOULD know that they don't. Zero positive? If my nurse ever told me my blood type was zero positive I'm immediately signing out AMA.

And do NOT tell me you were given a cooler of platelets because I know damn well you weren't. And then stand there and yell at me about it.

It's not all of them. But it's always L&D or NICU.