All posts by michael

“Flu in Kathmandu”

When I was offered the chance to go to a WHO influenza meeting in Kathmandu, I grabbed it with both hands. Such opportunities certainly don’t come by every day…

However the trip to Nepal did not get off to the best of starts.

On the flight to Kathmandu, I started to get toothache. By the time we landed I was in agony. The pain was compounded by the fact that my suitcase didn’t make the connection at Singapore. Ouch!

Things could only get better…

However my initial impressions of Kathmandu did little to lift my spirits. There were three power cuts in the first 24 hours, apparently a hangover from the 2015 earthquake. I had to pass on coffee in my hotel room as the tapwater had a distinct greeny brown tinge to it. I then attempted to do some initial exploration of the city on foot, but crossing roads in this city is not for the faint-hearted! Eventually fatigue and my nerves got the better of me and I retreated to the safer confines of my hotel room, wondering just what I had got myself into…

But things did eventually improve (as they almost always do!). The conference started the next day and it was good to focus for a change on just one microbiological subject (influenza) for two and a half days, as this allowed the acquisition of some in-depth knowledge. It was also good to speak to representatives from countries that I have very little knowledge of and have certainly never met anybody from before , i.e.  Timor Leste, Mongolia, Bhutan. The Nepalese people themselves were very friendly and as most of them knew a little bit of English, it was easy to strike up a conversation.

And my suitcase eventually turned up, albeit the day before I was due to leave (carry-on bag next time!). As for my toothache, the hotel concierge kept me going with a steady supply of paracetamol, which took the edge off the pain and allowed me to function. I fear a visit to the dentist will be required though on return to NZ.

The highlight of the whole trip was the final day visit of local hospitals, public health laboratories, and the Nepal National Influenza Centre. This was a fantastic opportunity to meet local laboratory professionals, and to discuss what particular challenges they faced in a sometimes challenging environment. I was extremely impressed at the systems they had in place.


“Lab and hospital tour in Kathmandu”

So despite the challenges the trip turned out to be hugely educational, both in an academic and cultural sense. I learnt a good deal about Influenza, and even more about Nepal. It is very different to New Zealand! I look forward to going back there one day,  hopefully to do some trekking in the Himalayas.

And I have made a new resolution:- to attend at least one microbiology conference a year in a place I have never been to before, even if I have to pay for it myself.

Michael

 

“Going on leave…or not?”

When an “Out of office autoreply” is received into your inbox, it is increasingly common to get something like this…

“Please note I am on annual leave for the next two weeks. I will only be checking my emails intermittently.”

Hmmm….

There are two reasons why this “halfway house” is a bad idea, regardless of your responsibilities or seniority. Firstly, by checking your emails at all, you are not getting away from work completely. By checking your emails, you will never get work out of your mind, the things in the laboratory which were stressing you will still be stressing you, defeating the purpose of leave in the first place. Time is a great healer…

And secondly, by checking emails whilst on leave, you are giving the perception of distrust for those colleagues who are covering for you. Leave them to it. They are more than capable.

There is not much that cannot wait in the microbiology laboratory. And anything that cannot wait, should never be sent by email.

With smartphones, the temptation to keep in touch with work whilst on leave is almost overwhelming. Don’t do it! Switch the notifications off. Even better disconnect the email app from the server. Remove yourself from temptation, you will still have a job to go back to when you return, and people won’t think any less of you because you have been totally incommunicado during your holidays. In fact they may well have a grudging respect….

Enjoy your holidays, spend quality time with your family, and forget all about work for a while. You will likely come back rejuvenated, and ready to provide value to your microbiology laboratory.

Trust me, the sky will not fall because you are not there.

So the next time you are on leave, put something like the following on your out of office autoreply.

“I am on leave until date X. Person Y is covering for me. If necessary I will get back to you on my return.”

Take leave like you mean it!

Michael

p.s. Worried about that mountain of emails that awaits you on your return? Don’t be. Give yourself 1 hour exactly to clear the bulk of your inbox. Be brutal, ruthless and without remorse. Many of the email topics will have been sorted, or forgotten about. You will soon work out which emails are actually important, which in reality is about 1%!

“We’ll see what we can do…”

You might be familiar with the following phone calls to the microbiology laboratory:

  • “I know you only have 0.1ml of CSF left at the lab. Can you still do a viral CSF panel for me?”
  • “Although (I swear) the blood culture was from Mr X, the bottles were accidentally labelled as Mrs Y. Can you still process it?”
  • “The patient is currently on erythromycin for a chest infection. Please can you test the E. coli in the patient’s urine against this antibiotic?”
  • “Regarding that stool sample that we sent to the laboratory five days ago. Can we now check it for C. difficile toxin?”
  • “My patient has a mixed growth in her urine. Can you check to see if everything that you have grown is susceptible to augmentin?”
  • “Sorry I sent the B. pertussis PCR swab in the wrong transport media. Would you process it nevertheless?”

We’ll see what we can do….

We often get requests to do something in the laboratory which is either simply inappropriate or has a good chance of producing a sub-optimal result. This might be because of inadequate sample volume, transport delays, labelling errors, wrong sample type, etc. etc.  Because we want to be nice, because we want to keep everybody happy, we often pander to such requests. However by doing so we compromise the quality standards in the laboratory, with potential harm to that all important end user, the patient.

And we also set a precedent for further such requests…

The staff working in the microbiology laboratory are the key gatekeepers of a high quality service. If a sample or test is unacceptable for whatever reason, they should have the authority to reject/refuse it, and this authority should be backed up to the hilt by lab managers and pathologists.

It is only by doing this consistently that high quality standards become the norm within the department. And what’s more, laboratory users soon learn that future requests of a similar nature will be futile. With time, laboratory users will increasingly understand why you take this approach.

So instead of saying “We’ll see what we can do,” we should be replying “Sorry we are unable to do this.” to such requests.

Occasionally this might provoke a grumble or even a complaint. I have had my fair share!, but trust me, such complaints are completely ungrounded and never go very far. If you don’t receive the odd “complaint” from time to time, you probably aren’t doing your job properly.

When it comes to test quality, ensure your microbiology laboratory is both strict and consistent in its messages, and the respect will come…

Michael