Vol. 15 •Issue 22 • Page 1A
ADVANCE EXTRA!
Careers in Blood Banking/Transfusion Medicine
Blood banking involves the collection of donor blood and recipient blood, the testing necessary to insure that the two are compatible and that the donor blood is free of hazards and then, the delivery of donor blood to the recipient.
Although blood banking is a required, multi-step process within transfusion medicine, transfusion medicine involves in vivo benefits and complications involved in the infusion of blood from donor to recipient, whereas blood banking is traditionally thought of as the in vitro testing in the laboratory.
In a field where the blood supply level fluctuates throughout the year, and in a career where teachers, as one source told us, tell their students to practice “controlled paranoia,” it’s no surprise that tensions run high in blood banking/transfusion medicine. But instilling high standards into a blood bank can ease the tension.
In this special ADVANCE Extra!, we examine the paths that some have taken on their journey through the field of blood banking/transfusion medicine. If there’s one thing that’s evident, it’s that this is a career where the benefits truly outweigh the risks, and where many doors of opportunity can be openened when you climb the career ladder.
Be sure to visit our Web site at www.laboratorian.advanceweb.com where you’ll find additional information on blood banking/transfusion medicine programs to advance your own career, including a listing of blood banking programs, related features and links to some professional resources.
As always, ADVANCE relies on its readers to improve the quality and effectiveness of special sections. If you have any input, please share with us by writing: Editor, ADVANCE for Medical Laboratory Professionals, 2900 Horizon Dr., King of Prussia, PA 19406; fax: 610-278-1425 or E-mail: [email protected].
A Career to Bank On
Benefits of working in blood banking/transfusion medicine far outweigh risks.
On any given day, an average of 38,000 units of RBCs are needed. Blood transfusions often are needed for trauma victims—due to accidents and burns—heart surgery, organ transplants and patients receiving treatment for leukemia, cancer or other diseases, such as sickle cell disease and thalassemia, the AABB says.
The National Blood Data Resource Center reports that in 2001, nearly 29 million units of blood components were transfused. And with an aging population and advances in medical treatments and procedures requiring blood transfusions, the demand for blood continues to increase.
If you’re ready to advance your career in the field of blood banking, then it could probably be stated as fact that blood banking/transfusion medicine is a noble profession, one providing many paths for career exploration. And although it’s true that one error can be devastating, those who have dedicated their lives to the career say that maintaining highly regulated, quality environments makes all the difference in preventing such a mistake.
Career Defined
Blood banking and transfusion medicine are terms that refer to the science of immunohematology, or the study of all aspects of immunology relating to the blood, including blood types and blood disorders, says Brenda C. Barnes, MT(ASCP)SBB, blood bank supervisor, Great Plains Regional Medical Center, North Platte, NE.
“Typically, the term blood banking refers to blood collection and processing, including selecting donors, drawing and typing blood, and performing pretransfusion viral screening and confirmatory tests,” Barnes said. “The ‘patients’ dealt with are generally not patients at all, but are healthy people willing to donate blood for patients who may need a transfusion of blood or a blood component.”
She notes that transfusion medicine responsibilities include testing for blood group antigens; compatibility and antibody identification; investigating abnormalities such as hemolytic disease of the newborn, hemolytic anemias and adverse responses to transfusion; and supporting physicians in transfusion therapy, including patients with coagulopathies or candidates for allogeneic organ transplant.
“Ultimately, the goal of blood banking/transfusion medicine is to provide the patient with the safest component possible,” Barnes said.
Transfusion medicine, she adds, offers a broad range of choices, so many different types of people can find rewarding careers. Generally, people who enjoy working in highly regulated environments find that they fit well in the blood bank. “Blood bank technologists are often labeled as ‘perfectionists,’ and can efficiently multi-task and handle stressful situations,” she explained. “Working in a blood bank is much like what a forensic scientist might do, but without digging through filth and decay.” Describing why she enjoys her career so much, Barnes explained, “I find that there is nothing quite as rewarding as solving a multiple antibody problem and providing a patient with compatible blood.”
People who need transfusions are either severely injured from traumas and may require life-saving transfusions, or debilitated from chronic disease in which a transfusion can greatly improve their quality of life. “The blood bank may have a complex environment to work in, but it is also the only lab department that can be directly responsible for saving a person’s life by providing a life-saving transfusion,” Barnes said. “In my opinion, the benefits of working in the blood bank far outweigh the risks.”
Taking it to the Next Level
Ann M. King, MT(ASCP), medical technologist, Scott and White Memorial Hospital, Temple, Texas, agrees that the benefits outweigh the risks. As a matter of fact, she’s in the middle of stepping up her own career. She recently began SBB school and hopes to receive her SBB certification by next fall.
King sees many advantages to taking her certification to the specialist level. “One gets a deeper knowledge of all aspects in blood banking, not just the field in which one is currently working,” she said. “For example, I have only worked in transfusion services, but going to SBB school will help broaden my knowledge in donor services, component processing, donor testing, quality assurance and control, reference lab work, HLA testing, [the] stem cell lab and many other areas.” She feels that this knowledge and experience will make her a better blood banker overall, and will also open doors to other opportunities, which will open much easier as she works toward the supervisory level.
“Because I have not been blood banking very long, I do not have the experience in years that I believe are needed to become a supervisor. Going to SBB school is consolidating this learning period to 1 year, and assures that I do get exposure to all areas of interest.”
Different Paths
Lt. Richard Henry, senior program analyst, Office of the Secretary, HHS, Rockville, MD, can attest to the fact that his career in blood banking has taken him to a job where he never thought he would be—especially with such a humble, albeit extremely important beginning as a technologist.
He is a commissioned officer with the U.S. Public Health Service who works closely with the sister services of the Army, Navy and Air Force. He works in the Office of the Secretary of DHHS with the Secretary’s Advisory Committee on Blood Safety and Availability and deals with the entire blood community including the military personnel who are in the Armed Services Blood Program Office near Washington, D.C.
“We are currently working together on the Department of Defense/DHHS/Department of Homeland Security critical infrastructure program concerning blood products,” Henry said, a task he describes as “fascinating.” He spent his first 8 years in the laboratory as active duty in the Air Force as a technologist and a laboratory instructor.
Henry says that the field of blood banking offers many lucrative and appealing career paths, including:
• Member of donor blood collection teams—perform numerous administrative and technical procedures culminating in the delivery of blood units to the testing facility for screening.
• Donor blood screening medical technologists—perform complex tests on donor units to detect common diseases that could potentially make the recipient ill.
• Traditional blood banking medical technologists—perform complex tests (i.e., “the crossmatch”) on donor and recipient blood culminating in the delivery of compatible blood to the patient.
• Administrative medical technologists—oversee the entire process or a specific portion with titles such as supervisor, manager, quality control officer or director.
• Industry employees—manufacture reagents and test kits used in blood banking, working at such firms as Baxter Healthcare and Ortho-Clinical Diagnostics.
Randall D. Williams, MT(ASCP)BB, Mercy Medical Center, Sioux City, Iowa, adds that there’s also a need for sales and support people for computers, reagents, supplies and other equipment. “One could further [his/her] education and opportunities by obtaining a master’s and/or doctorate and pursue research into some of the challenges to transfusion medicine such as pathogen inactivation, preservation of products and alternates to standard blood products,” Williams said. “There’s also a relatively new opportunity involving stem cell and other precursor cell transplantation.”
Staying abreast of the field and learning of the new opportunities is easily facilitated through several mediums, Williams says. One avenue he uses is e-mail listservs. “E-mail lists provide a wonderful ‘group mind’ to ask for directions in problem solving. The answers may not exactly work for your facility but there is always something of value in this peer network,” he said. Other methods include continuing education, by reading and/or joining professional organizations and trustworthy Web sites.
Conclusion
Barnes says that she has heard many people say they wouldn’t or don’t like to work in a blood bank because it’s the one department where errors can be deadly. “It is true that one error can be devastating,” she explained, “but this is offset by maintaining highly regulated quality environments—training and competency assessment programs are priorities, and are only part of the quality picture.”
Matthew T. Patton is associate editor of ADVANCE. He can be reached at [email protected].
Table 1: ASCP Certification of Technologist in Blood Banking, BB(ASCP)
To be eligible for this examination category, an applicant must satisfy the requirements of at least one of the following routes:
Route 1: MT(ASCP) certification and a baccalaureate degree from a regionally accredited college/university, or
Route 2: Baccalaureate degree from a regionally accredited college/university, with a major in biological science or chemistry, or baccalaureate degree from a regionally accredited college/university with a combination of 30 semester hours (45 quarter hours) of biology and chemistry, and 2 years full-time acceptable clinical laboratory experience in blood banking within the last 10 years. These 2 years of experience must be under the supervision of a pathologist (certified by the American Board of Pathology, or eligible) or an appropriately certified medical scientist and a certified medical technologist, or
Route 3: Baccalaureate degree from a regionally accredited college/university with a combination of 30 semester hours (45 quarter hours) of biology and chemistry, and successful completion of a structured program in blood banking under the auspices of a NAACLS-accredited Medical Technology Program. The structured program in blood banking must be at least 1 year in length and equivalent to the curriculum for blood banking in the medical technology program, or
Route 4: Master’s or doctorate degree in chemistry, biology, immunology, immunohematology, microbiology, allied health, clinical laboratory sciences or an appropriately related field, from a regionally accredited college/university, and 6 months full-time acceptable clinical laboratory experience in blood banking within the last 10 years. These 6 months of experience must be under the supervision of a pathologist (certified by the American Board of Pathology, or eligible) or an appropriately certified medical scientist and a certified medical technologist.
Clinical Laboratory Experience, BB(ASCP)
To fulfill the experience requirement for the Technologist in Blood Banking examination, you must have clinical laboratory experience within the last 10 years in all of the following procedures:
Serologic Testing
• ABO, Rh typing
• antibody detection and identification
• crossmatching
• test for other blood group antigens
• direct antiglobulin tests
Routine Problem Solving
• transfusion reactions
• immune hemolytic anemias
• hemolytic disease of the newborn
• Rh immune globulin evaluation
Quality Control
• reagents, equipment
Donor Blood
• processing or reconfirmation testing
• donor selection, preparation, and collection (proficiency may be demonstrated through performance, observation or simulation)
• component preparation for storage and administration (proficiency may be demonstrated through performance, observation or simulation)
Source
ASCP Board of Registry Certification. Available at http://www.ascp.org/bor/certification/procedures. Accessed Sept. 25, 2003.
Table 2: Certification of Specialist in Blood Banking, SBB(ASCP)
To be eligible for this examination category, an applicant must satisfy the requirements of at least one of the following routes:
Route 1: Baccalaureate degree from a regionally accredited college/university including biological science, chemistry and mathematics courses, and successful completion of a CAAHEP-accredited specialist in a blood bank technology program, or
Route 2: MT(ASCP) or BB(ASCP) certification, and a baccalaureate degree from a regionally accredited college/university, and 3 years of full-time acceptable clinical laboratory experience in blood banking within the last 10 years. These 3 years of experience must be acquired post baccalaureate degree and be under the supervision of a pathologist (certified by the American Board of Pathology, or eligible) or an appropriately board certified medical scientist, or
Route 3: Master’s or doctorate degree in chemistry, biology, immunology, immunohematology, microbiology, allied health, clinical laboratory sciences, or an appropriately related field, from a regionally accredited college/university and 3 years of full-time acceptable clinical laboratory experience in blood banking within the last 10 years. These 3 years of experience must be acquired post baccalaureate degree and be under the supervision of a pathology (certified by the American Board of Pathology, or eligible) or an appropriately board certified medical scientist, or
Route 4: Doctorate degree in chemistry, biology, immunology, immunohematology, microbiology, allied health, clinical laboratory sciences, or an appropriately related field, from a regionally accredited college/university and 2 years of post-doctoral fellowship in blood banking within the last 10 years.
Clinical Laboratory Experience, SBB(ASCP)
To fulfill the experience requirement for the specialist in blood banking examination, you must have clinical laboratory experience within the last 10 years in all of the following procedures:
Serologic Testing
• ABO, Rh typing
• antibody detection and identification
• crossmatching
• tests for other blood group antigens
• direct antiglobulin tests
Routine Problem Solving
• transfusion reactions
• immune hemolytic anemias
• hemolytic disease of the newborn
• Rh immune globulin evaluation
Quality Control/Assurance Laboratory Operations
Donor Blood
• processing and confirmation testing
• donor selection, preparation and collection
• component preparation for storage and administration
Source
ASCP Board of Registry Certification. Available at http://www.ascp.org/bor/certification/procedures. Accessed Sept. 25, 2003.
