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I will remember you: Kate Gagliardi

Pat Letendre interviews our TM colleagues - past & present:

It's my pleasure, indeed an honour, to write a series of blogs for CSTM to celebrate the careers of transfusion professionals who came before and made a difference. Some names you may recognize, some you may not. But rest assured they all made a difference and we are the better for it.

Each blog begins with a brief background on the person's career, followed by musings on their career and my comments throughout. If you're looking for a rosy view of Canada's transfusion medicine field, this ain't it. Why? Although all participants enjoyed their careers and love the transfusion profession, they speak honestly about both the ups and downs. Perhaps their reflections will resonate with your experiences.

I will remember you: Kate Gagliardi

This blog features Kate Gagliardi, a medical laboratory technologist I first got to know in 1995 via MEDLAB-L but got to really know at CSTM 2000 in Quebec City and afterwards. Kate had the vision that Canada's newly created transfusion safety officer (TSO) positions should have a mailing list to communicate and asked me to create one. Although the 'transfusion' list has transmogrified over the years, it still lives due to ongoing funding by Grifols arranged by Transfusion Safety Officers at McGill University Health Centre, currently Ann Wilson. Today, 'transfusion' includes most of Canada's leading medical lab technologists and nurses involved in transfusion safety, regardless of official job title, and has attracted a few physicians. If you would like to subscribe, see Canada's TSOs.

BACKGROUND

Before you can appreciate how Kate made a difference and understand her musing, you should know a few of her experiences. I encourage you to consider your career compared to hers and how you may muse on transfusion medicine.

Kate's 38 year career (and counting) occurred in Hamilton and environs, but her reach spans all of Canada and beyond. That's because Kate has been active in CSMLS and CSTM,  given many presentations at their conferences, as well as at AABB's, and offered transfusion-related CSMLS CE courses for years. Kate is a born educator and mentor, whether as an instructor for formal courses, on-the-job training, or as a presenter at conferences.

Kate is also a most generous and kind colleague as I can personally attest to over 20 years. And I mean Big-Time! My own career has been enhanced by Kate's generosity and kindness in many ways. As but one small example, Kate always alerted me to Ontario transfusion resources she knew of so they could be added to the BC PBCO's TraQwebsite and be more widely distributed to help others around the globe. She's totally into sharing and collaborating, not competing.

For a few of Kate's many contributions to Canada's transfusion community, see her resumé. Consider what it took to work fulltime and take all those CE and university courses, serve on all those committees, volunteer for professionals societies, and prepare all those publications and presentations. I'm exhausted just thinking about it! Of course, Kate would also credit sacrifices made by her family and fellow staff, and she's right. Successful professionals do require much love and support from family, colleagues, and friends to accomplish what they do.

KATE'S MUSINGS

Legacy

Teaching basic transfusion science and transfusion medicine

I'm not known for this in local circles; it is just something I’m proud to have helped with in a variety of ways. I hope I've made an impact on all those MLT students who take online courses in transfusion through CSMLS.  It's a two way street like many things in life - as instructors we learn a lot from the teaching experience, as much or more than we are able to share back to students in various points in their careers in MLS:
  • Newcomers to Canada;
  • MLTs needing to refresh entry to practice knowledge
  • Those wishing to upgrade their confidence in transfusion for career adjustments
What a joy to meet people one has taught over the wires and never met, who have thrived in their work and give some homage to their experience in a course I offered.

This answer overlaps with 'what was the most fun in your career'. Even when I had the best job in my career, which was helping to build ORBCoN from the ground up (see below), when people asked, I found myself saying I missed teaching and the interaction with clinical year students entering the profession (and even taught at the didactic phase for a few months). I learned that many of them needed empathetic and supportive mentoring to learn transfusion, something we did not receive in our clinical time in the 1970s.

Clinical teaching was a big responsibility, and it was fabulous fun to see people get their feet under them after a sometimes mediocre didactic training experience. Of course, because my career was in such a rich environment, I was also teaching hematology residents in the laboratory – people who now head transfusion laboratories across the country, at hospitals and at CBS.

Enjoyed most?

ORBCoN

The opportunity to be part of starting the Ontario Regional Blood Coordinating Network (ORBCoN) was a terrific experience.  Sure, ups and downs, big learning curve, but that is part of defining experiences in our career. While there was not a direct patient impact seen on a day-to-day basis (something many of us miss from early days in health care. e.g., how many crossmatches you did this shift), being involved in structuring a provincial program intended to truly support small and community hospital transfusion services was an honour, a privilege I will never forget.

McMaster transfusion lab

Another part of the fun was working with some sincerely dedicated and overlooked people in the transfusion laboratory at McMaster. They are the people who should really get the credit for supporting excellence in patient care and laboratory camaraderie…despite many challenges, personal and professional.  What laughs we had, from the days of surviving preparation of saline from scratch (for years past what you might expect) and thawing FFP in a plastic tub…to regionalization and regulation.

[Photos courtesy of Pat L. & Kate G.]







Regrets / Realities?

Regionalization – most of us minions had no control over fundamental changes in the environment which led to multi-sited organizations – and yet I sincerely missed the glory days of a single-site academic institution and the world within it that we had created.  It would have been nice to retain some of the good things – tight, dedicated teams, which endured despite changes in the personnel and services.

A lot of pride and quality was lost when people became part of a multi-service multi-site environment – and I think that people in other provinces like Alberta experienced this type of paradigm shift many years before we did in our part of Ontario.  We were lucky not to run into it ‘big time’ until the new century arrived.

Recognition of the profession

It hurts me to no end that our profession is, and never will be in Canada, recognized as the third largest healthcare profession in the world – and worthy of a much higher profile. Credentialing is a major issue, and when the opportunity was missed to move into a university-based entry to practice in Canada, the time passed to make us part of the movers and shakers in the healthcare environment. That is not to say that I am not fiercely proud of our services and our knowledge and our contribution. Quite the opposite…relegated to a low profile and intensely important behind the scenes role, we labour away providing a vital part of patient care.

The other opportunity missed was not to make transfusion medicine a part of the department of medicine – or its own department like pharmacy - instead of part of laboratory services. Laboratory services are perennially under-recognized, under-funded for what it entails, and transfusion never really fit well there.

Sure, we do a bit of testing – but mostly we are the gate keepers of a myriad of products (obviously not as many as pharmacy, but you get my drift). Moving out of the lab might have afforded the service the opportunity to become better sooner - I can dream can’t I?

PAT'S FINAL MUSINGS

Kate introduced a sidebar in her musings on recognizing medical laboratory technologists as the third largest health profession in the world, one that I'd like to briefly expand upon. As Kate notes, Canada opting not to transition to a university-based entry to practice was a missed opportunity. While there are valid rationales in support of diploma entry and against a BSc as entry level, my regret for not moving to a degree-based entry is two-fold:
First, it relates to maximizing individual and career potential. For example, when med lab technologist jobs disappeared as they did in Alberta in the 1990s, MLS graduates could work in the USA (where NAFTA requires a bachelors degree) and abroad in England and Down Under, where university degrees are increasingly the norm. And if a person wants to move up a career ladder by earning an MBA or MSc or MEd or PhD, it helps to already have a bachelors degree.
Second, many allied health professions require a degree, e.g., RNs, physical therapists, pharmacists. Without a degree as entry level, medical laboratory technologists will never get the recognition they deserve.
Had Canada chosen a degree as entry level, diploma holders would have been grandfathered and distance education programs to allow diploma holders to work while obtaining a BSc in MLS could have flourished. As we know, the now defunct CSMLS ART never was recognized within Canada's hospitals beyond the laboratory.  If you disagree, please leave a comment.

In summary, Kate Gagliardi is another 'oner' we are so lucky to have in Canada. I mean, who gets a BA in Philosophy 25 years after graduating as an MLT? Kate, of course, and it fits her to a T, a lifelong learner who is curious about the world.

As testimony to how colleagues respect and admire her, in 2003 Kate was awarded both the Dr. Donald I. Buchanon Memorial Lecture Award from CSTM and the A.R. Shearer Pride of the Profession award from CSMLS. The Shearer award Fact Sheet could have been written with Kate in mind:
 
  • Do you work with someone whom you view as the ideal medical laboratory technologist?
  • Someone who helps out a colleague, pitches in to lend a hand when their work is complete, who works hard to develop themselves as a professional, helps others with their professional development?
  • Where the individual's professionalism is so contagious that it rubs off on those around them?

Have you ever met a colleague who you knew from day one was sympatico with your vision of how the transfusion world should be? That's how I felt about Kate and it's only strengthened over the years. She's one of the medical laboratory technologists who have truly made a positive difference for all of us.

Comments are most welcome. Do any of Kate's experiences resonate with yours? Please add to the record of what it was (or is) like to work as a transfusion professional in Canada by commenting.

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