Pat Letendre interviews our TM colleagues - past & present:
This blog is a follow-up to an earlier one and presents musings by Dianne Powell on laboratory restructuring in Edmonton in the 1990s. As noted, blog participants enjoyed their careers and love the transfusion profession but also speak honestly about the ups and downs. This blog is about a 'down' that Alberta clinical laboratories experienced before others in Canada and more severely. Eventually, laboratory restructuring came to all of Canada. It's a tale worth recounting because there are many lessons to be learned if we can only see them.
As you will see, like all Alberta health care professionals, Dianne experienced lab restructuring and centralization of services first hand. The transfusion service she managed was merged with that of another hospital and effectively disappeared. Dianne survived the merger, but....
BACKGROUND
As background, in the early and mid-1990s, Alberta's government drastically cut laboratory medicine funding. This resulted in laboratory restructuring, including centralization and regionalization of transfusion services. Up to 40% of medical laboratory technologists (MLTs) working in Edmonton's clinical labs lost their jobs. Many were faced with a career change unless they qualified to work as MLTs in other countries, which mostly meant having a BSc, ideally in Medical Laboratory Science.
Dianne's experience and insights are reflected in her musings on realities she wished were different.
DIANNE'S MUSINGS - Lab Restructuring in Edmonton
As I put pen to paper, I realize there are huge gaps that I don't remember. The beginning of the process in late 1992 and 1993 is fresh in my memory because I was directly affected. But after I went back to Red Cross around late 1993, I just turned off what was happening at the hospitals since I found it disturbing and chaotic.
My recollection is that the government mandated massive cuts to healthcare and, unfortunately, without a long term plan going forward.
As a cost cutting measure, the Royal Alexandra Hospital and Charles Camsell Hospital laboratory services were to merge. The process involved much uncertainly and anxiety. Our laboratory manager at the Camsell was given a package and quietly disappeared and staff felt quite un-tethered. As supervisors, we tried to provide support for the lab staff as we were dealing with the uncertainty, but as supervisors we were also dealing with maintaining the daily routine in the lab and ensuring testing got done.
And we were told almost immediately that
- We would need to submit our resumes and compete with our counterparts at the Royal Alexandra Laboratory for our positions.
- If unsuccessful in the competition, there was no place in the organization for us.
- We would be given a package and be asked to leave immediately so we should have our personal stuff packed up.
- Sounds like the reality TV show 'Survivor', no?
Any job interview is stressful, but this one more than most. Of three Camsell supervisors, I was the only one that got to stay. I was now Manager of Hematology and Immunohematology based at the Royal Alexandra Hospital (RAH). Facing RAH staff on the Monday, after competing for the job the Friday before, was worse than the interview! I did not feel comfortable in this position and after staying for 9 months, I was most grateful when a position came up at Red Cross that I fortunately succeeded in getting.
Laboratory restructuring in Alberta seems to be almost continuous since then and people have come to accept it. But 1992 was the beginning and therefore sticks in my mind (and also because I was directly affected).
The process was demoralizing. Sadly, many good people have been lost over the years, and training programs have been disrupted. I remember in the midst of the changes going to a conference in Vancouver and someone from BC told me that BC was having to make some cuts and were looking at Alberta as the model of how NOT to do it!
Final Thoughts
I feel very fortunate to have been involved in Canada's transfusion medicine community for some 35 years. It was a most rewarding and excellent career. As expressed earlier, I had the opportunity to work for both the blood supplier and hospitals, in both Edmonton and Calgary, and have colleagues across Canada.
While I still miss the people and the work, I am not sorry I left when I did. Not long after leaving, I had to deal with aging parents and other family matters. Fortunately, I was able to devote myself to family without feeling guilty about conflicting career commitments. Many people have to deal with both!
As well, in my last years, I was glad to have been involved just as technology was exploding and things became more complex. However, I also have fond memories of the simpler era when I was a new grad and donor testing consisted of forward and reverse grouping by tube, Rh typing, a screen for irregular antibodies, syphilis testing (VDRL), and testing for HBsAg (CIEP).
When I began my career at the blood service (CRC-BTS):
- There was no automation;
- Blood was collected into ACD (with a shelf-life of 21 days) and donors could donate every three months;
- Blood components/products were limited to
- Red cells (still a significant amount of whole blood!);
- Platelet rich plasma;
- Fresh frozen plasma and stored plasma;
- Cryoprecipitate;
- Albumin and Rh immune globulin.
MY MUSINGS (Pat)
On restructuring, job losses, and career mobility
Since Canada had opted, under advice from employers and governments like Alberta's, not to go with the degree as entry level, Canadian MLT choices were limited. The most logical possibility for singles or MLTs whose families could pick up stakes and move, was the USA. But NAFTA requires folks to have a degree in a professions with shortages. Accordingly, lab restructuring resulted in many dedicated MLTs with diplomas leaving the profession. At the time I counselled many experienced MLTs about their options. Frankly, it was heartbreaking.
In contrast, University of Alberta Med Lab Science grads, including those with diplomas who took the BSc (MLS) after initial certification, obtained jobs in the USA as many had already written ASCP exams for MT certification as an option upon graduating from MLS. As MLS grads qualified to work in NZ, six were brave enough to work for New Zealand's Blood Service for up to 4 years until jobs opened up again in Canada.
Another job loss reality that comes to mind: A common anecdote was those made redundant from senior positions typically lost computer access immediately and were often escorted from the premises, presumably out of fear they might do damage. Many were loyal employees for decades. You can imagine how staff observing such exits felt.
On early days at CRC-BTS
Like Dianne, and all retired med lab professionals, I've seen enormous changes in Canada's blood service (and hospital transfusion services). If interested, later read
SUMMARY
I hope you enjoyed Dianne's reminisces about her transfusion medicine career from the perspective of a medical laboratory technologist who experienced 'the best of times and the worst of times'. Like all those featured in this series, Dianne made a difference.
Comments are most welcome. Do any of Dianne'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.
Disclosure: For 22 years I taught University of Alberta Med Lab Science students in multiple years of the program and NAIT MLT students who rotated through the University of Alberta Hospitals blood bank. Also was the first CRC-BTS clinical instructor in Winnipeg, teaching Red River Community College MLT students and blood service staff for 3 years before moving to Edmonton.