Sometimes, in my line of work as a low-level hospital worker, I learn things that disappoint or shock. The latest discovery is related to time-dependent blood tests. I would say that at least 75% of the people who work in the laboratory drawing blood do not have education beyond high school and vocational training - those who do have more education are usually working toward getting into a nursing program. For those who stay in the lab, sometimes the vocational training is not thorough enough and common sense just does not exist. The following case demonstrates how important it is for all people in the medical field to have a basic understanding of medicine; they need to understand why they have to do the things a certain way and the consequences if they do not follow instructions.
Some phlebotomists, particularly on the graveyard and night shifts when it is not very busy, do not want to waste time going up to get multiple samples of blood from the same patient. This is understandable if the person is a hard stick and there will be no difference if the blood is drawn at that time, or at two different times. However, some tests are measuring a person's metabolism of certain medications, and are supposed to be drawn right on time, sometimes as often as every two hours. Vancomycin is one of the common antibiotics which requires blood tests to determine the trough and peak levels of the medication. Learning that some lab assistants draw all the tubes at the same time and then write fake times (as in, they draw a tube at midnight but write that they drew it at 2:00 am) is rather alarming. If I were a patient's doctor and I thought their trough and peak levels were lower than in actuality, I would have to increase their medication and possibly cause harmful side effects. The ramifications of giving doctors incorrect information can be fatal - hearing this almost makes me want to draw all of my future patients' blood samples myself! Alas, it is not feasible, but it will at least make me think twice when I get back unexpected drug level reports.