Hematology Lab: Proficiency #2

I’ve started, erased and re-started this post four times.  Perhaps tonight the fifth time is the charm 🙂  Fridays are school days.  I have all my classes on the same day so I only need to drive to school once a week.  Pharmacology is in the morning (and is generally pretty uneventful) and in the afternoons I have hematology (which is much more interactive and fun than pharm lab).  In the first part of hematology lab today, we practiced performing a complete CBC (complete blood count).  We’ve been doing these for weeks, so by now, we’re all pretty good at them.  (We did have last week off, so we were a bit rusty, but certainly not out of practice.)  Everyone has their “thing” they have trouble with, but overall we all do pretty well.

In the second part of lab, we had a proficiency (test), where we did the same thing we did in the first part of lab.  The first part of lab went fine.   I ended up not getting the entire CBC done due to microscope problems, but had my microscope been decent, I would have had no problem complete the CBC in under an hour.  On my second CBC, things didn’t go nearly so smooth.  I couldn’t get good blood smears (the quality of my smears has been declining steadily since the start of the semester), my WBC (white blood cell) estimate was off, my platelet estimate was low, my actual WBC numbers didn’t correlate, and I couldn’t find ANY red blood cells on my reticulocyte slide.  It was so frustrating!  I’ve been doing this for weeks.  I know I can do it.  I know I can do it well.  If you asked me the steps to a CBC, I would be able to tell you each step and how to do it.  I remember the formulas for determine actual and estimated counts (at least I didn’t forget them during my test).  It was just one of those days…  My instructor was great, though.  She even helped me out a bit when I couldn’t find any RBCs (red blood cells) on my reticulocyte count slide (I had the objective focused on the wrong spot on the slide – how silly of me).  She got the microcope focused on the right spot and then let me do my count.  I finished with 10 second to spare.  Whew!

I know I didn’t get a perfect score on it.  My WBC estimate was low, my platelet estimate was low, and my actual WBC count numbers didn’t correlate (to do an actual white blood cell count, you have to count two sets of WBCs; those two sets of WBCs have to be within a certain number of each other to be considered accurate – mine were not accurate), and my WBC estimate and actuals didn’t correlate (they have to be within a certain percentage of each other).  I did, however, get the extra credit question right!  And really, I didn’t do too badly.  My score may not be great, but during my proficiency I re-did my WBC estimate, platelet estimate, and actual WBC count once, so I did them all two times.  Even with repeating those three things, I still got done in an hour.  That’s pretty good.  Think how quickly I would have been done if I hadn’t needed to repeat those three procedures.  My instructor agreed that my time management was really quite good.

In other school news, I didn’t do so great on a pharmacology lecture quiz I took today.  Even though I did all my readings (some more than once), I still did poorly on the quiz (70 or 80% – two questions haven’t been graded yet, but I know I got at least one of them wrong).  I still have a hematology test and hematology quiz to take before Sunday and have a huge lab project due next Friday.  It looks like the laptop and I will be spending some quality time in Caribou’s comfy chairs on Monday!

If you’d like to know more about any particular aspect of the CBC, feel free to leave a comment asking me about it.

On a totally unrelated note, the temperature here dropped 18 degrees (Fahrenheit) in one hour!  Today it was hot and humid with temps in 90s and dew points in the 70s.  We had a line of storms come through this evening, which brought us much cooler (but still humid) air.  Ahhhh….  I have the fan near the window now and it’s blowing some of that nice, cool air into our apartment.  It’s so neat to see how drastically the temperature can drop in a short period of time when storm systems come through, isn’t it?

Have a splendid weekend!

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