What does a pathologist assistant do during a regular day in the lab?
In this video I'm covering what an average day looks like in a lab that has one other PA in addition to myself.
Mornings always start the same way - I will check our phone for messages, unpack courier buckets which contain slides for our pathologists, and check for specimens that were delivered overnight (usually specimens that come after hours are in formalin or get put in a fridge if fresh). This last part is only something I worry about if we don't have a lab assistant that day.
Then I can prep my bench for the day (which is mostly logging in to the different computer programs I need) and start collecting the cases I will be responsible for grossing. For this day I'm responsible for all the small gross - cases like gallbladders, biopsies, polyps, appendixes, cysts and other "small" odds and ends that get removed. These aren't typically cancer resections but are often done for diagnostic purposes (eg biopsies, polyps) which may end up guiding further treatment or are done to prevent/treat potential inflammatory conditions (eg appendicitis, diverticulitis).
The cases I'm going to work on have been split up by our lab tech into bins and each bin is assigned to a different pathologist - this helps ensure there is a roughly equal division of work. I could have 12-15 bins of small gross to work through on a given day.
But it's not all about me either. I'll check with my coworker who is covering large gross for the day and see how their workload is. Because a courier delivers our tissue blocks to a central processing site we need to ship our breast blocks before noon and this means it can be a rush to get them done. So when I check with my coworker I'm asking if they need any help or if they can handle the workload they have and if they need help I'll grab a couple cases from them. The rest of the large gross can be sent on a courier as late as 1600 so once the breasts are done they're usually ok for the rest of the day.
Just to recap, grossing = a dictated report of a specimen which includes tissue size/appearance, tumor size/appearance and distance to margins (if tumor is present). In cases without a tumor I'm still looking over the tissue for any pathology eg) hemorrhage, necrosis, obstruction, evidence of inflammation etc. Once I've completed this report I will sample pieces of the specimen (or sometimes whole specimen if very small) and submit tissue for processing → this gets turned into a slide for a pathologist and they make a diagnosis based on what they see on slides.
By early to mid afternoon (1330-1400) we're close to done grossing our cases for the day and at this point I'll look through our decals. Anything with bone in it can't be cut without going through decal and we keep an eye on these cases, changing the decal solution daily, until they're ready to gross and submit.
Once our grossing is done there are a couple other things like packing up blocks for the day to send for processing and opening fresh specimens. We try to open/cut fresh tissue as it comes in so it starts fixing right away (important for breast cancer cases) but anything we haven't gotten to yet we deal with now. After opening specimens we put them into trays which splits the work between pathologists.
Once everything is opened we will file leftover tissue from the cases we've grossed. We keep everything (even garbage and empty containers) for a couple days to weeks after a case is signed out. This helps in case we have to go back to put more tissue through or double check something.
Last few orders of business are to print off the OR slate for the next day (upcoming surgeries) and go through the major surgeries, check patient histories and any imaging reports for tumors. I'm also looking for cases that look like they will come for frozen/intra-operative consult and definitely make sure to review radiology and histories for them - they have to be done quickly when they arrive so I won't have time to check these things the next day.
Lastly I'll call the OR front desk to see if there are any ongoing surgeries they might need us for/make sure all fresh tissue has been sent to us. If anything is going late I'll give them the on call pathologist phone number. One last check for fresh specimens and then I'm done for the day.
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WHO AM I:
I'm a full time Pathologists' Assistant working in western Canada. I'm making videos about becoming a PA, giving you tips about school and letting you know what this career is like.
GET IN TOUCH:
If you'd like to talk, I'd love to hear from you! Leaving a comment will be the quickest way to get a response but if you have a longer question or want to keep your question private, feel free to email me at canadianpathassistant@gmail.com.
2 авг 2024