Case Study: Biomedical Scientist - Caroline

What do you do?

I'm a biomedical scientist, in haematology. I work in an NHS hospital. We study the morphology of the cells - what they actually look like, such as their size and shape. We compare them to reference ranges.

We also look at measurements of the red cells. We work on analysers and microscopes. We have a wide range of analysers for looking at different things. One of the main ones we use counts the number of cells in the blood. There are different kinds of cells that it counts.

We can tell so many things from that. For example, from counting red blood cells we can see if the patient is likely to be anaemic. Then, we can look a bit further and say why they're likely to be anaemic.

We'd normally do more than one test, to get an overall picture. That helps the doctor decide what's actually wrong with the patient.

What is your background?

It was just following what I enjoyed doing. I didn't grow up thinking, "I want to be a biomedical scientist". But, I did have interviews with career officers, and biomedical science was one of the things they suggested I look into. It followed on from the A levels I did; I took Biology and Chemistry, with English and German, so I did a wide range.

When it got to applying to university, I was just looking at things that interested me. This is one of the things that jumped out. I looked into it a bit further and found out that some universities offered courses that are accredited by the Institute of Biomedical Science.

I went for one of those, because it means that you can go straight from doing your degree into a job, and you can be employed without having to do a further qualification initially.

I did my degree at Bradford University. I qualified from that in 2000 and had my job here already.

While at university, I did a summer job placement at a lab in Leeds as a medical laboratory assistant. I'd got some experience in the field. This hospital was looking for people, so they said that as long as I graduated with a good degree, they'd be happy to take me.

I started here in July 2000. You have to do at least a year's on-the-job training, filling in a portfolio of work, which is evidence-based. This covers all the basic things that you'd need to work as a biomedical scientist. That's assessed by an external person, and then you've become a biomedical scientist.

What characteristics do you need to be successful in your job?

You really have to be able to focus, no matter what's going on around you. It can be really hectic but you still have to be able to produce results. You have to be able to organise your workload so that everything gets done in the time frame that's needed.

A full blood count is one of the most common tests we do; we do up to a thousand of those a day. It's a huge number but we have instrumentation to help with such a huge volume of work. But, we look at the most abnormal samples in more detail. There can then be quite a few tests for one person.

Not everything's urgent but some things will be. We have to do some tests quickly because samples can deteriorate. It's being able to work under pressure and prioritise.

You need attention to detail. If you really focus on the job, you get so much more out of it.

We have continuing professional development, which means you need to keep on top of scientific developments.

You must be able to communicate with a wide range of people. We don't tend to meet many people face to face - our communication is generally done on the phone.

It's being able to relay information in a way that the other person will understand.

You might speak to a consultant, so you have to be able to talk to them at the level they want you to. And, you might have to speak to a hospital porter who's just dropped off a sample at our reception. They may ask you a question about where to put it and you have to be able to explain that to them. You have to be able to talk to people on a level that they're happy with.

What other jobs could you do using the skills from this job?

Optometry would be quite a good one. That's a similar sort of job but you'd be more customer-focused. You could go into clinical research. Forensic scientist is one of the more similar jobs to this one because you're more lab-based, apart from the reporting side of it.

There's also research scientist, to some extent, although the workload is slightly different and you're probably more focused on one study. Although, some of the skills, like using a pipette, calibrating, analysing, microscope work and maintenance, are transferable.

What changes will there be in the future?

We are getting lots of new technology, but that's usually to help us do our job rather than taking people away from their jobs.

Because the population's changing generally, more people are coming into the area and into the country. There's a wider range of people. The number of tests that we offer tends to increase because of this, and we'll get technology to help with those tests. Then, we need the expertise of people to do and interpret those tests.

A good example is that we've recently started doing a particular type of screening test of all new-born babies. That's because the population of the area has changed. We have to train people in this new technique, and probably similar things like that will happen over the next few years.

We're led partially by the consultants and the kind of tests they think we should be able to offer. We're quite flexible like that - we don't just train in some techniques and that's that.

What are the biggest challenges in your job?

More complex cases are challenging. You get them more often in blood transfusion, which is a particular area of haematology.

We have to be able to provide blood for patients when they need it, in what is usually an urgent situation. If there's a problem to overcome, you've got a time pressure on you. You've also got an academic issue - you've got to think of all the different things that are causing the problem you're dealing with.

Quite often you're doing this by yourself because we run our service 24 hours a day, 365 days a year. You can be by yourself, in the night, with lots of other things going on. You can be working on something that can save someone's life. It's a bit like being a detective sometimes.

And, if you can overcome those problems and provide the blood to the patient, who then survives because of it, it's a really good feeling. At the time, it can be very stressful but you're actually getting an adrenaline rush from it as well.

It's your problem and you have to deal with it, but you do it, and you think, "it wasn't so bad". You can do it again because you've done it before.

Are there many opportunities to enter this career?

It depends on local demand. There's no guarantee once you've done your degree that there will be a job waiting for you at the end of it. Saying that, we quite often do have vacancies.

We're taking part in a co-terminus training programme, where the students do their degree at the university but come to us during their holidays. They're paid for it, and their tuition fees are paid as well.

They do their training portfolio during their time here; normally you'd do that straight after your degree, over a year in employment.

Straight after doing their degree, they're also qualified. They're also training in all disciplines, they move around. Traditionally, you'd choose the discipline you wanted to follow before you worked in a hospital.

What do you like about your job?

I like the satisfaction of knowing that you've helped people, even if they don't know it themselves.

You have the satisfaction of getting a job done, whether or not you've had a busy day or a quiet day. If you really put your all into it, at the end of the day you know you've done the best that you could. You know that the test you're doing is important to somebody.

What do you dislike about your job?

People don't always appreciate what we've done. Even people within the hospital don't always realise what we're doing. For example, they might phone us at night, when there's only one person working, covering three areas of haematology: the routine lab, the coagulation lab and the blood transfusion lab (we have a bleep).

They'll ring us because they want a result for a full blood count and they'll say, "Oh, do you know what the bleep is for the blood bank person?" I'll say, "That's me actually, I'm doing everything tonight". They'll say, "Oh, are you?"

There's definitely a lack of information to help the ward staff know what we do.

There's probably loads that we don't know about them, too. They don't see us; we don't have people coming into the lab from other areas of the hospital, so you can understand why we have this situation.

We're on a level with optometry and pharmacy, which are quite a high level. If someone goes to an optician, they know what to expect. When I tell people that I'm a biomedical scientist, they find that interesting but they don't make the connection between that and going for a blood test - there isn't that link in people's minds.

The other thing that's probably not so great is that we have to provide a 24-hour service, so we have to cover Christmas Day and New Year's Eve; if you're on one of those shifts, it's not great.

What are your ambitions?

I'm a senior biomedical scientist already, so I've come on quite quickly in a short time, anyway. I'm really looking to develop my role and just make myself a better senior biomedical scientist. Maybe I'll develop my managerial skills and experience of the quality control side of things.

There are other things that people can do. You can do a specialist diploma in your chosen subject. That's like the equivalent of being a consultant but in biomedical science, so it's a high level to achieve. People usually do that when they've been in the job for quite a number of years.

What advice would you give to someone interested in your career?

Do an accredited degree in biomedical science. Make sure it's accredited!

That's caused so many problems, with people doing a biomedical science degree that's not accredited and then applying for a job as a trainee. They might still get the job, but they might find that they have to do further training, whether it's a full MSc or another year at university.

The Institute of Biomedical Science lists accredited degrees on its website.

A day in the life

9:00 am

Perform daily maintenance on full blood count analysers.

Ensure all quality control checks are within set limits for the full blood count analysers.

Use laboratory computer system to check any abnormal results.

Some of the results require further action, such as blood film analysis or glandular fever screening.

Receive several phone calls from GPs' surgeries and hospital wards for results on patients.

10:00 am

Receive bone marrow samples which have been collected at the weekly bone marrow clinic.

Two of the bone marrow samples require immunophenotyping (specialist immunology testing). This test is not offered at this hospital, so the samples are packaged according to health and safety guidelines and sent to a local teaching hospital.

10:30 am

Tea break.

10:45 am

All of the bone marrow smears are fixed and then stained with specific chemicals to highlight particular areas of the cells. The stains are prepared by mixing different chemicals together. The quality of the stain is checked before referring the bone marrow smears to the consultant haematologists to be analysed.

11:00 am

Centrifuge samples in preparation for glandular fever testing. A manual technique is used to detect antibodies to glandular fever using tiny latex beads which clump together if the antibodies are present (the test is positive).

There are twelve glandular fever tests to do, along with a positive and a negative control to make sure the test is working. Ten of the tests are negative and two of them are positive. The control samples gave the correct results; therefore the accuracy of the test is confirmed.

Load samples onto the blood film staining analyser. This piece on instrumentation helps to speed up the processing of samples by making and staining the blood films.

12:00 pm

Lunch break.

1:00 pm

Use a microscope to assess the blood films which had been made and stained during the lunch break.

The size, shape and number of the cells seen in the blood film are assessed. Theoretical knowledge is taken into account when deciding whether the changes seen in the blood film are acceptable or need further action, such as referral to a consultant haematologist.

One of the blood films is particularly abnormal and is shown to have malaria parasites in the blood cells. The patient's GP and the consultant haematologist are informed of the result. Further tests are performed to identify the type of malaria (this helps the doctors decide which treatment to give the patient).

2:00 pm

Spent some time teaching a trainee biomedical scientist.

3:00 pm

Tea break.

3:20 pm

Use the laboratory computer system to check any abnormal full blood results. One result showed that the patient was extremely anaemic (had a very low haemoglobin level). The patient's GP was informed of the result, and as a consequence the patient was admitted to hospital to receive a blood transfusion.

4:00 pm

An error occurs with the full blood count analyser, which requires manual intervention. The fault is complex and requires discussion with a colleague to diagnose the problem. The problem is solved without loss of the service to the users.

5:00 pm

The computer system is used to make sure all of the tests requested for the day have been processed. This check highlights that some of the blood films are still waiting to be assessed. This information is passed onto the biomedical scientist who is working throughout the night.

5:30 pm

Another day finished.

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