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Clinical Laboratories and Pathology Groups

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Medical Residency ‘Match Day’ Yields Rare Mother and Son Placements with Mother Matched to Pathology Program at the University of Wisconsin-Madison

It was a special and unusual moment for this mother and son duo as they applied for acceptance into residency programs and were both matched on the same day

Pathologists and other clinical laboratory scientists who underwent the matching process will be interested to learn how a mother and son were matched on the same day as part of the National Resident Matching Program (NRMP) 2023 Match Day.

Match Day is the next step for medical and medical technology students to be placed into desired training programs in chosen specialties. According to the NRMP website, pairings are determined by a mathematical algorithm to match applicants with residency positions.

Wenjing Cao, MD, PhD, and her son Hefei Liu, MD, didn’t plan to apply for residency together, but when Cao wanted to return to medicine, the pair realized they could be matched to programs at the same time, Good Morning America reported.

Cao, 54, is currently a research scientist/professor at the University of Kansas. She graduated from medical school in China and spent 10 years practicing internal medicine there before immigrating with her family to the US in 2006. Liu, 26, is finishing his oncology studies at the Medical College of Wisconsin where he expects to graduate in May.

Hefei Liu, MD and Wenjing Cao, MD, PhD

Hefei Liu, MD (left), a radiation oncology student at Medical College of Wisconsin, and his mom hematologist Wenjing Cao, MD, PhD (right), a research scientist and professor at the University of Kansas, matched residencies on the same day during the annual National Resident Matching Program 2023 Match Day. Pathologists and clinical laboratory scientists know how exciting this day can be for residency applicants. (Photo copyright: Good Morning America.)

Pair Express Their Excitement, Awe

The matching program will take the pair to different locations for their training. Cao will be headed to the clinical pathology residency program at the University of Wisconsin-Madison and Liu to the University of Pennsylvania for the radiation oncology residency program, Good Morning America noted.

“When she told me she was going to reapply this year and it was the same year I was applying, I thought, this could actually happen. Somehow it did and it’s still incredible to me,” Liu said.

Cao is also thrilled. “This is incredible and amazing, something I feel very excited about. I never thought I would go through this process with my son together,” she told Good Morning America.

National Resident Matching Program

Though this is a special and rare moment, it’s not the first time the NRMP matched a parent/child in the Main Residency Match. However, Stephanie Bartek, Senior Communications Analyst for the NRMP, told Dark Daily that the NRMP does not track whether applicants are related, so there is no way to provide odds of it occurring.

The NRMP has matched physicians to residency training programs since 1952, but in 1984 it formalized the Medical Specialties Matching Program (MSMP) which matches physicians into fellowships and subspecialty training programs.

The first fellowship match was for Colon and Rectal Surgery. Since then, the NRMP has grown the MSMP to 73 subspecialties in 20 separate fellowship Matches, according to an NRMP press release.

2023’s Matches Speak to Healthcare Growth

“The 2023 Main Residency Match proved once again to be a highly successful Match with outstanding results for participants. We were excited to see the record number of primary care positions offered in this year’s Match and how the number of positions has consistently increased over the past five years, and most importantly, the fill rate for primary care has remained steady,” said Donna L. Lamb, PhD, NRMP President and CEO, in a press release announcing the release of “Results and Data Specialties Matching Service, 2023 Appointment Year for Fellowship Matches Conducted by the NRMP’s Specialties Matching Service (SMS)” in April.

The report shows 13,919 active applicants competed for 13,365 fellowship positions offered by 5,734 programs, according to the press release.

“For the past 70 years, the NRMP has been proud to play a part in helping physicians transition into residency training and begin careers serving their patients and community,” she added.

Age is Only a Number

Cao hopes her match will impact individuals who are holding back from following their desires.

“I hope my story can inspire so many others like me, at my age, [in their] 50s, and as a mother, as a woman, as an immigrant, [anyone] can pursue their dream, as long as you want it,” she said. “It’s your dream, put hard work on it. Keep positive. Stay motivated. You can get it.”

Her son Liu mirrored her sentiment. “If you see your parents or any of your family members who are interested in pursuing medicine and they have an interest, but they clearly have some sort of obstacles in their life, you should … be supportive of them and encourage them to pursue that dream because I think with dedication, hard work, and sometimes just even luck, that you can truly achieve your success.”

With the demand for pathologists in the United States outstripping the supply, Wenjing Cao, MD, PhD, may have her pick of positions when she finishes her pathology residency program and any pathology fellowship programs she may undertake.

—Kristin Althea O’Connor

Related Information:

Mom and Son Celebrate Matching Residency Programs Together: ‘Still incredible to me’

NRMP Publishes Comprehensive Data Book for Fellowship Matches

Medical Specialties Matching Program

Results and Data Specialties Matching Service, 2023 Appointment Year for Fellowship Matches Conducted by the NRMP’s Specialties Matching Service

Great Resignation Hits Retail Pharmacies, Causing Shorter Hours, Closures

As with clinical laboratories, worker shortage is affecting large retail pharmacy chains and independent pharmacies alike

Staffing shortages in clinical laboratories and anatomic pathology groups caused by the Great Resignation is having a similar impact on retail pharmacy chains. Consequently, pharmacy chains are reducing store hours and even closing sites, according to USA Today.

As Dark Daily covered in “Clinical Laboratories Suffer During the ‘Great Resignation,” the US Bureau of Labor Statistics reported that from August 2021 through December 2021, the healthcare and social assistance workforce saw nearly 2.8 million workers quit—an average of 551,000 people during each of those months. By comparison, in December 2020, 419,000 healthcare workers left their jobs.

Pharmacies now report similar shortages in qualified workers, partly due to the sharp decrease in revenue from COVID-19 vaccinations, but also due to worker burnout. Both developments have counterparts in clinical laboratories as well.

B. Douglas Hoey, PharmD

“I’m concerned that without the help from the COVID-19 vaccinations that everyone needed, these pharmacies that were able to tough it out for another year or two might not be able to continue,” B. Douglas Hoey, PharmD, CEO of the National Community Pharmacists Association (NCPA), told USA Today. Clinical laboratories that processed large numbers of SARS-CoV-2 diagnostics have experienced the same sudden drop in revenue causing similar difficulties maintaining staffing levels. (Photo copyright: Cardinal Health.)

Staffing Shortages Leading to Safety Concerns

According to the Washington Post’s coverage of a study conducted in 2021 of 6,400 pharmacists in various retail and hospital environments, a majority did not feel they could conduct their jobs efficiently or safely.

  • “75% of the pharmacists in [the] survey disagreed with the statement ‘Sufficient time is allocated for me to safely perform patient care/clinical duties.’”
  • “71% said there were not enough pharmacists working to ‘meet patient care/clinical duties.’”
  • “65% said ‘payment for pharmacy services’ did not support their ‘ability to meet clinical and non-clinical duties.’”

“Workplace conditions have pushed many pharmacists and pharmacy teams to the brink of despair,” said the board of trustees of the American Pharmacists Association (APhA) in a press release, the Washington Post reported. “Pharmacy burnout is a significant patient safety issue. It is impacting patients today with delayed prescription fulfillment, unacceptable waits for vaccines and testing, and potential errors due to high volume, long hours, and pressure to meet performance metrics.”

This is a sentiment that has been repeated across every facet of healthcare—including in clinical laboratories—where staff shortages are being felt.

Shortage of Pharmacists or Lack of Morale?

In “Drugstores Make Slow Headway on Staffing Problems,” the Associated Press outlined from where it believes the staffing problems originate. “There isn’t a shortage of pharmacists. There’s just a shortage of pharmacists who want to work in those high-stress environments that aren’t adequately resourced,” Richard Dang, PharmD, Assistant Professor of Clinical Pharmacy at the University of Southern California (USC), told the Associated Press.

This statement is reminiscent of the views expressed by Susanna Bator, a former clinical laboratory technician, in her personal essay published in The Daily Nurse titled, “The Hidden Healthcare Heroes: A Lab Techs Journey Through the Pandemic.” She previously worked at the Cleveland Clinic and with MetroHealth System in Cleveland, Ohio.

Dark Daily covered Bator’s journey as a clinical laboratory technician working in the trenches during the COVID-19 pandemic in “Clinical Laboratory Technician Shares Personal Journey and Experience with Burnout During the COVID-19 Pandemic.”

“The pressure never let up. No matter how mind-numbing and repetitive the work could get, we had to work with constant vigilance, as there was absolutely no room for error,” Bator wrote.

“We techs were left unsupported and unmentored throughout the pandemic,” she continued. “No one cared if we were learning or growing in our job, and there was little encouragement for us to enter training or residency programs. We were just expendable foot soldiers: this is not a policy that leads to long-term job retention.”

Healthcare workers feeling burnt out and under-appreciated during the pandemic led to mass resignations that produced staffing shortages throughout the industry. It appears this trend has caught up to pharmacies as well.

Workforce Wasn’t Ready

Local and chain pharmacies played an important role in the COVID-19 pandemic. Pharmacists distributed COVID-19 tests and treatment to their communities. But for many it was a struggle to keep up.

Stefanie Ferreri, PharmD, Distinguished Professor in Pharmacy Practice and Chair of the Division of Practice Advancement and Clinical Education at University of North Carolina’s Eshelman School of Pharmacy, told the Associated Press that she felt the expanding role of pharmacies in public health was “awesome” but stated that “the workforce wasn’t quite ready” for what took place during the pandemic.

Much like Bator recounted in her essay, pharmacy workers suddenly had new responsibilities, longer working hours, and little room for error.

“There are multiple stories about pharmacists just getting overwhelmed. The stress level and burnout is high,” Dima M. Qato, PharmD, PhD, told USA Today. Qato is Hygeia Centennial Chair and Associate Professor (with tenure) in the Titus Family Department of Clinical Pharmacy at the University of Southern California. “So, pharmacists leave, and stores have to shorten” their hours, she added.

Scheduling and Patience Can Help

What can be done to soften some of the issues staff shortages are causing? Ferreri suggests that pharmacies set appointment times for regular customers so that a pharmacist’s workload can be more predictable. An appointment system can ease stress for both the pharmacist and patient. Ferreri advises customers to be patient when it comes to their prescriptions. She suggests patients give pharmacies more than a day’s notice for refills.

“I think on both sides of the counter, we need to all have grace and realize this is a very challenging and stressful time for everyone,” said Brigid Groves, PharmD, Vice President, Pharmacy Practice at the American Pharmacists Association.

With burnout, staff shortages, and stress affecting nearly every aspect of the healthcare industry, having patience with each other will go a long way to helping clinical laboratories, pharmacies, and patients navigate the road ahead.

Ashley Croce

Related Information:

Pharmacies Are Cutting Hours and Closing Stores. What It Means for Customers.

Pharmacists Are Burning Out. Patients Are Feeling the Effects.

Drugstores Make Slow Headway on Staffing Problems

The Hidden Healthcare Heroes: A Lab Techs Journey Through the Pandemic

US Hospitals Continue to Be Squeezed by Shortage of Nurses, Rising Salaries

Clinical Laboratories Suffer During the ‘Great Resignation’

Clinical Laboratory Technician Shares Personal Journey and Experience with Burnout During the COVID-19 Pandemic

Salary Rates for Travel Nurses Remain Strikingly High, Spurring States to Lobby Against Alleged Price Gouging by Staffing Agencies

Proposed regulation to limit rate increases during health crises gets pushback from staffing agencies and travel nurses who disagree with salary restrictions

Hospitals across the nation are seeking relief from skyrocketing costs due to increased demand for temporary workers—especially travel nurses. This has led organizations like the American Hospital Association (AHA) to step in and call for legislators to cap spiking salary rates. Many clinical laboratories report similar increases in salaries following the outbreak of SARS-CoV-2 for medical technologists (MTs), clinical laboratory scientists (CLSs), histologists, and other skilled positions. This increase in salaries of lab scientists was mirrored by an even greater increase in the cost of travel MTs.

According to analysis conducted by Becker’s Hospital Review of hiring data from Vivian Health, an online job placement website for healthcare professionals, “Average weekly travel nurse pay climbed from $1,896 in January 2020 to $3,782 in December 2021, a 99.47% increase.”

A prior study by Kaufman Hall and Associates, LLC., found rates for temporary workers almost 500% higher than pre-pandemic times. While numbers are trending downward, it’s clear that rates are still high enough to cause alarm, KFF Health News reported.

Dave Dillon

“During the pandemic there were staffing companies who were making a lot of promises and not necessarily delivering,” Dave Dillon (above), VP of Public and Media Relations at Missouri Hospital Association, told KFF Health News. “It created an opportunity for both profiteering and for bad actors to be able to play in that space.” (Photo copyright: L.G. Patterson/Missouri Hospital Association.)

AHA Alleges Price Gouging

Demand for temporary healthcare workers surged during the COVID-19 pandemic, and, because supply was limited, salaries for temporary workers—such as travel nurses—soared as well. This dramatic increase in hospitals’ costs prompted the AHA in 2021 to send a letter to the Federal Trade Commission seeking relief for healthcare providers from what the organization called “anticompetitive pricing by nurse-staffing agencies.”

In January 2022, about 200 House members urged then White House COVID-19 Response Team Coordinator Jeffrey Zients “to investigate reports that nurse staffing agencies are taking advantage of the COVID-19 pandemic to increase their profits at the expense of patients and the hospitals that treat them,” an AHA new release noted.

In an AHA House Statement titled, “Pandemic Profiteers: Legislation to Stop Corporate Price Gouging,” the AHA wrote “Our concerns range from potential collusion to increased prices way beyond competitive levels and/or egregious price gouging and the impact these behaviors could have on efforts to care for patients and communities.”

Temporary nurses make up a large portion of staff nationwide with 1,760,111 employed nationally as of September, according to Zippia research. With some nurses commandeering $40,000 signing bonuses and pay rates up to $10,000 a week for ICU nurses during the height of the COVID-19 pandemic, the significant impact of these rate hikes cannot be ignored.

“We have received reports that the nurse staffing agencies are vastly inflating price by two, three, or more times pre-pandemic rates, and then taking 40% or more of the amount being charged to the hospitals for themselves as profits. This situation is urgent and reliance on temporary workers caused normal staffing costs to balloon in all areas of the country,” Representatives Peter Welch, D-VT, and Morgan Griffith, R-VA, wrote in the letter submitted by the AHA to House members.

States Take a Stand

But nothing was done at the federal level to cap rates for travel nurses, so hospital organizations in 14 states lobbied legislators to cap rates at the local level. However, this has proven to be problematic.

At this time, at least 14 states have proposed legislation that impose limits on what temp nursing services can charge and what stipulations they must follow during a crisis. Navigating this patchwork of state laws could be challenging for both hospitals and temporary nurses.

Some states are taking sterner measures, KFF Health News reported:

  • Missouri regulators proposed legislation that would allow felony charges to be brought against healthcare staffing agencies that raise prices during emergencies.
  • Texas lawmakers proposed legislation that would administer civil penalties against agency price-gouging—laws which the state does not have on the books at all—and also would allow fees up to $10,000 to be assessed per violation of the proposed law.
  • New York proposed amendments to legislation that would cap the amount temporary staffing agencies could charge.

Nurses, Staffing Agencies Tell Their Side

The implementation of new laws to protect hospitals from alleged temp agency price gouging presents new challenges. One issue is state-to-state competition.

“It might become difficult to hire travel nurses, and some states could face a lower-quality hiring pool during a national crises if the neighboring state doesn’t have strict measures,” Hannah Neprash, PhD, Assistant Professor, Division of Health Policy and Management at the University of Minnesota, told KFF Health News.

And financial handcuffs may not sit well with staffing agencies that feel misunderstood by hospital organizations pushing for regulation. According to KFF Health News, “Typically about 75% of the price charged by a staffing agency to a healthcare facility goes to costs such as salary, payroll taxes, workers’ compensation programs, unemployment insurance, recruiting, training, certification, and credential verification, said Toby Malara, a Vice President at the American Staffing Association trade group.”

Malara added, “hospital executives have, ‘without understanding how a staffing firm works,’ wrongly assumed price gouging has been occurring. In fact, he said many of his trade group’s members reported decreased profits during the pandemic because of the high compensation nurses were able to command,” KFF Health News reported.

Not surprisingly, many nurses have also come out against government regulation of their wages.

“Imagine the government attempting to dictate how much a lawyer, electrician, or plumber would make in Missouri. This would never be allowed, yet this is exactly what’s happening right now to nurses,” Theresa Newbanks, FNP, a nurse practitioner who is affiliated with several hospitals in multiple states.

Creative Responses Required

Increases in both rates and legislation continue to spur creativity among hospitals needing to fill shifts, support staff, and prevent worker burnout.

The American Hospital Association December 2022 Task Force noted this in their “Creative Staffing Models” paper. The AHA cited telehealth visits, technical support, and working with non-traditional partners as beneficial ideas. These were also noted as meaningful ways to recruit and retain staff.

Other hospital systems have even created their own staffing agencies. Allegheny Health Network (AHN) developed a variety of systems where nurses can work a single weeklong assignment, multiple-week assignments, or transfer to other facilities, Kaiser Health News reported. While these staffing scenarios make up a small percentage of the hospital staff, it’s a worthwhile addition to increase options for nurses.

Staff turnover for RNs increased from 8.4% to 27.1% last year, as reported by the 2022 NSI National Healthcare Retention and RN Staffing Report. Finding solutions to staffing shortages—and consequently increased temporary nursing cost—is crucial because burnout is still a problem, just as it is in clinical laboratories and pathology groups.

—Kristin Althea O’Connor

Related Information:

Temp Nursing Cost Hospitals Big During Pandemic, Now Hospitals Mulling Limits

White House Urged to Investigate Price Gouging by Nursing Staffing Agencies

AHA House Statement: Pandemic Profiteers: Legislation to Stop Corporate Price Gouging

AG Campbell Issues Advisory on Maximum Rates for Temporary Staffing in Nursing Homes

Attorney General’s Advisory: Rates for Temporary Nursing Services Charged to Long- Term Care Facilities

Agency Nurse Demographics and Statistics in the US

Move Over Gen Xers and Boomers! This is the Year Radiology Matches Its First Class of Generation Z Residents

It’s not just radiology. Gen Z residents will be matching in pathology and other specialties, and that means clinical laboratories should be ready to adapt their recruiting and training to Gen Z’s unique characteristics

It’s a big event in medical schools across the nation when it is time for residency programs to match residency candidates with first-year and second-year post-graduate training positions. But this year has a special twist because—for example in radiology—this is the first class of Generation Z (Gen Z) residency candidates to be matched with radiology residency programs.

The arrival of the newest generation to progress through medical school and into residency was the topic of a Viewpoint story in the American Journal of Roentgenology (AJR) titled, “Generation Z and the Radiology Workforce: Ready or Not, Here I Come.”  

In their abstract, the authors wrote, “This year, the radiology community will experience the beginning of a generational change by matching its first class of Generation Z residents. To best welcome and embrace the changing face of the radiology workforce, this Viewpoint highlights the values that this next generation will bring, how radiologists can improve the way they teach the next generation, and the positive impact that Generation Z will have on the specialty and the way radiologists care for patients.”

Members of Gen Z are now entering the workforce in large numbers. To recruit high-quality candidates from this generation, healthcare employers—including clinical laboratories and pathology practices—may have to adapt the way they interact with and train these individuals. 

Gen Z is generally described as individuals who were born between 1995 and 2012. Also known as “Zoomers,” the demographic comprises approximately 25% of the current population of the United States. They are extremely diverse, tend to be very socially conscious, and can easily adapt to rapid changes in communications and education, according to the AJR paper.

Although the paper deals with radiology, this type of information can also be valuable to clinical laboratories as Gen Z pathologists are poised to enter clinical practice in growing numbers. This marks the beginning of the professional laboratory careers of Zoomers, while Millennials move up into higher levels of lab management, the oldest Gen Xers near retirement age, and Baby Boomers retire out of the profession.

Paul McDonald

“Gen Z employees bring unique values, expectations, and perspectives to their jobs,” said Paul McDonald (above), Senior Executive Director at staffing firm Robert Half in a news release. “They’ve grown up in economically turbulent times, and many of their characteristics and motivations reflect that.” Thus, clinical laboratories may have to develop methods for recruiting and training Gen Z staff that match the unique characteristics of Gen Z candidates. (Photo copyright: LinkedIn.)

Zoomers Like Digital and Artificial Intelligence Technology

One of the most unique aspects of Gen Z is that they have never lived in a world without the Internet and have little memory of life without smartphones. Zoomers grew up totally immersed in digital technology and tend to be comfortable using digital tools in their everyday life and in the workplace. They lean towards being very open to artificial intelligence (AI) and how it can assist humans in analysis and diagnostic methods.

“This group of professionals has grown up with technology available to them around the clock and is accustomed to constant learning,” said Paul McDonald, Senior Executive Director at staffing firm Robert Half in a news release. “Companies with a solid understanding of this generation’s values and preferences will be well prepared to create work environments that attract a new generation of employees and maximize their potential.”

According to the AJR paper, Zoomers learn best by doing, so employers should concentrate on interactive learning opportunities, such as simulations, virtual reality, and case-based methods for teaching the aspects of the job. They are likely to expect digital and blended resources as well as traditional approaches to learning their new job responsibilities.

The paper goes on to state that Gen Z members value diversity, equity, inclusivity, sustainability, civic engagement, and organizational transparency. Their social consciousness and diversity may yield a greater range of perspectives and problem-solving approaches which may bolster their sensitivity to patient-centered care.

“The oldest in Gen Z have already seen a recession and a war on terrorism. They’ve seen politics at its worst. And now they’ve seen a global pandemic and are about to see recession again,” said David Stillman, founder of GenGuru, a boutique management consulting firm that provides insights on how best to connect with Baby Boomers, Generation X, Millennials, and Gen Z, in an interview with the Society for Human Resource Management (SHRM). “They are survivors,” he added.

According to the SHRM, “Stillman says Millennials, who preceded Generation Z, were coddled by their parents. He maintains that Generation Z’s parents were more truthful, telling their offspring, ‘You’re going to have a really tough time out there, you have to work super hard,’ which he says created ‘the most competitive generation in the workforce since the Baby Boomers.’”

Gen Z Wants More than a Paycheck, They Want Purpose

The American Journal of Roentgenology paper also states that Gen Z members grew up in a rapidly changing world and tend to be resilient, adaptable, and flexible. They have experienced and witnessed many stressors and navigate these issues by focusing on mental health and a meaningful work-life balance. With respect to a profession, they are searching for more than just a paycheck, and they want a purposeful career where they feel a sense of belonging. 

In “Helping Gen Z Employees Find Their Place at Work,” the Harvard Business Review offered the following advice for employers to help Gen Z employees thrive at work:

  • Increase information sharing and transparency to help alleviate fear and anxiety.
  • Incentivize them by showing them clear paths to career progression.
  • Make sure they know how their individual contributions matter to the organization.
  • Motivate them by giving them room for autonomy and experimentation.
  • Provide specific and constructive feedback.
  • Harness community and in-person interactions to boost professional collaborations.
  • Prioritize wellness and mental health.

“Be prepared to spend time with them face to face,” McDonald stated. “They want to be mentored and coached. If you coach them, you’re going to retain them.”

Preparing to Attract Gen Z to Clinical Laboratories

As Generation Z comes of age, more of them will be working in the medical professions. Clinical laboratories and anatomic pathology groups would be well advised to prepare their businesses by adjusting leadership, adapting recruiting efforts, and shifting marketing to attract Zoomers and remain relevant and successful in the future.

In, “Generation Z Will Soon be Looking for Employment Opportunities in Clinical Laboratories and Anatomic Pathology Groups,” Dark Daily covered how this newest, youngest generation brings unique attributes and values to the clinical laboratory industry. Laboratory managers, pathologists, and business leaders need to understand those characteristics to work with them effectively.

Although sweeping statements about individual generations may be limiting, understanding their unique insights, values, and backgrounds can be helpful in the workplace. With a large amount of Gen Z workers now transitioning from college into careers, it will be beneficial for clinical laboratory managers to recognize their unique characteristics to recruit and maintain talented workers more effectively.

—JP Schlingman

Related Information:

Generation Z and the Radiology Workforce: Ready or Not, Here I Come

Understanding Generation Z in the Workplace

Helping Gen Z Employees Find Their Place at Work

Generation Disconnected: Data on Gen Z in the Workplace

Stressed, Indebted and Idealistic, Generation Z Pushed Further into the Workforce

Generation Z: Five Surprising Insights

Generation Z Will Soon Be Looking for Employment Opportunities in Clinical Laboratories and Anatomic Pathology Groups

Understanding Generation Z in the Workplace

US Hospitals Continue to Be Squeezed by Shortage of Nurses, Rising Salaries

It is more than a shortage of nurses, as most clinical laboratories report the same shortages of medical technologists and increased labor costs

Just as hospital-based clinical laboratories are unable to hire and retain adequate numbers of medical technologists (MTs) and clinical laboratory scientists (CLSs), the nursing shortage is also acute. Compounding the challenge of staffing nurses is the rapid rise in the salaries of nurses because hospitals need nurses to keep their emergency departments, operating rooms, and other services open and treating patients while also generating revenue.

The nursing shortage has been blamed on burnout due to the COVID-19 pandemic, but nurses also report consistently deteriorating conditions and say they feel undervalued and under-appreciated, according to Michigan Advance, which recently covered an averted strike by nurses at 118-bed acute care McLaren Central Hospital in Mt. Pleasant and 97-bed teaching hospital MyMichigan Medical Center Alma, both in Central Michigan.

“Nurses are leaving the bedside because the conditions that hospital corporations are creating are unbearable. The more nurses leave, the worse it becomes. This was a problem before the pandemic, and the situation has only deteriorated over the last three years,” said Jamie Brown, RN, President of the Michigan Nurses Association (MNA) and a critical care nurse at Ascension Borgess Hospital in Kalamazoo, Michigan Advance reported.

Jamie Brown, RN

“The staffing crisis will never be adequately addressed until working conditions at hospitals are improved,” said Jamie Brown, RN (above), President of the Michigan Nurses Association in a press release. Brown’s statement correlates with claims by laboratory technicians about working conditions in clinical laboratories all over the country that are experiencing similar shortages of critical staff. (Photo copyright: Michigan Nurses Association.)

Nurse Understaffing Dangerous to Patients

In the lead up to the Michigan nurses’ strike, NPR reported on a poll conducted by market research firm Emma White Research LLC on behalf of the MNA that found 42% of nurses surveyed claimed “they know of a patient death due to nurses being assigned too many patients.” The same poll in 2016 found only 22% of nurses making the same claim.

And yet, according to an MNA news release, “There is no law that sets safe RN-to-patient ratios in hospitals, leading to RNs having too many patients at one time too often. This puts patients in danger and drives nurses out of the profession.”

Other survey findings noted in the Emma White Research memo to NPR include:

  • Seven in 10 RNs working in direct care say they are assigned an unsafe patient load in half or more of their shifts.
  • Over nine in 10 RNs say requiring nurses to care for too many patients at once is affecting the quality of patient care.
  • Requiring set nurse-to-patient ratios could also make a difference in retention and in returning qualified nurses to the field.

According to NPR, “Nurses across the state say dangerous levels of understaffing are becoming the norm, even though hospitals are no longer overwhelmed by COVID-19 patients.”

Thus, nursing organizations in Michigan, and the legislators who support change, have proposed the Safe Patient Care Act which sets out to “to increase patient safety in Michigan hospitals by establishing minimum nurse staffing levels, limiting mandatory overtime for RNs, and adding transparency,” according to an MNA news release.

Huge Increase in Nursing Costs

Another pressure on hospitals is the rise in the cost of replacing nurses with temporary or travel nurses to maintain adequate staffing levels.

In “Hospital Temporary Labor Costs: a Staggering $1.52 Billion in FY2022,” the Massachusetts Health and Hospital Association noted that “To fill gaps in staffing, hospitals hire registered nurses and other staff through ‘traveler’ agencies. Traveler workers, especially RNs in high demand, command higher hourly wages—at least two or three times more than what an on-staff clinician would earn. Many often receive signing bonuses. In Fiscal Year 2019, [Massachusetts] hospitals spent $204 million on temporary staff. In FY2022, they spent $1.52 billion—a 610% increase. According to the MHA survey, approximately 77% of the $1.52 billion went to hiring temporary RNs.”

It’s likely this same scenario is playing out in hospitals all across America.

Are Nursing Strikes a Symptom of a Larger Healthcare Problem?

In “Nurses on Strike Are Just the Tip of the Iceberg. The Care Worker Shortage Is About to Touch Every Corner of the US Economy,” Fortune reported that nationally the US is facing a shortage of more than 200,000 nurses.

“But the problem is much bigger,” Fortune wrote. “Care workers—physicians, home health aides, early childhood care workers, physician assistants, and more—face critical challenges as a result of America’s immense care gap that may soon touch every corner of the American economy.”

Clinical laboratories are experiencing the same shortages of critical staff due in large part to the same workplace issues affecting nurses. Dark Daily covered this growing crisis in several ebriefings.

In “Forbes Senior Contributor Covers Reasons for Growing Staff Shortages at Medical Laboratories and Possible Solutions,” we covered an article written by infectious disease expert Judy Stone, MD, in which she noted that factors contributing to the shortage of medical technologists and other clinical laboratory scientists include limited training programs in clinical laboratory science, pay disparity, and staff retention.

We also covered in that ebrief how the so-called “Great Resignation” caused by the COVID-19 pandemic has had a severe impact on clinical laboratory staffs, creating shortages of pathologists as well as of medical technologists, medical laboratory technicians, and other lab scientists who are vital to the nation’s network of clinical laboratories.

And in “Clinical Laboratory Technician Shares Personal Journey and Experience with Burnout During the COVID-19 Pandemic,” we reported on the personal story of Suzanna Bator, a former laboratory technician with the Cleveland Clinic and with MetroHealth System in Cleveland, Ohio. Bator shared her experiences in an essay for Daily Nurse that took a personalized, human look at the strain clinical laboratory technicians were put under during the SARS-CoV-2 pandemic. Her story presents the quandary of how to keep these critical frontline healthcare workers from experiencing burnout and leaving the field.

Did Experts See the Shortages Coming?

Hospitals across the United States—and in the UK, according to Reuters—are facing worker strikes, staff shortages, rising costs, and uncertainty about the future. Just like clinical laboratories and other segments of the healthcare industry, worker burnout and exhaustion in the wake of the COVID-19 pandemic are being cited as culprits for these woes.

But was it predictable and could it have been avoided?

“One of the big things to clear up for the public is that … we saw the writing on the wall that vacancies were going to be a problem for us, before the pandemic hit our shores,” Christopher Friese, PhD, professor of Nursing and Health Management Policy at the University of Michigan (UM), told NPR. Friese is also Director of the Center for Improving Patient and Population Health at UM.

Effects of the COVID-19 pandemic, and staffing shortages exasperated by it, will be felt by clinical laboratories, pathology groups, and the healthcare industry in general for years to come. Creative solutions must be employed to avoid more staff shortages and increase employee retention and recruitment.

Ashley Croce

Related Information:

Amid Burnout and Exhaustion, Nurses at Two Mid-Michigan Hospitals OK New Contracts

‘Everyone Is Exhausted and Burned Out’: McLaren Central Nurses Authorize Potential Strike

New Poll Shows a Nurse-to-Patient Ratio Law Could Be Key to Addressing Staffing Crisis

42% of Michigan Nurses Say High Patient Load Led to Deaths

Michigan Nurses Report More Patients Dying Due to Understaffing, Poll Finds

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US News and World Report Ranks Clinical Laboratory Technician 17th Best Healthcare Support Job

High demand for medical laboratory technicians that exists throughout the country motivates some colleges to create training programs to meet this need

Clinical laboratory technicians will be interested to learn that US News and World Report (USNWR) recently ranked their work the 17th Best Healthcare Support Job and 86th of 100 in the magazine’s list of Best Jobs in 2023. The position also ranked “average” in upward mobility and flexibility, but “above average” in stress level. This squares with Dark Daily’s previous reporting on high levels of stress clinical laboratories are still experiencing following the SARS-CoV-2 pandemic.

The median pay, according to USNWR, is $57,800/year and can be as high as $74,530/year. The best paying cities for clinical laboratory technicians are all in California: Redding, Napa, Merced, San Jose, and San Francisco. And the best paying states are New York ($72,500), Rhode Island ($70,580), Connecticut ($70,220), Oregon ($69,330), and California ($68,450).

In comparison to similar jobs in healthcare, clinical laboratory technician earnings exceed Medical Records Technicians, but come in lower than MRI Technologists, Radiologic Technologists, and Cardiovascular Technologists, USNWR noted.

The US Bureau of Labor Statistics, a division of the US Department of Labor, projects the clinical laboratory technician position will grow by 7% between 2021-2031.

Salary graphic

The graphic above, taken from the US News and World Report’s list of “Best Healthcare Support Jobs in 2023,” illustrates how the base salary for clinical laboratory technicians has risen over the past 10 years. Projections are positive for earnings and availability of clinical laboratory positions continuing to grow around the nation. (Graphic copyright: US News and World Report.)

Clinical Laboratory Technician a Growing Profession

The US News and World Report’s definition of this job drew heavily on the US Bureau of Labor Statistics’ Occupational Outlook Handbook for its description of the position “Clinical Laboratory Technician.” The Labor Department clearly defines the difference between a clinical laboratory “technician” and “technologist” and USNWR carried that over into its analysis.

Accordingly, USNWR described this job category by stating “Clinical laboratory technicians are responsible for a number of tasks, including examining body fluids and cells and matching blood for transfusions. The job requires the use of sophisticated laboratory equipment, such as microscopes and cell counters. With continued advancements in technology, lab work has become more analytical, so laboratory personnel should have excellent judgment skills. More complex procedures are reserved for clinical laboratory technologists, who must possess a bachelor’s degree. Technicians, who must hold at least an associate degree, often work under the supervision of technologists.”

Demand for clinical laboratory technicians spans the country and appears to be increasing.

In “Filling Another Labor Gap; Medical Labs,” the Quad-City Times reports that the Trinity College of Nursing and Health Sciences in Rock Island, Illinois, has unveiled a new program to meet that need: the Medical Laboratory Science Program.

The program is the result of a local hospital querying Trinity College about implementing just a program.

“It’s been about a year and a half now, getting it up and rolling,” Stephanie Tieso, MS, MLS(ASCP)CM, Program Director Med Lab Sciences, Trinity College, told Quad-City Times. “I know both big hospital systems in the area are very excited about this coming on, and there’s definitely chatter in the lab community about this new program opening.”

Trinity’s program will be the only one of its kind within a 90-mile radius. The initial cohort will consist of 10 students. The Quad-City Times reports “Program majors will earn a Bachelor of Health Sciences degree and qualify to take the MLS certification exam upon program completion and graduation.”

The creation of this program at Trinity College of Nursing and Health Sciences is just one example of programs that could be needed all over the US in the coming years as demand for clinical laboratory workers grows.

Job Outlook Good but Burnout a Possibility

The US Bureau of Labor Statistics’ Occupational Outlook Handbook states, “About 25,600 openings for clinical laboratory technologists and technicians are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.” However, the shortage may also be due to the well-reported worker burnout being experienced across the entire healthcare industry which was exacerbated by the SARS-CoV-2 pandemic.

As Dark Daily reported in “Clinical Laboratory Technician Shares Personal Journey and Experience with Burnout During the COVID-19 Pandemic,” burnout in healthcare is a constant problem, especially in overstressed clinical laboratories and anatomic pathology groups.

This ebrief follows the story of Susanna Bator, a former clinical laboratory technician with the Cleveland Clinic and with MetroHealth System in Cleveland, Ohio. Bator shared her story of working in various laboratories during the coronavirus pandemic in an essay she wrote for Daily Nurse titled, “The Hidden Healthcare Heroes: A Lab Tech’s Journey Through the Pandemic.” Bator’s essay is a personalized, human look at the strain clinical laboratory technicians were put under during the pandemic. Her story presents the quandary of how to keep these critical frontline healthcare workers from experiencing burnout and leaving the field.

“We techs were left unsupported and unmentored throughout the pandemic. No one cared if we were learning or growing in our job, and there was little encouragement for us to enter training or residency programs. We were just expendable foot soldiers: this is not a policy that leads to long-term job retention,” she wrote.

This validates US News and World Report’s statistic that the work of clinical laboratory technicians comes with an “above average” level of stress. For those who can handle it, however, the job has many benefits and provides multiple opportunities for growth.

But the burnout Bator and other techs encountered is very real. Hopefully more training programs like the one at Trinity College will become available to provide the learning and support lab techs need as we move into post-pandemic healthcare. As the US News and World Report article shows, clinical laboratory technicians are filling a critical need in the laboratory industry and new training programs will be instrumental to their success.

Ashley Croce

Related Information:

Best Health Care Support Jobs

What is a Clinical Laboratory Technician?

The Mental Health of Healthcare Workers in COVID-19

Clinical Laboratory Technologists and Technicians

Filling Another Labor Gap; Medical Labs

Clinical Laboratory Technician Shares Personal Journey and Experience with Burnout During the COVID-19 Pandemic

The Hidden Healthcare Heroes: A Lab Techs Journey Through the Pandemic

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