Volume 40 Number 1 | February 2026
Summary
A new medical laboratory technician describes the shock of transitioning from supervised student work to making independent, high‑stakes clinical decisions. Initially overwhelmed by the responsibility, she gains confidence through mentorship and trust from colleagues. The article highlights the emotional weight of becoming a “hidden clinician” and the growth that comes with embracing that responsibility.
Eleanor Guhl, MLT(ASCP), ASCLS Developing Professionals Forum Vice Chair
The second my job title was officially changed in the laboratory information system (LIS), I felt all my hard work was about to pay off. I had spent the better part of two years trying to absorb all the information I could from my teachers, course material, and clinical hours, and I walked in feeling ready. Although the plan was to make me a generalist, the first area of the lab I was assigned was hematology. Perfect. I had looked at thousands of cells between school and clinical, and I radiated confidence. Training flew by; I almost found it dull going through slides I’d already mastered. I passed my competencies with ease, exactly how I’d imagined, and six weeks later, I was officially signed off. I clocked in at work and sat down for my first shift as a new, fully-fledged medical laboratory technician.
It didn’t take long before I got my first flag; nothing special, but it did require a manual differential. I made the smear, stained it, and eagerly popped it under the microscope. Cell by cell passed under my lenses, and slowly a dreaded feeling came over me. I was alone. Not physically, the lab was bustling as usual. I was alone in my decisions and my calls. All at once, I suddenly realized the weight of my work. Even with all the practice and resources, every cell looked unfamiliar. I realized too quickly how much my judgment would affect this patient’s life. The pressure felt almost paralyzing.
“Now that I’m in a real clinical lab, there are no ‘knowns.’ Every specimen could be a first-time cancer patient or a critically low hemoglobin level. My work no longer carried a grade; it carried a life.”
In school, we repeat these procedures endlessly, and although every lab is different, the core skills stay the same. Most samples were taken directly from healthy peers with playful aliases. Abnormal blood was clearly labeled, and you knew what to expect. After every test and every lab, my work was checked. If I messed up, the only thing that would suffer is my grade. Now that I’m in a real clinical lab, there are no “knowns.” Every specimen could be a first-time cancer patient or a critically low hemoglobin level. My work no longer carried a grade; it carried a life.
It was only through the support of my fellow medical laboratory professionals that I was able to build the confidence I so desperately needed. I would sit there forever trying to decide whether one cell met the criteria for abnormal, and even after all that time, I still lifted my head for reassurance. My mentors always knew what I was going to ask. I had been conditioned through years of schooling to rely on second eyes to make my final decision. Although it would have only taken my mentor a moment to check, he said something to me I remember even now, “I don’t need to look, I trust you.” All at once, I realized something: the only thing holding me back is me. My mind flipped through all the times I had asked for a second opinion, and every time, the senior technician agreed. It reaffirmed it wasn’t the skill I was lacking; it was the confidence.
That first shift taught me the hardest part about becoming a new technician isn’t the science—it’s stepping into the role of the “hidden clinician.” As a new professional, I learned that our job is more than mastering procedures; it’s about taking on the weight that our decisions matter. I know every new laboratorian has faced some version of that moment. The fear is that one wrong move could cause harm or misdiagnosis. When faced with the anxieties of our impact, we need to build trust within ourselves.
Beyond the steep learning curve, the impact of transitioning from school into this role becomes unmistakable. It’s not wrong to feel overwhelmed; on the contrary, I believe it’s healthy. I would be more worried if new technicians didn’t care how vital their job is to the lab. If you are feeling this pressure, know that with time and support, that feeling will subside. Your confidence will grow, and with that, your pride in what you do.
Eleanor Guhl is a CLS at SSM St Mary’s Hospital in Madison, Wisconsin.