Volume 36 Number 1 | February 2022

Stacey Robinson, MS, MLS(ASCP)CMSH, SCYM, ASCLS Region II Director

Laboratory StaffWhen I think about diversity, equity, and inclusion, I immediately think about the laboratory that I work in. We are a truly diverse group. Even though we are all U.S. citizens, we are from Nepal, South Korea, Nigeria, the Philippines, China, Iran, India, Antigua, several other countries, and the United States. This level of diversity creates the type of environment where I feel most comfortable.

I was born here, but I am third culture. I was raised in three different countries, and I have worked in American laboratories in four countries. Everyone here is different, and in that way, we are all the same. To describe the section that I supervise a little further, we are 59.3 percent (16) men, 40.7 percent (11) women, 59.3 percent MLS level, 40.7 percent MLT level, 29.7 percent military, and 40.7 percent within their first five years in the field. I couldn’t tell you how we came to be this diverse, but I love it and it works!

“Having a diverse staff increases creativity in problem solving. Many have seen different and sometimes better ways of doing things.”

One of the obvious advantages is scheduling. We don’t all care about the same holidays. Sure, everyone enjoys a paid day off, but extra pay for a holiday that you don’t celebrate can be nice, too. I don’t always know when important holidays are for cultures other than my own, but I do my best to respect them. The New Year can be in February, March, April, or October, and given enough notice, I will do my best to give time off around them without requiring anyone to take vacation. A lot of times these are the same people who are willing to fill in on January 1. We also have a good mix of folks who take short leaves throughout the year and those who work for long stretches without a break to save their vacation for a month-long trip home.

For equity, we have put process controls in place. To ensure fairness in hiring, we control for individual bias by using a panel to review resumes and interview. We document and are prepared to justify our choices based on qualifications, certification, and experience. During interviews, we use the exact same set of questions for each applicant. Difficult accents and variations in terminology may mean that we sometimes have to rephrase, repeat, or redirect questions, but we have gotten pretty adept at trying to get at what we need to know without giving away the answers. Each question has a list of expected responses with associated point values. Our panel discusses each question where there is more than a one-point difference in scoring. Selections are based on the final overall scores. Towards the end of each interview, we give the applicant some background on the facility, benefits, and the level of diversity that they can expect to encounter.

Once new employees are on-board, we have a responsibility to treat them fairly, offer equal opportunities for development, and ensure that all employees are all held to the same standards. We have standardized pay, vacation and sick time accrual, and position descriptions. For evaluations, each group (MLS, lead, MLT, supervisors) has standardized performance objectives. When I look at a staff member’s performance or behavior, I must always take culture into consideration. Consideration of their cultural background effects how I approach them and how I interpret their responses, but it can never dictate what opportunities they are given.

For example, in bone marrow processing, the staff assisting the procedure are expected to evaluate the quality of the sample immediately after collection. If there are no spicules or the core is mostly cortical bone, they need to be able to tell the provider while the sample can still be recollected. If a woman from a culture where women tend to be very deferential, and who displays those behaviors, wants to train to assist bone marrows, I can’t deny her that opportunity based on the belief that she won’t speak up to the provider. The risk that staff will not speak up when needed is the same as that for the laboratorian/doctor or the enlisted/officer dynamics.

While those processes are helpful, they don’t cover all nuances, and I have at times found that I didn’t see something important. For example, I sat on an interview panel for a lead tech position. We intentionally made the questions difficult and included tasks that we knew were beyond the expectations of daily bench work: Did they know how to investigate proficiency testing failures? What do they know about performance improvement? Can they tell us about test validation/verification? The biggest thing that I learned from sitting on that panel was that I needed to do a better job of developing the people on my team. They didn’t know the things that I thought they should.

There could be a lot of reasons for that. Is it cultural? Are they not comfortable approaching a female boss for career advice? Did I interpret the laid-back affect as not ambitious? Did I assume the older staff member already knew this stuff? Or that they were winding down for retirement? Did I assume that the younger staff member was not ready and left them out? I have spent a lot of time considering this. It was my job to ensure that they all had the opportunities they needed to develop these skills.

I have always tried to be fair about training opportunities for specialty benches and analyzer schools, but I have learned to be just as careful about the extra duties I hand out. They are career development opportunities, and I present them that way. When a new piece of equipment comes along, I offer everyone the opportunity to volunteer to help work on it. I have had a relatively new MLT ask to write the SOP. I gave them a template, suggestions, and feedback when they were ready for it. For validations, I make time for that staff member to work with the vendor to learn the new instrument and perform and assist with the precision studies and method comparisons. Being involved in the process helps them become more proficient with it and gives us a subject matter expert out on the bench.

Another thing that I like to do is assign everyone five or six questions from the CAP checklist when we are preparing for inspection. They link them to the appropriate sections of the procedures and upload current examples. It’s important that they understand these requirements and where they come from and see what we do to meet them. It benefits all of us to have a more competent and capable staff. I also take survey results back to the performing staff member, show them the statistics that I am looking for, and if there are any unacceptable responses, I will get them started on the initial investigation.

I hope that all employees feel included and that they belong. I think spontaneous multicultural potlucks are a really good sign, but unfortunately those have been on hold for the pandemic. Having a diverse staff increases creativity in problem solving. Many have seen different and sometimes better ways of doing things. Their suggestions are appreciated, and many are implemented. We try to recognize and celebrate their efforts at a department level or higher. I would like to see them all apply for lead and supervisor positions in the future, and I want them to be well prepared.

Stacey Robinson is a Clinical Microscopy Supervisor in Bethesda, Maryland.