Week Two at Thomas Memorial Hospital

Grossing at Thomas Memorial has continued to go smoothly. I have become much more accustomed to the voice-recording style of dictation than using the voice-recognition software CoPath. It seems that on some computer systems, CoPath just makes so many mistakes that I spend a considerable amount of time correcting the spelling and grammar mistakes instead of doing what's really important, that is, grossing and gaining more experience.

Especially, when it comes to dictating biopsies, I have found that speaking into the voice recorder saves me about half the normal time. As with all surgical pathology laboratories, biopsies make up a significant portion of the specimens that are processed. That doesn't make doing them any less important, however their simplicity often means that speed, rather than detail, becomes the focus point of the gross. (Hey, laboratories need to make money to run, too.) Of course, as with all specimens, completeness of the gross is absolutely necessary and I make sure to pick up every little piece of tissue found in the containers. I also make sure that my instruments are clean between each specimen. Now that I have gotten used to processing large volumes of biopsies, I am challenging myself to increase my speed even faster. I would never take a short cut to improperly decrease my time, such as not inking a resection margin on a polyp, but I look for other ways that I can take. Questions such as the following help to challenge me in improving my dexterity and decrease my processing time while still retaining my accuracy.
-"How fast can I say the sentences while still allowing the transcriptionists to understand me?"
-"How can I arrange my table so that I have to make the least amount of hand movements?"
-"Which materials should I use (plastic bag vs. empty container) to most quickly and efficiently gather endometrial curettage tissue?"
-"Should I ink a specimen using the applicator stick blot-by-blot or use a sponge?"
Now that I think about it, the grossing bench has a very feng shui feel to it. Every tool, every material, every container has it's proper and individual place. When one is out of place, the whole grossing process becomes sluggish and delayed. When the grosser is looking for a misplaced pen or reaches with their left hand to instinctively grab a forcep on the right side of the bench, the bench is out of harmony. I am sure that Confucius would be proud of me.

I am always trying to find ways to improve my grossing abilities and I'm really glad that this program at WVU gives us that opportunity at so many different clinical sites.