Understaffed at work - and why it matters to you.

So, so, so, so tired.

We've been working so short for so long at work and it's really wearing me out. We're understaffed, and someone's been off sick for a month, so we're trying to run things with too few people. We're doing a damn good job of it, but it's exhausting everyone to their limits. Everyone is getting progressively more tired and cranky, myself included (hell, myself's probably the worst one).

I hope it ends soon, but the heart of the problem is never going to go away. It's only going to get worse. Nobody is entering the lab profession because they don't know it exists and medical technology programs are being shut down in schools everywhere. A massive number of seasoned techs are approaching retirement and there are nowhere near enough new graduates to fill the vacancies. You'd think this would mean we're in huge demand, with hospitals offering bonuses and juicy salaries to the relatively few techs out there, trying to entice them. But they're not. Everywhere, everyone is trying to run their lab with fewer and fewer people, cutting costs as much as possible.

This article (worth reading in full) from the American Association for Clinical Chemistry has some statistics about the shortage.

According to the Bureau of Labor Statistics, in 2006 there were 167,000 practicing clinical laboratory technologists, and a projected need for 21,000 more by 2016. “However, in 2005 only 2,079 people graduated from accredited programs, the number of which keeps shrinking,” explained Susan Gross, MS, MT (ASCP), Senior Supervisor, Clinical Laboratory, Chemistry/Toxicology at San Francisco General Hospital and the University of California-San Francisco. “In 1975 there were 709 clinical laboratory science programs with 6,121 graduates; in 2005 there were 232 programs and 2,079 graduates”

The lab is important. So important. Most medical decisions are made based on lab results, and without techs there to run the instruments and read the slides and count the cells, you don't have any results. We are the ones telling the doctors whether you have strep throat or the flu. We see the bacteria and white cells in your urine that tell the doctor you have a UTI. We're the first to see the leukemia cells in your blood. We make sure you have compatible blood available in case your surgery gets complicated.

I know some of my friends reading this blog are also medical technologists (or clinical laboratory scientists, depending on where you're certified). Please get out there and talk about the profession. Sign on at Labs Are Vital and get involved. Tell people who we are and what we do and why it's an important job. We don't have anyone out there fighting for us and singing our praises, so we'll need to start doing it ourselves if we ever want any sort of respect and recognition.

From this American Society for Clinical Pathology article about their Wage and Vacancy Survey:

Exposure and awareness of the laboratory profession has had an effect on recruitment. A recent survey by the Coordinating Council on the Clinical Laboratory Workforce showed that of 4,500 students enrolled in a clinical science program, 75 percent were not even aware of the profession until after high school.

I personally didn't know it existed until after my first University degree in a different field. I am sure that there are hundreds of other students who are like I was, loving science and the medical field, but not wanting to be a doctor or nurse. Someone needs to tell them there are more options!

I'll get off my soapbox now. I promise I'll go back to posting recipes and projects this weekend.

Things that Horton will eat

I love Horton, my little murder kitten, despite how he keeps trying to kill the other cats, squeaks at our bedroom door all night, and generally gets himself into a lot of trouble. He was a tiny runt of a thing when I adopted him at the shelter, and he's stayed very small, which I think has given him a feline Napoleon complex. He's got redeeming qualities, though - he's loving when he wants to be, and he is painfully cute when he's sucking on his teddy bear. He runs to that bear several times a day and kneads it and sucks on it and fluffs up huge while he's doing it. His tail gets puffy when he's happy - how odd is that?

His health problems have caused us a lot of grief, between his broken hip that left him with a limp, and his massive emergency surgery for urinary crystals, (shout out to the fabulous emergency vet on rte 40!) With his kidney problems, he's supposed to be eating special food, so we can avoid further medical interventions. Except that he's an unruly brat who wants to eat everything but what he's supposed to. For example:

• Banana bread (but hates bananas)
  
• Pumpkin bread (will also eat the batter)
• Milk from my cereal
• Water from the bathtub faucet
• Bugs (mostly chews and spits out because they're wiggly, but at least he disables them)
• Grapefruit (will attack me for it)
• My spaghetti sauce
• Garlic (toxic to cats, so I don't let him eat it, but he will fight to lick my hands if I've been chopping garlic)
• Petals that fell off the tulips Dave got for my birthday (those didn't stay down)
• Butter
• Raw chicken
• Cooked chicken
• Pepperoni
  
• Ice cream
• The other cats' indoor-formula food, no matter where we hide it
  
• My perfume (licked off my wrists)
• Tufts of fur/hair/fluff found on the carpet (I have to be careful when brushing him or he will try to eat all the fluff I take off him)

I'm not sure how his ancestors survived long enough to breed. But I'm glad they did.

Biometrics day - update

Easy peasy. There was nobody else ahead of me so I was able to walk right in and get everything finished within about fifteen minutes. It was a nondescript little storefront in a strip mall, with the unhelpful words "application processing center" on the front door.

Step One: Surly government worker checks my ID, stamps my paperwork, and hands me a clipboard. He instructs me to fill out the demographic info and bring it to the next guy.


Step Two: Fill out demographic info and bring it to the next guy.
Step two-and-a-half: Cry inside at the weight I had to put down because it's a crime to lie to the government.

Step Three: Next guy wipes down my fingers and smooshes them onto a glass panel and my fingerprints appear on a screen. My right ring finger was a rebel and required three smooshes before giving up a decent print.

Side note: my fingerprints are pretty. I wonder if I can get "prints" of them enlarged and framed as artwork.

Step Four: Take off earrings and glasses, tie back hair, and sit unsmilingly for a photo. They say you can't smile because they need the photo to be identifiable through face recognition software, but I think it's because these employees have forgotten what smiling is and it would confuse and frighten them.

The end. As usual, I stressed out over nothing. The next part is waiting for our summons for an interview in the Baltimore office, where they will determine that we're actually married because we, you know, love each other and stuff, and I'm not just some foreign hussy marrying an American dupe so I can get a green card. No idea how long it will be until the interview, unfortunately, but I'm hoping it's before our first anniversary.

Biometrics day

Today I will be fingerprinted and photographed and put into a database. I am doing this because it's the next step in the green card process. I'm nervous about getting there on time so I want to leave very early, just in case we get lost or hit some traffic or can't find parking. In big BOLD letters on my appointment notice it says that failing to show up for my scheduled appointment will be considered as abandonment of the petition. I'm sure they won't tear up my paperwork if we're a few minutes late, but I feel like these folks have complete control over whether I get to stay, and what if we get an asshole who's having a bad day and wants to spread his misery around? I've encountered those everywhere - I'm just hoping everyone we deal with today got up on the right side of the bed.

The entire process is very stressful. It's a whole lot of paperwork (in duplicate or triplicate) and waiting, and confusing instructions. I understand the need for the background checks and the fingerprints, but it makes me feel like a criminal. It doesn't help that the document I received allowing me to travel freely while my case is pending is called "Advance Parole". At least I don't have a parole officer or an electronic ankle bracelet tracking my movements. I promise to be better at "parole" than Lindsay Lohan.

Oh well, whatever it takes to be able to stay here with my husband and not get my ass deported back to the Great White North. I just hope they don't implant a microchip in my skin...

Recipe Fail - Honey Cinnamon Muffins

I'm not going to post the recipe because I'm still not sure how I botched these, and I don't want someone out there to make bad muffins and blame me.

I've made these before and they were delicious, but this time they got crispy and burned very quickly. Did I copy down the recipe wrong, or is my oven too hot? Or is it because I used our CSA honey and it's cursed?

My husband enjoyed eating the burnt offerings for breakfast today, which is sweet of him. But I'm going to try them again next weekend and use an oven thermometer to see what's going on. The oven is a near-antique wall oven and I think its temperature sensor is broken. There's a... thing... on the inside of the oven wall, which I suspect might be a sensor of some sort. If I knock it while putting something in, it shrieks. Just before sticking my muffin pans in, this happened, so maybe I messed something up, but I've also noticed that my oven tends to cook things faster than it is supposed to, and I need to keep a closer eye on things near the end of the cooking time.

My stove has issues too - the rings stay so hot for so long that even after I've turned the heat off, water will continue to boil for several minutes. It makes me nervous to try anything fancy that would require good heat control.

One of my long-term hopes for this place is to get a new stove and oven so I have something better to work with.

Our first CSA experience

I like to cook. You may have gathered that. I have a hippie foodie friend (love ya, Tasha!) who kept telling me about something called Community Supported Agriculture, or CSA. She sent me the website localharvest.org a while ago and encouraged me to look into it, for reasons of fun and health and the environment. Essentially, the idea of a CSA is a farm selling "shares" of produce to consumers who either get stuff delivered or pick it up at a convenient spot. You get a selection of whatever's in season, usually in a basket or cooler. Some farms are more fruit-heavy or veggie-heavy, some farms offer extras like bread and cheese and eggs. Either way you're getting very fresh, locally-grown food, and you're helping encourage and support local farming. The only negative side is that you get whatever they're sending you, and you don't get a choice about what's in your basket (although most places advertise that they're accommodating for allergies), so you may end up with a huge pile of kale you don't know what to do with.

This year, settled into the new house and feeling somewhat housewifey, I thought the fall might be a good time to try this out, because we could do a shorter session (8 weeks), and see how we liked it. I split a share with my mother-in-law because it seemed like too much food for just the two of us, and she was also available to pick up our shares on Thursday afternoons.

We weren't all that impressed, which is unfortunate because I think this is a great idea. The experiment did get us to try new types of vegetables (mostly squash), some of which we liked. It was a good way to learn new recipes and broaden our horizons. But sadly the quality was inconsistent. Many times the apples looked like they'd been used as tennis balls, and some of the tomatoes and squashes molded or rotted after two days. This was an organic farm, so I expected our produce to look less than perfect, but pesticides aren't what prevent bruising and rotting, so I"m not sure what was going on.

Do these look like healthy carrots to you?


The strange part was that their farm stand at the farmer's market seemed to have much nicer stuff than what we were getting. We should have complained earlier, I guess, but we kept thinking it would get better. The bug-coated kale and rotten-on-the-inside nectarines were the last straw, though, and we had to say something. The underside of the kale leaves seemed sandy to me and so I tried to wash them off, only to discover that the "sand" was a layer of aphids. And not washing off easily, either. I was going to make kale and potato soup out of it but I got nauseated thinking about little green aphids swimming in the bowl. The guy at the stand the next week was kind enough to offer us a "refund" by letting us take stuff that would cancel out the value of the kale and nectarines, but still. We won't use that farm again. Especially when they got all snotty with us when I posted a less-than-stellar review of their CSA on that website.

I want to try again with a different place next year but I'm nervous. We'll see. Spring shares mean salad greens and berries, so maybe it'll be worth it.

What's for Dinner: Pâté Chinois (Shepherd's Pie)

I'm not sure why it's got such different names in English and French. I like to think that it originated with Chinese shepherds and so we've both got it right. Either way, it's one of my favorite examples of cold-weather comfort food, and one of the easiest to throw together. My recipe is really simple, and I will eventually start tweaking it to add different seasonings and vegetables, but for now it's still appreciated every time I make it so I hesitate to play with it.

6 to 8 meduim potatoes (plus butter, and a dairy-based liquid of choice for mashing)
About a pound of ground beef
A packet of powdered beef gravy
One small onion or half a big one
1 can corn
1 can creamed corn

Peel, chop, and boil up the potatoes for mashing. Then, obviously, mash them. Use milk or cream, whatever you like better, but definitely toss in some butter. Everything is yummier with butter.
Dice the onion and fry it up in some butter (see - yummier!), set it aside.
Brown some ground beef in a pan. The amount is up to you - I used about a pound of it because that's what I had. Season the meat with salt and pepper, and when it's all done, mix a couple teaspoons of powdered beef gravy with about a 1/4 cup of water and stir it into the meat. Mix the onion back in.

Pour the meat into a baking dish*. Spread it around to get a nice even layer. Add the two cans of corn and spread that around. Use a big spoon to plop a scoop of mashed potatoes every couple inches across the top of the corn - you can't really spread very well because the corn is squishy and you'll make a mess, so the trick is to use smaller scoops of potatoes and try to cover a lot of surface with well-placed blobs. Then you spread the tops of the blobs so they all connect, leaving you with a smooth potatoey surface. Which you can then poke at with various utensils to make it look pretty (I used a fork and made lines). It's important to spread the potatoes to the edges to "seal" everything, otherwise you'll get meat juice bubbling up and it might make a mess.

Into the oven for about 30 min at 350. The top of the potatoes should get the slightest bit brown and will be firm when you poke at it.

And when you scoop some out to eat it, it will be delicious.

*I used an oval Corningware casserole dish, but a lasagna pan would work pretty well too. I like my shepherd's pie to be thick, as opposed to all spread out in a flatter pan, so I usually use smaller dishes with higher sides. If you're using a flatter one, check the oven often, because you won't need to leave it in as long.

What's for Dinner: Chicken "Parm"

Well. You learn something new every day.

I haven't been grocery shopping so we're down to frozen pizza and other boring emergency foods, none of which appealed to me. I had chicken and marinara sauce and thought "hey, why not try making Chicken Parm tonight? I have chicken and parmesan!"

Except that upon closer inspection of, oh, every recipe I could find, Chicken Parmigiana is sneakily not made with parmesan cheese, despite the fact that its name totally sounds like parmesan. It needs mozzarella, which I sadly did not have on hand. So, I pretended like I'd never seen the recipes and forged blindly ahead with total disregard for the rules.

I took two thin chicken cutlets and salted and peppered them, then flopped them around in a bowl of breadcrumbs to which I'd added some oregano and garlic salt. I heated up some olive oil in a pan, waited for it to get ridiculously hot (that's the trick to good breaded chicken cutlets - extreme and ridiculous heat), and fried the chicken till the outsides were nice and crispy brown. Then I moved them to the oven in a glass baking dish in a little pool of marinara and left them at 350 for about 10 minutes. Then I sprinkled grated parmesan on top, ground some fresh pepper onto the cheese, and gave them another 5 minutes. I served them with a side of whole wheat spaghetti and Bertolli sauce (Marinara with burgundy wine).

Verdict: yummy! I'll definitely try this again. I know it wasn't really chicken parmigiana, but who cares.

We were starving and so I didn't take time for photos. Sorry, gentle readers, you'll have to use your imagination until I make it again!

Project: Halloween

It's Halloween! There are dozens of little kids in our new neighborhood, and I'll be stationed at the front door all night to hand out candy to the vampires and princesses and Transformers.

I carved a small pumpkin to put out front, just to make sure kids know this is a house worth stopping at. I think he's adorable! He needed a friend, so I used an acorn squash and made him one. Can't wait to see how they look all lit up tonight!

Restaurant Night: Fleming's

Celebration time!

With the sale of the townhouse, we decided to splurge on a fancy celebratory dinner. My only requirements were that it be fancier than our usual spots and have a wine list because celebrating something this big requires a decent glass of wine. So I left the decision up to Dave, and he picked Fleming's in Baltimore.

We didn't dress up, just headed there straight after work, arriving about 10pm. Garmin got us there easily - it's right near the inner harbor area of the city surrounded by dozens of other really fancy-looking restaurants that I will need to investigate for future outings.

The hostess greeted us and congratulated us on the sale of our house as she walked us to our table - Dave had mentioned it when calling for reservations, and I thought it was nice that they brought it up. The menu was pretty simple - steak, steak, steak, and some options for potatoes and sides. We decided to go all out and try appetizers through dessert, because how often will we celebrate selling a house? (It better not happen again for another 30 years, anyway)

Our wine selection was a Cab Sauvignon from Château Ste-Michelle in the Columbia valley (pacific northwest). We first had it a couple of years ago for my birthday dinner at Hy's, a fancy steak joint in Vancouver, and we loved it. All of a sudden we're finding it at restaurants we're trying, and it's great to be able to enjoy it again.

We got mushroom ravioli and crab cakes for our starters, and they were fabulous. I think the sauce for the pasta was butter and pureed mushrooms. Incredible. The crab cakes were delicious too - this means a lot coming from a woman who hates seafood. The cakes were so crispy outside and the spices were just right and the red pepper fancy sauce on the plate was delicious. I kept picking at them even though they were technically not my appetizer, but Dave was more entertained than annoyed.

And then, steak happened. We both got the filet mignon and it was butter. I ordered it medium (I know the foodies will gnash their teeth and cry that it's a waste of steak unless it's bleeding on me, but blah on them) and it was soft and pink in the middle and seared and salty on the outside and just plain wonderful. I got the big one but probably should have chosen the little one, because it was a lot of steak! I was going to try the baked potato but our server (Derek) told us about the Lyonnaise potatoes that were the special that night, and so we shared an order of those instead. Chunks of potato and onion fried up in olive oil - absolutely delicious, but for what he called a "family style side" it was a very small portion. No matter, we were extremely full by the end anyway.

Not that we let that keep us from ordering dessert. We could have shared dessert, but we went crazy and each got our own crème brulée. I have a hard time admitting this because of my love of all things chocolate, but I think that a well-made crème brulée, with real flecks of real vanilla, is at the near-top of my favorite desserts list.

Service was impeccable the whole night. We were visited a couple of times by important folks - an owner and a manager, I think. Someone took our picture for us to commemorate our celebration for selling our house (everyone who spoke to us all night knew why we were there, which I though was a very nice touch), and we got a free print of it to take home.

Best celebration night ever. It was all wonderful and we have to go back. Very pricey, though, so we'll be keeping it for fancy-pants occasions. But I can't have a steak like that and then never go back. It's on the must-return list.