I’ve been continuing work on the manuscript and the descriptive statistics while we await the full analysis from the statistician.
Tuesday I spent the day with the technicians at K&C Hospital. As someone who is isn’t very good with technology or the practical side of most things I wasn’t entirely sure what to expect! However, I really enjoyed it and felt like I took a lot of it in. We started by looking at the current dialysis machines that are in use, seeing the principles behind how they work and all the components that contribute to this. There are 2 different machines currently used.
We looked at the machines that were used in the 70’s through to today and it was amazing to see just how far technology has come in such a short space of time and how this benefits the patients.
I was shown the water purification room where water is cleaned and processed before being used. The discarded water is then recycled by using it in the laundry rooms or other areas, as it’s not at all dirty, just not of a standard high enough for using in dialysis.
The dialysis machine itself is much like a computer, with circuit boards and switches inside. It looked more complicated then I was expecting, but maybe that’s just my untrained eye! I was shown the equipment used for home dialysis and watched as a technician repaired one of the broken machines.
Whilst I was there they received a quote for the new dialysis machines they’d hoped to get (they last roughly 7 years). For 17 machines it was a quote near £250,000. Very expensive!
Wednesday I went to William Harvey in Ashford for the day. This was to spend time in the Microbiology labs. All of the microbiology for East Kent is done here, so it was busy as you can imagine. After a quick tour of the place as a whole I spent time in the different departments. They have multiple labs, specific for work in each area, such as Serology, Virology, Molecular, Urine analysis, Enterics, Bacteriology and General Microbiology. Much like the biochemistry lab that I spent time in the samples are received at the reception, labelled/barcoded appropriately and then added to their computer system.
First I spent time in the serology lab just getting an overview of the process. Of all the labs I saw this was most like the biochemistry lab with lots of automation. The test took longer and the machines were more expensive, but the principles were almost the same.
Next I spent time in the Molecular lab where genetics is used to determine the pathogen (if there is one) in the sample received. This is extremely accurate and will no doubt be the future, however, it’s time consuming and very expensive. The work is almost completely for respiratory diseases (at the moment). Fluid is collected, diluted and spun down, the dna is extracted, amplified using PCR and then run on electrophoretic gels and a photo taken of the gel to give the results. There are around 15 pathogens that are looked for, such as Influenza A and B. It was really interesting and a process I understood from practical’s I’d carried out at in year1/2 of Uni.
During the lunch break I attending a meeting which was discussing protocol for if something goes wrong, how its right to deal with and finding the root cause of the problem. It was sort of a group exercise to make sure everyone understood the process and why it had to be carried out.
I spent the afternoon in the General Microbiology lab which I loved. They receive samples that could be fluid or tissue. After being labelled and entered onto the system appropriately they are dealt with in the right manor. For example, you have to decide using the sample and any data that might have been given about the patient to decide which plates you need to use, if you need microscopy or staining etc. I really liked this element of it, there seemed much more variety in the work than in the Biochemistry labs. For example whilst I was there, I looked at CSF (urgent) fluid under the microscope to count the white blood cells that were present, I saw TB in a sample under the microscope, and also the difference between bacterial vaginitis and normal vaginal flora. I saw tissue from a voice box, a man’s knee and a lady’s hip and how these would be analysed. The majority of samples are spread on the appropriate plates and then left to culture, and be analysed. The microscopy results can be sent back straight away. If a tissue sample has come from someone who is post op, or had tissue taken from deep beneath the surface they will have an additional plate that is cultured in anaerobic conditions, as it would be inside you, for example your gut flora. Other plates used are chocolate, maconkey, blood agar, agars that are specific for staph. Aureus or mrsa.
MRSA screening is done on anyone who is due to have surgery or anyone that has a prolonged stay in the hospital and they therefore create a bulk of the work in this section of the lab. The swabs are spread on plates and cultured, along with a positive control. If MRSA is there the colonies, which are very rounded, grow a blue colour. All the plates are looked at, an empty plate is a negative but also a few other things can grow on the plates that are not MRSA so you have to know what you’re looking for as its only MRSA that you are interested in.
Sexual health swabs make up a large amount of the work load too, testing for chlamydia and gonorrhoea primarily. I was told by one of the BMS’s, who had worked in this field for ~30 years, that around 20 years ago when he carried out chlamydia tests, a good rate would be to get 8-10 done weekly. Now with the advances in technology the machines carry out hundreds of tests each day!
I also managed to speak to some of BMS’s about how they got to this position as it’s something I’m really interested in and considering as a career option. I had a brilliant day and would love to work in a place like that so it was great for me to gain that little bit of experience and a taster of what day to day work as a Biomedical Scientist would be like. My favourite day of the placement so far!
Sorry this blog is extra-long! Only 1 week left now! Hoping to get the statistical analysis back so we can go full steam ahead with the discussion and get as much done as we can before my last day.