Like many 2020 graduates, I was forced out of school and thrown into a mid-pandemic job search which, for a time, yielded nothing but rejection as most companies were reeling from the early days of lockdown. Eventually, The Cleveland Clinic asked me to join their Covid team at their main campus’ laboratory. I felt lucky to get the position without having any lab tech accreditations. The benefits were second-to-none, the pay was great, and it just made sense at the time. The Clinic is a prestigious institution, their lab was first-rate, and I would be joining the fight against Covid.

The circumstances were unprecedented for the Clinic as well. The Clinic had always staffed the Molecular Microbiology team with certified professionals. Still, the demand for testing during the pandemic was so high that the Clinic had to staff two additional shifts to accommodate round-the-clock Covid testing and hired uncertified technicians to fill the positions. As a result, 12 other fresh graduates and I were onboarded quickly and thrown right into the midnight shift. In the beginning, I was so happy to be helping and working during the pandemic. I felt proud to be on the front lines, honing my skills and discovering what it was like to work under intense pressure. My work was good even when the work was hard. There was no room for error and no time to waste. At the Clinic, we used state-of-the-art equipment and rarely felt the shortages we were hearing other colleagues complain about at the two other hospital systems in the county. However, once the learning curve shifted and the pressure intensified in late 2020, the happiness I felt about coming in every day began to fade.

Although the Clinic had stockpiles of reagents and personal protective equipment (PPE), our most powerful analyzer only had enough supplies to run a few hundred Covid tests per shift. The rest were extracted and resulted by hand. Although the STAT samples were run in a different department, the routine, employee, and pre-op samples were sent to us, corresponding to almost 2000 samples per shift. Though the best in the business, the machines we worked on were never meant to be run at this intensity and would frequently break down during the second shift. Those of us on the third shift were then left to deal with these problems despite our lack of technical training. Even worse, there were no supervisors on staff to help us problem-solve or troubleshoot, which only added to the pressure. The demand for Covid testing was so great that we were stuck running the same tests every day, with no room to train on other platforms and no opportunity to learn something new to keep us interested in our careers. The pressure never let up. No matter how mind-numbing and repetitive the work could get, we had to work with constant vigilance, as there was absolutely no room for error.

After a year and at least 50,000 Covid tests later, I decided to move to the smaller county hospital to get off the graveyard shift and begin working on more than just Covid testing. No sooner had I started my training, I was forced back into Molecular Microbiology to handle the Omicron variant surge. This time, the hospital environment was completely different. Suddenly, a team of two to three people had to manage over 700 samples, including STATs, without the money, instrumentation, and supplies we had at the Clinic. The hospital asked us to put in as many overtime hours as we could manage, and from December to February, I worked at least 60 hours per week. There would be some days when I would get deep blisters on my hands from opening up sample tubes for 12 hours straight, and there would be days when we would have to skip lunch because there were too many ICU samples. Vacation days or brief time off to see my family was simply out of the question. After only six months at the hospital, I burnt out. Although I had been earning a lot of overtime pay, I decided it wasn’t worth it. I became another frontline worker who dropped out of the industry after only a few years. Unfortunately, it wasn’t just me who felt overwhelmed. Around the time I resigned, the Clinic began to hemorrhage techs, who left for better opportunities at different hospitals or in different fields. Of my original 15-or-so-member team two years ago, only four remain in the same department, and only about half remain in the clinical lab field at all. 

The American Society of Clinical Pathology - the largest association for laboratory professionals - has stressed the importance of promoting MLS/MLT programs to produce certified, well-trained lab professionals, to fill major staffing shortages. However, filling the positions is only one piece of the puzzle. In my experience, we techs were left unsupported and unmentored. No one cared if we were learning or growing in our job, and there was little encouragement for us to enter training or residency programs. We were just expendable foot soldiers: this is not a policy that leads to long-term job retention. 

I am not writing this simply to bemoan my plight. It takes a particularly strong person to stay in a job like this, and I turned out not to be that kind of person. You need to be a warrior with the physical and mental toughness of a soldier or superhero. I don’t regret the experience because I now understand how difficult this industry is for unseen workers. The nursing profession has been hit extremely hard, and I saw that firsthand. The effort from the lab techs needs to be acknowledged as well. We, too, are a female-dominated profession facing the same problems of burnout and understaffing. We also feel like expendable resources on the healthcare team, even though patient care couldn’t happen without us. Like nurses, techs are a well-educated, intelligent group of people who must work with care and focus, yet no one recognizes how hard they work, and no one praises them. Not to mention that within the healthcare industry, the profession lacks prestige, even though 70% of medical decisions are based on laboratory test results.

Late last year, during the worst of the Omicron variant surge, the only people I could commiserate with were the nurses who thanked us for running their pediatric ICU tests first. They understood what we meant when we said we were drowning and stopped calling the lab to pester us for results because they knew that the positivity rate in Cuyahoga county was the third highest in the country and that the entire system was overwhelmed. Unfortunately, when things died down, that kindness seemed to fade. 

Lab techs still need your recognition and respect. In addition, hospitals need to address the issues of staffing and career development, or we will be woefully unprepared for the next pandemic.