You need at the very least a Standard Operational procedure for 'grossing'.
This will have each specimen and how the Pathologist has trained you to 'cut
it'. For example skin biopsies of a ?mole, would be cut TS with three slices
across the mole. The ends retained 'just in case'. The same for anything
else you dissect or 'put in'. That is each sample with have a procedure for
you to follow, which you do with no alteration. 

I would have thought that if a Pathologist sat in for a few days whilst you
carried out the 'cut up' then you would learn quickly; if I was the
Pathologist then I would occasionally revisit to make sure. It really
depends on your experience and training; the issues relating to tissue
'cross over' (on forceps, cut up board, etc) are maybe the most important,
but other issues concerning under fixed tissue and your ability to know when
to ask for help given an unusually finding need to be addressed. The latter
is one of the most important; you can train people to do almost anything,
the trick is to get them to recognise when they are 'stepping out' of that
training (i.e. it's not a mole, but the Clinical data and gross macro
suggests that a melanoma may be a likelihood, then you refer). 

Kemlo Rogerson
Cellular Pathology Manager
East Lancashire Hospitals NHS Trust
DD. 01254-294162
Mobile 0774-9754194
 
-----Original Message-----
From: Heather.A.Harper@pcola.med.navy.mil
[mailto:Heather.A.Harper@pcola.med.navy.mil] 
Sent: 03 March 2005 11:54
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Need an opinion[Scanned]

  I had written last week in regards to the sudden work change of me having
to learn how to gross. I'm going to go ahead and learn but I need an
opinion. I have 30 days to learn how to gross. Presently, the pathologist is
training a cyto tech to gross. She got trained last week and this week is
flying solo and she is very unsure of what she is doing and I have been
telling her what she has to do. She already lost 2 cxbx on a case. I also
observed this same type of training with my military co-worker. Trained one
week, flying solo the next and that particular pathologist isn't always in
his office. So she would have to de-glove and pick up the phone and call a
pathologist. If you were in my situation, tell me in your opinion what 30
days of training would entail because maybe I'm expecting too much. I
believe for those 30 days, the pathologist should be standing in the
background, watching, listening and observing, no matter how fast you caught
on to grossing and be there for any questions. I start training April 1st
and would just like to know what the histo world would expect. Thanks in
advance for any opinions.

 

Heather A. Harper          

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