Reflections on Four Decades in Laboratory Services with Rice Hospital

Karen Samuelson, Director of Laboratory Services, has seen and experienced many changes during her career with CentraCare - Rice Memorial Hospital. August 15, 2023, marked her forty-year work anniversary.

A lifelong career in laboratory services

"When I was a senior at Sacred Heart High School my guidance counselor asked if I ever thought about becoming a lab technician. At the time I was able to shadow at the Granite Falls Hospital for a half day, and they showed me a blood smear, and I thought it had pretty colors," laughed Karen. "That's what helped me decide."

After completing her 2-year degree at Alexandria Technical College and clinical rotations at Buffalo Hospital to become a medical lab technician (MLT), Karen started her very first job at Rice Memorial Hospital in 1983.

"I made $6.32 an hour and worked the PM shift from 2:30 - 11:00," recalled Karen. "After having children, I volunteered to be on the night shifts by myself on Fridays and Saturdays so I could have Sundays off."

Around 1995, a change in pre-surgical care resulted in less work on the PM shift as patients came the day of surgery for any laboratory testing. Then Chemistry Section Head, Eldon Ronnei (Ron), needed additional help, so Karen asked Ron to teach her extra things to do during the PM's when things weren't as busy.

"When Ron decided he needed an assistant, I was the logical choice because I had been learning and helping him," said Karen. "I moved to the day shift so I could continue to assist him."

In 1998, Ron passed away unexpectedly, and Karen became the interim laboratory lead. However, without a 4-year degree, Karen couldn't step into the lead role. Over the years Karen supported several leadership transitions and helped train new supervisors.

After both of her children were out of the house, Karen made the decision to return to school and get her bachelor's degree online through the University of Cincinnati while continuing to work full-time.

"It took me two years and three months and I would not have been able to do it without my amazing husband's support," smiled Karen.

In 2007 Karen graduated with her bachelor's in medical lab sciences. Shortly after receiving her 4-year degree, Karen accepted a position as Lab Manager for Granite Falls Hospital, employed through Rice Memorial Hospital.

A few years later, the Director of Lab Services at Rice, Jason Mayer, restructured lab leadership to include an operations manager and a technical manager. Karen became the Rice Lab Operations Manager in 2010 and continued in this role until she accepted the Director position in 2015. At that time, they chose to combine the Director and Ops Manager roles and maintain a separate person for the Technical Manager.

Change and Innovation

Karen marvels at what she refers to as "the awesomeness of technology" and how far things have come during her years in the lab.

"Everyone seems to love their area (of science) the best," says Karen. "Chemistry has always been my favorite. I remember long ago having to start the machine with a gas burner and a flame, which had to be a certain color for us to know when it was ready. Now of course we're on computers. There have been unbelievable changes with instrumentation through the years."

Although the instruments have improved greatly, and there is now auto verification, lab staff still must look at the results to ensure they make sense. Sample volume requirements are also much less than they used to be when Karen started in the field.

While stressful at the time, the remodel of the intensive care unit pathology, and microbiology labs in 2016 was noted as one of the biggest changes while Karen was Director. When a new PT scanner was installed at Rice, it took up part of the space that previously housed cytology/pathology on the first floor. Microbiology was also outgrowing their space at that time. The decision was made to remodel the second floor and move both departments.

"I remember it kept me up all night before we made the move to the new space. I was a nervous wreck," recalled Karen. "We had to move all the instruments to the second floor – and we had to make certain everything got moved without disrupting patient care. Everyone involved in the remodel was great. We didn't need to shut down lab services at all. We got the machines relocated and back up and running immediately following the move."

Standardization across the system has also been a big initiative. Most recently, in the fall of 2022, Rice lab updated their chemistry analyzer.

"It takes months to prove the results of new machines match the previous machines. We had four machines at one time, and we took out pieces as we got through the crossover testing," explained Karen. "We have wonderful people that worked together to make these updates successful. While many lab systems are automated now, we'll always need good people."

The impact of COVID-19 on laboratory medicine

It's well known that the COVID-19 pandemic had a dramatic impact across the field of laboratory medicine and pathology. The development of new tests and increased access to testing were important innovations.

"The COVID pandemic really elevated our profession," explained Karen. "We've always been behind the scenes, and suddenly, everyone was talking about lab and testing. We became much more of a well-known service. Medical lab technicians and lab scientists all became better known."

Prior to the COVID-19 outbreak in 2020, Rice Hospital had just joined CentraCare in 2018.

"I was so thankful that we were part of the CentraCare system when the pandemic hit," said Karen. "Being a part of a larger health system allowed us to have the resources we needed, including contracts for the reagents."

A reagent is a substance or compound that can facilitate a reaction, they are used in tests such as most COVID-19 test kits.

Karen remembers how Dr. Steven Vanderwerf, laboratory Medical Director, put in countless hours staying up late to investigate how they could bring in more tests with the platform they had.

"Our staff put in many, many hours as the kit we could run was manually long to perform. For our facility we could do 100 tests a day. That was a really big deal at the time. People don't always understand what is going on in the background to make things happen. Our staff put in lots of extra hours."

During the pandemic the lab team came together three times a day to 'huddle.' "Huddles were, and still are, vitally important," said Karen. "During the peak of COVID, what I would tell my staff in the morning would change by the afternoon. We've always pulled together, and it takes dedication from every single teammate. We really could not have made it through COVID-19 without each other."

A family you won't find everywhere.

The Rice Memorial Hospital lab department is currently made up of 47 team members.

"We have always been a tight group. I've had so many close friendships over the years, and we've done lots of things together outside of work. I used to be a lot of fun," she chuckled. "When students come through here, I tell them that we are unique. We are a family, and you will not find this everywhere you go to work. We have some really good people here – people who are passionate about what they do."

September 1, 2023, is Karen's last official day in the lab before her retirement.

"Forty years is a long time, but it went so fast," Karen responded thoughtfully. "They're my work family. I will miss them all. The people here are what make it so special. I have had a wonderful career here at Rice!

"While I'm sad to leave my people, I know we have future leaders amongst us right now. It helps me know that everything will be just fine."