“Never a Dull Moment”

Victoria Cary
MLS(ASCP)CM, SBBCM

Victoria Cary, MLS(ASCP)^CM, SBBCM, earned her bachelor of arts degree in medical laboratory technology from The Ohio State University in 2006. During the early part of her career, she worked in the laboratory at Nationwide Children’s Hospital (2005–2008). She subsequently completed the Specialist in Blood Banking (SBB) program at the University of Cincinnati’s Hoxworth Blood Center (2008–2010). Following her training, Cary joined the Blood Bank at University Hospitals Cleveland Medical Center in 2010, where she served as both a bench technologist and technical coordinator, contributing to the operational and technical aspects of transfusion services. In 2022, she earned her SBB certification, recognizing her advanced expertise in blood banking. In 2023, she was promoted to manager of the Blood Bank at University Hospitals Cleveland Medical Center in Ohio.

Cary spoke with AABB News about her leadership path in blood banking, workforce challenges and her upcoming AABB Annual Meeting session on blood bank staffing in tertiary care centers.

AABB NEWS: What first drew you to laboratory medicine and, ultimately, to blood banking?

Cary: I always knew I wanted to work in the medical field, but I didn’t want to be a nurse. I found laboratory medicine by accident while looking at careers in the medical field. I have always had the “blood banking bug”; it was my favorite subject in school. I took the first blood bank position I could find post-graduation working at Nationwide Children’s Hospital. Working there just further impressed upon me how much I enjoy blood banking and want to work in a large specialty blood bank.

AABB NEWS: You’ve worked at University Hospitals Cleveland Medical Center since 2010, progressing from a bench technologist to technical coordinator and now blood bank manager. How did those earlier roles prepare you for leadership?

Cary: Starting as a bench tech and moving up the career ladder gave me an appreciation of what my staff does every day. Having previous experience of working with many of my staff, I find they are more comfortable bringing me workflow ideas or problems they have identified. You never want to have staff too afraid to talk to leadership; problems don’t get fixed if they just talk amongst themselves. Similarly, when I identify a problem in the blood bank, I have a comfort level with my staff that allows me to work with them to make any necessary changes.

AABB NEWS: What do you find most rewarding about leading a blood bank in a tertiary care setting? What are some of the biggest challenges?

Cary: Never a dull moment in a tertiary care setting. You see everything. I tell people during interviews that if you have read about it in the textbook, we have probably seen it. With the services provided at this unique tertiary care facility, we have the capability of impacting patients’ lives from before birth all the way through their life.

The biggest challenge is that every clinical service wants something different for their patients. We try to avoid making too many of these accommodations, but we recognize there is a standard of care for certain populations that needs to be met.

AABB NEWS: How have workforce shortages affected blood bank operations, and what challenges are you seeing most often?

Cary: When staffing is critical you must start prioritizing patients (surgical cases>inpatient> next day transfusions> outpatient).

Look at the current test menu and consider batching testing (eluates, outpatient panels, CORDs, FMS) or sending work to your imunohematology reference laboratory for routine testing. Finding the next new employee is always challenging. When you are critically staffed, bringing in inexperienced new hires can be a little bit of a morale booster. It’s not that your staff don’t love to teach; it’s that they don’t have the time to sit down and teach the basics. That is the struggle with the Bachelor of Science candidates. You need to find the right mix of experienced blood bankers and new, inexperienced hires.

You never want to have staff too afraid to talk to leadership; problems don’t get fixed if they just talk amongst themselves.”

AABB NEWS: Your Annual Meeting session will explore workflow efficiencies as one strategy for mitigating staffing shortages. Where do you see the greatest opportunities to improve workflows without compromising quality or patient care?

Cary: Work to eliminate repetitive tasks. With new Hospital Information Systems (HISs) and Laboratory Information Systems (LISs) software, look for logic that can be designed to generate automatic notifications to the clinical teams (i.e., a new type and screen needed, a second ABO confirmation required, a need for additional samples for a reference lab workup or an electronic pre-admission questionnaire).

Review internal workflows. All those times you thought, “Why do we do it that way?” Sometimes the answer is, “Because we always have.” Have you duplicated this task in a new workflow? Is this an old practice that is no longer necessary, but people have been afraid to stop doing it? Can it be improved?

AABB NEWS: What skills or experiences do you think are most important for laboratory professionals who want to grow into leadership roles?

Cary: Being open to understanding and learning. Things seem to change frequently while working in a highly regulated department. Take the initiative; everything happens once leadership leaves for the day. That experience will be helpful as you advance.  

AABB NEWS: What is the best decision you have made about your career?

Cary: Saying “YES.” Clinical team members have ideas or just want to understand better. Having that relationship with the clinical team makes the day easier. It makes saying, “No, I can’t do that because…” a lot easier when necessary.

AABB NEWS: What advice would you give to someone who is considering a career in blood banking or transfusion medicine today?

Cary: Be confident in yourself, know your limits and don’t be afraid to say “no.”

The blood bank can be a stressful department. It takes a certain type of person to want to work in a blood bank of any size.  

Know when you need to ask for help. Emotions are heightened during patient care, but don’t let that get in the way of doing what is best for the patient because of outside pressure. Many clinical providers are less familiar with transfusion medicine.

AABB NEWS: Tell us about the last book/podcast that inspired you.

Cary: My go-to podcasts are non-fiction, history and true crime. Listening to the Cardiac Cowboys, which explores the trial and errors of the early stages of open-heart surgery and cardiac bypass, got me excited to work with some of our clinical teams to look at new ways to do the same things we have always done.