A Day at the Lab (Job Shadowing)

Job Shadowing AT JC Internal Medicine

Johnson City Internal Medicine is one of only a few medical offices in the Johnson City, Tennessee, area with an on-site lab, much to the delight of patients and doctors who like quick results, and while I didn’t observe anyone who seemed overly excited to have their blood drawn, the cheerful nature of the phlebotomists kept things light and relaxed for everyone. More than 200 people flowed through the lab Friday, and I never heard anyone wince. Although from the stories I heard while I shadowed Trish, Josh, and Joe that afternoon, there are people who wince—or worse. But confidence in your job and a clear sense of purpose makes even the most difficult situation bearable. I also learned from them that a robust sense of humor is a necessary job skill in this setting.

Trish and Josh collaborate over a patient’s lab order.

I hung out in the lab with Josh and Joe, who are phlebotomists by training, and Trish, who is a medical assistant but mainly works as a phlebotomist. A phlebotomist is trained to draw blood and prepare it for testing at a larger lab by spinning it down, for example, but as Josh demonstrated for me, they’ve learned to run several tests in their mini-lab such as tests for strep, flu, and pregnancy in addition to urine and stool testing. And that’s just a surface description of what their jobs entail. In fact, science, technology, and math permeate their day in more ways then I imagined.

What’s more, these STEM careers do not require a medical degree, or even a bachelor’s degree, yet they are full of science and technology. For example, the machinery used for running tests need to be understood and properly used, and the computer programs to track doctor/patient orders and results require careful attention to detail. Not only that, a full command of medical terminology is needed as well as an in-depth understanding of the science involved in the testing, a solid knowledge of veins (where they hide, how to find them, how to raise them up for a needle stick), the ability to problem solve, and of course a constant smile when working with patients. In addition, all the precautions you learned about in your high school science lab are in effect here too!

I find it very exciting to learn that such excellent jobs are available to young people who don’t wish to go to college but really enjoy the idea of working in a STEM setting. One book that I kept in my classroom library when I taught 6th grade, Blue Collar & Proud of It, clearly and effectively argues a case for blue collar (or non-college degree) jobs–including laboratory technicians! I made it a practice to balance my encouragement to all students by telling them “yes, you can” and pointing out all of the avenues they could take to fulfill their goals and dreams. Many students of mine gained encouragement about their future just by reading the introduction to this book and then flipping through the chapters. Click here for a book synopsis.

So much medical terminology is used in a lab!
Here’s a sampling of some of the words and codes that I didn’t understand!

Today’s job shadowing lent a perfect example of this. When asked what it takes to become a phlebotomist, Josh explained that he learned his trade in eight weeks. Of course, after his training he needed to correctly perform 100 blood draws in a hospital setting and pass a state exam before he could be hired. After that, he landed in an interesting scientific job with reasonable pay and no 4-year college loans to pay off. He clearly enjoys his job and even gave me my first lessons in urine and stool sample testing, which is where I began to realize the amount of terminology one must know in this job, and the amount of care one must take to not tip over “the pee!” Clearly, scientific terminology isn’t always used in a lab setting.

Best invention for a phlebotomy lab! A vacutainer tubes holder!
Best invention for a phlebotomy lab! A vacutainer tubes holder!

In between patients, Joe loved taking me around the lab to point out and explain various advancements in technology in a phlebotomy lab setting. For example, the tubes in which blood is collected are now vacuum tubes, making blood draws easier and safer. “Tech is super cool,” he said as he explained the scientific reasons for the gel in some of the tubes. The spinning machines cause the plasma to separate from the blood, he continued, “and look at these cool clips! Necessity breeds invention!” He pointed at clips that hold the tubes as blood is drawn and explained how before the clip, finding a safe, non-rolling surface for the tubes was not fun.

Colorfully coded, the tubes await their next blood sample.
Colorfully coded, the tubes await their next blood sample.

Trish, who holds a medical assistant license, chose to work at Johnson City Internal Medicine several years ago because it was an established medical practice that had “room for growth,” she said.  It’s a great job, she declared in all honesty, but like all jobs, it can be stressful at times. Some days, patients seem to come in and out of her chair as if on a conveyor belt – no time for a smoothie in the break room! Other days can be a challenge when multiple patients are hard sticks—phlebotomy lingo for “difficult to draw blood.” Patients newly released from hospitals tend to be dehydrated, which can make it difficult to raise a vein. Similarly, patients undergoing chemotherapy can have hard-to-find veins. Elderly folks, through the natural process of aging, tend to have thin skin and weakened blood vessels, making it difficult to draw blood. Even when faced with a hard stick, Trish calmly soothes and encourages the patient. I observed many interactions between her and her patients and knew—even without being the one to get the stick—that she was good at her job.

Separating blood and plasma is one job of this spinner.
Separating blood and plasma is one job of this spinner.

Nurses, carriers, and patients moved in and out of the lab all day. The place bustled with small talk and science talk, laughter and stillness, greetings and joking, the pop of Nitrile gloves going on clean hands and the whirring of the blood spinning machines. Maybe this is a place where the STEM generation is meeting its purpose which is, as researcher Allan Zollman says, “to resolve (1) societal needs for new technological and scientific advances…and (3) personal needs to become a fulfilled, productive, knowledgeable citizen” (Zollman, 2012).


Zollman, A. (2012). Learning for STEM Literacy: STEM Literacy for Learning. School Science and Mathematics, 12-19.