Platelet Hand Agitation

 

What is it about HP's that when we do our job we might have to do it well, but not too well? I have been challenged several times in the course of my career, not because I wasn't being a good enough porter, but because I was too good a porter. One of these examples involves platelets. Platelets are blood cells whose function is to cause coagulation when a blood vessel is breached. They clump together at the rupture site and form a gelatinous blockage which eventually hardens into a scab. This is essential for stopping bleeding; without it we could not live. Platelets are extracted when blood components are separated in the transfusion laboratory before being given to patients. They look like opaque yellow fluid and are stored in a plastic bag, illustrated above. Unlike red corpuscles and plasma which have to be chilled, platelets have to be stored at a warm room temperature, twenty to twenty-four degrees. They also have to be continuously "agitated", this means kept in constant motion otherwise coagulation initiates and they set into a solid lump of jelly; making them useless. In the storage cabinet they are put on a machine that constantly lurches and rotates. Now, when I was being trained in the late '80's the porters who trained me told me that when I'm carrying the platelet units to where they are needed I have to do something called "hand agitation". This means simply imitating the action of the storage machine with our hands. I did this for my entire career when delivering platelets. Newer porters didn't do this because that part of our training was discontinued, like so much else in our traditional skill-set. Welcome to a result of the casualization that I have described elsewhere, for example: https://hpanwo-hpwa.blogspot.com/2011/09/why-do-we-need-hpwa.html.
 
One day I was delivering platelets and was accompanied by a "boy wonder", a young and well-connected individual with "one foot in the lodge", as we used to say. Basically they all had ambitions to be trust directors and were doing their standard six months in portering for three words on their CV. I can't recall why this boy wonder was with me, but we were standing in a lift together while I did the hand agitation and he frowned and said "Why are you doing that?" I explained why and he immediately replied: "Don't do it please." I asked: "Why?" He said: "It looks unprofessional." I asked him to explain and he made a chopping motion with his hands and said: "I'm not going to have this conversation with you here and now; I am a senior member of staff and I am just asking you not to do that with the platelets." I refused and continued, calmly and politely, to demand some clarity and he said: "Very well, Ben; if you're refusing to obey my order I will have to report you to the office." He looked almost as agitated as the platelets I was holding. I shrugged and said: "Go ahead." He never did. Actually I was never really worried that he would. Despite this, I was dismayed and baffled at his actions, and his insistence that I do not do the hand agitation. What difference does it make? Where's the harm? It is almost as if he had been given instructions to pull the porters up if they did their jobs too well. Are the original skills of hospital portering not merely being accidentally forgotten, they are being deliberately outlawed? Is the enforcement of mediocrity a policy? Is porters' Pride and Dignity a threat? Is expertise and commitment in the Hospital Portering Service a detriment to today's NHS? If so, why is that? I can think of other examples and I will describe them in future articles. Something to think about, isn't it?