Tissue Bank and Autopsy Rotations

Life has been pretty busy since I finished my last rotation and started the next one. I’ve moved back to Morgantown for the next 6 weeks, created a CV and started looking for jobs, prepared a 30 minute presentation for this Friday, and our monthly test is coming up so I’ve been increasing my study time.

Tissue Bank Rotation:

From February 10-14^th I was at the University of Pittsburgh HSC Tissue Bank (located in UPMC Shadyside Hospital).  Tissue banks serve as reservoirs of tissue/samples for researchers to use. These samples can come in the form of tissues from certain organs, tumor cells, blood, etc.  A researcher may want to use these samples to test out new therapies, perform molecular studies, or track specific data.

The employees of the tissue bank act as “honest brokers” between the researcher and the patient/sample collected. They de-identify the patient’s tissue and assign it an anonymous number; therefore the researcher never has patient information on the tissue that they’re working on.

A researcher can’t just take any and every tissue they want; they have to have approval from the Institutional Review Board (IRB) first.  The IRB is a committee that monitors biomedical and behavioral research involving humans and serves to protect patient rights and minimize risk. In addition to IRB approval, some sample types (ex-blood) require consent from the patient as well.  Therefore the patient can be reassured that their diagnosis and care comes before any research.

How does all this apply to Pathologists’ Assistants? Pathologists' Assisstants can work for and manage tissue banks. Also it’s great to have knowledge of tissue banking procedures so that when working in the surgical gross room, you will know what to do with a bankable specimen if it comes across your grossing bench.

This is a really simplistic overview, but I hope it gives you an understanding of what the tissue bank entails!

WVUH Autopsy Rotation:

This past week I started my new rotation at the WVUH autopsy suite. It wasn’t too busy this week, which was great because it allowed myself and the other student to dive right in and start eviscerating.  It has been a big change going from surgical pathology to autopsy pathology. Not everything has to be “museum perfect” for autopsy pathology.  I don’t know how many times I was told this week to stop using the surgeon tools and pick up the long butcher knife (don’t worry I’m not hacking away at things as much as this statement makes it seem).  I’m slowly but surely getting a little less awkward with the tools, recovering my anatomy knowledge, and becoming more comfortable with eviscerating.  

Last Week at St. Clair

On Friday I said goodbye to my first clinical rotation site. Turning in my badge was a bittersweet moment. On the one hand I had completed my FIRST EVER clinical rotation, but on the other I had become so comfortable at St. Clair and really enjoyed going to work each day and loved working with all the employees. I've never felt so accomplished, yet sad at the same time. 

If I had to give one word to sum up my grossing experience at St. Clair it would be "hysterectomy".  I would have never thought that I would have grossed 14 hysterectomy specimens by the end of my first five weeks. It even got to the point where one of the Pathologists walked through the lab one day and said "Nicole, every time I come in here you have a uterus at your bench!" Don't get me wrong, I was able to gross plenty of other specimens as well, but each day didn't feel complete unless there was a uterus involved. 

I am so appreciative that they let me have a try at a variety of specimens, including the bigger, more complex ones. I was able to see and learn a lot in my first five weeks (but still have a lot more to see) and I definitely have gotten the hang of dictating. It was an awesome feeling every time I was able to gross a specimen without referencing a textbook or past dictations. This rotation definitely gave me the confidence I needed and was an awesome foundation to the start of my career as a PA. I couldn't have asked for a better first rotation!

This next week I'll be at UPMC Shadyside Tissue Bank - more to follow!

Getting a Workout at Work (Weeks 2-4 at St. Clair)

I cannot believe that on Monday I will be starting my fifth week of clinical rotations! Having been in a classroom setting for the past 18 years of my life, I thought I would have a much harder time adjusting to life outside the classroom.  But I absolutely love going to work each day and it feels so rewarding to see that all the hard work of the past year is finally paying off.

In the past couple of weeks I have been progressing to grossing bigger, more complex specimens (hysterectomies, prostates, colons, thyroids, and even a twin placenta). It's funny how deathly afraid I was of receiving these specimens while I was learning about them in textbooks. But when you actually have them on your grossing bench and work out a systematic approach, they're pretty painless.  I still feel that I am slow at grossing and I obviously have plenty more specimens to experience, but I’m starting to gain much more confidence in my work. 

I also grossed my first femoral head (the portion of bone that is removed during a hip replacement surgery) specimen. When dealing with such dense bone specimens you can’t just cut through them with a regular scalpel; you have to pull out the bone saw. Now I’ve cut down a few Christmas trees in my day, but I had no idea how difficult (and noisy) it would be to cut through bone. I was pathetically red-faced and sweaty by the time I had finished cutting my perfect section. Who knew that as a PA you’d get an arm work out while at work – I definitely need to start doing more push ups.

Example of a femoral head specimen