This document provides details about Helen Rodgers' placement as a trainee Biomedical Scientist at The Rotherham NHS Foundation Trust. It outlines her duties and training plan over a 12 month rotation through various departments, including microbiology specimen reception, urines, enterics, genitourinary bench, blood cultures, wounds/MRSA, containment level 3, sensitivities and virology. It also discusses completing an IBMS portfolio, gaining experience in other departments, the value of the placement experience, and provides advice for securing placements.
1. Helen Rodgers
PSP3 Placement Presentation
BSc Biomedical Sciences
Department of Biosciences and
Chemistry
Faculty of Health and Wellbeing
Sheffield Hallam University
2. The Rotherham NHS Foundation Trust
Trainee Biomedical Scientist in Microbiology
3. Duties as a trainee Biomedical Scientist
• To be able to identify pathogenic isolates which have grown on agar/in media
• To carry out further bacterial identification tests e.g oxidase, gram stains, catalase
• To be able to read sensitivity patterns
• To be able to perform light and fluorescent microscopy readings
• To be able to choose the appropriate media to culture samples onto
• To be able to work to health and safety regulations
• To follow the HCPC standards of conduct / IBMS document of good professional
practice
• To pipette accurately
• To interpret data
• To be able to operate specialist equipment
• To carry out IQA/EQA
4. Placement training plan
• Monthly rotation supported by a trainer
September 2016 Specimen reception March 2017 Wounds
October 2016 Urines April 2017 Blood
cultures/genitals
November 2016 Enterics May 2017 Sensitivities
December 2016 Genitourinary bench June 2017 Wounds
January 2017 Blood cultures July/August 2017 Virology
February 2017 Containment level 3 September 2017 Cover
5. Microbiology specimen reception
• Duties:
• Labelling up samples/checking for patient
identifiers
• Taking phone calls
• Setting up MRSA swabs
• Centrifuging bloods
• Typing in request forms/scanning request forms
6. Urines
• MLA Duties:
• Operation/cleaning/maintenance of UF1000i (Flow cytometer)
• Judgement of whether urine samples should be put through the
UF1000i or pipetted for a manual microscopy
• Running QC’s
• Culturing urine samples which have abnormal cell counts
• Rotation of samples from laboratory storage to cold room storage
• BMS Duties:
• Reading off urine culture plates looking for isolates which cause
infection e.g E.coli (pink), Klebsiella spp (Green), Entercoccus spp
(Blue), Proteus spp, Staphyloccocus and yeasts.
• Setting up plate sensitivities
• Reading manual microscopies
• Recording controls
7. Enterics
• Duties:
• To culture faeces onto selective media
• To carry out auramine and gram staining
• To read fluorescent microscopies looking for Cryptospordium
• To be able to identify parasites with microscopy
• To read off plates and be able to identify pathogenic isolates e.g E.coli (0157),
Salmonella spp, Shigella spp, Campylobacter spp
• To be able to carry out further bacterial identification tests e.g. oxidase, gram film,
slopes, agglutinations, api20e test strips
• To be able to perform lateral flow tests e.g GDH, C.difficile toxin, Norovirus
• To be able to prepare samples for Helicobacter pylori testing on the DS2 (virology)
• To incubate samples in the appropriate conditions for growth e.g O2, CO2, ANO2
• To have good health and safety practice
• To maintain contact with infection control nurses during outbreaks
• To identify samples which need to be sent away to reference laboratories
8. Genitourinary Bench
• Duties:
• To identify Staphylococcus and Streptococcus spp in
high vaginal swabs
• To identify Trichomonas vaginalis from microscopy /
enrichment broths
• To identify Neiserria spp including Neiserria meningitidis
and gonhorrea from selective agars
• To identify the presence of yeast in genital swabs
(cultured and through microscopy)
• To look for Actinomyces spp
• To process genital swabs / semen / interuterine devices
• To perform gram staining
• To identify clue cells – these are indicative of bacterial
vaginosis (see top right)
• To pass all group B Streptococcus isolates from
pregnant patients through for a sensitivity
9. Blood cultures
• Duties:
• To use microscopy to identify gram negative and gram positive bacteria in blood films
and record their morphology to give a presumptive organism e.g Staphyloccus (gram
positive cocci in clusters), Streptococcus (gram positive cocci in chains), Coliform
bacterium (gram negative bacilli)
• To carry out further identification tests on blood cultures e.g Binax for Staphylococcus
aureus and Pneumo antigen spot test for Streptococcus pneumonaie
• To be able to read off culture plates to give a confirmatory ID alongside gram stain result
• To be able to set up plate sensitivities
• To perform gram staining
• To carry out IQC/EQA – LabQuality gram films
• To operate/troubleshoot the BacT/Alert
• To record the temperature of the BacT/Alert
• To maintain good contact with consultants
• To process CSF’s. Perform a cell count (WBC, RBC, organisms?) and send away for
viral/bacterial PCR’s where necessary
10. Wounds/MRSAs
• Duties:
• To read off the MRSA plates from 11am/send any new MRSA’s for
a sensitivity or any MRSA’s without a recent sensitivity
• Maintenance of the anaerobic cabinet
• To read wound plates incubated in 02, CO2 and anaerobic
conditions. To look for a variety of isolates: Staphylococcus spp,
Streptococcus spp, Haemophilus spp, Pseudomonas spp,
Proteus spp, Pasteurella spp, Coliforms
• To carry out further bacterial identification tests e.g oxidase,
catalase, gram film, Staph prolex, Strep grouping, MALDI ID
• To work in a timely manner to pass work over to sensitivity bench
• To carry out IQC/EQA
• To check incompletes regularly for extended culture samples
• To set up swabs/tissues (to recognise when a sample needs
processing in containment level 3)
11. Containment level 3
• Duties:
• To culture sputum/respiratory samples
• To test samples for Mycobacterium spp (primarily to
isolate TB) / liquid bottles / slopes
• To read mycology
• To read routine plates
• To carry out gram, auramine and ZN staining
(confirmatory staining for TB)
• To use fluorescent microscopy to identify TB
• Maintenance of the BacT/Alert / temperature
checks
• To culture high risk samples from wound bench
• To follow containment level 3 health and safety
practice
• To send positive TB samples off to reference
laboratories
12. Sensitivities
• Duties:
• Operation of the Vitek Compact 2 (produces a
sensitivity pattern for an isolate)
• To produce inoculums to a McFarlan standard (0.5)
for reliable Vitek testing
• To alert consultants to new MRSA’s, ESBL isolates
• To read off sensitivity plates e.g Streptococcus,
Haemophilus spp, urines
• To carry out further identification tests e.g B-
lactamase, X&V discs
• To prepare isolates and operate the Vitek MS (MALDI)
• To set up plate sensitivities
• To identify isolates which may need a specific
antibiotic reporting e.g. isolates isolated from eyes
need chloramphenicol
• To prepare weekly controls for all laboratory isolates
from storage beads and measure disc zones for IQC
• To carry out EQA
• To complete reports for authorisation by senior staff
13. Virology
• Duties:
• Maintenance/operation of the DS2 (ELISA-based equipment) – tests for Parvo virus,
Epstein-Barr virus, Helicobacter pylori antigen, Quantiferons (TB)
• Maintenance/operation of the Bdmax (PCR) – performs Chlamydia/Gonhorrea
confirmations, C.difficile gene, rapid MRSA detection
• Maintenance/operation of Sofia – tests for the detection of Legionella / Streptococcus
pneumoniae antigens (lateral flow cassette reader)
• Maintenance/operation of Vidas – used to test blood samples for HIV, Hepatitis A,B,C,
Measles, Mumps, Rubella, Cytomegalovirus, Helicobacter pylori antibodies, Procalcitonin
• Maintenance/operation of Chorus – tests for Mycoplasma IgG / IgM
• Entering reference laboratory report results / sending away samples to reference labs
• IQC/EQA testing
• Storage of samples (up to 2 years)
• Interpretation of results, e.g Does the sample need to be sent for PCR? Does the
consultant need to be informed?
• Use of unity web – IQC graph recordings
• Labelling blood samples up – it is important to check with experienced/senior staff that
the correct test sets have been added
14. Experience in other departments/CPD
• Barnsley Hospital Microbiology – 1 week
• Histology – 1 day
• Point of care analysers in Biochemistry – 1 afternoon
• Visited a patient on the intensive care unit
• Attended lunchtime talks
15. IBMS portfolio
• Beneficial to complete the registration portfolio on placement as this enables you to become
registered with the HCPC once you had finished your degree – employers favour students
who already have HCPC registration
• It is important to have some understanding of what the portfolio entails for interview questions
• Two sections: Professional Practice and Knowledge - 5 modules per section - 3 evidences per
module (total of 30 pieces of evidence)
• Verification is a 40 minute tour with 90 minutes marking time for the assessor
• Completed over the year with regular training meetings / feedback /suggestions
• Mixture of witness statements / annotated documents / set questions / reflections / logs
16. Value of placement
• Extremely valuable!
• Had experience of 1 or 2 microbiology labs at university – opened my eyes to Microbiology as I previously
thought I wanted to go into Haematology
• Work is varied and busy, I have developed a lot of practical skills and knowledge whilst here
• IBMS portfolio completed
• Experienced one of the least automated disciplines in biomedical science
• In December 2016 I was asked if I would like to apply for the part-time BMS position. In March 2017 I started
as the new part-time trainee BMS (getting paid!) alongside my other placement days. I have now been given
3-4 months off for third year lectures/exams and will return to work in February to carry out my final year
project
17. Advice
• Do not panic if you don’t have a placement towards the end of the year – most NHS ones
are released from April/May!
• Don’t let an NHS placement put you off because it’s unpaid – if you make the right
impression this gets you known to a hospital (more likely to get an interview).
• ALWAYS ask to have a look around the lab after/before you have applied – this year my
manager said she was only interviewing candidates who had come to look round. Helps
to get a feel for the environment
• Any placement type (private, NHS ect) looks good on your CV
• Use the year to help focus your career plan for after uni – I used the year to figure out
whether I could work in a lab as a career as I considered teaching