SMLC Office Nurse

Office Nurse Training and Reference Materials



EKG training for the MidMark IQecg machine obtained through a grant from KAMA.

An 11 minute online training video for correct use of the MidMark IQecg machine and the computer software. Please click the picture or click here.

• Initial overview of medical record- 12 minutes
• Scheduling- 8 minutes
• Overview for triage and clinic nurses- 16 minutes
• For Intake/triage nurse volunteers, you can view or print the step-by-step instructions here: Triage step by step instructions

Order of lab draw:

Phlebotomy/Lab Specimens 
If you are not clear on a specimen to be collected, please check with the provider. 
 
Please refer to the sheet hanging in the lab next to the centrifuge for draw order and specimen collection.  These are the directions from Labcorp (the company that processes our labs).   
If you have any questions on specimen collection, look it up in the Big Book of Labs from Labcorp or call Labcorp at (865) 312-8455. 
 
For urine specimens: Collect specimen in a paper cup, perform the dipstick analysis, and keep the specimen in the paper cup with the patient’s name on it (if needed for further analysis, it may be collected from the specimen in the paper cup). Labcorp indicated that the specimen will not be affected if collected in a paper cup and then sent in the clear cup with yellow lid for a sterile specimen or for transfer to the routine urine (grey) tube. 
 
LabCorp Details 
Find a test and details through LabCorp by clicking here.

Any tube to be centrifuged should set at room temp for 30-45 minutes and then centrifuged.  Specimens should be re-drawn if held for more than 60 minutes before centrifuging. 

• The gel-barrier tube is an additive tube and should be inverted five to six times after collection. Allow the tube to stand for 30 to 60 minutes for complete clotting to occur prior to centrifugation.  

• If 2 mL serum are required, draw at least 5 mL whole blood. If there is difficulty in performing venipuncture, minimum volume may be submitted if it is indicated in the test description. For most profile testing, draw at least two 8.5-mL gel-barrier tubes. 
• It is critical, especially for any specimen collection tube containing an additive, to allow the tube to fill completely with specimen. This requirement is important in order to achieve the proper blood-to-additive ratio; otherwise, the specimen may be found to be QNS (insufficient). 

Note: When multiple specimens are drawn from a single venipuncture, the following order is recommended: 
(1) sterile blood culture tubes, 
(2) nonadditive clotting tubes including solid red and red/grey (tiger) top tubes 
(3) coagulation tubes and tubes containing citrate (blue), 
(4) gel-barrier tubes and tubes with additives (red).  This includes the gold tubes and RED ONLY if used because there are no gold/gel tubes available. 
(5) tubes containing heparin, 
(6) tubes containing EDTA (lavender, royal blue), 
(7) tubes containing acid citrate dextrose (yellow) 
(8) tubes containing sodium fluoride and potassium oxalate (gray). 
Classically, tests 1 and 2 were done mid-stream “clean catch”.  While we are trying to keep the wipes in stock for this, don’t let this stop you.  More and more these tests are being done on random specimens.  I need to research this myself to see why clean catch is no longer a requirement. 
You can also access the TEST MENU notes on the Labcorp Link site which is bookmarked on the lab laptop.  You do not need a login/password.  At the top of the page you will see the TEST MENU options.  Select TEST MENU and enter the lab in question (https://www.Labcorp.com/provider-services/connectivity-solutions/Labcorp-Link). 
 
Monitor the following for expiration dates: 
Urine HCG test strips 
Urine dipstick test strips (mark date opened on container for new containers of strips) 
Lab tubes 
PAP specimen bottles 
Vaginal swabs 
 
Restock Sheet:
Please be specific when adding items to the restock sheet (more than just listing syringes or needles).  Help make the clinic cleaners and pharmacy job a little easier by stating exactly what is needed. 
Do not forget to check the attic for supplies-the green box contains extra lab supplies.  If supplies are low in the boxes in the attic, please add that note to the restock list. 
Add anything to the restock list that may be a few weeks of being out of date (helps with ordering). We do not automatically order or purchase a supply if we are out (try to build an order so to save on shipping).   
All of our lab supplies come from Labcorp (urine cups, STI kits, PAP specimen containers, lab tubes (anything we send to Labcorp)).  Even though we have fairly regular service from Labcorp, it can still take several days or more to get supplies.

Additional training opportunities are offered for volunteers throughout the year. Please check our calendar for up-coming events, and call the office if you have any questions.