A lot of students – myself included ask if we need to memorize the lab values for acute care or even inpatient rehab.
If you ask 2 different CIs, one might say yes – memorize them or be very familiar with them, and another might say no because you can reference a cheat sheet or look it up online. Neither would be necessarily wrong.
For example, when I was oriented to acute care, I got several printouts of lab values. I never memorized them myself because personally, I don’t think my brain has the ability to remember numbers. I have always struggled with history class for this reason such as remembering the years that events occurred. I barely remember birthdays, only know several family member’s phone numbers, and am still memorizing my newborn son’s birthday. So when I first learned about lab values in OT school, I thought to myself, if I want to work in this setting, it is going to be impossible to memorize these lab values.
And when we say lab values, they really are ranges, low to high values. Kind of like how hypertension is for blood pressure. The term you may hear is reference ranges, and basically what is considered low, high, or critical is based on population norms – therefore ranges technically vary by age, gender, ethnicity, and so on.
Here is one tip: I like to carry around a small notebook with me in my scrubs at all times to reference things I use a lot, including lab values. You could also use your phone, but sometimes, your phone can be a distraction when you really just want to focus and don’t have a lot of time and have to do a chart review.
The next thing I am going to share might be controversial and provocative, but the great thing about electronic medical records is that most of the software alerts you when lab values are not looking so great.
For example, my system has different colors for lab values – black for “normal”, yellow for slightly abnormal, and most importantly, red for critical lab values. Your system may have a letter next to the lab value, such as L for low, H for H, C for critical. If you click on the lab value, it will then show you ranges and you can compare the actual value to how far off from the range it is.
Different settings, even in the same country may use different units of measurement. And lab value ranges for what is considered “critical” may be critical for one hospital, but slightly abnormal for another. And as many of my viewers are from around the world, the units of measurement are surely going to be different from the US.
When you are doing fieldwork or during onboarding when you are hired, ask if there is a cheat sheet for lab values for your work setting. Also, what one employer considers dangerous for the same lab value may not be dangerous for another employer and there may be different protocols.
What I think is more important is to understand the “big picture”, and what it means when a certain value is abnormally critical for the patient, how they will likely present, what precautions to take, and whether you should “hold” for therapies altogether. For example, a patient who is trending down in white blood count in the CBS is likely to be more fatigued and weak than before.
Another thing to keep in mind is not to rely on just asking the nurse if it is okay to see the patient because your rehab team may have more strict protocols to restrict exertion levels or again, hold therapy altogether. Hope this reassures you that lab values are not another thing that necessarily needs to be memorized but to think of the big picture and what they mean and their relationship to each other and body systems.
