In the 1964 classic movie, Mothra versus Godzilla (released in the US as Godzilla vs. the Thing), a giant egg is washed ashore after a hurricane in Japan. Godzilla finds the egg and tries to break it, but when it hatches, twin giant worms are released which end up causing trouble for the title monster. Godzilla ends up covered in webbing and falling helplessly into the sea. He never expected that kind of trouble from opening a simple egg. There are lab safety stories that are like that, too. An incident occurs and it is discovered during an investigation that the unsafe practice that caused it was common. Someone asks a specific safety question, and a huge system-wide issue is discovered that could become a major project. Opening these eggs of cans of worms can happen, but the lab safety professional needs to be prepared for them.
The hospital clinic began rapid COVID-19 testing, and several other clinic locations followed suit. An office manager contacted the lab safety department wondering what personal protective equipment was appropriate for specimen collection. When the safety officer traveled to the site to perform a risk assessment, she discovered the patient collection and testing process was occurring in the manager’s office – a designated clean space where food and drink was stored and consumed - because there wasn’t any other space. Upon further investigation, it was discovered this was a common practice in several offices.
This particular can of worms is deep. There are safety issues at multiple locations, and the staff does not even seem aware of the problems. One way to handle a larger system set of issues is to discover who oversees the clinics- perhaps a clinic regional director or a quality officer. Finding this person can be done by asking at any clinic. If potential danger to staff is imminent, be sure the current process is stopped as soon as possible. Hold a meeting with the appropriate clinic leader (or leaders) to discuss and present the issues, citing safety regulations and offering potential solutions. Provide a reasonable timeline to get the safety issues corrected. Once the immediate issues are resolved, train the clinic leaders to use risk assessments before implementing other processes. That way, other long-term safety issues can be prevented.
The histology lab manager had provided chemical spill training for years and had written the spill response procedure many years ago. The plan included contacting security and the facilities department when a large spill occurs so that those employees can protect the spill site and bring a wet vac for clean-up. When an actual chemical spill occurred in the lab, an overhead alert was called, but no one responded from outside the department. The safety shower was used, and water kept flooding the department and equipment was damaged. Upon investigation, the manager learned no one ever trained the other non-lab departments to respond to large spill alerts in the building, and no one had communicated the lab policy to them.
For this unexpected can of worms, the first step should be to meet with the other department heads to discuss the incident and review the older spill response procedure. It is likely the old policy describes a process that once was approved, but with staff and leadership changes in the other departments, was not continued. If the lab now needs help and response from other departments for large spills, continue discussions with those leaders about a complete response all can agree to. Once a new process is created, educate all involved departmental staff. Conduct regular spill drills and include all involved departments moving forward so that no part of the important response process is forgotten.
In the movie, when the giant egg opened, Godzilla was overwhelmed by the number of worms that came out, and he was surprised by their menacing webbing until he was completely overcome. That can happen with certain safety issues when they are discovered, and each problem may contain unexpected troubles that run throughout several departments or even a system. Even so, the issues can be resolved. Look at the big picture, prioritize, and remember to bite off only one piece at a time. No safety can of worms is insurmountable, and with care and patience, the necessary corrections can be discovered and implemented.