Any phlebotomists here?

[Disney1fan2002]

I got accepted into a phlebotomy program for September. I am really excited, but I am not sure I am going to be able to figure out how to locate a vein. How difficult is it?

Also..the magic touch...is that something a person is born with or a learned skill? I have had people stick me and it hurt like hell, while some others will say "little pinch" and I don't feel a thing!! I want to be that person.

 

[Pop Daddy]

I think its one man for one wife

 

[Cantw8]

I think its one man for one wife

 

[Desiree]

Not a phlebotomist but as a person who has "difficult" veins, I applaud you for doing this. It takes an average of 3-5 sticks before finding a vein on me. And I have to get poked about once every three weeks (I'm on Coumadin for life for Anti-phospholipid Antibody Syndrome).

Just remember to take your time and you'll do great!

 

[Lanie]

If you're afraid of needles, you will likely be a good phlebotomist (this from my husband who is a phlebotomist).

 

[DL55]

Like most skills...practice, practice, practice. The more you do it the better you'll become. Unfortunately sometimes the "stick" is going to hurt. Every so often I've had a painful "stick", but most aren't very painful. Also it varies by days, sometimes you feel you could do it in the dark and on other days you can't seem to hit the broadside of a barn.

 

[tigercat]

Another person with no veins. Usually several pokes until a vein is found. One time I needed an IV. It took 4 people and 2 hours for them to finally put it in the top of my foot. Boy that hurt. Be kind, have patience and you will do fine.
tigercat

 

[dis-happy]

My advice as a veteran of many, many blood draws: always have your supplies in place in advance. I had a phlebotomist-in-training one time (at a hospital) who had me hold the needle and tube in my arm while she ran across the room to grab the gauze and band-aid.

 

[RNMOM]

Not a phlebotomist but used to be an IV nurse. I can tell you that some people just have a gift. I think having a good teacher is prime too. If you know or run into someone who seems to have the 'gift', work closely with them. Ask them to teach you.

I worked in a 1200 bed hospital on a team of 17 nurses and we each did about 30 IV's a shift. This was back in the early 80's when hospitals knew the importance of good patient care and could afford it. Many of these people had chronic health problems and were in the hospital all the time. Most were very hard to find veins on.

First, relax. If you are relaxed and can get your patient relaxed, it will help the veins dilate. Fear triggers adrenaline and it pushes blood to the vital organs and away from the arms and legs. Make sense? So... get chatty with them. Take a little extra time and ask them how the feel, about sports, family, anything to get their minds elsewhere. Ask them about their positive experiences with blood draws. Ask where their best veins are, if they know.

When you begin to look for a vein, tell them you are just going to look first then will decide where to stick.

Now, here is my best advice. Remove the tourniquet and put it back on again right away. Really. When you put it on the first time, we all tend to do it too tight. By taking it off and resetting it you let some more blood fill the veins and you tend to put it on looser which is actually better most of the time.

If you can't find veins, warm wet compresses help. Heck, if I had my way I would have a heating pad and let them sit for 10 min. to dilate the veins up.

Here is a big tip for those veins that roll. The worst are the kind you can see without a tourniquet. My DH has these and they always miss on him. I wish I could do his blood/IV's. Put the tourniquet on looser than usual. The veins are lined with muscle fibers and this kind are very tough to puncture. If you fill them tightly full of blood it only makes it worse. Sometimes I would do the IV without a tourniquet. Yep, it is possible. Just remember to pull down on the vein with your other thumb as you are sticking and it helps to keep them from rolling.

It is important to develop your 'touch'. I am right handed so my left index and middle finger were those I developed. I can feel much 'finer' with those two fingers as they were trained over years of practice. Find your vein, then put on the gloves until you are well practiced.

Most of all, enjoy your job. Have fun!

 

[Cool-Beans]

I was told right from the get-go that I had a knack for it. I guess that's true. But I don't see how some folks are so bad at it. I really don't. It's not that flippin hard.

Practice makes perfect, though. The more practice you get with people who are harder to stick, the easier it gets.

Like another poster said, the biggest rookie mistake is NOT getting the blood in there. Let that arm hang down while you set up. The veins will fill.

Word of advice: if you get REALLY good at it, keep it secret. If you don't keep it a secret, EVERYONE who sucks at it will be calling you. Bet on it.

 

[imabrat]

As another one with deep, little veins, the one piece of advice I can offer is - PLEASE don't put the tourniquet so tight it peels my skin.
O.M.G. I know I have deep, little veins and constant dehydration doesn't help, but that hurt more than the needle. I had to finally say "HEY! This tourniquet is so tight I can't feel my arm, loosen it please!".

Oh, and I second the idea of getting chatty. That always helps me.

 

[Luv Bunnies]

My mom is a retired nurse and worked in the county jail for most of her career. The nurses did their own blood draws there and she got to be quite good at it. She said it's a matter of practice and having a knack for it. Some of the other nurses hated it and would leave it for my mom to do.

Funny story - my dad was applying for life insurance many years ago. Part of the process was that a paramedic came to the house and gave him a physical that included a blood draw. The guy kept stabbing my dad's arm with no luck. Finally, my dad said, "Is it OK if my wife draws my blood? She's very good at it." The guy said, "Well, OK, but don't let anyone at my company know about this." So my mom went into the living room and drew my dad's blood with no problem. Us kids were in the other room laughing!

 

[Disney1fan2002]

Thanks everyone!

RNMOM..I am going to print you post and keep it with me for my class. Great advice...thanks.

To all those people who have deep small veins like me..have you ever had them go to the back of you hand? It works for me, but not many phlebotomists like going there. So they are determined to find a vein in my arm.

One thing I know I am going to do is LISTEN TO THE PATIENT.

 

[Laurabearz]

I have lovely veins that collapse and roll (fun fun) although I find if I over load on water for a day or two before a blood draw it's better...

But I have a question for all you blood suckers hehe

I am a hard stick... should I tell you that I am a hard stick? One lady yelled at me and said to not tell her that, but I would think you would want to know, so you could do all your tricks...

 

[Muushka]

I have lovely veins that collapse and roll (fun fun) although I find if I over load on water for a day or two before a blood draw it's better...

But I have a question for all you blood suckers hehe

I am a hard stick... should I tell you that I am a hard stick? One lady yelled at me and said to not tell her that, but I would think you would want to know, so you could do all your tricks...

I am not a phlebotomist exactly, but as a medical technologist (the one who tests the stuff), drawing blood was part of my job at many places I worked.

To answer your question about telling them if you are a hard stick, here is my experience. My least favorite thing was "you only have 1 shot" (which I am sure nobody on these boards would say!). But if someone was difficult and explained what the problems had been, that is helpful. And then shut up and let me do my job! I also have difficult veins. I always tell them that if they use a 22 gauge needle, my one surface veing works great. But they are always welcome to look around (with their eyes of course!). They put on the tourniquet, look around, and go to the exact vein I suggested. Works like a charm. Otherwise, it is so not pretty.

OP, being a phlebotomist is not the best job in the world. A necessary one, but not a fun job. Pretty much everyone you come in contact with does not want to be in that chair or bed and certainly does not want to see you.

My sister had a career change many years ago and asked my advice about the field. I told her the same thing. But she took the course anyway. After about 3 years of hospital heck, she told me I was right and asked for more advice. I suggested working for a blood bank (Red Cross and the like). The donors are healthy (for the most part unless they are donating for themselves) and they are volunteering for the procedure. It is a pretty happy working environment and the donors know that what they do is appreciated.

Good luck and feel free to PM me if you have any more questions.

 

[pixiedustaholic]

I took a phlebotomy course a couple of years ago and I loved it. I was actually pretty good at it and it gets so much easier the more you do it. It was funny to see the reaction of patients when they see your "student" badge. Most of the time, if the patient is a difficult stick, they know exactly where they have been successful in the past. On the other hand, sometimes they get so nervous, they tell you the absolute wrong arm. So, just trust your own judgement and skills and block them out mentally if you have to.
There is more to it than just sticking the patients. You also have to know which colored tubes to draw in and which order to draw them in(each has a different additive that can alter the results of a particular lab test). Some places have computer systems that will actually print this info out on the tube labels but others don't. I thought this was one of the more difficult parts than sticking the patients. I was actually amazed that alot of the hospital personnel didn't follow these procedures! I wouldn't want to be responsible for the test results not being accurate. Also, a word about the tourniquets...if you leave them on for too long, they can also alter the test results(I don't remember if it's more than 1-2 min.)...so if you have to leave them on while you search for a vein, you will need to release it and wait. A lot of phlebotomists try to hurry and get it done or maybe simply don't know.
Start thinking about what type of setting you want to work in. Hospital, dr. office, etc. In hospitals, you will have to stick the elderly, children, terminally ill, beligerent, etc. I hated sticking kids. Also, the blood donor centers in our area usually do not hire if you've been through the phlebotomy courses b/c they basically have to retrain you. They have thier own training courses since it's a little different as far as the equipment and the angle that you put the needle, etc. I worked at a weightloss clinic and hospital and loved it. However, I found that I earned more $ in my current job at a car wash than I did at either of those minus the stress and possibly hurting someone else or myself.
The local community colleges were turning out a lot of phlebotomists through thier courses and the field was saturated and it was difficult to find positions. This is also a field where they want you to have 1year of experience at most places. On the other hand, they don't like to hire if you haven't done it in while b/c it's something you need constant practice at to keep your skills. So, there are lots of things to think about. Good luck.

 

[PrincessKitty1]

Thanks everyone!

RNMOM..I am going to print you post and keep it with me for my class. Great advice...thanks.

To all those people who have deep small veins like me..have you ever had them go to the back of you hand? It works for me, but not many phlebotomists like going there. So they are determined to find a vein in my arm.

One thing I know I am going to do is LISTEN TO THE PATIENT.

I learned to draw blood on children before I ever drew on adults, and I was taught by a very experienced pediatric nurse who mostly used hand veins, so yes I've made a lot of blood draws from hand veins. Little kids generally freak out no matter what you say, but I always told older kids "This will hurt a little, but not a lot" and they usually told me afterwards "You're right, it did hurt a little, not a lot!" (Of course, occasionally they told me I was wrong too!).

I also would tell crying kids that it was OK to cry, and I assured kids who were scared (and their parents) that "It's normal to be scared, but I want you to know that this will hurt a little, not a lot. The most important thing is to hold really, really still." This was good because it gave concrete instructions to kids ("hold still") and gave them something to focus on. Again, this was older kids (like 6 and up). I would still say the same thing to younger kids, but we would have to pin them down to hold them still , I would always explain that "We're just helping you hold still." (It's still awful, though).

Kids get really, really scared when people lie to them and tell them it's not going to hurt. So I never lie to anybody about that. (Adults either!)

I always chat people up, and it does really help. At my last job I drew a lot of blood and started a lot of IVs on adults, and many many many of them told me "Gosh, I was so nervous, but that wasn't bad at all!" Some of it was my sticking technique, but a lot of it was the chatting!

The more practice you get, the better you'll be. I have great veins so I let nursing students practice on me. When I had to go to the Emergency Room last month a paramedic student started the IV on me and did an awesome job and I told him so.

 

[pixiedustaholic]

Oh, yeah! Be prepared for the other students to practice on you. EVERYONE had to be willing to be stuck. I remember one of the girls freaking out b/c she had to be stuck...by me of course. Who did she think we were going to practice on?? She was a real baby about the whole thing. Just be willing.

 

[PrincessKitty1]

Oh, yeah! Be prepared for the other students to practice on you. EVERYONE had to be willing to be stuck. I remember one of the girls freaking out b/c she had to be stuck...by me of course. Who did she think we were going to practice on?? She was a real baby about the whole thing. Just be willing.

That's OK, one of my fellow nursing students freaked out when she had to GIVE a shot (to me!) She literally sobbed and kept wailing , "I can't do it! I can't do it!" (She did just fine!)

 

[Desiree]

I've had so many needle marks up and down my arms I'm sure people kept thinking the worst when they saw me!

To answer OPs question, yes, I've had to have it drawn out of my hand. And for the most part that stick never tends to fail. The phlebotomists tend to use that as a last resort on me but even though I tell them ahead of time, they still insist on "trying" my arm, which leads to them trying my other arm, the top of the forearm and the most painful place for me, underside of my arm. Only then to give up and draw out of my hand.