Etiquette ?: Docs/Nurses

[Liberty Belle]

I'm the same way. The last time I had to get stuck, it took 5 people and 18 tries. I was in tears by the end of it and some ******* doctor had the nerve to ask me why I was crying.

Anyway, I was told by a nurse to tell them before hand that I'm a very difficult stick and they should use a butterfly "something" (sorry, can't remember what) and a peds nurse should do it. I usually don't say that about the peds nurse because I don't want to insult anyone, but I do tell them that I was told to tell them that I need one of those butterfly things.

Thanks to the poster who gave the hint about the water. I'm going to try that next time.

Good luck!

 

[RNMOM]

I used to be an IV nurse many moons ago and have always loved doing IV's. Yes, mention it to them.

A few hints for you.....

Keep yourself warm, especially your arms. When you are warm, your veins dilate and are more visable. If you can't get warm on your own, ask for a warm blanket or put your robe or sweater on. When we couldn't find veins easily, we wrapped the patient's arm in towels with warm tap water and those blue pads to keep the heat in and came back in 5 min. It works nearly every time.

Keep yourself calm and distracted. When you know you are a tough stick, your adrenalin kicks in and your body pushes the blood to your core, the heart and brain. The blood vessels in your arms and legs constrict. Talk to the people in the room. Tell them you want to distract yourself to keep calm. I used to ask people about their family, work, baseball, whatever fit the occassion. If you get people concentrating on answering questions they usually don't notice the IV till it is being taped up. It really has worked that way for me hundreds of times. I used to do that when taking out catheters too.

Keep yourself well hydrated. Drink lots of fluids right up until they tell you to stop. Midnight usually. If you don't drink much in the evening you will be low on fluids and less blood volume in the morning.

Really, a lot of people are hard to stick. The worst for me are the ones with the big promenant veins. Those veins are so muscular and tough they roll right away from the needle. I was taught a terrific grip with my left hand to stabilize the veins and it works 99% of the time but there is always a difficult client out there. Good luck and remember to try the advice above.

 

[LuvN~Travel]

Except for when I had surgery and no choice about the big needle I insist on a "butterfly" needle because I know it takes one stick. What the phlebotomist dont like about it is the small bore needle takes longer to get the blood out into the tubes.

My dd is the same way. She is SO hard to stick she always asks the nurses if they could just use a butterfly. I get tickled when the nurses look at her like how do you know about those?
They've literally had to put her under for surgeries, and then do the stick.
Kim

 

[Mono~rail]

post deleted

 

[Mono~rail]

See, RNMom is what I was talking about with IV certified nurses. They know their stuff!

 

[WonderfulDreamer2]

I don't say this about many people, but that nurse is so mean and I really hate her guts for the way she treats people. One day a social worker lost it on her and yelled at her telling her she was a cold, heartless b word! We had a trauma come in with a poor outcome. The family was in the room with the pt. That nurse went in there and told them it was time fo rthem to leave because "this isn't a funeral home." The social worker heard her and got her in the station with the doors closed and let her have it!

OMG.

 

[Pea-n-Me]

Telling someone you're a hard stick is perfectly fine. As someone else said, it's giving a "heads up" and is helpful information.

This, OTOH

you get 2 tries

would not be particularly helpful, IMO. Creates more stress for the person with the needle. Better to simply ask for someone else to try if the two sticks haven't been successful.

I agree with RNMOM about being warm. I got to my chemo session one winter day and was freezing cold. Veins constricted, and probably dehydrated, too. I'm limited to one arm to begin with and it took 5 tries (with a large bore needle) to get a line started (no, I didn't want a port). A nurse friend who was with me that day was very upset; I wasn't, it wasn't anyone's fault. My being upset wouldn't have helped the situation. I told them not to worry about it, just keep going (being a nurse myself I understand you can have good skills but an off day too). From then on I always arrived for chemo toasty warm and well hydrated, and never had another day like that. They also hot packed my arm as soon as I arrived thereafter. I still get my blood drawn every 12 weeks (and will forever, possibly less so as time goes on). I hate it, but what can you do?

We have an IV team in my hospital. They're awesome, but even sometimes they have a hard time or can't get a line in at all. It happens.

 

[Mono~rail]

Wonderful Dreamer, your pm box is full.

 

[Pea-n-Me]

Hey Mono~rail - that nurse wasn't the snoring, gassy one, was it?

 

[WonderfulDreamer2]

Wonderful Dreamer, your pm box is full.

Fixed now

 

[bekkiz]

Thank you all for the advice...and, I'm glad to know I'm not the only one out there with this problem! I did tell a doc once who was doing a blood patch on me (spinal headache...blech) and he just went straight to the artery in my wrist. Hurt like the dickens for a second, but not futzing around with a dinky vein in my arm

I guess I should count my lucky stars I'm not super needle phopic!

 

[teacherforhi]

I always appreciate it when people tell me they are a "hard stick," or "my veins always blow," or "my veins roll," or "my right arm is usually better," or "a pediatric needle works best." I thank people when they tell me!

The only thing I don't appreciate is having people tell me where to stick them. I'm pretty good at starting IVs, and I have started numerous IVs in people with absolutely no problem after being told they were a hard stick. I really dislike it when peole say things like, "I won't let you start it in my hands, because nobody can ever get it in my hands." Tell me your hand veins roll or blow or whatever, but please don't tell me I can't stick them!

P.S., the recommendation to drink lots of water and be well hydrated when you know you will need a blood draw or IV is very good advice.

I'm sorry, but it's my body and you will stick me where I tell you to stick me.

After being on a blood thinner for three weeks, I'm so sick of fussing with multiple nurses over taking blood out of my hand. Is there some sort of medal they get for doing the opposite of what I ask?

The veins in my arms are too deep to find. I don't care how many years someone has been doing it; unless they're a wizard, they aren't getting blood out of my arm. I kicked one person out of my hospital room on my third day in the hospital. She had been doing this for eighteen years and I wasn't going to tell her how to do her job! I informed her she was welcome to go do it somewhere else then.

 

[PrincessKitty1]

I never thought it was rude, but i do do this. I will not let anyone draw blood or do IVs in my arm. Im not rude about it, and most people dont have a problem..I wont even let anyone look at the arms

Sorry, I didn't mean to imply it's rude. I don't think it's rude, just self-defeating when people have had a few negative experiences and then for the rest of their treatment, refuse to get stuck except in certain places.

As Cool-Beans mentioned, sometimes people who are inexperienced phlebotomists say somebody is a hard stick when really, the phlebotomist just missed the veins. I've had many, many people tell me "my hand veins aren't very good" when they are actually just fine. I appreciate input from patients, but they don't always know which veins will work and which ones don't. "Good veins" can vary from day to day due to (as mentioned in other posts) hydration, warmth, anxiety, etc.

You are right that many phlebotomists automatically want to stick antecubital veins (in the crook of the elbow) rather than hand veins. I think that's the way most phlebotomists are taught. I was taught phlebotomy by another pediatric nurse who had to stick "hard sticks" all day long (renal patients), and she taught me to look at ALL the veins, and that hand veins often work best.

 

[PrincessKitty1]

I'm sorry, but it's my body and you will stick me where I tell you to stick me.

After being on a blood thinner for three weeks, I'm so sick of fussing with multiple nurses over taking blood out of my hand. Is there some sort of medal they get for doing the opposite of what I ask?

The veins in my arms are too deep to find. I don't care how many years someone has been doing it; unless they're a wizard, they aren't getting blood out of my arm. I kicked one person out of my hospital room on my third day in the hospital. She had been doing this for eighteen years and I wasn't going to tell her how to do her job! I informed her she was welcome to go do it somewhere else then.

I definitely won't stick someone where they tell me not to, but I will try gentle persuasion (e.g., if they have great veins in their hands and nothing in their arms but they tell me their hand veins are "no good," I might tell them, "I'm not seeing anything in your arms but your hand veins look great to me!").

I won't go "fishing" for veins I can't see just because I patient tells me they want to be stuck in a certain place, but if they have preferences and I can see/palpate the vein, I definitely go along with their preference.

I would NEVER get confrontational with a patient about an IV stick or blood draw. I stay pleasant and reasonable, and do everything within my power to help them feel comfortable and in control of the situation. The nurse who told you not to tell her how to do her job was just plain unprofessional.

 

[Blueeyes101817]

Sorry, I didn't mean to imply it's rude. I don't think it's rude, just self-defeating when people have had a few negative experiences and then for the rest of their treatment, refuse to get stuck except in certain places.

As Cool-Beans mentioned, sometimes people who are inexperienced phlebotomists say somebody is a hard stick when really, the phlebotomist just missed the veins. I've had many, many people tell me "my hand veins aren't very good" when they are actually just fine. I appreciate input from patients, but they don't always know which veins will work and which ones don't. "Good veins" can vary from day to day due to (as mentioned in other posts) hydration, warmth, anxiety, etc.

You are right that many phlebotomists automatically want to stick antecubital veins (in the crook of the elbow) rather than hand veins. I think that's the way most phlebotomists are taught. I was taught phlebotomy by another pediatric nurse who had to stick "hard sticks" all day long (renal patients), and she taught me to look at ALL the veins, and that hand veins often work best.

I understand your point as well...

I have had a couple get angry at me for not letting them draw blood from my arm. Now, i have had 3 surgeries and the first one, they had to put me under before they did the IV because they couldnt get a vein that didnt roll. I have had people from 3 different hospitals and a few drs offices try to get blood out of my arm....now, i dont even give them a chance,,,

 

[C.Ann]

After 2 attempts you can request a "specialist" in that field..

If giving them a "heads up" creates an attitude problem, it's a hospital that you don't want to be admitted to..