ok I just had to post this. As you may or may not know, I used to be a phlebotomist. (the spell check thinks that should say lobotomist - no that came after kids ha ha). And I must say, even though I did it for only a short time, and 10 years ago, I was a pretty damn good one. I did my clinical rotation at a hospital in Munster, IN and they really wanted to hire me but I was moving to Chicago. I then worked for a short time at a horrible little hole-in-the-wall hospital called Thorek. (seriously if I was bleeding on the street in front of that hospital, I would catch a cab to go to a different hospital - it was that bad) 95% of the patients there were Hepatitis and/or HIV positive. And I was drawing their blood. scary. Which is why I only worked there a short time. Plus the people there basically sucked. I worked the late shift and when I would go in, the previous shift would hand me all of their "hard-sticks". Basically if you couldn't draw blood on someone after a couple tries, you handed it off to someone who could. Now I don't kid myself into thinking that these people weren't just lazy and waiting for the next shift to hand off their work... but I will tell you I never had one I couldn't get. I was good. I once drew 3 tubes out of a tiny vein on this lady's index finger. That good.
But, on my last day there, I drew on this guy in a wheel chair, with one eye and a nervous system malfunction which made him twitch uncontrollably. All this was a result of IV drug use. He was HIV positive. If I saw him on the street, I would have crossed to the other side and had my hand on my knife which was always in my coat pocket. But as it was, I was in there to draw his blood, and although he was pretty scary looking, he was very nice. He had one arm that was usable, and it was the one that had spasms and twitches like crazy, he was apologetic and tried to hold it still with his other arm, but it wasn't working too well. Somehow I got the tubes and as I was taking the needle out, he spasmed and a drop or two of blood spilled on the table. And I stood there looking at it, like there's HIV right there on that table. I went to the lab, turned in his blood, and quit.
Anyway, yesterday I went to the doctor's and had a blood test for my thyroid levels. And I have to vent about it. The girl was very nice, although a little green. I complimented her at first because she did something that MANY phlebotomists don't do (and it's something my teacher used to have a fit about). When they palpate for the vein, then they swab the spot with alcohol, then grab the needle and tube, then come back and palpate again - what was the point of the alcohol? They just recontaminated the site. Anyway, this girl actually swabbed her gloved finger with alcohol (which is what you should do if you need to re-palpate) so I complimented her on that. So, I don't know if I made her nervous by telling her I used to do that or what, but my left arm is always an easier draw. Well I think the tourniquet wasn't on tight enough, she couldn't find a good vein, went in and got nothing. So she fished around a tiny bit then tried the other arm. She found a good vein and went in. She said, let's see if I got it, I think it rolled. Which left me wondering, why didn't she anchor the vein? When they put their index finger and thumb above and below where they stick, that's what they're doing - and it's to avoid just that. So she engaged the tube, and nothing, then she fished around a little, a little deeper, finally got some blood. Very slow trickle, She kept moving it around and deeper. I know you have to do this if you miss, you're supposed to retract a little, go left, retract a little, go right, but seriously I thought this girl was going to come out on the other side of my arm at one point. Not comfortable.
She got 2 out of 3 tubes and called it good.
And then she did what is my BIGGEST blood draw pet peeve. If you look at a picture of a syringe needle, you will see the end of it is beveled. It is like a tiny little knife so that it can puncture the skin. Well, the object after the blood draw is to remove the needle - then apply pressure. THEN apply pressure. Not WHILE you are pulling the needle out. I have had so many phlebotomists do this and it drives me crazy - not to mention it hurts. If they pull out the needle and THEN apply pressure, there should be no pain. But if they apply pressure while they are pulling the needle out, it is basically cutting you the whole way out. Why do so few "trained professionals" get this concept?
So long story short, I have a lovely bruise on my anticubital fossa, and I'm sure it will only get lovelier as the week progresses.
So next time you need to have blood drawn (if you're a person who can stand to watch - I can't stand NOT to), notice if they re-palpate without disinfecting their finger. And if they apply pressure AFTER retracting the needle, consider yourself lucky!
