Tuesday, August 10, 2010

A Good Nurse Knows A Prick When She Sees One (And Some Nurses Are Just Pricks)

I try not to take myself too seriously. And I try to focus on the funny, silly, ridiculous experiences that come with being chronically ill, rather than the horrible ones, although sometimes they are hard to ignore. Sometimes, however, we just have to laugh at the funny parts, which brings me to this post.

I’d say that one of the most up and down experiences you can have as a chronically ill person is getting blood drawn. I have to get monthly blood draws to make sure that Methotrexate isn’t getting my immune system too down, and also to make sure it’s not negatively impacting my liver. Aside from this, I have to get blood drawn for appointments, tests, and occasionally, research. If the person knows what they’re doing and hit the right spot, no problem. But if they don’t, it can literally and figuratively be a major pain. So this is to say that I have had, and will continue to have, a lot of experience in the blood drawing department.

In my opinion, a really good nurse will be able to tell if you’ve been poked recently, and sometimes they’ll even be able to spot their own work, or definitely know that they didn’t prick you like that or leave a bruise. So imagine that in a one-week period, I was stuck seven different times. I guess I’m no one poke wonder…

I know that I’m not an “easy stick”. This is something I’ve come to accept. When I go for blood draws and they ask which arm they should use, I hold both arms out and say, “Pick your poison”. Most of my veins are superficial and blow easily. And I’m a small person, so naturally, I have small veins. I’m lucky if they get two tubes out of one stick. I’m a veritable pin cushion.

It’s also weird when nurses and techs say things that are on the list of things you don’t say to a patient. For instance, one nurse, after administering my EKG, asked when I would be seeing my doctor again. Like when are you seeing your doctor, because you need to.

Then another asked what I do for work. But she didn’t phrase it that way. She asked if I’m capable of working. Why, because I told you I have lupus? Or because you see something going on with my heart, on my ECHO, and you can’t imagine how I walked myself in here, let alone get out of bed every day in an attempt to be a productive member of society?

Finally, another nurse says to me, “You look so familiar”. And in my head, I’m thinking, I’m laying here with my boobs hanging out of this gown, with ultrasound goop all over me, and an arm which is about to be shot up with agitated saline. But hey, I get that ALL the time.

And let’s talk about the “agitated saline” for a second. Basically, they inject microscopic air bubbles into your arm, and then they inject saline. This provides contrast and identifies any holes that may be in your heart. It’s not as bad as it sounds, except when the nurse misses the vein and has to stick twice. All the while, I’m thinking that I’m agitated enough as it is, I don’t need agitation flowing freely through my veins.

It’s not just what they say, but how they say it. And one of the reasons I’ve stuck with the doctors that are currently on my medical team is because none of them are alarmists. And that’s what I need. I don’t need someone who is going to make me nervous by saying or doing stupid things.

So why is it, that as patients, we feel compelled to apologize for being hard sticks or for asking too many questions? Why don’t nurses ever feel compelled to apologize for their tactless behavior?

Today, I went for my monthly blood draw. The phlebotomist asked me my birthday and I said, “8-11-85”. She said, “Happy birthday”. I said, “Thanks, it’s tomorrow”. She proceeded to argue with me, “It’s today”, and I said, “No, it’s tomorrow”. The tech next to her said, “How much longer are you going to argue with her? Today’s the 10th”. And then the other tech said to me, “Are you really sure you want her to draw your blood?”

That’s exactly my question…

When you’re chronically ill, blood draws become routine very quickly. But, seriously. As patients, we allow these people to have way more power in our lives than they deserve. And lab techs simply see us as things to prick. Because we see them for such a short time. They don’t see the person behind the needle, the human instead of the disease.

These experiences are frustrating, although it is pretty humorous that someone argued with me about when my birthday is. After all, I should know, right?

So I have to wonder: when we stick out our arms, are we sticking out a whole lot more than that?


  1. I totally agree. Have a great birthday tomorrow!

  2. I get "stuck" often, too, though not as often now as I used to. And like you, I appreciate nurses and phlebotomists who can draw blood without hurting me, bruising me, or having to stab me multiple times.

    I think it's important that as patients, we also try to see our nurses and techs as human beings who are fallible, have good days and bad days, and who (in most cases, at least) would prefer NOT to hurt us, if they can help it.

    Maybe I'm strange, but I like it when the nurse/tech talks to me during a blood draw. It proves I'm NOT just another "stick" to them, but a real person with a life and feelings, just like they are.

  3. I have found a majority rule when it comes to this topic. The sticker is only as nice as the person before you.

    I am lucky to be a good easy stick. HOWEVER, that said, they use a butterfly on me now vs a larger letting device. When you miss my vein, you get one more shot. after that, get me someone from the ER or Ped's please. WHY, because they are the only one's who I have ever found to know when to say when.

    My arms are not cheese of any variety and I have blood drawn A LOT. I have to, meds, diseases whatever pick your poison. I have learned my veins no longer like IV's but I will give any nurse two tries. Why, they need the practice. If she is bitchy, only one shot. Take your anger out on someone who doesn't give a poo.

    My husband is a blood letter as his second profession. He practiced on me during his clinicals. I told him, If you can get me, you can do anyone. I have had a lot of surgery and it is not good for the veins. He passed on his first try. I'm so proud of him and... he smiles before and after!! Hugs... great topic... tazzy

  4. Thanks, Tricia!

    Wren - It's not that I don't like being talked to, but don't talk to me about stuff that you shouldn't be, you know? There are several techs that I have experience with, and I like chatting with them.

    Tazzy - When I was in the hospital, they got a peds person for me. And I sometimes get the peds person when I go the lab, and they're great.

  5. I have let out two blood-curling screams during two routine pricks and I'm not a screamer.

    I finally figured out that nerve endings are near the veins on that arm and I will not allow anyone near it with a needle. I do have one small one that isn't affected.

    Some techs feel like you're trying to control them but no...you're trying to avoid being shocked.

    Unfortunately I have small veins so the other arm is ignored. Some techs can tackle the one tiny vein with great confidence, others are scared to death of it.


  6. Especially when it violates HIPA eh? Good gawd if I had dollar for everytime i saw a chart left in public, a name first and last called out in a waiting room or calls left on answering machines without consent. Man it drives me nuts.

    HAPPY BIRTHDAY no it's tomorrow...


  7. Happy Birthday!! Hope you have a wonderful day. I totally get the blood drawing drama. Between the MTX and Enbrel, I've been going every 3-4 weeks for the past 8 years. I tend to watch them do the draw. It freaks them out so its pretty entertaining. :) They seem to feel that if you're watching them you're gonna pass out or something. I'm a regular lady, get over it. Sometimes I feel like I could do a better job than they can. Seriously, whats with the tournaquets lately? they've been pulling them so tight I'm not sure how they're getting any blood drawn at all. I went one time when the lady overshot my vein and actually pulled the needle in and out five times like she was sawing through something trying to find it. That actually did almost succeed to make me pass out. Not cool, and I refuse to see that lady anymore.

  8. I hate getting blood drawn and I think a great deal of my doctor avoiding has to do with that.

    Every single time, I either scream, or start crying uncontrollably. I'm not the easiest person to stick either apparently.

    Happy birthday!

  9. Hey!! Happy Birthday! This reminds me a lot of where I am from. It is a small area, so almost everyone knows everyone. I have actually become great friends with people in the medical community after getting X-rays, MRI's, blood draws, etc. from them!!

  10. As a nurse...and chronic pain sufferer, I can assure you they do not intentionally hurt you. There are gonna be times when they miss a vein...it's pretty inevitable. I speak to my patients fairly candidly and they seem to appreciate that. Perhaps they were just trying to be friendly with you and strick up a conversation?

  11. Re: " Why don’t nurses ever feel compelled to apologize for their tactless behavior?"
    If its medically tactless behavior, they probably don't apologize for the same reason my uncle told me not to apologize when i'm driving: If i don't apologize, people may not notice i made a mistake in the first place. I think "they" probably tell nurses never to apologize since its an implicit admission of guilt.

  12. I am so sorry you guys have had to deal with the tactless behavior of some nurses. There are, unfortunatley, alot of them out there that are jaded and do not really care.

    Since I have been a patient many times (I was a patient all last week in the hospital), I think it has made me a better nurse. I also do apologize for my mistakes...esp when it does come to IV's. I HATE to miss a vein or have to stick my patient more than once. I certainly never would want to give someone added pain intentionally.

  13. I have had the full range of blood-letting experiences, from the new phlebo who joked "I hope you're not a bleeder like the last guy..." and then proceeded to roll my vein twice, to my usual nurse at my GP who updates me on her new phone woes to keep me distracted and knows that if I flinch even slightly something is Very Wrong.

    After my first few draws of collapsed veins and nasty bruising/scarring, I know most of the things that I can do to make the process as painless as possible for everyone involved (I do so love butterfly needles!). That said, if the veins in my arms are not cooperating, they tend to pounce on the veins in the back of my hands like a starving vampire. While they are certainly effective, it is one of the more painful processes and I'll avoid it as much as possible.

  14. Wow! I just love seeing all these comments here, and getting readers talkiing and sharing their experiences. I just want to clarify that this post was not meant as an indictment of the nursing profession. It is simply me commenting on some fairly ridiculous experiences I've had. Please note the humor!