Monday, June 19, 2017

10 Things Phlebotomists Should Never Say

When I first got sick, I was totally scared of needles.  After getting 27 tubes of blood drawn – yes, I’m not exaggerating, I counted before I passed out (just kidding, I didn’t pass out, shockingly) – at my first rheumatologist appointment, that knocked the fear out of me real quick.

But that doesn’t mean I enjoy getting blood drawn or that it is a particularly pleasant experience.  In fact, most of the time, it’s not.  I’m a hard stick and I’ll be the first to admit that.

After my recent hellish appointment with my new rheumatologist – read until I fire her – the phlebotomists at her office stuck me four times to no avail.  I’d like to blame it all on the fact that I hadn’t eaten lunch or had anything to drink because I ended up spending three hours sitting in the doctor’s office.  But the next day, I went to a hospital lab in the morning, after just eating and drinking, and got stuck four times, as well.  Thankfully, at least the second time around, they were able to get all the blood they needed.

But in the process, between both labs, a lot of pretty dumb stuff was said.  Most of it isn’t stuff that I haven’t heard before.  But the more I hear it, the more annoyed I get. 

So, without further ado and in no particular order:

1.       “You don’t have any veins.”

Clearly I have veins.  I am alive.

2.      “You really are a hard stick.”

My body may be a lot of things.  Weird is definitely one of them. And unpredictable.  But one thing I know with certainty is that I AM A HARD STICK!!!  Don’t say I didn’t warn you.

3.      About those attempts where no blood flows, but as soon as they pull the needle out, out comes the blood:

“Well, at least it’s bleeding now.”

Literally, if another phlebotomist says this to me ever again, I will probably punch them.  This isn’t cute or funny.  It’s called DO YOUR JOB and GET IT RIGHT.

4.      “I bet that didn’t hurt at all.”

Yeah, well, that’s something that I wouldn’t bet money on, because you will lose that gamble.

And don’t ever, ever tell me how I should or should not feel.  Until you’re sitting in my seat, having a stranger poke and prod you, you have no idea what it’s like.

5.      “Can you straighten your arm more please?”

No I cannot.  I have ARTHRITIS.  What part of that is so difficult to understand?  Thanks for asking nicely though.  You get an A for effort and an E for execution.

6.      “Are you sure you’re okay/don’t want any juice?”

I’m super, thanks for asking.  But in reality, if you really cared, you wouldn’t ask that question because you know that the answer is “no”.  There’s nothing enjoyable about the experience, whether it goes “well” or terrible. 

I know that you just want to make sure that I’m not about to pass out and hit my head on the floor and make your job even more difficult than it already is. 

This isn’t my first rodeo.  I’ve never passed out from a blood draw and I’m not about to start now.

7.      “I’m going to try one more time…”

Don’t get me wrong, there’s nothing I love more than getting stuck with a needle, so I could let you poke me all day if you really want to, but if you’ve tried twice and failed, you’re out.  Do not pass go, do not collect $200.  And I don’t care if the lab you work for allows for three or four sticks per phlebotomist.  If you try twice and get nothing, there is a high likelihood that you won’t get anything no matter how hard, or how many times, you try. 

8.     “Wow, the last lab did a really bad job.”

You’re only allowed to say this if you do an arguably better job.  So in theory, if the previous lab stuck me four times and didn’t get any blood, and you stick me four times and get blood, you did a slightly better job.  But to me, unless you get everything in one or two sticks, you haven’t earned the right to bash whoever maimed me previously. 

9.      “You’re going to feel the teensiest, tiniest, little prick.”

And you’re just a prick, no size required.  So I guess it all balances out in the end.

10.  “That’s going to leave a mark.”

I know I bruise easily, and in some ways, it comes with the territory.  But if you’ve stabbed me in such a way that you can already tell I’m going to bruise, we have a big, big problem. 

So please don’t state the obvious and don’t pat yourself on the back for a job NOT well done.  Sorry if I’m not signing your praises.  Sorry if I don’t want to see you ever again.  Don’t quit your day job.  Oh wait…this is your day job…

So there you have it.  If you’re chronically ill, you’ve probably heard some variation on many of these phrases.  And if by chance a phlebotomist or future phlebotomist happens to be reading this, please don’t take a page out of this book.  This is a guide of what not to do. 

Sorry if I sound angry.  But if something had been done to me unwilling and without my consent, and I had the bruises pictured below, it would probably be considered assault.  So forgive me if the routine is starting to wear on me. 
  


Last Week’s War Wounds
#thecarnageisreal


It’s all a little too reminiscent of That Time I Got Manhandled By A Phlebotomist

11 comments:

  1. I did go to my new rheumy appt. He knew my previous doc so I did better in that part. But the office was very cold and they could not get blood from me. I have chicken veins. I knew they would draw blood so I did drink yesterday, but I was in the garden yesterday. No telling for me. I am a hard stick too. I will drink today and go again in the morning. They also did an urinalysis. ??? I have never had that done for RA. Not sure what they are looking for. The doc seemed nice. Pretty thorough check up.

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  2. Spot on! Hate it when they blame everything else but their lack of skills. Thank goodness there's a super talented phlebotomist at my hosp (for now...they always chase the good ones away..) and I always request for her if I can.

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  3. Bwahahahahahaaaaa! Sorry. That was funny, Which healthy people might not understand.

    They've tried butterfly needles, right?

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  4. Yep! I request certain phlebotomist now because he has the best track record so far. It's enough that I have this disease, I'm also a pin cushion because of it. After having a bein or two blown, I am no longer ashamed to say, "I'll wait for him". Lol!

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  5. Thanks. This made me laugh. It's not really a laughing matter but it's better than crying - I only have a 25% success rate for blood collection so I appreciate your comments.

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  6. That was so funny - but not laughing at you, rather in compassion for you.
    I wonder if you have also said this to them - as in my experience with the blood drawing angels (who soon become devils).

    Required - 20 tubes blood.
    Tubes at the ready - check.
    Alcohol swab, butterfly, cotton wool - check.

    'Can you please anchor the vein - I have runaway veins'

    Ah, that's ok, I should be able to get it ....
    Nekminute,
    'Gosh, this has never happened before, your vein just collapsed, ... let me try again'

    To which point they proceed to anther vein.
    As the phlebotomist approached again, I had to stop her immediately.

    'You need to use a new needle'
    'That's ok, I only used it once, and I did not manage to get any blood'

    ...

    'Seriously, have you not heard of infection control'

    And the battle begins - round 3, 4, 5, 6
    After which time, I walked out.

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  7. I’ve had the same problem until I got one who knew her stuff and used a butterfly needle and said to suggest this whenever I have to have blood taken. It worked first time!!

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  8. “That’s going to leave a mark.”
    I personally would not word it that way, its called a hematoma or bruise. Either way, sometimes veins tear and leak blood into the surrounding tissue, this can be seen as a flash of color under the skin, most of the time it is just a flash, sometimes, it pools and creates a "bubble" for lack of a better word, at this point the needle should be withdrawn, and pressure applied, its GOING to leave a visible bruise. I tell you this because I want you to expect it and take care of it and I dont want you coming back and saying Im bad at my job because it often has no correlation to my skill or lack of, UNLESS of course it is painful during and after the draw. This can be minimized if considerable pressure remains applied for a prolonged amount of time, otherwise, it could just continue to leak (there's a HOLE in your vein, it doesn't just mend Wolverine style) Furthermore, this is also the case in ALL blood draws (the leaking) to some extent, I could have done an excellent job but if you refuse to apply a good amount of pressure and maintain it using a bandaid/tape/coban then that is on YOU, and blood will continue to leak under the skin via that HOLE. IN. YOUR. VEIN.
    Similarly, small bruises are made while inserting the needle because the needle is cut at a BEVEL meaning it could be properly in the vein but the diameter of your vein is smaller than the bevel leaving a gap between the top of the needle opening and the opening of your vein. So if you dont take the bandage I offer, and refuse to hold pressure like I ask, please don't come back and complain to me or my coworkers about the bruise on your arm and say I did a bad job.

    I have always thought it to be bad form to bad talk other labs or phlebotomists, however, since you are not my patient, and this is anonymous I can say this; if your veins didn't roll, you would not be able to walk, therefore, if you have a big vein, it needs to be ANCHORED WELL.

    Theorhetically, I/we have a skill INDEPENDENT of the patient's water intake, nervousness, or illness. So if someone tells you to drink more water or that they missed because you are not hydrated, then they should practice more, get another profession, go back to school, or watch and learn from the people they always ask to finish the job they started rather than walking away and moving on to the next task. There will be a time when someone comes in SEVERELY DEHYDRATED, or suffering a HEAT STROKE and they're still going to need blood drawn! Whaddaya gonna do? Turn them away?!? hahahahaha NOPE

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    1. 100% agree with you on this one spot on

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  9. So you're not a patient, I take it? Do you know what it's like to be stuck multiple times for one tube of blood? Do you know what it's like to have your arms lined with bruises because many phlebotomists are not good at their jobs? Do you know what it's like to be a hard stick and be honest about that and not have people believe you? As a patient of 12+ years, I can say whatever I want. I'm the one that sits in the chair, deals with the pain, etc., not you. So honestly, I'm allowed to phrase things however I want.

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    1. I take it you're not a phlebotomist. As good as one may be as a phlebotomist there WILL be times where you will miss and not get blood from a pt. Many variables come into play when performing venipuncture. It is not as easy as putting the needle into the vein. Bruising can occur, it is an invasive medical procedure. There is a higher chance of success with pt cooperation.
      Remember in order to be a phlebotomist we had to get poked multiple times a day in class as a student, by students. So yes we know how it feels. As an inpatient phlebotomist at a local hospital I'd perform 600-800 successful venipuncture a month and probably have about 30 unsuccessful venipunctures. Just because one may struggle getting your blood doesn't make them shitty at their job.

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