Hello all! Let me begin by telling you that I am a phlebotomist, which means- I draw blood via venipuncture and collect and process other bodily specimens for lab testing. I am confident and upbeat which is the perfect personality type for this job because most people groan or grimace when they see me. Not many people enjoy having their blood drawn but the ones that need it on a regular basis really appreciate me, because I am good at what I do and always strive to be quick, efficient and painless- as does any good phleb. So, now that you essentially have an idea of what my job is as a health care professional, allow me to begin with…
1) I am a technician, not a nurse.
Many times, patients come to us, extend their arm and begin graphically telling us about the consistency and color of their bowel movements and ask us a barrage of medical questions that we are not qualified to answer. I am honored that you find me to be someone you can trust with your medical problems but please don’t get upset that I do not have the answers you need. I will listen and sympathize but am not really allowed (or certified) to guide you either way. I can tell you about the lab tests that will be run on which ever specimen I am receiving from you and if I don’t know, I will happily look it up (there are literally thousands upon thousands of possible tests available), but I am also not qualified to translate your results. That is something you will have to discuss with whomever ordered the tests. I do consider myself an empathetic, compassionate individual (other wise, I wouldn’t be in this line of work) and have had many personal moments with some of my patients, seen some of the greatest struggles through personal tragedy, triumph and illness, and am grateful to have this insight into human experience and will gladly listen to anything you have to say but I am not able to give medical advice (and would be fine with not having to not hear about your boogers and poo.). Now, it could very well be a nurse or medical assistant who is drawing your blood and if that is the case- request a phlebotomist or go directly to a lab drawing center, if you are an especially hard “stick”. (No offense to nurses or MAs, they do many incredible things during their work day that I could not ever begin to know how to do or want to, but- all that phlebotomists do is draw blood so we are more practiced and better at extracting the blood painlessly. That is a fact.) It is your right to request a phlebotomist when available- always.
2) Fasting Facts
Often times, patients are asked to fast for a particular lab test (cholesterol checks, glucose, etc) which means no eating or imbibing anything that can alter the results. Some doctors do not require a fast for these tests, always double check. During a fast for basic fasting lab tests, you are allowed to drink water and we as phlebotomists, encourage you to do so as it makes it easier for both of us to get your blood (or for you to pee in a cup, if that is required too). Being dehydrated can cause your veins to wizzle up and not be as plump and readily available. It is not your fault, dear patient, that the doctor or nurse declined to tell you this important fact. They just assume that you would know as it would be cruel and inhuman punishment to insist that one not hydrate them self for 10-12 hours. Yet, many times, I get cranky, thirsty patients coming in with hard enough veins to find as it is and I am always floored that they have gone so long without water. Always get the verification from your doctor that you are allowed to drink water and if you are a coffee drinker, ask if you are allowed to have black coffee- some docs allow it, others don’t (most do, thankfully!) Also- brush your teeth. Please, brush your teeth. This is allowed, as long as you don’t swallow the toothpaste which you are not supposed to do anyway. (don’t chew gum though, as you will likely swallow the ingredients with your spit) Nothing is as rank as the morning breath of a person who is fasting without brushing their teeth. Your phlebotomist will thank you and likely have an easier time getting your blood as she isn’t focused on making sure she doesn’t grimace at your nasty breath.
3) “It is not the size but how you use it” applies in phlebotomy.
My favorite is when a patient with gigantic, popping veins (in the field, we refer to these as “pipelines”) comes in and requests a butterfly needle. First off, a butterfly needle isn’t necessarily smaller than a straight needle. The main purpose of a butterfly needle is to get at a vein that is oddly angled or closer to the surface, as a straight needle cannot be manipulated in such a way to get in there (it gives us more range in motion.) It is also good for tests that require more blood so we can be further away from the needle when switching out tubes and reduces the chance of aggravation/bruising from the needle being wiggled around while in the vein for a long time to do so. Yes, there are pediatric butterfly needles that are smaller than the straight needles we are given, we reserve those for patients who have super small veins to get, or when the hand is the best choice. …but if you have pipelines and need less than a couple of tubes drawn and instantly request a butterfly, I will use the largest butterfly I have (which is a 21 gauge) then tell you about it after when you are proclaiming how painless that was to let you know that I actually used a bigger needle, therefore proving my point. Maybe then, I will save your future phlebotomist that secret eye roll that we all do when a butterfly is needlessly requested. We are professionals and our goal is to get your blood and use whatever resources we fit. A good phleb tech should be able to hit a flimsy hand vein with a 21 gauge straight needle with little pain- not that I recommend it, but I have seen it done. So let us save the butterflies for those who truly need them. Often times, the company we work for requests that we use as less as possible because they are more expensive. Some places even make us sign them out and give us a limited supply to use. Not that the quality of your care should be determined by company costs, but just a little fact I thought you should know. (PS: There are some tricky patients that have their blood drawn on a regular basis that know themselves and what works best for a blood draw. I will always listen and do as I am told in that case, as do most of us. But if your way doesn’t work, allow us to try ours.)
4) Yes, you’re scared.
I don’t expect anyone to hop into my chair all excitedly cheering about having their blood drawn. No one really likes it. How do you think I felt while in training to do what I do? Often times, as phlebotomy tech students, we are asked to draw each other’s blood. So yeah, I have had countless people that have taken my blood with little to no experience and I survived, you will too, I promise. There are some people who are way more scared than you that suffer from a fear that is so vast that they actually faint, vomit or go into full blown seizures at the prospect of having their blood drawn. So when you come in warning me in a shaky voice that you are unfathomably scared of needles, don’t be surprised if concern instantly crosses my face and I begin asking questions about what adverse side effects you have experienced. Many patients are shocked to hear about what some people go through while having their blood drawn but it happens on a regular enough basis that we are trained to accommodate these folks, at the beginning of the blood draw, during and after. Every patient is unique and has different triggers for these side effects. Some require being reclined in a chair, others just need a distraction from the task at hand (and no one can talk your ear off like a phebotomist trying to detract from a venipuncture.) some people do specialized breathing techniques or meditation, while others just need a cool glass of water of a cold compress on the back of the neck before they leave to wait out the sweats and ill at ease feelings. If you are one of these people, please let us know at the beginning of the blood draw so we can best prepare to care for you. FYI: We actually profile the type that this commonly occurs with. It is usually healthy, buff, tough looking young men with tattoos and piercings that experience such reactions. I know some phlebs that ask these types right away if they have experienced any adverse reactions from a blood draw, but it can happen to anyone. You are in good hands with a trained phlebotomist though. I watched a cute little tiny phleb wearing heels catch a full grown man who fainted after a blood draw and cradle his head so he wouldn’t get hurt on the way down. We are on it.
5) We are human.
Though we are trained technicians, we are human and privy to human mistake from time to time. Sorry if I miss your vein on the first try- I assure you I am just as upset about it as you are. Most phlebotomists are instant gratification types of folks and it gives us pleasure to see your blood pouring into that tube as it is a sign of a job well done. If you get a bruise from my handiwork, I am also sorry. Sticking a needle into your skin while not as hard as it seems is still just that- sticking a needle into your skin and can come with a little bit of bruising. We are fine with you having your favorite phlebotomist and ok with you passing us by to request them. I have my own share of regulars that I jive well with who will pass your favorite phleb by to request me. Please do not trash talk my co-workers to me if you had a bad experience with them, unless it is something truly catastrophic. While I strive to leave no mark on you, sometimes bruising can occur or a re-stick is necessary. We are allowed only two tries a piece and you have a right at anytime to request someone different but please be merciful. A lot of times if I miss I want to redeem myself and your experience with me by getting you on the second try. Or, you could vouch for this blood drawing robot (link below) to be your phlebotomist but I guarantee that it is not as good as a conversationalist as I am and if it malfunctions, the result could be a bit more messy than me missing your vein.
OH WAIT… Here is a bonus “thing”. PLEASE make sure that when you turn in a urine, stool or sputum specimen, that the lid is on the cup TIGHTLY. We do not like having someone else’s excrement all over us and I imagine that you will not be thrilled to have to recollect the specimen if it is spilled and we are not able to save it. Thanks!