Trina Herrin’s Real-Life Phlebotomy Experiences

One of the main reasons I chose Phlebotomy and working in the Laboratory as a career is because each day brought me new experiences.

I am the type of person that needs a challenge I cannot stand the mundane. I worked numerous jobs before beginning my career and they only lasted a couple of years.

I would become bored with the position. The challenges disappeared and so did I.

I have always been interested in the Medical field. Phlebotomy was the quickest and least expensive route to take to become a medical professional. The sooner I started, the sooner my career would begin.

I waste no time and begin searching for a school. I apply, take the exam and make it through two interviews. I am one of the lucky 12, so I start my phlebotomy course. The course lasts only 3 months. I study hard and love every minute of it. I knew I was headed down a path that leads to an exciting future.

The medical field offers stability. Generally, medical establishments have exceptional medical insurance for employees as well.

I complete my training and receive offers to work at the clinics where I perform my clinical training. However, these clinics are about 30 miles from my home so I begin looking for something closer to where I live. St. Anthony Medical Center hires me as a Phlebotomist.

Following graduation, I obtain my ASCP Certification. The majority of medical establishments prefer certified Phlebotomists/Laboratory Assistants.

My career has just begun. Of course, I am nervous, but excited as well. I admit that in the beginning I missed a few veins, as I am sure every new phlebotomist does. Nevertheless, in no time I become extremely skilled (if I do say so myself). One of the most valuable tips I can give a new phlebotomist is to wait for the alcohol to dry before beginning the draw. Otherwise, there is a burning sensation during needle insertion and sometimes it lasts for a bit after completion. If you want patients to like you, avoid the burn!

How effective is this method?

Well, I was preparing to draw a woman who is terrified of needles. She had her head turned away. I think it is a good practice to warn patients prior to needle insertion. I do this because I feel it is better if the patient knows right before she feels the pinch. Otherwise, she may jerk upon needle insertion, which could cause me to miss the vein. Anyway, back to the story… I completed preparation of the site and prior to needle insertion I tell her “Ok, here we go.” I was already drawing the blood and she says, “I’m waiting.” I inform her that I am almost done. She states, “I didn’t even feel it.” This is a perfect example of how important it is that the alcohol (or iodine) dries prior to needle insertion.

Skin Texture & Phlebotomy

During my phlebotomy training, I was attempting to obtain blood from a male construction worker. Because he spends a lot of time outside in the sun and tans frequently, his skin has a much tougher texture than most. I could not believe how difficult it was to puncture his skin. I was able to pierce his skin, but it took a bit of effort.

The Tourniquet & Hematomas

I was drawing an elderly woman during my clinical training. The elderly have very thin skin. I forgot to take the tourniquet off prior to withdrawing the needle. Because of this, the pierced vein began leaking blood under her skin. Her thin skin made it evident to me that this was happening. I did not realize that this occurred because I forgot to release the tourniquet. I was panicking. Once I realized I had neglected to remove the tourniquet, I took it off. I felt bad because I knew the woman would have an enormous bruise there due to the blood leakage. Chances are it would not hurt, just look unsightly. It still bothered me though. I held pressure on the site so as to help with dispersal of the leaked blood underneath the skin and stop the vein from leaking any more blood.

Comatose, Thin Skin & Swelling

As a hospital phlebotomist, you collect blood samples from comatose patients. Many times, they are swollen. Instances like these are challenging. The swelling makes feeling the vein more difficult and because the patient is comatose, she cannot assist you in any way.

If you are drawing from her arm, you may need to hold her arm in position yourself. To do this, it is best to gently roll her arm into position and use your forearm to hold her forearm down on the bed. Of course, you need to hold her down with the forearm of the hand you do not use to draw blood.

Draw her blood as usual. When a patient is swollen, there is excess water in the skin. Band Aids and tape can actually pull her first layer of skin off. Ouch! I know this from my experience. I went to draw blood from a swollen comatose patient. She had a band-aid on the median cubital area of her arm; I took the band-aid off and sadly some of her skin too. I was not aware that this could happen; even now, I cringe remembering it. Anyone who has lost a layer of skin knows how painful it is. A continuous stinging sensation occurs whenever it touches anything at all. Avoid using band-aids on swollen patients, use the paper tape and gauze.

Fasting Patients & Fainting

When working in an outpatient setting, many patients need to fast for their blood tests. It is important to ask when the last time was that the patient ate or drank anything. Typically, a patient needs to fast 8 to 12-hours before the blood draw. You cannot draw the blood specimen, if the patient neglects to fast. The fasting is required to ensure the test results are accurate. There are certain tests that require a fasting specimen for accuracy.

Many times, fasting patients are more likely to faint. I drew a young girl once who had been fasting for 16-hours. She decided to fast this long because she did not have time to eat before her 12-hour work shift. Therefore, because she wanted to get her blood drawn directly thereafter, she had to fast this long. She fainted. A phlebotomist must always be prepared for this prospect, especially in the outpatient lab. Inpatients are generally drawn in their beds, so if they pass out they are already laying down.

The majority of the chairs used in the outpatient lab have an arm attached to them. You will place the patient’s arm on the chair arm in front of her prior to beginning the blood draw. This chair arm helps the phlebotomist in several ways. She can use the chair arm to help keep the patient from falling forward, should the patient faint. It is also a great place to put some of the tools used during the draw.

Most phlebotomists will draw the blood into the vacutainer tubes and gently place the filled tubes in the pocket of their lab coat for safekeeping. Always remember to label all your tubes/specimens directly after collection. Take it one patient at a time. This ensures accuracy.

Inpatients

Remember the Time of Day

No one wants to have his or her blood drawn. One of the most important things you can do as a phlebotomist is make the patient as comfortable as possible. Try to be cheerful during the day. Remember that patients are sleeping when you draw them in the wee hours of the morning or during the night. Chances are they do not want you coming in all loud and cheerful. They are tired and just want you to complete your task and leave. This does not mean that you should be rude to the patient. Just be kind, inform them what you are doing and generally, patients understand and are kind back to you. Most patients know that these tests are important to help them get well.

Heartfelt Moments in My Career

Rose

I was contracted out to a nursing home. I had a woman there that I drew quite frequently. We will call her Rose. Rose was an amputee and bound to a wheelchair. While it is true that some of the phlebotomists found her difficult, she had a sweet demeanor with me. I believe it is because of my demeanor with her. I am a very compassionate person and I think that quality is evident in my relations with the patients. This is true especially with the patients that visited the hospital frequently and the nursing home patients.

One day I entered the room to take Rose’s sugar reading with a glucometer. She told me to open the bottom drawer in her dresser, so I did. In that drawer, she had numerous beautifully crocheted heart-shaped pillows. She told me to pick one. I picked a beautiful pink and purple one.

As time went on, the nurses realized the connection that Rose and I had. One day I walked into the nursing home and the nurse pulled me aside to tell me that Rose had passed away the night before. She said she knew we were close and did not want me to walk into her room and find it empty. I still have that heart-shaped pillow and every time I look at it, I think of her.

The Baby

Sometimes as a phlebotomist, patients will open up to you. For example, I had to draw a mother who had just given birth to a beautiful baby girl.

She began telling me that she had four children at home that she could not take care of and because of this; she was giving the little girl up for adoption. This was extremely difficult for me to hear because I knew that directly after drawing her, I would be entering the nursery to perform a healstick on her baby.

What do you say when someone opens up to you like that? Well, it is a difficult situation. All I could say to her is that I understood. I do not know if this is true, but according to the nurses, her husband dropped her at the door and left her there to have the baby. Then, upon her release, he just came back, called up to the nurses’ station and they wheeled her out. He never even stepped foot in the hospital. He just left her there to deal with this stressful and sad situation on her own. How awful for her.

I went into the nursery to perform the healstick on the baby girl. I overheard the nurses conversing about the baby. One nurse stated to the other nurse that DCFS was on its way to take the baby.

She was gorgeous and I remember looking at her in sorrow. I wanted to adopt her myself. I did not have any children, but there was no way that I could. I knew that her mother wanted her but just could not take care of her properly. Looking at her and knowing that her mother was selfless enough to deal with the pain in hopes of giving her baby girl a better life was a very touching moment for me. I also imagined the day might come when this little girl would search for her birth mother to find answers.

I thought about the other children at home who knew mommy was pregnant. What would happen when she returned home without a baby? What would she tell them? If she tells them, the baby passed away and this little girl finds them all someday, then what? How will this baby girl feel if she finds her birth mother someday and realizes that she has four siblings that the mother kept, only deciding to give her away? Will she be happy that her mother loved her enough to know her limits and try to give her a better life or will she be upset and feel rejected?

Later, I realized that this woman was one of my school colleagues. I did not know personally, but I knew her face and then remembered her name. Maybe she recognized me right away and that is why she talked to be about her dilemma. I will never know.

The Decision

I entered a room to draw blood from a man in his early 50s. It was a typical blood drawing procedure with idle chitchat about whatever was on the television or the news of the day. As I was labeling his tubes and getting ready to leave his room he said to me, “I need a new heart and I don’t know what to do.” I said if you need a new heart, then you need to get a new heart. There is no decision to make. If you want to live, it must be done. What else could I say? This is an enormous decision for an individual to make. However, in the end it comes down to two things, live or die. That is it.

He Cared Enough

Another patient that stands out in my thoughts is a man who had HIV. As a phlebotomist, you use Universal Precautions with every patient. Even so many of drawing orders/labels will warn you when a patient’s body fluids are extremely dangerous for whatever reason.

I walked in his room and he warned me right away that he had HIV. I was touched by his concern for me. HIV, for many, is one of the scariest diseases out there. At the time this incident occurred, HIV/AIDS was frequently referred to as a ‘Gay’ disease. Many people had the disease, but kept it hush. I imagine how difficult it was for him to just come out and tell me he had this ‘shameful’ disease at that time. I thanked him and prepared to draw his blood.

As the months passed, he was in and out of the hospital. Of course, I drew his blood numerous times. I watched him deteriorate over those months as the AIDs ravaged his body.

The last time I drew his blood he was unconscious and covered in vomit. Now, the important part of this story is that if he had not told me he had AIDs, I may not have known to turn my head while drawing his blood in case he vomited again. Today, we know that contraction of HIV through vomit is extremely rare and only occurs when blood is present in it. At that time, there were many questions and not enough answers.

He is Coming

I remember the one time when I was in a delivery room drawing a woman’s blood as she had contractions. I had never witnessed the birth of a baby in person at this time. I had already obtained the mother’s blood and was in the process of labeling it. I turned around to leave and in the process saw the baby’s head begin to crown. I must admit I was feeling a bit faint. The anxiety and excitement in the room was evident. I really thought that I could have passed out, so I hurried out of the room before I did.

The Phlebotomist’s Role in Helping People

Here is where we talk about taking your job of helping people seriously. In my mind, I was not just there to draw blood. I was helping people get better. The laboratory is, in reality, the diagnosis center. These tests are how the physician confirms what is going on with the patient. Sure, he can look at the patient and say, “Yes, you have strep throat”. Then, the lab performs a strep test to confirm his diagnosis.

Try to Go One Step Further

If She Cannot Reach It, How Can She Eat It?

I must say that one of my pet peeves is when the cafeteria staff did not complete their job. Many times, staff would place the patient’s food tray across the room on a table just inside the door. This really aggravates me because I feel like the job is not complete unless the patient can eat.

Sure, if the patient had family members in the room with her, she could obtain her food from across the room with their assistance. However, if the patient is bedridden with no one in the room and the staff member places it there, how and when will the patient eat? Therefore, the scenario is that all six of the nurse’s patients ring their bells so she/he can bring them their food. Nurses, who obviously have more important tasks to complete, must come to each of her patients’ rooms, just to deliver them their food. In my opinion, the staff did not deliver the patients their food.

One of the patients I drew was dealing with this very issue. Her food was across the room on that table just inside the door. I finished the blood draw and went to bring her the tray. She said, “No, just leave it there”. I said that I had no problem bringing to her so she could eat. She stated that she was angry that they set it there and she wanted them to come to take the tray back to the cafeteria full, still sitting across the room. This would be her demonstration to show them that their job was not completed. She also stated that she would be sure to tell them that I offered to give it to her, but she refused because it was not my job to do so.

I must admit that the next time I witnessed a cafeteria staff member place a tray of food on that table just inside the door of the room I asked her, “Do you actually consider your job complete if the patient is unable to reach the food you deliver?” The staff member replied, “We are just told to place it in the room”. That was that, I guess as long as the food is somewhere in the vicinity of the patient, their job is done. I found it sad that they had no desire to help people and they were just there to take home a paycheck.

Help Patients Whenever You Can

Here is a perfect example of helping people by stepping outside your element. I entered an elderly man’s room to draw his blood. While there, it became evident that he was blind. I drew his blood and his breakfast arrived just as I was finishing up.

Sure, I could have left the room and gone about my day. However, I was there to help people. I knew the nurses were busy with numerous patients and this man would be waiting quite some time for someone to show him which food was where on his tray.

I went to him, took his hand, and placed it above each item while I informed him which item it was. This allowed him to begin eating. It took me about 30 seconds. Unless you are dealing with a life or death situation or STAT draws, try to take a few seconds to make the patient’s hospital/nursing home experience a bit better.

Jan’s in a Coma

Many times people treat comatose patients like a slab of meat. They believe that the individual is not there and knows nothing of her surroundings. I beg to differ and I will tell you why.

I had a young girl; we will call her Jan that I drew several times while she was in a coma. She had been in a car accident and suffered a head injury.

Even though she was in a coma, while drawing her blood, I always told her what I was doing and just chatted about various current events. One day she came out of her coma. I saw her in the hallway as she was being pushed back to her room in a wheelchair. Her mother stood beside her holding her hand. When I spoke to Jan, her mother became extremely excited and stated, “She [Jan] must know who you are because she squeezed my hand really tight when you spoke to her!” This is the reason I believe that people in comas can hear you and do know at least some of the things occurring around them.

The lesson here is that even when you are drawing unconscious and comatose patients offer them the same courtesy that you would offer an alert patient.

The Emergency Room

Here is one of the funniest and most humiliating things that I ever did while working as a phlebotomist. It occurred in the ER. A girl in her mid-twenties was suffering with a migraine. If you have ever had a migraine, you know that light hurts your eyes. Therefore, when I entered the room to draw her blood, she asked me to turn off the light as I left. I completed my task and instead of turning off the light, I accidentally hit the ‘Code Blue’ button. A Code Blue is a big deal. It is a medical emergency where numerous nurses and the physician head to the room.

Over the loudspeaker, I hear “Code Blue, ER Room 5, Code Blue, ER Room 5.” At this point, I realize that I am in Room 5 in the Emergency Room; next, I realize that I hit the ‘Code Blue’ button on the wall. Can anyone say EMBARRASSING! Therefore, yes, the medical team arrives and there is no one to save. I give out my many apologies (and frantically look for the nearest rock to crawl underneath).

Emergency Rooms can be Stressful

Sometimes working in an Emergency Room can be difficult in many ways. I do have several things that stick out in my mind in relation to the ER.

Drinking & Driving Just Don’t Mix

A father and son had been restoring an antique vehicle. The son was in his early 20s. Upon completion of the restoration, the son said to the dad, “Let’s go for a ride.” Now, the father had been drinking, but decided to go ahead and drive anyway. Unfortunately, this joyous ride quickly turned into a nightmare. There was an automobile accident.

I was responsible for taking blood from both patients. I entered the son’s room first. The nurses and doctors were hard at work trying to save his life. I watched as the doctor inserted a tube into his lung to drain the blood from it in an attempt to help him breathe. I was unable to reach either of his arms for a blood draw and the doctor was too busy to obtain arterial blood for me. She told me to draw from his feet. Now, I know that this is possible, but I had never done it.

I figured it could not be much different from drawing from a patient’s hand. Just as I went to touch his feet and look for a vein, he sat straight up, looked right into my eyes and cried, “Help me, help me please!” He fell back and immediately coded (his heart stopped beating). Although there were many attempts to resuscitate him, he died that day.

Now, I have to draw blood from his dad. This was not going to be easy. I walked in his room. A police officer stood next to him because he was drinking and driving. One of the tests ordered is his blood alcohol level. He was sobbing as I drew him and begging me to go and help his son. He kept saying that his son was in worse shape than he was. He wanted me to leave him be and go help his son instead. My heart was breaking as I listened to him knowing that his son is gone. Knowing the blame he would feel for the rest of his life for ‘killing’ his son.

I also wondered if he would go to jail for driving drunk and causing a fatality. I imagined how difficult it was going to be for his son’s wife and the rest of his family to forgive him. I knew that this man’s life was ruined because of one mistake. This example only reiterates that drinking and driving do not mix.

I will never forget the sound of his wife’s cry echoing through the hospital halls as I headed back to the lab. He and his wife had just been blessed with a baby boy four months prior and now he is gone.

She Just Wanted to Have Fun

I remember a beautiful 18-year-old girl who came into the Emergency Room unresponsive. She had been drinking alcohol at a party. She fell backwards down a flight of stairs. I think she was Latin because she had beautiful black hair and olive colored skin. It was so sad; she was all dressed up, probably wearing her favorite outfit. I watched as the ER nurses and physician tried to resuscitate her.

My thoughts were deep, it is hard when older people pass on, but when you see young people die, it is much more difficult. She went out to have a good time and ended up here. Rumors spread that maybe she was pushed down the stairs during a confrontation. I do not know if anything ever came of that. All I know is that, sadly, she was brain dead. Her parents were kind enough to donate her organs so that others may continue to live.

Blood Transfusion

Some patients are afraid of receiving blood from others because they fear the blood could be tainted with some kind of bloodborne pathogen. Although there are pathogens that can be transmitted through the blood and during a blood transfusion, a phlebotomist needs to know how to deal with this type of situation.

HIV tends to be one of the biggest concerns that patients have. Blood typing for a blood transfusion requires that the patient receive another wristband. Patients usually realize that you are giving them another band. Many times, they inquire as to why you are giving them this band.

Although this can sometimes be a difficult situation, honesty is recommended. If a patient states that, she does not want a blood transfusion because she may contract a disease from contaminated blood. In my experience, the best response that you can give as a phlebotomist is to inform the patient that the blood used today is thoroughly screened to ensure its safety.

I would also tell her that the only reason her physician would give her a blood transfusion is because she needed it and without it, she may die. Generally, this is all that needs to be said and the patient understands and then becomes cooperative.

I would usually mention to a patient that is leery of receiving blood from another individual about autologous blood transfusions. When a patient knows that she is scheduled to have a surgery, she can donate blood to herself prior to the surgical procedure.

Would I Recommend a Career in Phlebotomy?

Without a doubt, in fact, I did. I have a younger sister (10 years my junior) who I recommended a phlebotomy career to. Today, she is well on her way to becoming a registered nurse. I recommend phlebotomy to any individual interested in becoming a medical professional.

While it is true that phlebotomy is a challenging career, it is also a worthwhile career. Individuals who want to help people are a perfect fit for phlebotomy. I reached a point in my career where the majority of patients (who I had already drawn) did not dread my arrival, but looked forward to it. I tried to make my visit more than just a typical blood draw. I made it an actual visit. Talking to the patient as if she is your friend about anything from the show she is watching on television to current events and even the weather is a great way to take her mind off the blood draw.

Would I Still Work as a Phlebotomist if I Could?

I love my career and am very sad that I had no choice but to give it up due to knee, neck and back injuries.

Be friendly, be careful, pay attention to what is going on around you and I have no doubt that you will love your career as a phlebotomist.