No more phlebotomist in the hospital?! - page 3

The place I work for wants to get rid of all phlebotomist and make nurses do lab draws. I work on a telly floor. This means many lab draws that get ordered all long.... K+, Mg+, Troponin, PT.... Read More

  1. by   psu_213
    Here's another way I look at it. When I first started in the ER, it took me a little bit of time to draw blood...between, getting the supplies, finding the appropriate vein, putting the needle/collection device together, drawing the blood, etc. On a floor, if there is a critical situation, it would be beneficial to the staff and especially to the pt having a crisis, to have nurses who are confident in drawing blood. After all, with all those "right now" calls you made to phlebotomy for less emergent draws, it is unlikely they will actually be there right then to draw blood.
  2. by   squatmunkie_RN
    Quote from rnmi2004
    Wow, I work med/surg with a lower ratio (1:4/5) WITH aides & I can't even imagine being on a tele floor with no aides AND having to do your own lab draws. Many cardiac tele patients are admitted with orders for Q8/6 hr enzymes. The time you're spending drawing would really add up & take away from routine patient care. It sounds unsafe!

    The other members saying this is the norm for them, what is your charting like? I can't imagine the amount of charting we are required to do with that many patients, and no aide, AND no phlebotomy. I think that is ridiculous and I'm not sure how anyone would ever be able to leave on time. I would think the amount of incidental OT would start to add up & not be much of a cost saving.
    I think you're one of the few to get what I'm saying. Taking in the fact that we have 6 tele pt's and no aid often times. So, it's 0400, I must get the vitals due at that time, draw my labs, and get all the meds passed that I need to in the AM. What about the pt's that need a potty break? I am in the middle of doing labs...passing meds. Oh did I mention we NEVER EVER have a clerk? So, if I get a admit at that time, all the paperwork and putting together the chart is also my responsibility. I think the hospital must be broke...or near it.
  3. by   DoeRN
    I worked at a hospital for over 10 years and they didn't have phlebotomist. The techs and nurses drew all the labs. Where I'm at now there are phlebotomist. And my first day on the job I didn't know and asked where that floor blood draw supplies where? Everyone looked at me as if I had 3 heads. So I guess it's what you are use too.

    Sent from my iPhone using
    Last edit by DoeRN on Dec 29, '13
  4. by   Anna Flaxis
    Six telemetry patients with no CNA is a heavy load, even for night shift. I don't blame you, OP, for being less than thrilled about this change. It does seem to be the trend these days to cut ancillary staff and assign their roles to the nursing staff. Do you have a collective bargaining agreement? Is this something the union might have something to say about?
  5. by   renardeau
    I think it's fine and great to practice blood draw/IV start skills and keep those maintained if the patient ratio is reasonable (sounds like this isn't the case in OP's situation). Where I did all my nursing school clinicals, we had an IV therapy team on top of phlebotomy (totally spoiled) and the system was very, very efficient. However, I understand that many hospitals are trying to cut costs, and let's be real, that's what cutting phlebotomy is about, none of these 'keeping up skills' excuses (that is a pro of cutting phlebotomy, but definitely not the main reason).

    Where I currently work, phlebotomy is being cut down to AM labs only. For the rest of day, non-routine labs are all nurse draws, which is okay with our 3:1 ratio on good days, but sometimes it really messes up your day when you have to take time to stick patients. (Even when patients have central lines, taking time to draw labs is hard when you have so many other tasks to do.) That aside, I do believe having phlebotomy is more proficient and saves patients pain. Yes, nurses should be able to do blood draws, and some are really quite good at it, but I really think a phlebotomist, whose only job day in and day out is to draw blood, will 9/10 times be a less painful/more successful stick. In short, I am pro-phlebotomy/IV teams. If the hospital can afford it, it saves time and pain all around.
  6. by   smartnurse1982
    My nusring school never taught us phlebotomy skills,vent management,nor how to read an Ekg.There reasoning? "Your place of employment will have phlebotomist and Rt's.At other times they said "the employers would train us'.
  7. by   anotherone
    OP , I think I understand. I have had 6-7pts no aides. Yeah, IV starts, rt stuff, labs are "basic" and nursing but we get pts with q4 labs. sometimes multiple. now it is yet another task. no aides (been there too) so some pts require 2 to turn, change, br etc.... some even more.. have to round up another nurse or 2 or 3 or 4! .. but alll the nurses are busy. it is yet another task piled on nursing. so things get slacked on......
  8. by   morte
    Quote from Been there,done that
    Of COURSE you shouldn't have the additional duty of phlebotomy.
    A cost cutting measure by the facility that makes them money and loads more on the backs of nurses.

    I find many comments regarding: keeping my skills up, labs are the nurses's responsibility.. ad nauseum.. have been made by failry new nurses who have been brainwashed to accept the HUGE time consuming chore of drawing their own labs. Let's do the EKG's, the respiratory treatments.... baths , beds, feeding ,ambulation now that's primary care!

    Great for the PRIMARY goal of the administration..... profits.

    Now when your patient complains of chest pain, add several blood draws to the other additional nursing interventions such patient would need.

    Been there, did that with 6 on a telemetry unit ... it was enough to put the already overworked nurses over the edge.
    another reason for getting rid of experienced nurses....
  9. by   psu_213
    Quote from dornavant
    I think it's fine and great to practice blood draw/IV start skills and keep those maintained if the patient ratio is reasonable
    Its not about practicing, it's about becoming proficient. If you draw blood from 25 people, there might be no one that is a hard stick. Well, suppose the person that is coding is a hard stick...even the nurse who is drawn those 25 "easy" sticks is a lot more likely to get the blood from the hard stick than a nurse who has never stuck someone.
  10. by   RNperdiem
    Interesting nursing topic! I remember in nursing school, we would face criticism from our instructors if we tried to "do it all". They taught us that part of nursing survival and time management involved delegation. "Delegation" was key and a sensible way to utilize all available resource for the benefit of the patient.
    It looks like more and more things are falling to the nurse without anything taken away to balance those new things added.
    OP, I understand. I have worked with 6 patients (mostly total care) without an aide, without a break and barely lasted a year in that job.
  11. by   Swellz
    I can't imagine 6-7 tele patients without techs to help me with EKGs and lab draws when I can't get to them. But what is the need for RT? Serious question.
  12. by   wanderlust99
    I think it's ridiculous. No RTs, no phlebotomists, nurse's aides, etc..? Next thing we'll be doing environmental services job too. Pathetic. Especially with 6 tele patients. How other nurses can justify this is beyond me.

    I'm used to not having phlebotomy, but I'm usually in the ICU with only 2 patients (and central lines or art lines). It's time consuming having to stick patients (even just my 2) when they don't have a a line. I can't imagine having to do it for all 6 patients (and you know they ALL have labs!).
  13. by   Been there,done that
    This is NOT about pitying (poor)??? RT ,EKG, or phlebotomy techs. This is about supporting nursing intervention. The RN directs the required interventions from all disciplines.

    I need NO reminders to mind MY manners. I always respectfully request the support of ancillary staff that have been assigned to assist me in my nursing interventions.

    Over 25 years of bedside nursing... no problems with achieving team support.