No more phlebotomist in the hospital?!

lindsayalyssa · Dec 29, 2013

I've worked at the same hospital for 2 yrs. we do all our own labs/IV starts/Abgs. That's TOTAL pt care.

PaxRN · Dec 29, 2013

I work on an Ortho unit and we draw all our labs too; I prefer it as I know it gets drawn, keep up my skills and know quickly about my patients vein status (should they need a new IV during my shift). It might not be as bad as you think, most of the time you will draw all the tubes at once unless they need cardiac markers or are on a heparin drip. Good luck!

jadelpn, LPN, EMT-B · Dec 29, 2013

It becomes part of your routine pretty quickly. Also, our Techs can draw labs. Triponins in our facility are every 8 hours, so conceiveably, you would have 1 extra blood draw per shift. There are lots of ways to incorporate this into your daily routine--we also do our own labs, our own IV's, etc. If you are a night shifter, you have one triponin to draw, and might as well draw for the am labs as well if your policy says you can do this. If you are rotating IV sites, draw off that, again if your policy allows this.

Perhaps if you have one aide on the floor per shift, they can do the draws for the floor if your facility policy allows them to do so?

I would feel badly that your phlebotomist's are losing their jobs. However, for a number of nurses drawing labs is part of the job that we do. The Joint Commission has some rules regarding this--mostly revolving around patient ID stickers need to be at the bedside, and labs labelled accordingly at bedside.

Otherwise, I would ask what the new policy is, get a copy of it, and just be sure--much like giving meds, that they are properly labelled and sent, entered in computer--and again, it becomes part of the daily routine when you assess your patients.

KelRN215, BSN, RN · Dec 29, 2013

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 ..day.. long.... K+, Mg+, Troponin, PT. Not to mention nearly everyone on the floor has daily CBC, and Chemistry.
Honestly, I am thinking about leaving. We already have too many patients, and never enough staff. Often no nurse aids, so we do everything. It's total pt care with up to 6 telemetry patients. (Most of the time I feel like I work in acute care nursing home).
Does this sound reasonable to you? We aren't getting an increase in pay for the increase in work.

When I worked in the hospital, phlebotomy was only around from 7:30-3:30 and they would not draw a patient more than once in a day so, if labs were ordered throughout the day, in the evening or at night, the onus was on the nurse to do them. Not to mention, once they did their am labs they went over to the outpatient phlebotomy area and were never to be heard from again... unless you paged them, waited 20 min for them to call back and then hoped they showed up for timed labs. It was always faster/more efficient to do them yourself.

Honestly, I wouldn't expect an increase in pay. Labs are the nurse's responsibility... it's an added bonus that you've had phlebotomy doing them up until now.

VANurse2010 · Dec 29, 2013

It's not at all unusual, but it's still ridiculous. 6 patients is too many for telemetry.

Been there,done that, ASN, RN · Dec 29, 2013

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.

psu_213, BSN, RN · Dec 29, 2013

I worked for a hospital that had (and still has) a very good reputation. Nurses/techs on the unit did all blood draws and all started all peripheral IVs. The nurse:pt ratio is another issue, but as for no phlebotomists--not all that uncommon.

squatmunkie_RN · Dec 29, 2013

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.

Exactly. The hospital doesn't care one bit about the nursing staff. It's all about saving them costs. I don't understand this "keeping my skills up, and knowing what type of veins my pt has" Don't you know that every time you have to start an IV? Push meds? Bend over if you're going to allow the hospital to do whatever they want to the nurses.

squatmunkie_RN · Dec 29, 2013

I work on an Ortho unit and we draw all our labs too; I prefer it as I know it gets drawn, keep up my skills and know quickly about my patients vein status (should they need a new IV during my shift). It might not be as bad as you think, most of the time you will draw all the tubes at once unless they need cardiac markers or are on a heparin drip. Good luck!

Working on Ortho is different than Telly. When an orthodox pt starts having chest pains, super high blood pressures EKG changes they are sent to a Telly floor. Nurses now deal with taking care of not only calling the doc, giving meds, labs. It's ridiculous! On top of all that I'll have a pt in the next room calling me for a potty break because we have no aids.

TraumaSurfer · Dec 29, 2013

We haven't had phlebotomists, EKGs techs nor RTs in some areas for a long time. Patient care has actually improved. RNs don't have to page someone, wait for them to decide to return the call and finally get to the patient when they decide they are ready. Too much wasted time trying to depend on others for simple tasks. You can do these basic tasks and get things started quickly. Ever tell someone who was having difficulty breathing that they would have wait until the RT finished lunch or their smoke break? How about the patient with chest pain and the EKG tech isn't answering their page?

KelRN215, BSN, RN · Dec 29, 2013

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.

I never had anyone else to do my EKGs or respiratory treatments when I worked in the hospital (respiratory therapists only worked in the ICUs). And when we actually had aides, they refused to do such things as bathing, beds, feeding or ambulation. No lie, all they would do is VS and most of the time they couldn't even do that. I'd much rather do everything for my patients and have fewer of them than have to rely on a bunch of unreliable people.