Not at all a dilemma-drawing bloods

[mother/babyRN, RN]

hello all, in my most recent job, we draw our own bloods. there is no phlebotomy department. no big deal but since i never had to do that before and have had no formal teaching other than hands on, as it were, when the blood draw is at a time when an iv start is not involved, i have resorted to using angiocaths just because it mimics the iv start technique i am used to. i know that drawing blood as a phlebotomist would involves a totally different, stabbing technique, and i am eager to try it, although i really don't want to practice on a poor unassuming pt. there are a few nurses who were phlebotomists before they were nurses and they seem to have the opposite problem, that is, having initial difficulty starting ivs because they are used to the blood drawing technique..i am an embryo blood drawer. anyone with any suggestions or anectdotes from their own experiences???

[SmilingBluEyes]

I think for safety's sake, you ought to have your manager get someone in to PROPERLY train everyone on lab draws/IV starts so EVERYONE feels proficient and is operating on the same page. We often do our own lab draws, also. WE DO HAVE a lab, but it is a timesaver for us to just do it ourselves, esp. when an IV is being started anyhow. And we do draw labs on our newborns also.

[mother/babyRN, RN]

Yep, that would be lovely, but it so isn't happening. Besides, I am the new person, and the only one who isn't proficient,,yet, that is....

[SmilingBluEyes]

so what you do is find the most proficient person on your floor and have him/her run you thru it. seems pretty simple to me.

[mother/babyRN, RN]

Yep, thats what I have done and am doing, and I heard that a local highschool is offering a phlebotomy course at night, which I am going to sign up for. In the meantime, I just wondered about pointers..I just don't want to practice on patients, but then, I guess that is how we all learned how to do most of what we do, right???Thanks for the feedback...:)

[bellehill, RN]

A few pointers....always use the smallest needle possible, I like to use butterflies; don't hesitate, stick the needle in quickly; only put the needle in far enough to hit blood, you don't have to put the whole needle in the arm; talk to the pt to distract them and look like you know what you are doing. Just like IV sticks, it takes some practice to get confident. If you are working mother/baby then you probably have fairly healthy patients with good veins (mothers)...go at it!

[Jen2]

I am a phlebotominst in nursing school and stick newborns on a daily basis. I never even held a baby let alone draw blood from one until I started working at the hospital. It's all in confidence. Just keep telling yourself, babies have veins just like we do, only smaller. Always use a butterfly. Using an angio-cath to draw blood from a newborn can lyse the cells and therefore cause the baby to have multiple sticks. If your hospital has micro containers you can draw most samples even using a heal stick, just the same as you would a PKU,. Having someone hold the arm for you until you get used to it is also a big help. Hope this helps a little.

[passing thru]

mother/baby RN/ I "picked the brains" of the lab techs when I was a new nurse and asked them to explain to me how they were able to stik patients so easily and successfully.

Their replies were: to palpate the vein....I was spending time looking and often couldn't see one. Now I palpate 1st.

Also, all lab draws --I do antecubital. 2 big veins there.

I don't do children/babies, so can't give any pointers there.

So, just practice....practice, practice.

'Thats how you get "good." I frequently go in and tell the patient that I need to start a saline lock (heparin lock), that the old one needs to be changed out. (Don't take out the old one til you have the new one in

And I personally never stik more than twice, if I don't have it by then, I'm having a bad stik day, and I go ask another nurse.

Keep practicing.

[dawngloves, BSN, RN]

You mean drawing blood from adults, right? We do heel sticks on our neonates unless it's a blood culture.

I agree with the butterfly method. You might feel more comfortable as it is similar to an angiocath since you can see the blood return.

[P_RN, ADN, RN]

Baxter has several sites with FREE CEUs! for various intravenous needs. http://www.baxter.com/doctors/iv_therapies/education/index.html

I learned to draw blood using a syringe and needle which is definiitely NOT the way to do it now days. The hardest thing for me was when to push the corvac into the holder. I found that if I reversed my arm holding hand so that my index and long finger make a V pointing towards the patients shoulder I could hold the arm and have freedom to manipulate the tube in the holder.

[mother/babyRN, RN]

Thanks everyone! I already use angiocaths in order to draw bloods on patients who already have Ivs....All my lab friends tell me that it is more of a getting the needle in stabbing sort of deal vs the actual advancing the needle as with an IV, hence the weirdness of simply getting used to a technique. I wanted to get out of the habit of using angiocaths only because that is just like advancing an iv and, while it technically serves my purposes, it doesn't really teach me anything...Also, I hate using the antecubitals for Ivs so that follows me with blood drawing. Must be an antecubital anxiety or something that I am getting over. Interestingly, one of the nurses working with me who was a phlebotomist during nursing school, told me she prefers to use the largest needle to facilitate the vacutainer draw from the antecubital, vs the smaller needles...I am learning a lot and so appreciate any and all of the advice you have given me...Thanks!

[mother/babyRN, RN]

Forgot to mention that mostly, I am referring to healthy moms for labs...Even the unhealthy ones most often have palpable veins. Occasionally we have to do newborns, but there are enough nurses with NICU backgrounds and pediatricians, that the lab draws on babies aren't such a big deal...