I am learning phlebotomy too now. I have 45 successful sticks and need to have 50 to take my test to be certified. I will be taking my test next Friday. I only work on Friday mornings since I take classes the rest of the week. I am learning at the hospital where I am volunteering. I agree with the tips from the people above. I think one of the most important things to remember is to just take your time. I tend to try to go faster when I get nervous so my teacher has had to remind me to slow down. Plus, the patient will sense if you are nervous. The more confidant you are, the more calm they will also be. Make sure that you keep your hand with the needle very steady. Keep the bevel up and at a 15-30 degree angle. Don't panic if no blood comes out at first. Sometimes it can be as simple as the bevel being at the wall of the vein in which case you just need to adjust the angle. Other times, you may have gone a bit far and can back up. Or you may just need to straighten out the vein by pulling the skin tighter distal to the needle. That works a lot. Get in a habit of doing the proper steps in the proper order. Never forget about safety and always assume every patient has either hepatitis b or AIDS. Make sure you always check the name on the orders with the patient and then again before placing the sticker on the tube. My teacher even messed that one up briefly the other day by placing my patient's sticker on her patient's tube. I was a bit worried when I couldn't find my patient's sticker at first to say the least. I totally agree with Steph that feeling is way more important than seeing. There are times when I close my eyes if I have trouble finding a vein and it really helps. It is a great feeling to get blood the first time and you can't even see a vein at all. I have had patients who have told me they were a hard stick and I closed my eyes and they were even surprised how fast I got the blood. You can also search for the veins without the gloves, then take the tourniquet off, then put your gloves on, and go from there. As for taking the tourniquet off once the blood is flowing, make sure that it is the last tube that you will be collecting first. As for butterfly needles, I am not great at those yet, but I found I need to anchor the vein and hold the needle steady with my right hand and hold the vacutainer and switch tubes with my left. If I drop the vacutainer while switching tubes, I do my best to pick it up and continue or ask the patient for a bit of help if I think they can. Make sure you know the colors of the tops of the tubes and the chemicals they contain and the tests they are for. Make sure that you also know the proper order of the draw and that the light blue top tube needs to be filled all the way. At least that is true at my hospital. They need it to be filled to perform that particular test. It has sodium citrate and is used for anticoagulation testing. When they use that, they also need a "clean catch" so it is necessary to draw a bit of blood in another tube first that can later be discarded. As for actually inserting the needle, warn the patient when you do it and just make it as smooth and quick as possible. Most of my patients now tell me that they don't even feel the needle go in or out. The book that I have used to study for this class is called "Plebotomy Workbook for the Multiskilled Healthcare Professional" by Susan King Strasinger and Marjorie A. Di Lorenzo. The hospital where I work usually just loans them out, but I bought my own copy since it has a lot of great information in it. I called B. Dalton and had them order it for me. I also figured that by learning it now while volunteering and taking my pre-requisites, it would be one less thing to worry about in nursing school
. I just re-read this and I almost forgot probably the most important thing of all. Listen to your patient. You will be surprised at how many people know exactly what needle and which vein should be used. Go with what they suggest. They usually know best from past experiences. That is about all I can think of. I haven't yet done IVs since I am not yet in nursing school so I don't have any advice for that.. I tried to talk them into teaching me that too, but they said I have to wait for that one. Good luck, don't forget to breath, don't rush, and you will do fine. I hope all this has helped a bit.