At my HH job I was sent out to draw a lab on this woman who has a portacath. I told the boss I've never drawn blood from a portacath and she gives me this instruction sheet and tells me it's easier than drawing from a PICC line.
So today I go out to this lady's house. She is really heavy and when I feel for her portacath it feels like it is about two inches below the skin. She says it is sore and I back off from this option because I am not comfortable with it.
So I drive to the hospital lab and come back with some butterfly needles and a tourniquet. She has no veins to speak of, but I make a sad attempt to hit what I hoped was a vein (the only place on her arm that felt elastic at all).
She winces in pain even though I am as gentle as I can be (she has metastatic bone cancer so no doubt she is in tremendous pain), so after one stick I tell her I won't subject her to any more and I will get a more experienced nurse to come out and see what they can do (there was an LPN staying with her but I couldn't get her off the couch to help me).
I call one of the nurses who told me he would help with anything I needed. He made some kind of excuse but said he would get it done in the morning and that was the last time I could get ahold of him (I know he won't do it, he can't do it because I never go the chance to tell him this woman's name
) So, I talked to the boss, basically she said to have her drink plenty of fluids and use warm compresses to get the veins to come to the surface and I had better get the blood tomorrow, or else.:gandalf:
Now I have been stressed out and worried because I am not the best at drawing blood and it is lucky for me to get it with good veins. I feel like I want to go sit in the corner and count my own fingers or suck my thumb. The stress with this job lately has been about to run me around the bend.
Does anyone have any other advice they can offer about how to get this done? I know I should have more experience/better orientation and it would be noble for me to refuse to take the case and find another job but this is not what is going to happen. For one thing, I had a hard enough time finding a job and I have too many bills to just up and quit.
First of all relax. You won't be able to find blood if you are uptight and shaking to boot. Second no one should loose a job over drawing blood from someone who is a hard stick. You did all the right things. Take a 23 ga. butterfly with you, several actually. Several small syringes in case you can only get a ml or two at a time. Find out if you can use bullets, small blood tubes used for kids and babies, lab should be able to provide you with these if possible and give you guidance on how much blood is needed for each. If you can get someone to help it would be better to have a second set of hands to put the blood into tubes as you get it from the veins. Don't leave in the syringe too long or it will clot. Don't use too much force to draw back the blood or it will hemolyze. Put about a half ml of air in syringe and pull back slightly and allow blood to drip into the syringe, this may get you small increments but it will get the job done. sit with the patient while you work and don't get in a hurry. Use the warm compresses and gravity to try to plump up the veins. Look at the hands or wrist (palm side) for a hint of a vein. You only need the tip in the vein to get what you need. If she blows when the needle touches the vein try without the tourniquet. You can use those little veins in the thumb or fingers if needed. Good luck
Last edit by kat911 on Jun 6, '06