Extreme difficulty drawing blood ! Please read...

[Cook23]

Hello ! I decided to join the forum since I've read a lot of posts on this site that were helpful. I hope You help me with my problem as well since I'm extremely disappointed.

I'm in nursing school and this is my final semester. We never had a formal teaching on phlebotomy, meaning it was never in our curriculum and no one ever bothered to teach us how to do it. Despite this however, in the clinic I practice this year, the medical workers send us to draw blood from the patients.

I've tried around 10 times to draw blood up to now and even though I succeeded the first time I couldn't seem to complete the procedure afterwards. I also ''broke'' some of the veins I tried to puncture and I felt really disappointed and embarrassed.

They made us use 20cc syringes from the very first time since there are no vacutainers or butterfly needles in our clinic. On top of it everyone else tells me how easy it is and how they manage to draw blood from every patient without much effort. Whenever I fail they look at me with a mocking look, making me feel dumb.

I looked up videos and FAQs online about venipuncture and even though it seems easy, everytime I try again no blood comes in the syringe or I go through the vein and break it. I asked some people to help me but they all say they have other things to do and leave.

Do you have any advise on how to deep to go and how I realize how deep the vein is ? I don't want to keep breaking veins and being mocked at. Do you believe I should have been better after 10 sticks ? After how many sticks should most people get good at venipuncture ?

[SopranoKris, MSN, RN, NP]

Do you have a clinical instructor? Or are you assigned to a nurse? I would ask one of them if they would verbalize what they're doing while you observe a venipuncture. Then have them walk you through a venipuncture. It really is an acquired skill.

The best advice I can give is to take your time to find an appropriate vein. Most people go right for the AC but that may not always be the best draw site for that patient. I usually ask the patient if they've had blood drawn before and which spot worked the best. Most patients will point to the exact area. Look at the left arm if they're right handed, check all possible draw sites. If you don't find a juicy vein, check the other arm. So many times I see people trying to force the draw to work on one arm, without looking at other site options. Checking sites with a tourniquet doesn't hurt nearly as bad a poking over & over.

Make sure you're using a flat enough angle. Remember, you don't want to go through the vein, you want the needle inside it. Sometimes you have to retract just a millimeter or 2 to get the blood to start flowing.

I'm surprised your facility only uses syringes. There's more risk for the sample clotting or hemolyzing.

And finally, I know this is easier said than done, but RELAX when you do the draw. If you're nervous & tense, it makes it a lot harder to do the fine movements you need. The more relaxed & confident you are, the easier it will be. Again, this comes from taking your time to select the best vein before proceeding.

If the hospital you're at has phlebotomy or lab techs, ask them to help you as well. Most of the phlebotomy techs I worked with were happy to show new people how to do a draw.

[HouTx, BSN, MSN, EdD]

Don't beat yourself up. This is a technical skill - requiring no formal 'education'... just training. Like all physical skills, it just takes practice and the right coach. A good bit of the success is related to your ability to correctly handle the syringe, butterfly or vacutainer equipment. If you have access to a task simulator, use it to become familiar with the equipment and basic techniques.

It's all good. As a nursing student I never was able to 'correctly' make an occupied bed that met my instructor's criteria for success. Srsly. But it had no impact on my actual practice.

Try not to sweat the small stuff. It's going to be all right.

[TheCommuter, BSN, RN]

If this makes you feel any better, I've been a nurse since 2006 but still cannot draw blood proficiently and am lousy at starting IV lines. I'm assured you already know the old adage: practice makes perfect. We do not become experts at procedural skills overnight.

Good luck to you!