If a phlebotomist corrected you on order of draw, what would you do? - page 3
by pyriticsilence 11,080 Views | 47 Comments
I currently work as a phlebotomist before entering nursing school. Today, a nurse tried to correct me on my order of draw (she thought I should draw a blood culture last). When I corrected her and tried to explain how she was... Read More
- 7Oct 9, '12 by SGoodyI used to work in a NICU at a large hospital where we did all of our own blood draws so I know the process of drawing infant labs from heelsticks, arterial, venous or umbilical lines. I now work in a small community hospital in OB and unfortunately I have had to correct a phlebotomist a couple of times when I saw something they were doing wrong. I would never question them about drawing an adult because I sure don't have experience with that (except drawing basic labs when starting an IV).
One girl was doing a heelstick draw for a NBS and was bending the babe's foot back all the way to the shin and squeezing HARD! I showed her the proper way to hold the foot and "milk it". I did it in a nice way though and she didn't feel like I was criticizing her and she actually thanked me for showing her because it was not only safer but also easier
I also had to stop someone who was getting ready to draw a serum bili while the bili lights were on. She wasn't aware (nor were some of my RN co-workers) that the lights have to be off for the result to be accurate. Our manager later made this an education topic during one of our skills days.
It would be nice if we could all work together in our different fields and accept advice and tips from fellow workers without being made to feel as if we're stupid. We all have different backgrounds and should share our knowledge with each other. I know, easier said than done, right?
- 2Oct 9, '12 by JBudd GuideI listen to the experts.....
Although I have to admit to teasing the phlebotomist who was doing my annual labs, for doing the CBC first just like I do...
our chart says coags first. It was on the wall next to us, I laughed and told him he was as bad as me, but he didn't know what I was talking about until I pointed it out on the chart.
He was blown away, said he'd never seen it! oh my....
OP is right though, first BCs, then coags. I'd have smiled, answered this is policy, and as long as the offer to get the chart was sincere and not done with an "attack attitude", it was the right thing to do.
- 1Oct 9, '12 by uRNmywayIve personally always worked places where we did our own blood draws. There is soooo much more delegation of nursing tasks in the US than in Quebec. But yes, if the person who's job consists solely of doing blood draws tells me I am doing it wrong, I will definitely ask for the reason, but if it makes sense, I will go with it. Some people just let their egos in the way instead of just trying to learn from others. Really, it is her loss for being so rigid.
- 1Oct 9, '12 by mariebaileyI find it odd that a nurse presumes to know more than a phlebotomist about phlebotomy. I am a nurse who has trained under a phlebotomist when I felt the need to refresh my skills. I have to do blood draws in the field (home visits) periodically, and I have relied on the phlebotomist's expertise to keep me up to speed.
- 0Oct 9, '12 by ArrowRNIf I was a nurse, I would assume I do not know squat compared to a phlebotomist who does like what 50 plus blood draws a day? I think you would be the expert in this field and the RN needs to fall off their "high chair" and onto their butt and then get up and go learn something...I've personally seen experienced RN's who have to run get a phlebotomist because they could not find a "viable vein" to draw from and the phlebotomist comes and does it in less than 30 seconds. One should never be too proud to learn.
- 0Oct 9, '12 by gonzo1Blood culture, blue top, red top, green, lavender, then the last blood culture, or preferably the last blood culture from a different site.
Most nurses don't know the order, but after not doing it right for about 8 years I finally listened to the lab as to why it needs to be in a certain order and I do that now.
- 1Oct 10, '12 by SopranoKrisI just finished my phlebotomy class and when we did rounds with the phlebotomists in the hospital, I was amazed at how condescending many of the RNs were towards them. It had a very negative vibe in that unit. The RNs mainly rolled their eyeballs at the phlebs, especially when a draw had to be done off a line. Only an RN, PA or doc can draw off a line (per this institution's policy). So, what does the RN expect? The phleb to break the rules? Stick the patient when he/she already has a line? I mean, honestly, there was no need whatsoever for the animosity between these groups. I got a good long look at how the pecking order works in that institution. Now, when I went to a different hospital in the area, there was more synergism between these roles. Bottom line: I know which hospital I'd rather work in!!!
In reference to the OP's post, the RN shouldn't have acted the way she did. The phleb was right...you always do cultures first to avoid sample contamination. If the RN wasn't open to listening to the phleb, then a quick word with the RN's supervisor (politely!) would be in order. Drawing samples incorrectly can lead to inaccurate lab results and the patient might not get the appropriate care due to the RN's carelessness with order of draw. That can definitely have a negative impact on the patient and needs to be addressed.
I would never argue in front of a patient, though. But I would definitely let the lab know the draw was done incorrectly. Let the RN explain why labs have to be re-done!!!! Hospitals don't like wasting time & resoucres!