Venipuncture Help

[middlekane]

Hello

As part of my summer job, I have to do blood draws and I'm having a lot of difficulty. I have gotten to the point that I can get the first tube most of the time, but when it comes to changing tubes, I don't anchor my hand steady enough and the needle comes out or I lose the vein. The person training me keeps telling me to stop shaking, but that doesn't really help.

Are there any more practical suggestions that anyone has so my patients don't end up a pin cushions? I am holding my hands the right way and using the flange of the tube to stabilize, but it's not working well. I'd love any suggestions. It's gotten to the point, where before I have to change tubes, I automatically start panicking and my hand starts shaking.

Then since I'm panicking, my instinct is to take out the needle before removing the tourniquet or to remove the needle before I have released the tube. Not good and I have to get the technique down to keep my job.

Thanks for any help!

[boomerfriend]

Take a supply home of all the stuff you'll use and PRACTICE, PRACTICE, PRACTICE. Do it till it is second nature to you --- the routine, where you put your stuff, everything. Try using a styrofoam cup to poke the needle into -- it feels kind of like going through tough skin and into a vein. Watch other people draw blood and see how they do it. Ask someone to critique your procedure to see if they see anything that you're doing differently that could be a problem. You'll get a routine that works for you.

[HM2VikingRN, RN]

Have you tried having the patient hold your second tube? As an HM I was shown that trick by a lab tech and it reduces reaching etc.

[Daytonite, BSN, RN]

I hold the vacutainer between my thumb and index finger. I always rest the index finger of the hand that is holding the needle and vacutainer on the patients arm to stabilize everything after I've hit the vein. As I'm changing the tubes I kind of press downward ever so slightly with my thumb in order to stabilize everything between my thumb and my index finger which is under it so I don't change the needle position. I hope I'm explaining this so you can understand. I can see myself doing it, but I may not be getting it across to you as clearly.

[EricJRN, MSN, RN]

Daytonite has some great advice regarding using your thumb and index finger to stabilize the hold. You can even use the backs of your free fingers (middle, ring and pinky) to press down against the patient's arm and further stabilize your hand. I've found it easier to avoid shaking hands that way.

Do you have access to butterfly needles? If so, those can allow you to do the stick, place a piece of tape near the wings, then draw your tubes. The tubing (that connects the butterfly to the Vacutainer barrel) will give you some slack to work with, so your patients won't feel the tugging of the tubes and you won't lose your position in the vein. Your boss might frown on the routine use of butterflies due to cost, but that technique might allow you to get used to the whole sticking routine first, without having to worry about the tube switching problem.

Good luck! Some of this stuff just takes a little practice, patience, deep breaths, etc.

[cardiacRN2006, ADN, RN]

Once I get in the vein, the hand that's holding the vacutainer never moves. I hold it very firmly. Don't try to compensate by pulling back on the vacutainer while you push in the next tube. Just keep that vacutainer hand steady and firm.

[HeartsOpenWide, RN]

I put the patients arm on a pillow and then line the tubes up in order againts their arm. They will not roll away because their arm causes the pillow to indent. If you are using a vacutainer always keep your dominate hand on the canula. Pull the test tube out with your opposite hand..( put your oposit fingers on the butt of the canula and pull out with your thumb and index finger) Blood drawing tips are hard to explain over the computer. Wish I could show you. Sounds like a big part of it is nerves, try to relax!