Blood draws and home health

caliotter3 · Sep 25, 2010

It would not hinder you if you are seeking extended care work. As for intermittent visit type work, I imagine the employer would be willing to have you go with another nurse to practice blood draws if you let them know about your lack of experience in this skill.

tdrynelle · Sep 27, 2010

Not a deal breaker for home care.

If you don't know how to do it, they will gladly teach you (if you even need to learn at all - at my place, we very rarely do blood draws in the home, most of our clients go in for that).

KateRN1 · Sep 28, 2010

I guess it depends on where you work. Our protocol for an INR >4 is to draw a stat level, so nurses who are doing PT/INRs must be able to draw blood and we have lots of PT/INR patients. We have a few nurses who are accomplished at phlebotomy, but we also have a few who are "reluctant" to learn (aka refuse to learn). It frustrates me to no end to have to pay for a second SNV when the first nurse just won't learn/practice the skill. Phlebotomy is one of my better skills and I am willing to donate my arms for practice, but few want to put forth the effort. I'd rather have someone who is willing and needs practice than to have someone who just won't be bothered.

anticoagulationurse · Sep 28, 2010

First let me assure you I was kind of (unnecessarily) terrified of phlebotomy.

I had never attempted a phlebotomy until I was in HH. I knew the principles, had IV training (but no real experience), and I was terrified. I avoided it for a long time, watched a few during my training. But, finally I just bit the bullet and tried one, and succeeded on the second poke. Same for the next several phlebotomies, took a couple of attempts. If I couldn't get it by the third try I was surely flustered by then and it's no use torturing the patient with more pokes if I hadn't got it by then, so I would send another nurse.

I do draws once maybe every 2-3 weeks so it made it hard to get a good feel and really learn the skill. I would say by the 10th poke I was starting to feel confident and since the 15 or 20th poke (maybe about 6 months into my HH job), I was golden. Haven't missed one since and nearly always on the first poke since then.

Sensoria17 · Sep 28, 2010

Thanks you Anticoag for the encouraging story.:)

annaedRN, RN · Sep 28, 2010

We average blood draws weekly or more. I actually had one day where out of the 6 patients I was seeing, 5 needed labs. Now with the Coaguchek for PT/INR, it has lessened some. I had no experience either and after a few "practice" draws on co-workers, was able to gain the confidence to do so on patients. Started off about 3 for 4, but like anticoagulationurse, after about the first dozen or so, really "got it" and now rarely miss. You can learn it fairly quickly. Learned over time that the key is to take your time...in finding the vein and once in, if not immediate blood return. If you are associated with a hospital, you may be able to spend a day in the lab too. In any case, it should not be a huge factor in obtaining a HH position.