Do you do venipunctures as a nurse?

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I have my BSN and have been out of school for a year and a half now. Since graduation, I have worked in the psychiatric field which I love! I recently started working for a home health agency doing visits for psych patients. During the orientation, I had to complete a skills lab. One of the skills I had to complete was drawing blood. I was never taught how to do this during nursing school and have never had to complete this task in either clinicals or on the job. My hospital has a phlebotomist come in for all the blood draws. Regardless, drawing blood is not that difficult of a task and I was able to get it right on the first try. What bothered me was the comment from the lady leading the skills lab saying how it was "scary" when I mentioned I had never done one before. This nurse is probably double my age, so nursing school is probably quite different from when she went. I was just wondering if any other recent grads did this during nursing school. I don't think my school taught it because 1) the majority of hospitals have their own lab people for blood draws and 2) if you can do an IV, a blood draw should be no problem. I was just a little offended by her comment and the possibility that she may have thought I was incompetent simply for never having done a venipuncture. In the end, it doesn't really matter because I was able to do it easily...but it just sparked my curiosity as to what other nurses have done. :)

Specializes in LTC, Subacute Rehab.

Certified in IV therapy, blood withdrawal (both optional for LVNs in my state). I'm the go-to nurse at my facility for IV starts, and I will draw labs if we have a stat order and the nearest hospital can't send a phlebotomist. Mind, this is perhaps once a week on average, so I'm certainly no guru.

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i do both but where I work it is optional so I end up doing everyones. I personally do not think it should be optional as a nurse. Also, as I work as a lab tech as well, the order of draw is important...but not noly that..one thing I learnt from this topic is that many people believe if you can start an IV you can draw blood...this is not always the case. Phlebotomy also includes using the right tubes...as an example, the ED department at out local hospital has the nurses draw blood...they draw one of every tube but have no idea exactly what they are for. Sometimes I end up having not enough SST samples and a spare citrate...tubes for certain tests are not interchangable. Dedicated samples require a dedicated tube, so sending one EDTA when i need two is not really good phlebotomy as you end up having to rebleed the patient...and dont get me started on how people forget to label tubes and send blank ones...oh so not helpful...Starnge thing when i work as a lab technician, I am horrified to say if I ring the nurses to redraw a blood due to hemolysis, inadequate sample, not labelled ect...they can be really rude.

One day I was working as a lab tech, one nurse spoke down to me. I ignored that and then another nurse came along and asked me how I was going where i was working ect, general gossip and catch up and the first nurse changed her tone and said "oh i didn't know you were a nurse as well in this hospital"

if I work as a lab tech i get paid $20.00 an hour, as a nurse $34.00 an hour...so why do i do it? Because I like it and just to go off track have learnt one VERY interesting fact...as nurses we earn every cent of our money..we are bled dry. As a lab tech my life is much better but damn that pay is not.

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Specializes in L&D/Maternity nursing.

my hospital has an IV team that we can page to start/restart IVs, though they generally only work specific hours during the week and even less on weekends. My hospital also trains LNAs to do blood/lab draws (all but draws off of central lines which RNs have to do) and if we dont have an LNA on our floor who is certified, we call other floors to send one of theirs up, or else we call the lab. As a new grad RN, we are not expected to know how to start IVs/do lab draws and we were not taught in school as we were told that this was on the job training. My trainings are coming up here within the next couple of weeks. So even though I will be getting this specific training, we still have other resources to call on should we need it.

The only unit that I saw their RNs routinely starting IVs was L&D. Other than that, usually the IV team is paged.

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I am an ADN RN. I graduated last May. It took 6 months to find a job working in a cardiologist's office. I learned to start IVs in school, but we never did venipuncture. I do both in the office. I am lucky, the veins talk to me and I can usually get even the hardest sticks...there is always one to keep you humble!

The theory that if you can start an IV you can do venipuncture sounds ok, but in reality the hand coordination required to swap tubes while holding the needle steady on a squirmy patient takes a lot of practice. I probably started 6 IVs during nursing school, hardly enough to get comfortable with it, but enough so I had the basic skill. Venipuncture was definitely a learned on the job skill.;)

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Part of the orientation at the facility I use to work included sending new nurses to the lab for 3 days to learn phlebotomy. They, also, had opportunity to spend a couple of days in the O.R. or E.R. inserting I.V.'s.

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Specializes in CVICU, CCU, SICU, MICU.

I LOVE the idea of having a day in pre-op to practice skills- I just graduated, but I'll bring that up to my program director. We learned IVs and got a fair amount of practice in clinicals. We didn't formally learn blood draws, but I learned during my ER rotation. I've thought about doing a blood draw certification to learn all about the order, which labs go in which tubes, etc.

I'm doing a phlebotomy clinical right now, but was a patient just a couple of weeks ago in a highly rated hospital in the Houston area where the nurses do all the draws. My nurses were fabulous, but they didn't follow any order of draw that I could see. When I asked one of my nurses what order she used, she said, "Well, whichever tests I think are probably most important to your doctor, I'll do first."

I thought that was pretty interesting. I didn't say anything because - well - I haven't even been accepted into nursing school, yet. :) And they only used butterflies. I liked that as the patient. :yeah:

Could someone explain how the samples could get contaminated and why order of draws matters? It's not like the sample is going from the tube back into the needle/tubing- doesn't make sense to me. I must be missing something.

Hi. Thanks to ALL of you who have participated in this discussion thread.

While I'm hoping to be accepted into MDC.edu ADN/RN school for Aug.2011, it is

not a done deal yet. I'm trying to figure out what to do in August

if I'm not accepted into RN school.

Do I take pharmacology at PBSC.edu? (PBSC.edu encourages students

to take pharm. class - in advance of being accepted to their RN school)

Do I instead sign up for LPN school?

Do I take the HESI which opens the door to apply to other RN schools?

My point is this - during my state of wondering what to do next -

my friend has suggested doing a phlebotomy course.

So, I look online thinking it would be EZ to locate a local school.

There were plenty of online phlebotomy courses, - blew my mind.

I'd think the whole point is to get hand-on experience.

Local phlebotomy schools with hands-on experience are hard to find.

The closest one I found was in Miami at Lindsey Hopkins Technical.

Anyway... reading this debate has helped me understand if I'm

just waiting to get into RN school, doing a hands-on

phlebotomy program certainly won't hurt me.

Further - on the flip side - if I don't do phlebotomy class

prior to RN school, it is not likely to hurt me either.

So, again, thanks for the debate on this topic.

Sincerely,

RNfem

Fern- please be careful to not represent yourself as an RN if you haven't even started school yet, much less passed NCLEX and obtained your license. That can get you in big trouble. Good luck with school!

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I LOVE the idea of having a day in pre-op to practice skills- I just graduated, but I'll bring that up to my program director. We learned IVs and got a fair amount of practice in clinicals. We didn't formally learn blood draws, but I learned during my ER rotation. I've thought about doing a blood draw certification to learn all about the order, which labs go in which tubes, etc.

Could someone explain how the samples could get contaminated and why order of draws matters? It's not like the sample is going from the tube back into the needle/tubing- doesn't make sense to me. I must be missing something.

Fern- please be careful to not represent yourself as an RN if you haven't even started school yet, much less passed NCLEX and obtained your license. That can get you in big trouble. Good luck with school!

Some tubes have additives that can interfere with tests conducted on other tubes. That's why order matters.

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Hi Jellycat & HiddencatRN,

Thanks for your warning.

I didn't realize a "sign-in" name was indicative of representing myself as an RN.

However, the moderators kindly notified me and changed my "sign-in" name to FEM.

Thanks again.

Sincerely

Fem

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Specializes in Infectious Disease, Neuro, Research.
...doing a hands-on phlebotomy program certainly won't hurt me.

Another thought is that this would give you practice developing those theraputic communication techniques. No one likes seeing the folks with the (generally) little red trays. Learning how to be friendly, courteous, and establish a basic rapport quickly is a valuable skill, especially when performing an unpleasant procedure. Few tasks will give you better practical experience.;)

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Rob,

Yes, people skills are useful no matter what you are doing in life.

I'm sure I'm not an expert at that either.

I notice you do RESEARCH.

How did you get into that? It certainly appeals to me.

Sincerely,

Fem

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We are not allowed to do IV's or venepuncture as students or newly qualified. I 'might' be allowed to do the training after ive been in my job for 6 months, depends on the wards finances and my competencies.

Its a pain in the rear! I cannot completely care for my patients and carry my workload (14 patients sometimes) as im constantly having to get the charge nurse to hang my fluids, do my IVAB's and even do my fingersticks (thankfully the diabetes course is mid july so i will at least be able to do that soon).

Cant do list

IV fluids hang or mix

IVAB

Fingersticks

Male caths

Bloods/cannulation

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Specializes in geriatrics.

Hi Chixie...just curious. Why is it that you cannot do fingersticks, IV fluids or caths? I can't do venipuncture until I am officially trained, but all the other skills I've been doing since before I graduated last year.

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