Hello fellow nurses! I recently transferred to another SNIF as an 11-7 RN and in the am, the labs phlebotomist would keep asking me to sign papers that the pt refused to have blood drawn, and I would go to the pt's room and ask them myself, and they always agree if its me asking ( this in the middle of med pass). I was just particularly irked today because last night was very busy, then at around 6.45am the labs called me to say that the phlebotomist would be late for 20 mins and to hold the residents' breakfasts until she comes! So I go, ok I got all the names of the residents with blood tests and asked the CNAs assigned to hold it (we are on full census!) So here she comes( while I was counting narcs with the incoming nurse) asking me to sign the lab again that the pt refused! I asked her what lab it was, and it was a PT/INR, so no way Im going to allow the pt not to have it. So off I go to ask the pt again, and she agreed, and the phleb brushed me aside(as usual!) saying, "I'll take it from here". Then I was counting with another cart and she interrupts me again saying that another pt with a PICC line wants her blood drawn from her PiCC line, and that I should do it because Im the RN! I absolutely am not comfortable drawing blood from a PICC line, there is so much policy to follow ( 2 pages long) and the pt has good veins! ( someone had informed her that since she is a hard stick, everything can be done with a PICC line). For me, the risks far outweighs the benefits (mainly the pt's comfort and the phlebs' time! sigh...) I hate losing my patience, but off I go to the pt again and asked her to have blood drawn from her other arm, and she said yes! Then here she goes again with her "I'll take it from here" line. I keep losing valuable time with this phleb because I needed to endorse my narcs, and do some more charting! My question is, do your lab rep ever do this to you? The phleb in the previous facility I worked at never asked me to do this! Im just venting and I do like to hear your views. Many thanks in advance!
I used to HATE g-tubes. Such a pain, having to crush the meds and check placement if it was NG. Now I love them. A little extra prep time and you can give the meds fast and be done. No waiting on a dawdling patient or in the case of kids, having to fight them and end up with them spitting half of it out.
I used to hate trachs. The trach care, what if it comes out, what if they need suctioning, how do you keep that heated trach collar on them, do I really have to change the trach ties everyday?
Now? GUARANTEED AIRWAY! Unless it comes out, and now that I've watched a fellow nurse pop one right back (thankfully that day my coworker who has a son with a trach was the one that noticed the patient's trach cannula lying on the floor), but a little KY and pop it back in. (To clarify, the extra one at bedside, not from right off the floor.hehe!) But guaranteed airway, how can you beat a day with a patient that you won't have to worry about the A in ABC?
I used to hate PICCs and ports and CVLs. So many policies to remember, flush with this, change that dressing, change the hubs how often?
Now, I just LOVE them. Guaranteed access. The couple extra things I have to do here and there are still time saved over the peripheral IV that goes bad when you have a list of meds due or right before shift change.
The mess of flushing and wasting and flushing and flushing is only a problem the first couple times. Then you get a system and can do it in your sleep.
Unless your policy doesn't allow it, (say you're an LPN somewhere that only RNs can do the draw), take it as a chance to expand your repertoire. Everything is intimidating the first few times. :)
:nurse:Hi: You should not be constantly interrupted by a phleb. who just does not care to do her job.
I would be calling the lab and explaining to them just what you told us. They need to know that their employee is behaving in this manner and would be glad to know.
By my experience you will see a change in her attitude or a new person drawing you labs. I had a phleb. who showed up at a different time each day who was scheduled at 4am. I notified my lab and they had no idea this was going on. I now have a new phleb. who loves my residents and is super!!!!
Ladies, The issue is not just the PICC line, but Phelobist is trying to get out of her job. I have had Lab people come and say Oh Ms. so and so refused blood. When I got to her, I asked her did the Lab girl come in and ask you about getting blood. The patient would say most of the time, No I never even saw her. If this is happening alot you might want to talk to the Director of Nursing so he/she can talk to the Lab. I understand about not wanting to access the PICC line because of the procedure, but sometimes you just have to do it.
wooh, BSN, RN
1 Article; 4,383 Posts
I used to HATE g-tubes. Such a pain, having to crush the meds and check placement if it was NG. Now I love them. A little extra prep time and you can give the meds fast and be done. No waiting on a dawdling patient or in the case of kids, having to fight them and end up with them spitting half of it out.
I used to hate trachs. The trach care, what if it comes out, what if they need suctioning, how do you keep that heated trach collar on them, do I really have to change the trach ties everyday?
Now? GUARANTEED AIRWAY! Unless it comes out, and now that I've watched a fellow nurse pop one right back (thankfully that day my coworker who has a son with a trach was the one that noticed the patient's trach cannula lying on the floor), but a little KY and pop it back in. (To clarify, the extra one at bedside, not from right off the floor.hehe!) But guaranteed airway, how can you beat a day with a patient that you won't have to worry about the A in ABC?
I used to hate PICCs and ports and CVLs. So many policies to remember, flush with this, change that dressing, change the hubs how often?
Now, I just LOVE them. Guaranteed access. The couple extra things I have to do here and there are still time saved over the peripheral IV that goes bad when you have a list of meds due or right before shift change.
The mess of flushing and wasting and flushing and flushing is only a problem the first couple times. Then you get a system and can do it in your sleep.
Unless your policy doesn't allow it, (say you're an LPN somewhere that only RNs can do the draw), take it as a chance to expand your repertoire. Everything is intimidating the first few times. :)