a question - when nurses can't get your blood - is this common?

Nurses General Nursing

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Hi, I'm posting this just because I'm curious, I don't really know any nurses (and not a nurse myself) so I don't know how common this is, ect.

I used to be an IV drug user - it is really, really hard to get a vein on me. I've been clean since March 2000, and am mostly healthy, but have a few heart issues. A couple years back, I was having chest pains, and decided to go in to the ER just to be on the safe side. I'm insured with Kaiser Permanente here in San Francisco, CA, so I went there. They did an exam and needed blood. One nurse tried two or three times to get some blood from me - no go. She asked another to try - no go. Then the first one tried again - no go. At this point I'd been there about two hours, and it was seeming that I was ok and wasn't having a heart attack, but I guess it's really important to have the blood test to make sure - we needed my blood. I had mentioned to the nurse that my veins weren't great because of my past IV drug use. Finally after like the 7th or so try, she looks at me and says "Do you want to try?" I had thought of asking if they wanted me to but figured there were rules against it. I had no problem trying though, she handled me the needle and I got it on the first try smile.gif She took the blood, and before she left the room I asked if it was ok to use my cell phone to call my bf - she said yes. She left. I called him and was just letting him know what was going on, and told him "Would you believe they had me take my own blood? They tried but couldn't find a vein". As I was saying that, the doctor came in. I hung up the phone, and he said "So how are you? I heard you had to take your own blood", and I laughed and said yes.

Now, my questions are: Have any of you ever heard of this happening, or asked a patient to take their own blood? Are there rules against this, and how serious are they? And lastly - after I left, I worried that the doctor "heard", not because the nurse told him, but because he overheard me talking on the phone, and that the nurse who had me take my own blood got in trouble. If she didn't tell him, and he found out by overhearing me, would she get in trouble?

I hope not. I had no problem taking my own blood - they needed the blood, they couldn't get the vein (not their fault, my veins are really bad) - it needed to be done, so I did it.

Any comments appreciated smile.gif

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Specializes in Ortho, Case Management, blabla.

I had a patient one time that was a super difficult IV start. He was a former paramedic, and offered to just do it himself instead of having to get poked a million times. He got it on the first try. No big deal. There's no rules/policies against it where I work that I'm aware of. I wouldn't recommend the practice unless the patient knows what they are doing.

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Specializes in Medical.

In my experience it's not that uncommon - people who inject (or, as in your case, have) can often find veins on temselves better than we can. I've even had a couple of patients self-cannulate in ED. As long as there's someone watching (RN or MD), to authorise/witness that it's actually your blood being collected it should be fine.

Contratulations on eight years, three months clean - I'm sure it wasn't easy.

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Specializes in Emergency Room.

i would never have a patient draw their own blood. it should be against hospital policy.

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Specializes in Hospice.

One of my nursing instructors said she did a similar thing once. When she worked in the hospital, she worked in the NICU and since she was used to having to do IV sticks on little babies with difficult veins she would often get called to the ER to help do a difficult stick. One time she tried and tried on a woman that was an admitted drug user and finally asked the patient if she could get a working vein. The woman said, "Sure!" and did it on the first try. IMO, why submit your patient to unneccessary discomfort, so long as you're not going against facility policy.

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I had a patient one time that was a super difficult IV start. He was a former paramedic, and offered to just do it himself instead of having to get poked a million times. He got it on the first try. No big deal. There's no rules/policies against it where I work that I'm aware of. I wouldn't recommend the practice unless the patient knows what they are doing.

Thanks for the reply :) That's interesting that there seems to be no official rule against it - I think that's a good thing. If the patient knows what they're doing, like you said, why mess around and waste time when it could be gotten over with quickly... obviously it should be a last resort, but the alternative was sticking me over and over and wasting both the nurses time and mine. I don't see any harm in it. :)

In my experience it's not that uncommon - people who inject (or, as in your case, have) can often find veins on temselves better than we can. I've even had a couple of patients self-cannulate in ED. As long as there's someone watching (RN or MD), to authorise/witness that it's actually your blood being collected it should be fine.

Contratulations on eight years, three months clean - I'm sure it wasn't easy.

Thanks :) The first year or two was the hardest, but after that it just kept getting easier - I found other things to fulfill me and make me happy, other ways to get excitement, other ways to feel good, ect. I think about it once in a while, but I don't think I'll ever do it again - I value my life too much now for that. Sometimes I look back and think damn, I mixed up street drugs with tap water and shot it up. God knows what was in it... what was I thinking? I was young though (early 20's), and invincible of course (or so I thought ;) )

I think it's true we can find the veins better - I got it on the first try, even though I hadn't done it in years and years. I was just glad to have gotten it done - sometimes I feel bad when nurses can't get my veins, like I'm a pain and wasting their time :/

i would never have a patient draw their own blood. it should be against hospital policy.

Can I ask why? Is it the worry that the patient could hurt themself? Just wondering...

mrsrainsinkain - I agree - why go through endless sticks that aren't working...and also, it seemed they'd done everything that needed to be done and were pretty sure I was ok (I had an EKG and everything), we were just waiting on the blood test and I could go - but they couldn't get my blood! I'm glad the nurse suggested it - she was really cool btw, talking and joking with me - she really helped take the stress out of the situation. At one point she almost had the vein and then lost it, and was like (to my arm) "you mother******" :D maybe you had to be there, but it was just funny the way she said it :)

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Specializes in Emergency Dept, M/S.

I think if the patient if familiar with it and has done it before, why not? I've had patients that put in their own Foley's at home, so when they're in-patient for some reason, if they want to continue doing it themselves, we give them the supplies and privacy.

Many patients know their own body better than anyone!

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Specializes in Nursing Ed, Ob/GYN, AD, LTC, Rehab.

I see no problem with it as long as someone is supervisisn the patient so its done correctly, why do so many attempts when they can do so easily. Seems simple enough to me

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I usually ask the IV drug users or former users to tell me where their veins are, but I don't let them do it. I can't say that there's a policy, because it's their body, but that I've never allowed them to do it. Not that I see anything particularly wrong with it.

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Specializes in Community Health, Med-Surg, Home Health.

Oh, sure! I am a 10 year experienced phlebotomist and there are times that I just can't get it. I have not worked with too many patients who have really no palpable veins (such as those hospitalized for a long time), so, occasionally, it can even be a struggle for me with all of the tricks up the sleeve I was taught over the years.

I did have a patient who was an ex-abuser who showed me a vein in a strange place. The other nurses were nervous about doing it, but experience also taught me to listen to the patient, they know best. I got it the first, very careful try. Sometimes, Army veterans know where veins are as well, especially medics who worked in combat, and occasionally, nurses have let them draw their own labs. Not sure if there is a policy against it, but, when the blood is an absolute must, I guess the nurse may allow it.

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Specializes in Community Health, Med-Surg, Home Health.
I usually ask the IV drug users or former users to tell me where their veins are, but I don't let them do it. I can't say that there's a policy, because it's their body, but that I've never allowed them to do it. Not that I see anything particularly wrong with it.

I agree with you, I see nothing wrong with it. I have never encountered the situation where the patient has actually done it himself, but, I honestly believe that I would let them if I really had to, because I wouldn't want to do continous sticks. I would just stay at his side and pray that they can get it.

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I've had patients who have used or use drug tell me which veins are the best to use. I've never had them draw their own blood. The nurse most likly felt bad she had made so many unsucessul attempts she didn't want to cause you any futher distress.

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