Help please...phlebotomy

Thunderwolf, MSN, RN · Feb 18, 2006

Moved to General Nursing Discussion forum.

Fonenurse · Feb 18, 2006

Hello I'm new to this site and need some help. I recently became a phlebotomist and I'm looking for advice on how to find the vein if you can't see it. If I can see it no problem if I can't see it then it's a different story. Any advice. All my instructor told me was you'll get it. I haven't started a job yet because I feel very uncomfortable about this. HELP..

Good morning sticker2 - and welcome! When taking blood, to be honest I don't usually go for the veins I can see as they tend to be thin and friable. I do however go for the ones I can feel- and have a very high success rate with this method. It might be worth getting some practice in palpating veins - even if its just friends and family, and you'll see what I mean.

My advice is get right in there and get doing it - its always the mental hurdle of doing it that is hardest at first - once you have done a few you will begin to feel a little better about this - I promise!

MIA-RN1, RN · Feb 18, 2006

If you put a heat pack on the area it will help the vein come up a bit. I also find better luck with the ones I feel---if I see them too clearly for some reason they roll.

Tap with your finger a few times as well. It takes practice; I've been drawing blood for a year now and it still challenges me sometimes.

NurseKevin · Feb 18, 2006

What I do instead of tapping the vein is rub the area vigorously with an ETOH wipe. It gives the patient the perception that the area is being prepped (and it accomplishes the same thing as tapping) rather than you are still looking for the vein and eases their apprehension somewhat, which makes your job easier.

thumperRN · Feb 18, 2006

I use a blood pressure cufff instead of a turnicate and my success rate has gone way up - just pump it up to about 100 and the veins seem to come out of hiding.

:chair:

Drysolong · Feb 18, 2006

Wow! I've just had a "real education moment" I've learned something I can really use (blood pressure cuff; heating pad, rubbing wi ETOH wipe) THanks

dtice · Feb 18, 2006

The best advice I got about phlebotomy is to go for the ones you can feel. It is good to know the general anatomy to give you a starting place. I put on the tourniquet, then palpate with only my index finger. Veins feel like your finger is bouncing on a trampoline. I hope this helps. The best way to master something is to practice, so ask friends and family to let you feel their veins.

LanaBanana · Feb 18, 2006

I got my phleb certification last spring and know how frustrating it can be to find those veins! I found that I wasn't tying the tourniquet tight enough most of the time (didn't want to hurt anyone!) Feel the area for the vein while either looking at a spot on the wall or closing your eyes - not looking at the arm. Like someone else said, if you press on the vein and then slightly lift your finger you will feel the vein bounce back up. If you don't find it in one arm, don't be afraid to say "let's check out the other arm to see if there's anything better." I've got bad veins and have had pbt's check one arm, then the other, then the first again, and back to the second. It's better to feel confident with the vein than to attempt something that isn't good. As for using a bp cuff, they were never available to us. We learned to use them in class but they weren't available at the lab where I drew or on the pbt carts we used in the hospital. Just tie the tourny tighter!

Did you do an internship with your training? We had to do a minimum of 100 hours and 100 successful sticks.

Also, at the hospitals here even if you already have your certification they start you out training with another pbt that observes you and can also give pointers.

Good luck! You can always pm me if you have any questions!