I suck at phlebotomy... Help?

I think you're fine. In a lot of facilities, PCTs don't draw blood at all. In fact, a lot of nurses do not routinely perform venipuncture for the purpose of obtain labs.

we weren't taught to start IV's in our nursing program, I was told by our program director that that was an on-the-job training thing. Fast forward to on the job training, and I pretty much blew what must've been 20 veins/20 very patient patients before I was able to finesse my touch and finally figure out what works for me.

This sounds like me throughout clinicals and my first job in a rehab. I was 1/4 on IV starts in clinicals and 0/4 at my first job. Now somehow in my first hospital job I'm 2/2 and I have the clinical judgement to not have tried to stick my assigned patient for today since she had nothing below the AC that wasn't irritated and the veins above the AC were far too small to even attempt, plus I only had the Left arm to work with due to history of lumpectomy on the Right side. So I called for a PICC insertion. It worked out well when 2 hours later orders came in for Potassium replacement, any peripheral I would have started would have been shot after the Potassium and her IV Antibiotics.

This is no big deal. The skill comes with experience. Just offer to try whenever permissible. You'll get the hang of it. :) (Or, you'll be fair to middlin' like me in that department, but have other wicked talents to brag about.)

Don't feel like crap! I drew blood for 2.5 years in one of my LPN jobs, then didn't do it for a year, when I had to start doing it again recently, I was pretty rusty. If you don't do it often its easy to loose your confidence and skills. What helps me is asking the patient (if they are able to answer) where blood draws have been successful for them in the past. If they are a hard stick, they say the lab always uses butterfly needles to get then I automatically go with that and the good blood draw spot.

If they have no idea, then I really check all sites out before I draw unless they just have a great vein staring back at me. I feel for it and when I am inserting the needles I hold the skin taut and try to keep the vein from rolling.

That said, I have had what looked like GREAT veins, and I couldn't get the blood. Sometimes the phlebotomy nursing gods just aren't on your side!

I want to thank you guys for making me feel better about this. But what do you do if you run into a job that lists "Must be comfortable with phlebotomy" or something to that extent? And then when they hire you and they see how much you suck, wouldn't they let you go?

Don't worry!! Practice is the only way to be truly good at phlebotomy and it's not necessary for many positions within medicine. If you ever want to improve your skills, just do more. As many draws as you can.

Unless you apply for a job in a lab to be a phlebotomist you will never see "must be comfortable with phlebotomy" in a help wanted post.

In my 33 years as a RN, in a wide variety of different nursing jobs, I have gone from great with phlebotomy but awful with IV's to awful with both. Ended my career in pre-op starting IV's all day long. It took a while but now am great with IV's.

If you get a job where you are performing phlebotomy or IV's frequently your skills will quickly come back to you.

Many nurses with great jobs and careers never have to do either skill.