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 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.
i would never have a patient draw their own blood. it should be against hospital policy.
Why? The only reason I can think of, (if it is done properly, aseptically, and carefully), is it might cause the patient to relive their addictions, and may be a stimulus to cause a relapse.
I have seen, and done an arterial stick, when it has been impossible to draw labs, via a vein, sometimes what works trumps over what is textbook.
I am really good at drawing blood and starting IVs (worked IV therapy for years) and yet, this one return drug addict that I saw about 4 or 5 times a year was impossible for me. The first time I met him, I tried to draw his blood and start an IV and just could not. He asked if he could help, I handed him the cannula and in it went, no problem. He stuck a place that I would have never tried and I never saw a vein. From then on, when he came in, I just handed him the cannula. It's his body and I had no problem letting him lessen him painful sticks. My ego could handle it and I didn't have a problem with it. After all this time, I still don't know how he got those veins!!!!:yeah:
i would never have a patient draw their own blood. it should be against hospital policy.
Why? The only reason I can think of, (if it is done properly, aseptically, and carefully), is it might cause the patient to relive their addictions, and may be a stimulus to cause a relapse.
I have seen, and done an arterial stick, when it has been impossible to draw labs, via a vein, sometimes what works trumps over what is textbook.
I was figuring I didn't see any harm in it till you posted this. I am not a user, but have had many many blood draws and IV's over the years for treatment of Leukemia. I had my treatment 10 or so years ago, but I still get teary-eyed when I get my blood drawn. Not becuase it hurts (used to the pain, and I almost like it) , but the familiar distinct pain and the association will cause me to want to cry. It's kinda twisted becuase I actually enjoy the pain and it feels like I get a release of inner pain (emotinal perhaps) almost like a high. It's almost like going back in time and reliving what I went through to a minut degree. It has nothing to do with drugs in my case because I hate how I feel on meds and don't even take cough medicine if I can help it! I can see how a user may be prone to relapse in that situation, especially if it hasn't been that long. Hope this made sense. Thanks for the post.
Specializes in Peds Critical Care, Dialysis, General.
Pediatrics is not really that different. While we don't get the abuser population, we do get chronic kids. They have been poked, stuck and prodded enough to know exactly where to tell you to go for IVs and lab draws. We've even been "reprimanded" - didn't get the tourniquet tight enough, didn't scrub the site enough before a stick or "hey, you, you didn't foam in!"
We had this discussion in nursing school. The professor was a nurse midwife and a lawyer. She was adamant that allowing a patient to preform their own IV stick would cause an unacceptable liability risk for the nurse and facility. I really don't understand her position but it was along the lines of anything that could be even remotely attributed to an improper IV stick would be the fault of the nurse.
Here is the problem as I see it. Sometimes you cannot get blood for love nor money, for labs, IV start, etc. Now it could be against policy, (and ivory tower nursing ideals). To have a patient draw their own labs, start IVs.
However, how you gonna get it done? I find 'doctor draws' to be somewhat of a joke. Occasionally some IV/Lab wizard can get blood outa a turnip, or a friendly CRNA might show up to do it...but sometimes, (most-of-times), its a little old ER/ICU/Floor nurse who's gotta do it.
Any complication from a adverse lab/iv start is gonna fall on the poor little nurse whose watch the situation haapen to come up on. Just like failure to start IV/draw lab is gonna bite 'em.
Of course in this law-suit happy world, it woul kind of be embarrasing to answer the judge why you let the patient start his own IV/lab draw.
Another episode of 'water retaining wall' if you do 'water retainig wall if you don't.
I've never had a patient ask but if they did I wouldn't have a problem with it as long as I watched to make sure proper technique was followed and I would document it.
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.
:yeahthat:
I usually tell the ER attending and let him/her make the call. Usually they come over and stick an EJ (and very, very rarely - like some of our very frequent fliers; a central line).
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.
Thanks for the post.
IndySkies
57 Posts
i would never have a patient draw their own blood. it should be against hospital policy.
Why? The only reason I can think of, (if it is done properly, aseptically, and carefully), is it might cause the patient to relive their addictions, and may be a stimulus to cause a relapse.
I have seen, and done an arterial stick, when it has been impossible to draw labs, via a vein, sometimes what works trumps over what is textbook.