Sticking at LTC

colleen10 · Oct 16, 2002

Hi shaboo,

I saw your message on the student board but having no experience working a hospital I didn't feel that I could respond.

I did want to add though, didn't you say in the post in the student section that they had cut your hours too? Weren't you told you would work 28 hrs. a week and now they said you would get less than 20?

If so, could you use that angle to get a transfer? I mean, a guy or gal's gotta make a living. Do you think they would be more open to helping you if you told them you really need to have a job where you get more hours?

Interested to see what those with experience in this advise.

Good luck,

Col

Youda · Oct 16, 2002

What don't you like about the job? Really. Can you identify and list your reasons?

I know you said you felt that 3 weeks isn't enough training as one reason. But sticking people is one of those things you aren't going to get good at without practice, lots of practice. Starting IVs and sticking people is essential to nursing. It's a skill you're going to need to learn. If you learn it on-the-job, you'll be ahead of the game.

If that's the ONLY reason for your dissatisfaction, then I'd agree. Give it more time. But, if there are other reasons, you need to look at those, too. If you can, identify them here, and maybe someone at allnurses can give you a some ideas. But with the info you posted, I'd have to agree . . . give it time.

Agnus · Oct 16, 2002

In nursing school you wil learn, "If you do not feel comfortable don't do it." If you do not feel ready to be turned loose then you need more supervised sticks.

You will also learn that you should follow your gut.

Perhaps you can work out a compromise with this employer.

I would not worry about my ability to be rehired Unless you are fired. Firing generally makes you unable to be rehired.

You will be asked why you left. You have some options, with your reply. I do not feel that I have sufficient training/experience to do this job, or you can use school as an excuse. (you have to get ready for it, or decided to take some time off before school starts) They are all honnorable reasons.

If you do not feel good about this dont be pushed into it. These sticks have the potential for causing harm. An unsure hand is more likely to cause harm.

We all take different amounts of time to learn things. Don't be bullied or shamed into thinking the fault lies with you or you are being silly and they are right.

My phlebotomy course was 17 weeks.

shabookitty · Oct 17, 2002

Thanks guys for your support. Youda, I probably didn't clarify how many times I went out for sticks in three weeks. Sorry! My mistake! I go out 3 days a week. On my other scheduled days I have other responsiblities. Although I feel comfortable with the technique of drawing, I feel in this particular dept., 3 days a week for three weeks...and only 5 sticks...you should not be let "loose" to be alone on your own. What do ya think Agnus? Little soon? Especially on combative LTC patients. The homes in this area contain very few patients that are in "ok" shape. They are pretty bad off, mentally and physically. Hiring someone like me "off the street with no former medical experience" and 5 sticks later...yikes! I wouldn't want my mom or dad being in that situation. And some of the labworkers that I have followed are terrible at sticking!You can tell they have half-learned the concept. They just go and go at it! It makes me cringe! Luckily I had a trained Phleb show me. And I will only stick twice! BUT! It isn't the sticks/nor the idea of sticking that i have trouble with... It is the "type" of patients I have to stick. It is not for me! I hate starting my days off like that...being cursed, hit, tears, screams and etc by 85% of my sticks. And it is not just a stick here and there...you may have 15-20 sticks at each of these homes. Many are stuck several times in a week. It is exhausting mentally to deal with. Anxiety city. Sadly enough, most nurses in my area claim to have no blood drawing experience and were really never taught...just IV's only.

I have good new though. Coleen, I suggested weekly shift rotation with other lab personnel and MORE hours...she agrees...but no one likes to go out at 5am...she said she will work something out and if all else fails she will transfer me...now my fellow employees are going to hate me

for 5am idea. Can't win for losin somethin' THANK YOU FOR REPLYING!

Agnus · Oct 18, 2002

It is true nurses, the ones I work with anyway were never trained to do phlebotomy. Some say another nurse taught them but then when You ask that other nurse did not go through a phlebotomy class she was inturn just showed by another nurse. Phelbotomy is different than IV. Nursed for instance do not generally know order of draw or the reason for it. They do not know how to properly handly specimens or understand how they cause eroneous lab results. Nurses just are not taught phlebotomy properly.

Youda · Oct 18, 2002

Having worked LTC for a number of years, I wouldn't want you drawing on my residents. Sorry. But, those little squirmy, combative, thin-veined folks . . . I now understand why you don't feel ready. When a new phlebotomist would come to our facility, he/she was always with a more experienced person for a week or two. Sounds like you need a long talk with your boss. Angus is right, you shouldn't do anything you don't feel comfortable and qualified to do. Stick to your guns, and your gut feelings.

KaroSnowQueen, RN · Oct 18, 2002

I have been a nurse for eighteen years and when I started my new job, AGENCY!!, a year and a half ago, they sent me to a metro hospital for a day long class in phlebotomy. I had to have 10 supervised sticks, and truthfully, although I had done it in another job several years before , I felt very unsure and did not feel good about drawing blood for about six months!!!

So you are not crazy for feeling uncomfortable and I don't blame you a bit. And sticking little old people in LTC is not fun.

shabookitty · Oct 18, 2002

Youda, I had to lol at your description! ha!

I have been offered a job in the office, and to do occassional sticks when needed. Whew! I actually got the first nights sleep last night and ate like a cavewoman!

Office work will not enable me to obtain any nursing skills, but it will help with learning tests/specimans/ and why and what they are taken for...This hospital requires you to be a CNA...and I do not have a certification. Once I begin nursing school in January HR said they will allow me to CNA while in school.

Agnus, isn't that strange about nurses? I would get angry going into LTC and having 15 draws! We are on a time frame and have several more LTC to go to and they know that! Yet, they would spring all of this on us at one time. We would finish and start to leave and a nurse would say "uh, we have found 5 more patients..." One nurse said "I would have done a few for you but I have no experience in draws...most nurses don't. They didn't teach us that in school" I didn't believe her of course. I chalked it up to laziness. But i asked around and most nurses agreed with her! Now there are just a handful that can...and they do help us when it is there day to work. I met a RN the other day that was so estatic about drawing. She begged us to let her help. She said "I never get to do it! And I love it!" :imbar Why don't they teach this in nursing school? Strange if ya ask me.

Agnus · Oct 19, 2002

You know I secretly think this about nuring school.

1. They already have a lot to teach us in too short a period of time.

2. The nursing instructors themselves never were taught to draw. Therefore they do not understand it is not the same as starting an IV.

3. They teach us that we should never do anything we have not been taught so we shoud refuses until the facility trains us. Like in the real world this will be enough. But they have relesed themselves of any liability as they told us to not do anthing you are not qualified to do or are not comfortable with.

4. They assume for some weird reason that the lab will always be able do the draws.

I had to have a minimum of 50 SUCESSFUL sticks, in my phlebotomy class. Here's a hint it was not a class taught by a hospital or a lab. So they were not looking for cheap labor. (i. e. train quick, cut corners ,so you can hire without a lot of expense)

There is an association American Society of Phlebotomy Technicians that certifies. To sit for the exam you must have 150 sucessful sticks. The exam is two part written and demonstration of a stick. They require CEs to renew each year. The provide CE's as well. The sade thing is certification though them is not required by any employer.

It is a private organization not recognized by any government and so the certification is not really pushed.

Phlebotomist who were trained in a few hours cannot begin to know what is need to pass this. Yet they are testing minimal compentency.

Now imagine nurses who have not even had that much training!!

But we think we know what we are doing because we start IVs'. I have seen more error due to nurse draw than you can immagine. There is more error that cannot necessairly be identified because it is not a glaring error that is cased by improper draw.

shabookitty · Oct 20, 2002

Agnus, my sister in law is an RN with a BSN and she listed all the above in your post believe it or not! #4 was her first response!haha! You are right! It is a definite skill just like any other that needs to be taught by qualified individuals. I hate going in and seeing where someone else has tried unsuccessfully 4-5x and here I am back to stick some more...poor things already polka dotted with cotton and tape. And they teach my coworkers that YOU MUST get that blood! And yes it is impt but c'mon! let there be a two stick limit! There have been several instances where we have had to go back for redraws...some our own patients and some not. I get aggravated b/c the correct/certified training could eliminate this! Patients just get so upset and say "well, they just stuck my three times yesterday/ or earlier today" So, what do I say? God, I can't say "well, they didn't mix your tube and now it is #%@* up!" I have done research and yes a correct draw can determine sooo much! Some tubes need inoculating, some don't. Also, their are various techniques(needle size, and style) to use on different patients. And probably my biggest dilemma is remembering what collection tube is used for what test! Some homes will literally just jot a test on the form and I am expected to know. I asked my trainer about this and her reply was "you'll learn them in time...just collect for all the containers if you are unsure" :eek: Bedside etiquette is also important, explain the procedure! I have seen and been shown so many questionable things that the safest place for me and my patients is behind a desk! LOL! I vote for certified training on this one! And the hospital should be doing this! For all clinical fields!

DODO · Oct 20, 2002

Hi

I had a very good friend of mine explain to me to remember the tubes

for all coga's (pt,ptt, protime) think blue blood (blue tube)

all chemistry, electrolytes red tube

for cbc purple top

then the new thing for cardiac enzemens trops in green top

I don't know if this will help

DODO