Tech new to blood draws, needles

[sweetstrwbrry1]

I am currently in my second semester of nursing school and I just got a job as a tech at a hospital. I've been a CNA for a year but we definitely didn't do any blood work or anything like that before.

My first day was Sunday and I was so nervous about the blood work. I am also worried about needlesticks and have always been. I think that's the one thing in nursing that is going to be difficult for me at first.

My first stick I got in fine, got the blood, but I couldn't figure out how to retract the needle. So I am fiddling with it while it is still in the patient, pressing where I can. I ended up having to take the needle out before retracting it bc I couldn't see where the button was. Retracted it safely after that. I noticed there was a tiny amount of blood on my gloved finger where I was holding the base of the butterfly needle. My finger has felt funny the past day. There is no break in skin or on the glove either. I did a ton of glucose checks and was rubbing a lot of alcohol pads with that finger and using constant sanitizer which I am not used to which could have possibly irritated it. I know I did not stick myself with the tip of the needle... Am I just being paranoid? Can blood leak out a little from the plastic part? I didn't get a close look at it the needle, so I didn't see the structure of the plastic base. Is the needle completely enclosed? Thank you, I know this may seem like a stupid question

[iluvivt, BSN, RN]

You will have unnecessary exposure to blood or worse yet a direct puncture of a bloody needle if you do not LEARN how to use the equipment BEFORE you perform any venipunture! The fact that you tried to activate the safety mechanism to engage the needle guard while still in the patient makes it more likely you will damage the patient's vein and also poke yourself in the process.

Do you have a preceptor and why were they not with you? You should have a thorough understanding of the anatomy of the veins,arteries and nerves especially those on the ACF, Do you know the "H" and "M" venous patterns in the ACF. You will need to learn both the skills to safely perform the task but also to keep yourself safe. When I get to work I will put in a link that has the best pictures of the anatomy of the ACF that I have found!

It does not sound like you poked yourself but the best way to protect yourself is to have the knowledge of how the equipment works and to always employ safety measures effectively. Anticipate that this is a process and take your time and do not let anyone rush you! Always wear gloves that FIT well because if you do sustain a puncture the needle is somewhat cleaned on the way in. I prefer to take all the steps necessary to eliminate the risk and I have been very successful in doing this even long before we had safety mechanisms and devices.

1. I always carry any catheters or needles separately to the sharps container. Safety mechanisms can fail or can become a hazard if not disposed or properly.

2. I make sure I have all my equipment and supplies at the ready before I perform any venipuncture.

3 I never place a tourniquet on anyone unless I have unsnapped the gown all the way to the shoulder or if they are clothed I tape up the clothing with a strip of tape. Unfortunately, I have seen may a phlebotomist and/or nurse leave a tourniquet in place.

4. Make sure you have the patient/s cooperation ( as much as possible) before you perform the venipuncture and communicate the procedure and what you need them to do and give them a warning before you poke!

5. Get help if you need do and if the patient is combative or uncooperative talk with the nurse and try to time the draw after they have been medicated or given sedation. You can do this if you feel your safety is compromised just document the actions you took and the plan to eventually get the specimen.

6. Before you leave the patient..... check and make sure you have the sharp(s) accounted for,the tourniquet is removed and discarded,the site is no longer bleeding and the patient is safe with the bed position down(or as it should be) and the call bell within reach and you have returned anything you have moved (such as a urinal) .Run through this every single time without fail. Then perform hand hygiene every single time without fail!