The inevitable: Blood draws

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I know this topic has been brought up many times before in various parts of the forum, but I didn't see any active topics for this general topic. I wanted to be able to discuss blood draws in general with everyone!

We all have to do it at some point. How do you feel about doing blood draws? Do you like doing them or hate doing them? What helps you guarantee a successful draw most of the time? Do you need to work on it? What other thoughts do you have on it?

Personally, I'm sort of fascinated by drawing blood! After drawing successfully on a patient, I get this awesome rush of excitement. I've hit more veins correctly than I've missed, but it totally gets me down when I miss. This is especially so when the patient has at least fairly good veins.

I don't have much issue finding veins before I puncture the skin. The problem is more of knowing when I hit the vein. My supervisor/trainer said you can feel when the needle breaks the surface of the vein. I'm not feeling this 80% of the time. Do you go by this technique, or can you tell another way? If you can feel the needle hitting the vein like my supervisor said, what tips do you have for me to better pay attention to that feeling? Maybe I just need to slow down and pay attention harder to the feeling. I haven't used a butterfly needle yet, so I can't go by the flash of blood with a regular straight needle.

Overall, I like doing blood draws!

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I worked 17 years in acute care bed side nursing and rarely did blood draws. Most hospitals prefer phlebotomist do blood draws. Then my last five years in acute care out patient surgery we routinely did blood draws and I became proficient.

As with most skills repetition is essential to becoming proficient.

I left that out patient job over ten years ago so my memory is poor. But I rarely "felt" anything, I thought, think I remember, that you would simply see a flash of blood? I used butterfly's, but occasionally used regular straight needles, even then you would see a flash of blood?

I dont think I am understanding exactly how you are drawing blood with a straight needle. But irregardless YouTube has great educational videos on how to do phlebotomy.

And irregardless every nurse/phlebotomist misses sometimes. It sounds like you are doing fairly well?

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Specializes in ED, School Nurse.

I worked in the ED and we did blood draws off of our IV starts, so I could see the flash in the IV cannula and knew I had hit the vein. Phlebotomy drew everything else. Some of our phlebotomists used needles attached to tubing where you could see a flash. I never paid enough attention to see what other supplies were used for blood draws. And from what I could tell, it was their preference as far as what they used as long as it was appropriate for the patient.

I've used butterfly needles attached to tubing a few times and the ones we used had a little reservoir where you could see the flash as well.

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I was fine with the idea of drawing blood until the first time I drew on an actual human person. No dummy arm can prepare you for the fact that the tubes are warm when they are full and that freaked me out so badly! Ew. This was when I took phlebotomy in HS, luckily I got over it by nursing school and didn't have a problem. I was bummed out when the had lab take over ALL draws

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I don't think I have feelings about it one way or another beyond 'let me hit this the first time, for the love of pete!' I'm pretty new and this is a skill that really does take time and practice. On our floor we draw our own labs and since I have oncology patients they're not the easiest sticks on the planet sometimes. I'm getting better. I got to shadow phlebotomy for half a day and learn their personal tricks and that's really helped.

I can say that I don't feel anything. I go by whether or not I get a flash.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I strongly dislike hands-on procedural skills. This includes blood draws.

I worked the floor for 10 years before accepting a desk job. However, I feel fortunate to have worked at facilities that utilized phlebotomists to perform all blood draws and venipuncture so I didn't have to do it.

The only times I drew blood were those instances in which the patient had a PICC, midline or central line. Since the phlebotomists were not permitted to draw from lines, a nurse had to complete this task.

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Specializes in critical care, ER,ICU, CVSURG, CCU.

After 50 years, 44.5 as RN, it is just like breathing. :angrybird3:

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Specializes in Family Nurse Practitioner.

There is sense of resistance that can be felt when the vein is poked. I can tell when I poke the vein but it rolls. When the vein is punctured passed the puncture of the skin there is a feeling of decreased resistance. I think this feeling depends on the size of the vein and how thick the skin and wall of the vein is. There is a flash of blood when drawing with butterfly needles as well.

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Specializes in ICU.

After 30 years, and half of it working with pediatric patients, I am very good at drawing blood and starting IV's. I have never been able to "feel" the vein, or feel when the needle punctures it, either. I rely on seeing the blood return. We use a regular needle, too, but I personally prefer butterflys on small or superficial veins. A longer, larger needle is better for deeper veins. I try to avoid drawing blood from ports or central lines due to the increased infection risk, unless I have no choice.

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But I rarely "felt" anything, I thought, think I remember, that you would simply see a flash of blood? I used butterfly's, but occasionally used regular straight needles, even then you would see a flash of blood?

I dont think I am understanding exactly how you are drawing blood with a straight needle. But irregardless YouTube has great educational videos on how to do phlebotomy.

And irregardless every nurse/phlebotomist misses sometimes. It sounds like you are doing fairly well?

Maybe it's just my clinic's straight needles that don't show the flash of blood. Oh well, I just need to keep practicing either way. Like others have said, it's practicing on a real human arm that helps you truly improve the skill. I think I'm doing well, especially for just beginning. I'm only taking my pre-nursing classes right now, too, just trying to get ahead!

I've watched several of RegisteredNurseRN's videos on youtube, she has stuff on blood draws and lots more. I love her advice!

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After 50 years, 44.5 as RN, it is just like breathing. :angrybird3:

Oh my goodness, I can imagine!

My grandma makes 50 years in 2017 of being an RN. She told me basically the same thing. "Lexx, you'll get there. I can do it in my sleep now. Practice and wear gloves, you don't wanna contract HIV!" :lol2:

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Specializes in Short Term/Skilled.

I think its fun. I took phlebotomy right before NS just to get some exposure and it was pretty invaluable. I'm one of the only nurses at my facility that know how to do it.

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