I Couldn't Believe My Eyes

A few weeks ago, I was at a routine doctor's appointment, and I had to get some labs done. I tend to be a little wary when my blood is drawn (which comes with being a phlebotomist, I suppose), but I'm always hopeful that things will go well, especially considering I have good veins. Despite my expectations, I was surprised by the number of mistakes and improper practices I ended up witnessing. I often see mistakes when having my blood drawn (some a big deal, some not), but this encounter ended up being one for the record books.

Let me first say that I really like this office. Everyone is very kind, patient, and professional - but their phlebotomy training is severely lacking. The phlebotomist led me down the hallway, chatting with me about my day. She was very friendly and seemed a really nice genuine person, but as soon as I sat down in the chair, the problems began. She asked me which arm I preferred; I told her my left arm was usually best, and then she applied the tourniquet, placed a foam ball in my hand, and told me to squeeze it repeatedly while she set up supplies. I held the foam ball in my hand but did not pump my fist. She noticed that but didn't say anything to me.

She put a glove on her right hand (only her right hand). She did a quick single swipe of the alcohol on my arm and then felt my vein with her gloved finger. At this point, I knew it was all going to be a train wreck, but it was also rather fascinating to watch. She grabbed a butterfly with her right hand and pulled my skin taut with her ungloved thumb and pointer finger (from above and below the site). Then she took the butterfly and inserted it at about an 80-degree angle, and let go of it. It stuck out of my arm like a lawn dart.

She began filling the tubes, and I struggled with the internal dilemma of saying something. Everything had been done wrong, but the biggest issue is that the tourniquet had been on for about a minute now, with several tubes still to go. I decided to ask her to take it off, to which she responded that she was almost done and would take it off soon. I knew that if I wanted my labs to have a chance to be accurate, it needed to come off now. I reached up and undid the tourniquet with my free hand - which is a really easy way to get your phlebotomist to hate you. I could see the annoyance on her face, and her attitude shifted from bubbly and friendly to irritated.

I apologized and quickly explained that leaving the tourniquet on for more than a minute could alter test results, but the damage was done. She silently finished filling the tubes up, removed the needle and dropped it onto her tray (without activating the safety), and then wrapped my arm with Coban. Then she (finally) activated the safety, inverted the tubes (hooray), and told me I could go and she would walk me out. There was one last serious issue, though. She had not identified me before the draw, and she had not labeled the tubes yet. I requested that she label the tubes in front of me before I left. She didn't say anything, but she applied the labels, and I double-checked that my info was correct on them. Her irritation had probably progressed to the contemplation of my murder at this point. I thanked her and let her walk me out; she said a clipped goodbye and left me at the front desk.

Unfortunately, we may never be friends, but at least my labs had a chance of having some accuracy - something that other patients would not have if this phlebotomist was the one drawing their blood. Typically I don't say anything while having my blood drawn. At least not unless there is a problem that could negatively affect me or my test results. I don't want to make them feel intimidated or nervous. Sometimes I'll say something after the draw if I think the phlebotomist may be open to a suggestion or tip. I usually find that they dismiss anything I say, which I understand. No one wants to hear a random stranger tell them how to do their job.

I have been on the other end as well, where someone tries to tell me I am doing something wrong, and I know how it feels. I don't blame anyone for being irritated at my requests. I blame the lack of phlebotomy regulations in my state. There is a lot of poor training, and unfortunately, I must say that I have never had my blood drawn entirely correct at any appointment since I became a phlebotomist myself and could recognize the problems. However, this recent appointment is one of the worst experiences I have ever had. I left frustrated, worried, and ended up with a hematoma from the crazy angle the needle was inserted at, along with it being unsecured and left to wobble around with every little movement.

So how do we fix issues like this? I know I am not alone in being dissatisfied with my experiences wherever I go as a patient. It's a really large issue and one that doesn't have a quick fix. In this situation, I reached out to the office and let them know about the problems I had seen. I told them that the phlebotomist was professional and very pleasant but that there were some technical issues that could be causing inaccuracies to tests and danger to patients. I told them who I was and that I would be happy to offer some training or resources for their staff, but I have not heard back from them regarding this issue. I don't have high hopes that they will take me up on my offer, but I will keep trying.

This is a problem that won't be addressed until there are standard state and national regulations put in place. There needs to be more attention on the practice of phlebotomy and how much of an impact it can have on patient lives. It's a critical skill necessary for nearly everyone at some point, so how is it so ignored? These issues have bothered me (and many of you as well) for years. Luckily, I am in a better position to help bring phlebotomy practices to where they need to be, but it will take all of our voices calling for change before anything will happen. I hope we can all work together to help accomplish this someday, and make healthcare safer for everyone.