Lab Chronicles: Three Important Lessons I Learned Performing Phlebotomy

One of the main reasons why I chose the medical laboratory profession was for the behind-the-scenes work in the medical field. Nevertheless, I am thankful for those individuals on the front line of the medical profession, directly taking care of patients and their illnesses. Even though this may have the initial reason that drew me to the medical laboratory profession, I have found, throughout my years in university, that I have many other qualities belonging to that of a medical laboratory technologist: I am analytical, process-driven, and a critical thinker. Nonetheless, there has been one aspect of my program that had me a bit worried…

One of the requirements of my clinical practicum year is to perform fifty successful blood draws on patients. I performed these blood draws within my first week in the Hematology laboratory, and throughout this week I learned some pretty important lessons.

11

Phlebotomy performed using EDTA evacuated tube

Lesson #1: I am not hurting the patient

Before this school year (and even at the beginning of it), I was extremely scared of performing phlebotomy. While I had practiced on a rubber arm and other students in my class, I still had severe anxiety that I was causing a large amount of pain to anyone I drew blood from. It did not help that my first time performing phlebotomy after five months resulted in someone fainting. Nevertheless, no matter how initially scarring this experience was, I had told myself that I must move forward and learn from it. In this specific case, there was nothing I could have done to prevent the fainting from occurring. The most important thing to remember if this happens to you as a new student is to respond appropriately, by first removing the tourniquet and needle from the patient, applying pressure to the site, calling for help, and making sure the patient doesn’t fall down and hit their head.

Due to these past experiences, one could say that I was not particularly looking forward to this first week in Hematology. However, after the week was done, I realized that it was not as bad as I initially thought it would be. Yes, I will be honest and say that I was still really nervous and somewhat shaky at the beginning of the week while drawing blood, but one of the things that really helped me throughout the week was how nice and understanding the patients were. I know this might not be a common experience for every medical laboratory student, but most of the patients that I met were more than happy to get their blood taken by a student, and many were even encouraging when I seemed nervous. They understood that I needed to get practice and even told me that I did a good job afterwards. Some patients even said that they barely felt anything, or that I was very gentle while drawing blood. One patient, and I am not even making this up, even gave me a candy for what he said was “a job well done”! Even for the patients who did flinch while I drew their blood, I tried to ease the tension by having some small talk to distract them from their apparent pain.

While I may have had a very positive experience, I know that this is not the reality for most phlebotomists and medical laboratory technicians. I did not have the experience of drawing blood from patients who were deathly afraid of needles, or children, and I could only imagine the added anxiety a student must feel while practicing on those types of patients. However, we all need practice drawing blood on those types of patients as well. The only downfall with these patients is that whether you are gentle or not while drawing blood, their response will always be the same; that you are causing the greatest pain imaginable to them. It is nothing personal to the technique that you are using, and there is nothing you can do to change their belief. Still, one thing that can do to decrease their perception of pain is by talking to them in hopes of distracting them.

On the other spectrum of pain are the patients that are “regulars” at the hospital, or have chronic conditions. For them, a simple blood draw is by far not the worst part of their day. These type of patients have experienced much more pain than you could ever imagine, and while a needle through their arm may cause them some discomfort, it is seen more as an inconvenience than painful to get their blood drawn so many times.

Lesson #2: There is a person attached to that sample

When you are always working in the laboratory, it is easy to become disconnected to the patient to which the sample belongs to. I am grateful for the week I spent performing phlebotomy around the hospital, as it gave me some perspective into the pre-analytical processes of the laboratory. Sometimes when taught in school, things may be seen clear cut, such as the rejection of samples for testing based on certain indices (such as hemolysis or lipemia). However, in the clinical setting, these rules may not apply in certain scenarios, and just like the saying goes: “what you see is what you get”. This might be due to an incredibly short draw from a young child, an elderly patient with collapsed veins, or stat blood work. While all samples must be treated carefully within the clinical laboratory, these types of specimens must be even more so, as there is a significantly lower chance of being able to recollect. In the clinical laboratory, we try our hardest to be understanding and accommodating to these types of samples that are given to us.

Lesson #3: Be humble

As I mentioned earlier, I initially felt scared and worried at the prospect of collecting blood from real patients. Thankfully, within a week, I made a complete 180 and am now very grateful of the experience I was given. As a student, I am in a very unique position, since I have been able to experience the clinical laboratory from both the technologist side of analysis and reporting, to the technician side of specimen collection and receiving. This has given be a comprehensive view of the processes within the clinical laboratory, and how these processes both begin and end with the patient. Take a moment to think about that, and it will humble you. This profession would not exist if it weren’t for the patients. While during hospital budget cuts, departments may be fighting for funding and acknowledgement, the truth is that all departments within the hospital are important in providing valuable services to the patient. What also humbled me from this experience is the amount of knowledge that I attained. Remember that no matter what situation you get put into in life, there is always something to be learned. You should capture those kinds of moments and take advantage of them.