I think none of us phlebotomists would want to stick a needle twice. If only the patient knows how we tried our best to get his blood once. BUT...We can't avoid having patients with difficult veins and because of this, we might fail to extract some of them. As a result, patients will get angry and all we have to do is to sigh and act like we never heard them.
But then, we're just humans. We're not perfect thus we make mistakes. Letting go might be hard but just like in getting blood where you think it's hopeless and it's hurting, maybe it's best to just pull it out. Well, if you want to know how I deal my patients in situations like these, then this might be of help for you. I tell you a secret: All extractions starts with setting the patient in a good mood before we stick the needle in them.
TRICKS TO ASSURE THE PATIENT...
I think one of the things to keep a patient comfortable is to show to them that you really know what you're doing, Make an impression that you can be trusted. Sometimes, a patient might ask: Are you a sharpshooter? Are you the senior phleb? To gain trust, you must be confident and set a positive attitude that you can do it. Always act like you're an expert. VEIN ASSESSMENT IS VERY IMPORTANT. Do not haste and take your time in finding the right vein. Just with that manner, the patient will understand that you are really taking time and didn't take him for granted. If must, communicate to them but not to the extent of being talkative (I usually ask them if their lab tests are on a monthly or weekly basis and later they do the talking).
WHAT IF IT REALLY FAILED...
Based on my experience, patients tend to understand why the extraction went wrong when you explain to them what happened and also the mood that you set for them can be helpful. So, the next thing you gonna do is to convince him/her to extract again.
If the patient is already angry, it is best to keep calm. Don't contest the patient's high temper. Deal them in a professional way. Don't argue. Why not try these options for yourself?
Option 1: See if there's a basilic or cephalic vein in that arm.
- Although median cubital vein is ideal but sometimes you need to consider other veins as well such as the cephalic vein in which obese ones have more palpable cephalic vein.
Option 2: Find vein in the other arm.
- Go try palpate the patient's other arm. You may find a vein there. As what I've said, take your time. Mostly, palpable veins are located in the dominant arm so it is helpful to ask if the patient is right-handed or left-handed.
Option 3: Look for a vein in the dorsal hand of the patient
- If there's no hope to find a vein in both arms, we can get blood in patient's dorsal hand if they allow it. Sometimes, I'm surprised how some people have palpable veins on their hands while they're having deep and thin veins in the arm.
Option 4: Use small-gauge needle or a butterfly
- An assessment of what to use when extracting blood can help you achieve a one-stick only goal. Take note that thin veins can't stand bigger gauge needles as the vein will collapse upon insertion. Butterfly method is advisable if the veins are thin and superficial or if you're going to extract in the dorsal hand.
Option 5: Ask help from a senior phlebotomist
- Only and only if the patient insisted..but if not, why not try your best? It's not always your senior will come and rescue you. Show to your senior that you made an effort and at least you've tried. If it still failed for the second time, allow the senior to do the job.
PLEASE STAY TUNED FOR AN UPDATE OF MY PHLEBO TIPS
But then, we're just humans. We're not perfect thus we make mistakes. Letting go might be hard but just like in getting blood where you think it's hopeless and it's hurting, maybe it's best to just pull it out. Well, if you want to know how I deal my patients in situations like these, then this might be of help for you. I tell you a secret: All extractions starts with setting the patient in a good mood before we stick the needle in them.
I think one of the things to keep a patient comfortable is to show to them that you really know what you're doing, Make an impression that you can be trusted. Sometimes, a patient might ask: Are you a sharpshooter? Are you the senior phleb? To gain trust, you must be confident and set a positive attitude that you can do it. Always act like you're an expert. VEIN ASSESSMENT IS VERY IMPORTANT. Do not haste and take your time in finding the right vein. Just with that manner, the patient will understand that you are really taking time and didn't take him for granted. If must, communicate to them but not to the extent of being talkative (I usually ask them if their lab tests are on a monthly or weekly basis and later they do the talking).
WHAT IF IT REALLY FAILED...
Based on my experience, patients tend to understand why the extraction went wrong when you explain to them what happened and also the mood that you set for them can be helpful. So, the next thing you gonna do is to convince him/her to extract again.
If the patient is already angry, it is best to keep calm. Don't contest the patient's high temper. Deal them in a professional way. Don't argue. Why not try these options for yourself?
Option 1: See if there's a basilic or cephalic vein in that arm.
- Although median cubital vein is ideal but sometimes you need to consider other veins as well such as the cephalic vein in which obese ones have more palpable cephalic vein.
Option 2: Find vein in the other arm.
- Go try palpate the patient's other arm. You may find a vein there. As what I've said, take your time. Mostly, palpable veins are located in the dominant arm so it is helpful to ask if the patient is right-handed or left-handed.
Option 3: Look for a vein in the dorsal hand of the patient
- If there's no hope to find a vein in both arms, we can get blood in patient's dorsal hand if they allow it. Sometimes, I'm surprised how some people have palpable veins on their hands while they're having deep and thin veins in the arm.
Option 4: Use small-gauge needle or a butterfly
- An assessment of what to use when extracting blood can help you achieve a one-stick only goal. Take note that thin veins can't stand bigger gauge needles as the vein will collapse upon insertion. Butterfly method is advisable if the veins are thin and superficial or if you're going to extract in the dorsal hand.
Option 5: Ask help from a senior phlebotomist
- Only and only if the patient insisted..but if not, why not try your best? It's not always your senior will come and rescue you. Show to your senior that you made an effort and at least you've tried. If it still failed for the second time, allow the senior to do the job.
PLEASE STAY TUNED FOR AN UPDATE OF MY PHLEBO TIPS
3 comments:
Hi! Ms.Cindy..I'm very happy na meron ka ulit blog about medtech and love ko bawat topic mo.. Thank you po pala sa mga tips nyo about sa board exam.. It really helps!!! More topic pa po.. Kakapasa ko pa lang po ng board exam last february 2017... Ako po yung mga nagcocomment minsan sa blog nyo po.. Super thank you po talaga!!
great blog! but the pop up is annoying, it appears at EVERY page I open in the blog, is there a way to disable it?
For some phlebotomists, extracting blood from difficult veins can cause stress. Addressing this issue and finding solutions is a great way to make the blood drawing process go smoother. Thanks for sharing!
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