I was recently hired for night shift (3am draws). 95% of the patients in my unit are elderly, dehydrated, paper thin skin with veins smaller than my smaller butterfly. The nurses draw from the lines and they get rejected for hemolysis (and watching them do so I can see why). So, then I have to draw. I feel terrible trying to find somewhere to draw on them especially when the tourniquet tears their skin and the vein immediately blows. It would be fantastic if I could use this device!!
This looks like a wonderful device! My only concern is that most RN’s who don’t have any laboratory knowledge do not understand Order of Draw. This was my experience working as a phlebotomist in the emergency department and inpatient. They just picked up tubes and started filling them when they would draw their own patients. Feedback always fell on deaf ears. Terrifying.
You are so right, Tezzy! That's why we have another video on the Order of draw (ruclips.net/video/1J9y_WPpzk8/видео.html) and a free download titled "Do I Have to Follow the Order of Draw?" Access it here: www.phlebotomy.com/FREE/NKH_FllwngOrdrDrw.pdf,
I think you are generalizing too much. You have no idea what nurses do or do not know and, as a phlebotomist, you have very little experience with patient interaction or phlebotomy generally compared to an ED nurse. This is absurd that there is this level of hemolysis with nurse draws. Y’all are trippin
@@johnnavarre4588 our nurses don't take any type of phlebotomy classes. They get a crash course. They watch a video for a couple of hours and work on a dummy arm and that's it.
The DNV considers NS flushes as medication. We are dinged if ever they find NS flushes lying around. It has to be in the med room or locked up on pt medicine cabinets.
@@centerforphlebotomyeducati4509 The RN would need to be present to stop the medication, flush the line at the ~rate of medication infusion or withdraw the med from the line, and only then would a lab member be able to draw. There are meds that have very slow trickle rates and flushing them in suddenly with 5-10cc of saline can have a negative outcome. But I do see a high patient request for drawing blood from peripheral IV's.
Every facility I’ve worked at has a policy against drawing off of an established IV. If you happen to catch IV team while they’re establishing a line- and they’re willing, you can give them the tubes to fill. Otherwise- this is a big no no and can get you fired. My only question on these stats is what is the tube size? In pediatrics we use a syringe and very small pediatric tubes (.5-1.0ml) or a 1cc syringe with those draws a specimen is unlikely to experience hemolysis because the draws with a 23g or even a 25g needle are so much lower. (This has been my experience in a pediatric hospitals lab.)
@@centerforphlebotomyeducati4509 that’s great! I’ll keep a lookout for them- these would be fantastic is very tough patients- like ICU patients or patients with compromised anatomy (like traumas, patients with multiple IVs and severe scarring (iv drug users/burn patients)
If you're working at a place that talks like "if you do this you could get fired" then find another place to work. I won't get into best practices in employment, but connecting harsh actions like that to work performance is counter productive overall. Especially for the employees. Just plan on going to work, being positive, do a good job even when it sucks, and don't let bosses treat you that way.
@@KarlH1980 not true. This is one of those severe consequences due to the severity of damage that can happen to a patient. It’s no different than being told if you assault a coworker you will be terminated. The severity of the action is reflected in the penalty. But then again, people these days just want to ride through life doing whatever they want and never suffer the consequences of their actions. If you’ve ever worked in a hospital- this environment you describe does not exist. Some environments are better than others but overall- there’s the constant looming reality that one mistake can kill or severely harm someone. That’s the reality of the job and any employer worth a damn let’s you know up front where they stand on things so there’s no surprise later when you’re trying to collect unemployment.
What if they need multiple draws? I am currently in the hospital. I have had blood drawn 12 times in 3 days. They have pokes all over both my arms making me look like a user. Now they have a hard time finding space and my veins are harder now. They wanted to take blood from my hand now. Should i be worried? I can't keep getting blood draws like this.
I was recently hired for night shift (3am draws). 95% of the patients in my unit are elderly, dehydrated, paper thin skin with veins smaller than my smaller butterfly. The nurses draw from the lines and they get rejected for hemolysis (and watching them do so I can see why). So, then I have to draw. I feel terrible trying to find somewhere to draw on them especially when the tourniquet tears their skin and the vein immediately blows. It would be fantastic if I could use this device!!
This looks like a wonderful device! My only concern is that most RN’s who don’t have any laboratory knowledge do not understand Order of Draw. This was my experience working as a phlebotomist in the emergency department and inpatient. They just picked up tubes and started filling them when they would draw their own patients. Feedback always fell on deaf ears. Terrifying.
You are so right, Tezzy! That's why we have another video on the Order of draw (ruclips.net/video/1J9y_WPpzk8/видео.html) and a free download titled "Do I Have to Follow the Order of Draw?" Access it here: www.phlebotomy.com/FREE/NKH_FllwngOrdrDrw.pdf,
Yikes!!!
I think you are generalizing too much. You have no idea what nurses do or do not know and, as a phlebotomist, you have very little experience with patient interaction or phlebotomy generally compared to an ED nurse. This is absurd that there is this level of hemolysis with nurse draws. Y’all are trippin
YES!!!! This is mind blowing to me!
@@johnnavarre4588 our nurses don't take any type of phlebotomy classes. They get a crash course. They watch a video for a couple of hours and work on a dummy arm and that's it.
The DNV considers NS flushes as medication. We are dinged if ever they find NS flushes lying around. It has to be in the med room or locked up on pt medicine cabinets.
That's interesting. The FDA and the pharmaceutical industry considers them devices, not medications.
@@centerforphlebotomyeducati4509 The RN would need to be present to stop the medication, flush the line at the ~rate of medication infusion or withdraw the med from the line, and only then would a lab member be able to draw. There are meds that have very slow trickle rates and flushing them in suddenly with 5-10cc of saline can have a negative outcome. But I do see a high patient request for drawing blood from peripheral IV's.
Every facility I’ve worked at has a policy against drawing off of an established IV. If you happen to catch IV team while they’re establishing a line- and they’re willing, you can give them the tubes to fill. Otherwise- this is a big no no and can get you fired. My only question on these stats is what is the tube size? In pediatrics we use a syringe and very small pediatric tubes (.5-1.0ml) or a 1cc syringe with those draws a specimen is unlikely to experience hemolysis because the draws with a 23g or even a 25g needle are so much lower. (This has been my experience in a pediatric hospitals lab.)
With this device, any size tube will work with significantly reduced hemolysis.
@@centerforphlebotomyeducati4509 that’s great! I’ll keep a lookout for them- these would be fantastic is very tough patients- like ICU patients or patients with compromised anatomy (like traumas, patients with multiple IVs and severe scarring (iv drug users/burn patients)
If you're working at a place that talks like "if you do this you could get fired" then find another place to work. I won't get into best practices in employment, but connecting harsh actions like that to work performance is counter productive overall. Especially for the employees. Just plan on going to work, being positive, do a good job even when it sucks, and don't let bosses treat you that way.
@@KarlH1980 not true. This is one of those severe consequences due to the severity of damage that can happen to a patient. It’s no different than being told if you assault a coworker you will be terminated. The severity of the action is reflected in the penalty. But then again, people these days just want to ride through life doing whatever they want and never suffer the consequences of their actions. If you’ve ever worked in a hospital- this environment you describe does not exist. Some environments are better than others but overall- there’s the constant looming reality that one mistake can kill or severely harm someone. That’s the reality of the job and any employer worth a damn let’s you know up front where they stand on things so there’s no surprise later when you’re trying to collect unemployment.
What if they need multiple draws? I am currently in the hospital. I have had blood drawn 12 times in 3 days. They have pokes all over both my arms making me look like a user. Now they have a hard time finding space and my veins are harder now. They wanted to take blood from my hand now. Should i be worried? I can't keep getting blood draws like this.
Great video Dennis....
Thanks!