phlebotomist needs crash course of icm or dr-pt relationship

25 Aug

It’s a little ironic.  Today was our first small group session in Introduction to Clinical Medicine.  We met with a few standardized patients and practiced taking patient histories of present illness.  We experimented with ways of making sure we hit on all the major, preliminary bullet points while creating a pleasant flow in the interview and demonstrating respect and empathy.  As a novice, it’s not always intuitive.  For me, it’s hard to always listen well while going through a check-list in my head.  I’ll practice.  I’ll get better.

Immediately following, I went to get some bloodwork performed.  Not unusual.  I get stuck a fair bit, and I’m actually a little proud of being good with needles, a talent that’s come with practice 🙂  So, no biggie: I heard my name; I sat in the chair with the funny armrests; I watched as one my usual phlebotomists (who still looks at me like it’s our first time meeting) wrapped a tourniquet around my right arm.  Then I made my first mistake: I asked her whether I needed to change my insurance information at their lab or whether just being in the Penn system would suffice.  Exactly what information she provided was unclear to me; she definitely did not answer my question, but at least she repeated herself multiple times while interrupting me as I tried to clarify.

Next comes the mildly humiliating part.  I’ve been told I’m a hard stick.  My veins, apparently, like to “jump”–as in, the phlebotomist or other care provider will see a nice, juicy vein right below my skin, and think he’s got it made, but then my vein dodges away after the needle pierces my skin, at which point he either attempts another stick or goes digging.  The former is preferred by me.  The latter was attempted by said phlebotomist today.  It was not pretty, and I think this was the first time I actually let a f—! escape from under my breath.  For most caregivers, this would be cue to apologize or demonstrate some empathy, even for a wimp like me.  Her reaction: “Looks like someone’s not good with needles!”

Are you kidding me?

A few more somewhat demeaning interactions later, and I was walking out of the lab livid.  Then I thought: Wait a sec.  She should know better.  I deserve better, and she should want to know how to do better.  So, in a moment of complete stupidity, I walked back into the lab and approached her.  I composed myself, looked into her eyes, referenced our long-standing, normally good relationship.  Then I expressed that I didn’t feel like today went so well, and I enumerated my reasons, using tons of “I” statements (ex. “I felt embarrassed when you commented that I wasn’t good with needles”).  She interrupted me and told me that she was sorry I was upset (which is not a real apology), then proceded to tell me techniques about how to become more comfortable with needles (seriously?).

I’ve decided that she either doesn’t care or she’s an idiot.  Too harsh?  I mean, I know I’m a biased opinion here but, in this case, I do not think this is a problem of anna’s oversensitive nature.

I ran into one of my doctor’s while leaving.  I hadn’t seen her in person in six months, but she called me by name, asked how I was doing, and said that she would call me ASAP with the results of my bloodwork.  She’s a brilliant physician (one of our lecturers at Penn) and she’s socially competent.  Today’s experience reaffirmed that it’s totally possible to be both or neither.

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6 Responses to “phlebotomist needs crash course of icm or dr-pt relationship”

  1. ericrosoff August 25, 2011 at 6:38 pm #

    Looks like someone else isn’t good with patients. I’m pretty sure I know which one I’d want to be.

    • annaojesus August 25, 2011 at 6:42 pm #

      me too! unfortunately, i’ve been fuming rather than vc-ing (it’s amazing how something so small can get under my skin so much–both figuratively and literally). felt good to vent, now i can start to be productive? hopefully?

  2. Erin Zoller August 25, 2011 at 7:42 pm #

    Pregnancy comes with lots of blood draws too. I had one phlebotomist that, upon my asking how many tubes she would need to fill, replied “crap if I know.” (!!!) Now, I wasn’t offended by the language but it sent across such a ridiculous sense of her having no idea what the hell she was doing that I thought she was going to print out my lab orders and the REAL phlebotomist was going to come in the room any moment.

    Then, I like to look away when I get stuck but I don’t get super freaked out or anything. So she says “oh, is this your first time getting blood drawn?” It made me feel like I was some hysterical patient.
    It was so confusing and awkward. I feel your pain how very weird. I think you need to complain to her supervisor. You did the right thing to confront her in a professional way, but she obviously wasn’t listening, and wasn’t apologetic at all. Like the previous commenter: you aren’t bad with needles, their employee is bad with patients.

    • annaojesus August 26, 2011 at 12:02 am #

      Erin! Oh. my. goodness. It’s so disconcerting when health care professionals a) don’t know what they’re doing, and b) truly don’t seem to give a damn. Sorry you had to deal with that!

      I’m so glad you told me about the looking away experience–I had an all too similar experience once before that really pissed me off. For me, I always just thought it felt less uncomfortable if I wasn’t bracing myself for it, ya know? The RN that was sticking me that time said something like, “If you want to enter the medical field, you’re going to have to get used to seeing a little blood.” Um…what?! Both offensive, non-productive, and so not relevant to me. We are not hysterical patients; we’re just adult enough to know how to moderate our own discomfort and pain.

      Thanks so much for your support, Erin. It feels good to get affirmation that my confrontation wasn’t overly aggressive. I have been debating whether or not to complain to her supervisor. I’m tempted to wait and see how our next interaction goes, because maybe she was just having an off day.

      I hope you’re feeling well! How’s the pregnancy treating you?

      By the way, one day I should thank you properly for that little chat you had with me about getting health stuff in order!

  3. ER Jedi August 27, 2011 at 7:58 pm #

    Something I have been told a few times this year, and found to be good advice, when you are doing a procedure and its not going as smoothly as you like, you can never say it’s the patients fault. It’s too easy to say the patient has rolly veins or is a hard stick or the like when it’s you that’s having a hard time. Apparently no one ever told her this.

    • annaojesus August 28, 2011 at 12:31 pm #

      Good advice! It’s nicely analogous to “the customer is always right” saying. Unfortunately, I’m sure I’ll be guilty of saying something similar to a patient one day, but I will definitely keep this in mind! Thank you!

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