Phlebotomy

From the Latin, “phleb,” meaning “to flounder” and “otomy,” meaning “around in a person’s actual living flesh.”

I’m taking Introductory Phlebotomy this term, as perhaps you have surmised. I looked forward to this class with a sort of glee: I would actually get to do stuff! Medical stuff! I planned to totally rock at it. I have no needle phobia, a high tolerance for pain, and an undying curiosity about all things medical. Bring it!

This is a Saturday class, with lecture for an hour and a half, and lab for an hour and a half. Usually, both are shorter.

During the first week of class, we spent an hour being lectured to on how to properly wash one’s’ hands. This may sound silly; however, when you’re dealing with bodily fluids and venipuncture and whatnot, you’ll want to be certain to be somewhat sanitary. So, we all washed our hands. A lot.

During class, two people (not one person, but TWO real, living, functional human beings) professed a fear of… cotton balls. Seriously. One of them is taking the class expressly to overcome her fear of them. While I cannot say I am afraid of cotton balls, per se, I can absolutely appreciate the foundation of their phobia: The sound cotton balls make when you rub them together. I hate that sound! It makes my skin crawl. Still, to out oneself with a bona fide fear of such an odd thing… it certainly takes a measure of courage.

Another student says she cries whenever she gets poked with a needle. Two say they might pass out. The only male present says he might cry, too. I admire their courage in taking the class, too. I mean, I’m taking this class largely because I thought it would be fun and interesting, and don’t especially mind the penetrative part. Them? They’re coming into school on a Saturday and facing a fear. Impressive.

Week two: We learned about the Vacutainer system, as well as the steps one goes through in order to get a clean draw. This was largely review for me, having done a few draws on canids during my time at Wolf Haven. The Vacutainer system is pretty much (fortunately) idiot-proof. For lab, we went through a faux-draw, doing all of the steps, minus the sharp, pointy bits.

One of the cotton-ball-phobes conquers her fear. The other has a hard time picking one up.

Week three: Actual venipuncture. There are no dummies, no oranges, no substitutes for actual blood-carrying vessels and the nerves in between them and the outside world. No. We applied our tourniquets to our quivering partners and we jabbed a needle into their arms. Some of us did it twice.

Thankfully, the instructors do not simply sit by and say, “GO!” as we stab, stab, stab our unwitting victims randomly in their elbowy parts. They actually hold our trembling hands and guide us to the proper angle, and to the proper depth. On week three, they did not go probing around for the vein, should it have rolled or not been where we thought it was.

My partner for my first draw had truly stunning veins, which was fantastic. I got blood on both draws. I have no actual memory, however, of the first one. I remember prepping her, I remember Stacy (our lab instructor) standing at my side and holding my right hand. Somehow, magically, the needle got put in correctly, I put on my tube, switched my tube and completed the procedure. Wow! I rule! Phlebotomy is so flipping easy!

I also have pretty spectacular veins (at least for now,) so my partner was able to get blood on me, too, and she did a fine job of it. I offered to let anyone who didn’t get blood draw on me, and Stacy happened to notice the tattoo I have on my right deltoid. “No wonder you don’t mind needles, young lady – you’ve had thousands of ’em.” Well, yes… sort of.

Week four: More of the same. I am paired up with a different partner, a medium-skinned woman from the Caribbean with teeny, tiny, deep veins that roll if you look at them oddly. Again, Stacy guided me, even helped me to locate the probable puncture point. No blood. Not on the first draw, and not on the second one. Not even on the fricking third one. Wow! I suck! Phlebotomy is so flipping hard!

During her draws on me, the first one went just fine. My veins are very superficial, quite large and do not roll. The tourniquet is mostly a formality in my case – my blood simply leaps into the tube. On the second draw, she apparently cranked the tourniquet down a bit too much, and as soon as she punctured the vein, a small spurt of blood popped out of my skin and scared the pants off of her. She recovered well, I reassured her that I was fine, and she completed the procedure.

After she was done, Stacy asked her, “Do you want to know what happened?” “YES,” we both said in unison. “Well… you can really tie a tourniquet, girl.” My partner opted not to attempt a third draw, and I bruised up quite nicely.

Week five: We learn about syringe draws. Many phlebotomy people seem to prefer the syringe draw, because it offers them a “finer grain of control of the flow of blood.” I’ve yet to be impressed with this in practice, but I can appreciate it in theory. Last week, however, I hated that fricking syringe.

My partner (the recovered cotton-ball-phobe) is a heavier girl with pale skin and no veins. Whatsoever. Upon palpation and visual inspection, we can only assume her blood returns to her heart via diffusion. We ratchet down the tourniquet, we hold her arm lower than her heart. Jerry, the other instructor, guides my hand in – nothing. We root around in her arm for a good 45 seconds, hunting.

More precisely, Jerry roots around in her arm, holding my hand captive in the process, with his feet spread apart and standing in this crazed sprinter starting-line position. My eyes are as big as my head. I am horrified. Surely, that could not be comfortable. Further, there was this wild battle raging in my head: On the one hand, I wanted my hand to be as limp as possible as Jerry “guided” me toward my prey; on the other hand, it is nearly impossible to fight the urge to try and hold one’s hand still when grasping a very thin, sharp instrument that is currently inserted into another human being’s living tissue.

Who won that battle for control of my appendage, I haven’t a clue: Jerry could’ve thought he was wrestling an alligator or grasping an al dente linguine. I was too conflicted to remember. Incidentally, this may not bode well for a life in trauma, but one hopes this sort of initial shock wears off after one acclimates briefly.

At any rate, back into this young lady’s dermal tissue, because that’s where I was. Not one damn drop of blood. She claims it doesn’t hurt, honestly. We give up anyhow. SHIT! Not again! Since we only get to do this once a week, having two no-blood weeks in a row would be totally devastating to my confidence.

On the second draw, we went back to the comfortable realm of the Vacutainer, and Stacy assisted. Stacy, wise after 20-mumble years at this sort of thing, sagely advised me thusly: “Aim for last week’s puncture mark – we got blood on that one.” Following her advise, I did my very first solo poke, and it worked like a charm. Yay! I love Phlebotomy!

At this point, several people have had days when they didn’t get blood. We have to have new partners every week, so at the beginning of class, we’re all sort of sizing each other up, some trying not to be totally obvious about it, others with eyes as big as saucers. We all look like new junkies, with our little bruises and track marks. No one has cried, screamed or passed out. There have been a few, loud “OUCH!” yelps and at least one, “HEY! That really hurt!”

Mostly, we’re functioning as a team, a team whose sport is to punch holes in each other’s circulatory systems, who are all stuck on the same boat, and that boat is the pirate ship, “Fledgling, Fumbling Vampyre.”

Avast.

I’m hoping my perfect, plump and willing veins don’t become overwrought from this class… giving blood has always been a breeze for me, and that’s not something I’d like to see slip-sliding away.

Ideally, we’d have this class several times per week… doing it two or three times, once per week, it just doesn’t build up the skill set terribly quickly. Still, I’m getting to Do Stuff. Medical Stuff.

And that’s good.

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