To insist on having someone competent take blood?

[nervousnelly8]

Just back from a GTT appointment. First sample taken fine by a midwife, drank the drink and waited the 2 hours for the second sample. As I'm waiting, I hear 2 others having a difficult time having bloods taken. One of them faints. Two nurses are having a conversation (with the door open) - one saying how useless she is at taking blood and that she hopes she gets better.

I'm called in to the room where nurse is, visibly nervous about trying to take my blood. I'm not great with needles, don't have great veins and already feeling a bit iffy after no food and the lovely sugar drink.

She tries and fails 4 times to take my blood, at which point I say please could you get someone else. She says no, I can do it. The fifth time, she hits something really painful and blood literally spurts everywhere - all over me, the pillow I've got my arm on, the chair I'm sitting on. I swore loudly and told her to get someone else, at which point she huffs "Fine!" And storms out. The next woman got it first time.

I realise I probably shouldn't have sworn, but it wasn't at her, just at the significant pain and blood everywhere (and it wasn't a conscious thing!). WIBU to make her get someone else? I wish I had refused to have her in the first place tbh. She was so put out when I told her she couldn't try again, it's made me doubt myself!

The only way for her to improve is to practice but after trying 4 times and then being asked to stop, she shouldn’t have tried again.

She obviously has a problem with that skill so needs to go back to practicing on non patients. You aren’t a pin cushion.

You’ve got the right to ask a clinician not to do something. They should have listened.

But you didn’t stop them from taking your blood again though? You let them?

Anyway, clinicians have to learn. But they don’t necessarily have to learn on you. So you have every right to refuse.

No, YNBU. I have to get bloods done regularly and my usual nurse is great, she's done before you even realise. I had a different nurse do ot last time and she butchered my arm, I'm not convinced she got blood from a vein because there was hardly any in the tube compared to usual. I'll be asking for someone else next time if the usual nurse isn't there again.

They have to practice on someone. It's not something that can solely be learned by watching training videos or reading textbooks - everyone is a beginner at some point.

It sounds like you already went in there looking for her to fail so you could kick off, after the other two came out so she didn’t really stand a chance. I’m sure she is perfectly competent, but had got spooked by the other two before hand.

It’s an actual thing that happens, you can bet your bottom dollar that any time a patient starts telling me how they’re a nightmare to get blood from, I’m straight in there and the blood is drawn no problem. And just as easily, a patient with actual drainpipes for drains can sit down, and I’ll say to myself “this is gonna be easy” and every single vein I attempt will blow and I won’t get it. Being that second person coming into to have a go where someone else has failed is very empowering.

I’d just give her a break if I were you.

I asked her after attempt 4 to get someone else and she said no. After attempt 5 she was lining up to go again and I physically moved away from her and said go and get someone else. I had no problem with the next person having a go as I didn't want to go through the whole fasting/sugar drink thing again!

But yes, you’re absolutely right, you can refuse for her to do it again and she should have stopped, but if she said “but I’ll get it next time” and you said “okay then”, well that’s not really her fault is it?

I had exactly the same experience at my GTT, I was in pain for 2 week after but I know they have to learn somehow

Yanbu. You are not a useful training aid, you are a patient. 5 goes is ridiculous.

Two nurses are having a conversation (with the door open) - one saying how useless she is at taking blood and that she hopes she gets better.

I’m sure she is perfectly competent, but had got spooked by the other two before hand.

I think that given her saying how useless she is and messing it up three patients in a row, she really isn't perfectly competent.

Four attempts isn’t a beginner though. It’s someone that needs to be supervised until they gain enough confidence to take blood accurately.

@PeppaPrick I’m almost certain she got blood from a vein as there’s only three places she could have got it from; a vein, a capillary - needle too big or an artery - and if she’d got it from an artery it would have been a full bottle and then some.

@QueenOfPain sorry I've read my post and it wasn't very clear - she was visibly nervous not me. In my head I was thinking "uh oh" but I did try hard not to let it show. She asked if I was OK on a chair or if I wanted to move rooms for a bed, and I said chair was fine. She asked how I was having blood taken and I said usually OK. I probably did mentally have her set up to fail though and maybe that somehow came across!

I'm training and at Uni we get taught to try twice on the patient if they're help for us to do so, but after that point it becomes unprofessional to keep prodding them uselessly and so we have to ask for a senior to do it instead. I'd be annoyed with that many attempts, it's unfair to patients to ask them to endure that.

*happy not help

I wouldn’t have been happy either. I’m not good with needles at the best of times.

I once had a phlebotomist miss the vein and my arm was black and blue the next day. I’d hate to think what it would have been like after five goes!

Sounds unprofessional of her. When I was still learning how to take blood if I hadn’t managed the second time whoever was supervising would then take over/ I would ask mentor to attempt; I would have never dreamed to keep trying 4/5 times when clearly you were uncomfortable!

I had to go to the phlebotomists a couple of times during pregnancy. My arm veins look good but are actually a bit "slippery"

Back of my right hand seems to be place of choice at the moment!

DH is a total disaster for bloods after chemo for lymphoma 5 years ago! The phlebotomists in the chemo ward where he goes for check ups are usually great, don't think anyone else dares try!

If I’d got another member of staff readily available to take over I’d personally have stopped after two attempts, and let someone else have a go.

But I work in A&E, so generally we really need that blood or that cannula and provided the patient is okay with it I’ll try a couple more times.

I give two attempts and then ask for someone else. I warn them my veins are bad and they usually drag someone out nicknamed the vampire

Of course they have to learn but when someone isn’t easy to get blood from it makes a huge difference. I could believe it when dh was having blood taken and they filled the bottle from 1 stick and 1 needles. I always say that it’ll be a struggle and they’ll need a butterfly or the back of my hand, mostly they listen but every now and then I’ve got to end up looking like a intravenous drug user before we’re through.

I’ve also had the blood spurt everywhere, it was a student when I was in labour and he was more upset than me.

Yanbu my GTT took 8 attempts by 2 ladies, think they were HCAs in the end they sent me down to the blood clinic where the lady got it first attempt, I wish I’d said no after a couple of attempts, I’m not sure why I didn’t but my arms and hand were bruised as hell. But after that I didn’t let anyone in maternity near me and asked to go straight to the clinic if they needed blood.

I have terrible veins and people always struggle to get blood from me. I've never had anyone try more than twice before getting someone else to try. I always thought that was a general rule? I always say that they might struggle and they are usually ok to try at least once or they just get someone more experienced.

I think someone has said this up thread, but I am a doctor and I tell my juniors that it is ok to have 2 goes, but if they fail twice, they need to get someone else to do it.
I think you were very good letting her have 5 attempts.

I asked her after attempt 4 to get someone else and she said no.

In my view this is a seriously bad call she made and I'd make a complaint to the ward manager or equivalent about it.

I'm somebody whose veins are difficult and I'm happy for people to have multiple attempts, but after anywhere between 0-3 failed attempts every medical professional I've ever seen has gone to get somebody else. After FOUR failed attempts and a patient removing consent she was absolutely bang out of order for having another go and I am on your behalf.

Patient consent is a thing.