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!

I think you were very good letting her have 5 attempts.

The 5th one was hardly consensual though, and resulted in a nicked artery and distressed patient.

This is why I hate having bloods taken last time she tried both arms and both hands - nothing. Went back to an arm and like you it hurt like hell but she got nothing, then she pulled it out and blood spurted everywhere. I was covered in holes and bruises when she'd finished.

She may have been upset but as a pp said you're not a pincushion.

YANBU. 5 attempts was too much. We allow 2 goes before getting someone else. That said if you have bad veins for bloods it is usually difficult to begin with!

I wouldn’t have been happy either

Granted I wouldn’t have heard her say she was rubbish at getting blood, but if I had, I would have refused her straight off.

Yes she has to learn on a real person, but she can practice on people who have a higher pain threshold and who isn’t bothered by blood tests

YANBU. I have a needle phobia and would have probably passed out. I know everyone has to learn but there's no way on earth they'd be practicing on me

Refusing to get someone else when you asked is not on. I'm not one for complaining unnecessarily, but I'd be seriously tempted to flag that up because no nurse (or any HCP) should be refusing to get another person when requested. Consent is important.

I'm incredibly difficult to get blood from. In hospital once it took 9 attempts by 4 different people (it had to be done, hence the attempts). No-one has ever even attempted anymore than 3 before getting someone else.

I’m a doctor. This is too many attempts. I’d advise students to ask for help after two failed attempts (obviously sooner if patient wants / unhappy) and everyone after three attempts. This would only be acceptable in an emergency situation where blood / access needed immediately and no one else available to help easily.

@ColleagueFromMars

I think you were very good letting her have 5 attempts.

The 5th one was hardly consensual though, and resulted in a nicked artery and distressed patient.

You could argue it was coerced consent, but legally it would be presumed consent as the OP didn’t remove her arm. (I’m not defending the HCP, I think she was totally wrong).

I'm a qualified midwife and even though I'm extremely competent at blood taking (I view it as a talent!) I still only have two attempts before asking someone else to try, where possible.

I’ve got overused veins that are difficult to take blood from. I’ll let them have two goes and then, if they don’t suggest getting someone else themselves, I politely ask they find someone else.

I don’t think this is acceptable. Usually if I’m having blood taken or a canula placed, if a practitioner can’t do it after two tries they would get someone else. I think it’s especially unacceptable that you asked her to get someone else and she said no. If you were uncomfortable with her continuing to try and take blood then it isn’t her decision to make.

I took part in a research study once where I had blood taken lots of times in one day. The phlebotomist was excellent at it. He advised that it helps a lot to keep the target arm warm and also to be very well hydrated from as early in the day as possible. I try to bear this in mind before giving blood. They failed to get enough blood out of me once at an early morning appointment and I was advised to stick to the afternoons if possible and it's been fine since.

My midwife used to refuse to do my blood tests and always booked me in at the GP for a nurse to do it because I have "mobile veins ". The nurse was always fine. I also had to do the glucose drink test thing at the local hospital. It , painfully and embarrassingly, took 4 health professionals at least 8 times to hit a vein and do the draw after the 2 hours. Each one had a couple of goes, apologised and went to fetch someone else.

I have 'burrowing veins'. They stand out proud until the needle touches skin. It's not me, I'm fine with the process. My favourite phlebotomist took multiple attempts in each elbow then switched to the back of my left hand. She did explain that she'd have switched to my feet if necessary, having been peas trained.

Her determination, confidence that it was me not her, got us through what could have been a tense time - she even got me to hold the canula in place whilst she got replacement phials. As I said, it isn't me.

I've had perfect fingerprints in blood on the inside of an elbow when giving blood. I was quite happy to be deregistered

Yanbu

I did have a student phlebotomist take my blood the other day, but it was fine. They asked me if it was ok first though! I said fine as I’m not a vulnerable person in any way and also I know I have good veins that are easy to take blood from.

However everyone has the right to be comfortable having their blood taken, and have a competent person.

I did ask for someone else once as the woman was really abrupt and rough and really scared me.

I'm very difficult to take blood from but need to have it taken at least every three months. Thankfully I'm also very relaxed about needles and go in with the expectation that it will take several attempts. Some nurses look at my veins and don't even try before getting the most experienced one. I've never experienced someone trying to take blood more that three times, they ALWAYS get a colleague after two or three goes. This is across different hospitals for decades. You also clearly were unhappy for her to try again. I think you should complain to be honest, this wasn't normal. She needs extra training, especially in when to give up.

They have to learn, sure, but they also have to learn how to deal with patients and trying several times, refusing to stop when asked, and huffing and stropping off when it goes wrong are not good practice.

I'd make a complaint about it – specifically about her failing to stop when asked.

The 2 nurses speaking so loud you could hear are unprofessional. They should have supported their colleague and like the poster above said taken over before the 4th attempt.

I used to have to go to East surrey twice a week to have bloods taken when pregnant. Always made sure a lovely midwife called Hazel was there. She was wonderful.

I agree, was also taught 2 attempts / 3 maximum (taking blood or inserting cannulas) as a student/ junior doctor. 3 attempts then get someone else no matter what level you're at.

As an aside, I remember having a little bit of fun my first year out of medical school. I needed some review bloods done for something, we had students attached to our team, and I've generally been easy to get blood out of. So I said to the pair of them, who's taking my blood then?

I have a high pain threshold and no problem with needles so I always let newbies have as many goes as they like on my arms
But no she was definitely wrong for attempting a fifth go when you already asked for someone else to come and do it.

YANBU, they have to practice but she should be supervised until confident.
I'd have done the same thing, the sight of squirting blood would have made me faint, I know it would and I don't mind needles.
She should have asked for support/help after the first failed attempt.

nurses have struggled to get blood from me before now, had to go to bid toe, but that was a problem with me, not incompetence of the nurse.

They get one bad attempt with me. If it doesn’t happen on the second try they have to get someone else. There are also certain people I won’t let draw my blood anymore.

I’m a difficult stick and have to get blood drawn regularly. I’ve learned that I must advocate for myself.

Where I work the general rule is to get someone else to try if you have failed twice, four is way too many!

It was completely unacceptable for her not to get someone else when asked. Make a complaint.