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!

Apparently mine are deep and at a funny angle
Haematology usually do my bloods but even there I get "hello Queen, I'll get the vampire for your bloods"
It's when they get the needle in, don't get it and start wiggling it about

I had the flu jab recently and was praised for not bleeding

Life is shit right now so I’ll take any praise going 😂

YANBU I've had this all throughout my midwife appts I've had collapsed veins about 4 times over the years now. And even in labour the Canulla I can't spell it sorry!, was put in wrong I had more pain from that, than what I did giving birth.
Last week a health care assistant kept trying to take blood it took her four attempts at different sites, I was nearly crying when she finally got it in.
I looked like a junkie the days after these appts.

YANBU I had a horrendous time with my DS (age 4) when an inexperienced doctor tried to put in a canula in A&E. It ended up with 7 members of staff being involved in holding him down and blood all over the floor. Needless to say it was a major trauma for a child and it has taken a huge amount of time and effort by other medical staff since to get to a point where DS can have blood taken again.(Unfortunately it is a regular occurance due to a chronic medical issue:()

I should have out my food down when i heard the doctor being given instructions on how to do it by the senior nurse on duty, but was preoccupied with a poorly child. Never again.

YANBU this happened to me too and I walked out . I was in ICU last year and their constant failed pricking brought back horrible memories . I should've asked for someone else like you did!

I am surprised they did not automatically change after two failed attempts. Standard procedure when I had chemo and the nurse failed to get a needle in. Didn't mean the nurse was not competent but just both patient and nurse tense up after misses making it more difficult.

Our policy at work is if you can’t get the blood after 2 attempts, then you stop and get someone else to do it. So no, she shouldn’t have kept trying. She should have apologised and got someone else.

Some patients have no usable superficial veins at all - long term IV drug users for example - and we have to use an ultrasound probe to find a deep arm vein in such cases.
However, if a nurse knows that her own technique is rubbish on normal veins, she absolutely should not persist in inflicting it on patients. She needs to get a senior person to supervise her and correct whatever she is doing wrong, until she is confident to work alone. Repeating the same mistakes on multiple patients is never going to magically improve her!

I’m a retired anaesthetist, and when teaching cannulation to medical students, paramedics etc, I found the commonest error was not fixing the vein in position with the index finger of their spare hand, before puncturing the skin. The vein was thus still mobile within the subcutaneous tissue, and slid away from the needle. Other errors include inserting too far, so the needle goes right through the vein and comes out the back of it, or not waiting long enough for the vein to fill adequately. It may be necessary to heat the arm, hang it down over the side of the trolley, or get the patient to repeatedly squeeze their fist, to bring a vein up.
There is also little point in blindly stabbing at the elbow on an obese patient with the veins buried in fat, when they may have a much more accessible one on their hand or foot.
Inspecting the patient and choosing the best vein, wherever it may be, rather than always going for the same site, is vital.
No doctor, nurse or phlebotomist is allowed to needle you for a sample if you refuse consent- it is legally an assault. Stand your ground and insist on a more experienced practitioner.
There is no doubt some people have better manual dexterity and venepuncture skills than others, but all can be taught the basics to reach an acceptable level of competence.

I had this with my GTT.
I was literally so tender and bruised after I could barely move my arms. 3 of them, used me like a practice tool. After the third one had tried 3 times, I said no, enough, please get someone senior
One of them slunk off to do that, the other walked off but the other one was so rude, asking what my problem was and there was no need to get someone else, she would've sorted it eventually, but I was tense. I said are you surprised after you've all taken turns to attack me unsuccessfully with a sodding needle.
I was so hungry as well and I got quite teary.
Senior nurse came in, got the bloods but instead of apologising told me I needed to learn to control my emotions if I was going to be a mum and I couldn't just cry at the first hardship
I honestly wish I'd have complained OP, but I didn't and I still regret it (and DD is 14).

When I was in hospital last year I had to have blood taken every morning. One morning the nurse was trying (and failing) to take blood firstly from the back of my hand (where she left bruises) then from my arm (where the vein collapsed,) Eventually she got it but I was covered in bruises. She happened to tell me that she didn’t usually work on that ward, and when I asked her which one she worked on she said “ Haematology” .

Was talking to one of the regular nurses the next day who never ever hurt or struggled, and she said she’d had to have blood taken for something the week before and the person doing it struggled and struggled, and in the end she asked for someone competent, and only then did she say she was a nurse. She said she’d had a massive bruise for over a week...

YNBU. Yes they need to practice and some people are cool with getting there bloods taken- so practice on them.

Don’t practice 5 times on someone that’s already made it clear they aren’t keen

I knew as soon as I clicked on this thread that it would involve an incompetent midwife. Shame on them. You are not a pin cushion. Any midwife that huffs at a patient should seriously consider a change of career - this one showed a distinct lack of patience and empathy.

@LadyofTheManners - that nurse was a miserable cow. Another example of a HCP that is in the wrong job.

I would not be happy about this.I recently had a blood test at a different Doctors surgery (due to Covid) and they had a phlebotamist there .First time! no problem at all . I would complain and ask to see someone else

I'm married to a vet, so he doesn't normally have a colleague around to solve the problem (not small animal so works out of his car).

His take on it sounds like mine for parallel parking, usually it's fine, sometimes for no apparent reason it just doesn't work, and once you've messed up once it's really hard to not stuff it up again.

I know full well my veins are unexpectedly shy in my elbows, do my best not to tense and definitely look away.

Embarrassingly in labour I managed to rip the placed but not yet taped catheter out of my hand when a contraction arrived. DH pinned me good and proper for the 2nd attempt and was generally pretty useful!

Not being well hydrated is a big factor for me too.

I was admitted at our local hospital for reconstructive surgery on my hand, the emergency doctor was adamant to get a canular into me before she sent me up to the ward, tried 4 times, failed every time, blew 3 veins and when she went to try again in an already blown vein I told her to stop. Meant I went without my iv antibiotics (dirty wound - horse bite) until I got to theatre some 4 hours later and the anesetist had a go, by which point I had 3 heamotomas from the last doctors attempt. Anesetist told me to never let a HCP try more than twice, particularly I have difficult veins

There is also little point in blindly stabbing at the elbow on an obese patient with the veins buried in fat, when they may have a much more accessible one on their hand or foot.

@Babdoc This used to absolute infuriate me. I have deep veins (apparently). I also used to be very, very overweight. I’m still considerably overweight, but much less. I’ve had blood taken monthly (at least) pretty much my whole life for various conditions. I have a prominent vein on the back of my hand...

Without fail every single person I’ve ever encountered has insisted on trying in my elbow because they are “good at dealing with tricky veins”. They all also insist on telling me it hurts much more in the back of the hand and never, ever grasp that one attempt in the back of my hand is much less painful than multiple attempts on my elbows.

I now refuse to allow folks to even try my elbow. Since I hit 30 I’ve been much tougher in my stance

Definitely not being unreasonable. I had a midwife try and fail to take blood from me 6 times.

I'm now really phobic about it.

My hospital policy is 2 attempts then someone else. When I was brand new if the patient looked really hard then I'd only try once so to leave a decent vein for someone else. I've occasionally had 3 attempts on a patient who weirdly loved it and would always say to try again, but I would never do it on someone else. I'm good at taking blood now even from the most difficult patients (and yes bad veins are a thing, not just an excuse!).

The midwife should not have had 4 attempts and absolutely should not have tried to force you into another go. I would complain at that, it isnt fair at all and it likely against policy.

No one person should be having more than 3 attempts on you.

I had the most amazing nurse take blood when i was pregnant - i never felt a thing.

However the doctor (I assume he was actually a doctor) in A&E tried to take it from the back of my hand and I heard another doctor give him a bolocking about it. He was digging and poking (and lifting the needle so I got drag marks) my arm, couldn't find a vein then looked at the veins on he back of my hands and decided that they would do - I did say 'isn't that unusual?'

@LadyofTheManners

I had this with my GTT. I was literally so tender and bruised after I could barely move my arms. 3 of them, used me like a practice tool. After the third one had tried 3 times, I said no, enough, please get someone senior One of them slunk off to do that, the other walked off but the other one was so rude, asking what my problem was and there was no need to get someone else, she would've sorted it eventually, but I was tense. I said are you surprised after you've all taken turns to attack me unsuccessfully with a sodding needle. I was so hungry as well and I got quite teary. Senior nurse came in, got the bloods but instead of apologising told me I needed to learn to control my emotions if I was going to be a mum and I couldn't just cry at the first hardship I honestly wish I'd have complained OP, but I didn't and I still regret it (and DD is 14).

The thing is, you don't generally want someone senior. You want someone who is taking blood day in day out. I got on better with phlebotomists than doctors- inliterally have one vein you can get blood out of now.

I had to take blood very regularly I dreaded the patient who told you before you started that it was difficult to have blood taken!!! (Majority of times I managed) If after two failed attempts, IF the patient agreed, I sometimes made a third attempt. I would try BUT would never have attempts more than that.

Complain,she should NEVER have attempted 5 times,I am a retired Midwife,that is unacceptable practice.

I've just had to have a blood test done for the third time. The first two there were errors with the sample that led to an invalid result. A previous visit to the pathlab left me with bruising from my armpit to my wrist. Suffice to say I have little confidence in them now and only go if there is no alternative. My GP's don't offer the test that I've had redone.

@contrmary

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.

When I received my training on taking blood we were given fake arms with “veins” in them that had a red liquid. We practised on them. We then had to be supervised for a minimum of 10 times taking blood (if not satisfactory, more times), before we were signed of as competent to carry out the procedure by ourselves!

The general rule we were given was to only try twice to get blood. If you couldn’t get it after two goes, get someone else to try. The nurse in this situation was completely out of order to, not only try 5 times (plus want to keep going), but to refuse when the OP asked her to get someone else! If someone is so incompetent (because that is what she is) at this procedure, she should be sent for further training and not allowed to take anyone else’s blood until she receives further training.

@contrmary it isn’t a case of keep going until you succeed. There are some dangers in getting blood taken by someone this incompetent, such as bruising, uncontrolled bleeding, fainting (caused by drop in bp or heart rate), infection and in some cases permanent nerve damage! There have been cases where patients have successfully sued nurses/phlebotomists for the injury they have received when having blood taken.