Venepuncture and a nurse at work

[Shiningstarr]

Hi, just wondered if I am being unreasonable or not. Any nurses or healthcare professionals that can advise me would be great.

A nurse I work with seems to have an unusual way of taking bloods. She is regularly unsuccessful, and I observed her on a few occasions recently doing this...

1. glancing at the patient's arm, doesn't palpate the area to feel for a suitable vein.

2. attaches tourniquet and cleans area

3. always chooses GREEN butterfly (thicker one), and inserts... no flashback. Even though there is no flashback, attaches the vaccutainer... no success.

4. starts fishing around for a vein, digging the green butterfly in further and in different directions. Patient squirming in pain.

Surely this is not best practice? I do this..

1. put the tourniquet on, palpate the area and find a suitable vein.. should feel bouncy. If no vein is found, remove the tourniquet until one is found.

2. clean area

3. insert needle, if there is flashback, attach vaccutainer, remove tourniquet etc etc.

A lot of our patients are teenagers and they are fainting when she is fishing around with the huge needle. What should I do?

If it’s causing patients harm (eg fainting when they probably wouldn’t from normal bloods being taken) you HAVE to report it.

You take it to your line manager, not social media.

Thanks, just want a few opinions first, so that's why I am asking on here.

I have crap veins and if she started wiggling around for a vein I would be asking politely for someone else
To be fair they usually look at my veins and go off to find "the vampire, she always gets blood"

I am also a nurse and her way obviously sounds incorrect! Has she actually been signed off to take bloods? I had to be observed 5 times taking them before classed as competent. I'm not great at it (I work with elderly patients with average age 80-100) but i have maybe one or two goes and if not successful I ask someone else to help... Sounds like she needs more training!

Yes she's been signed off. She's actually only got a few years left until she retires, she's been a nurse a long time. Maybe she needs to re-train?

It's not so much not being successful that's concerning, it's the technique.. eg.. why attach the vaccutainer when there is no flashback? If no flashback then you've not got the needle in the vein

Has she always been this bad, do you know? Maybe her eyesight's failing. Or even experiencing cognitive decline.

I've only suffered one nurse stabbing away with no result - she was telling me all about her big night out just gone, so I sent her away to get a cup of tea and some paracetamol for her hangover before she turned my arm into a colander.

The only thing more bonkers than her technique is you sharing it here instead of with your line manager.
Have you asked the colleague about it? Or do you just watch?

Sensible to feel the vein first unless it is visibly raised.
If no palpable vein , tap or ask patient to repeat it make fist to bring up a vein.

I have no problem with using a green butterfly . This is totally standard . Smaller calibre needles take longer and may cause the blood to haemolyse . There are some ‘safety needles’ where you don’t get a flashback. If your practice uses standard ones though you would expect a flashback and need to reposition the needle.

This.

💯

I have a needle phobia and if a nurse did that to me my veins would have disappeared and once I'd calmed down I'd be making a complaint - I can't believe no one has already.

Is she really that stupid that she can't see she's hurting people?

Green needle's fine - blood's less likely to haemolyse. Attaching the vacutainer's fine. Feeling/not feeling ...depends on the veins. DOI: anaesthetist (old enough to do all sorts of things that younger folk might think are a bit out of the ordinary when taking bloods/cannulating).

Not medical but really interested what a flashback is ?? My veins are a nightmare apparently and I've been butchered many a time so I find this fascinating!

Also have to have a cannula in my wrist, why would that usually be ?

if that's where your best veins are then that's the best place to put it.

wrist is a very good place to put it. Nice cephalic vein at the wrist is much better than one in the back of the hand ( often small vein and can be kinked if it goes over the wrist join) . Better than front of the elbow ( may kink and stop a drip from running ) .

The only opinion you should be interested in is your line managers.

Report poor practice in the correct channels.

What difference will opinions on here make?

Do you just want people to agree with you?

This is unprofessional and inappropriate. You do of course know this.

Just speak to your line manager, if you think she is not doing it correctly and patients are harmed. What is your role, are you able to teach her yourself.

That’s exactly what happens with me. They usually have to use my wrist as my veins are crap and more than once I’ve had to go back to see the other nurse who never fails 😂

@Greybeardy @olympicsrock ahhh I see !! Thank you.

I'm amazed no one else has noticed if your patients are fainting

Obviously she is wrong but why on earth haven’t you raised that with your manager

The last time I needed one they put it in the vein on the side of my wrist running over the wrist bone. I freaked out a bit (needle phobic) because I was expecting it in the back of my hand! But the nurse said the vein she put it in was "beautiful" so that's why it was going in there!

Are you serious, @Garlicpest? No nurse or HCP of any sort should be at work while still under the influence of alcohol. It used to be, and I hope still is, a disciplinary matter. Any colleagues covering up for her - likewise.

How standards have slipped if it's true.