Stick Like A Pro: Tips For Mastering The Art Of Venipuncture

Taking a blood sample or starting an IV usually isn’t the highlight of a medical worker’s day… and it’s definitely not a favorite moment for the patient, especially if multiple sticks or other complications are involved. But phlebotomy and venipuncture are necessary, and mastering them can make the experience better for both patient and lab tech.

For starters? Remember that there’s no such thing as normal when it comes to sticking a vein.

“Anybody who expects just routine draws is quickly disappointed,” says Dennis Ernst, director of the Center for Phlebotomy Education in Corydon, Ind. “Because you have five or six categories of patients who present challenges—and you never know who’s going to walk in the door.”

The best rules to remember, of course, are the ones you learned in your medical training, and you should always defer to those techniques or to your administration for proper procedure. But here are a few tips and tricks that can help keep the sample process “flowing smoothly”.

Take A Deep Breath – Not you (though you can if you’d like), but the patient. By asking the patient to take a deep breath just before the stick, it both keeps them occupied and keeps them distracted. Being given something to do helps a person feel more in control of the situation—and this works as the needle is being removed, also.

Anchors Away – Stretching the skin by “anchoring” the vein doesn’t just help you stick the vein on the first try, it also helps make the stick less painful. Remember, your thumb goes below the venipuncture site, and give yourself plenty of room so you don’t accidentally jab your own fingers.

Feelings, Nothing More Than Feelings – Finding the vein and choosing your venipuncture site is perhaps the most difficult part of phlebotomy, especially if your patient’s veins are small, fragile, or non-elastic, and much of selecting the vein comes down to feeling. Not gut feeling, literal feeling.

There’s an old joke about how the first thing lab nurses notice when meeting a new person is how good their arms veins are, and that joke isn’t far from reality. Some patients are gifts from the gods, with veins thick and visible. But others are more of a challenge.

To that end, feeling for the vein (not slapping, despite what you see in movies) will always be the most reliable approach. Palpate for that “spongy firmness”, and feel above and below your target area for a better idea of direction.

The Invisible Vein  – Still can’t find a place to stick? Dr. Jabr of Florence, Oregon suggests “to obviate the need for multiple inconvenient and painful attempts at securing the needle, apply a warm pad to the target vein for a few minutes. This helps dilate the vein and makes it more visible and accessible.”

Another trick (from the venipuncture site AimVein.com) is to bend the arm upward if the veins are hiding. This sometimes makes them easier to spot.

Less Than Thirty – You’ve probably heard this a hundred times in your nurses training, but it never hurts to hear again. The World Health Organization guidelines suggest keeping the angle of insertion at 30 degrees or less (15 is ideal) to avoid passing through the vein.

Label Immediately – There’s nothing worse than getting a great stick, drawing a great sample, then forgetting to label it right away. Actually, there is something worse… and that’s mixing up samples because they weren’t labeled at the bedside. For your sake and the patient’s sake, label all sample immediately, even if things are going a mile a minute.

Know When To Quit – Just can’t get that blood sample? Veins just aren’t cooperating? Considering a third or fourth attempt? Here’s something else to consider—getting help. Don’t think of it as failure or defeat, think of it as making the best decision for your patient. Getting a fresh set of eyes on the situation might be all that’s needed to finally draw a good sample, and knowing when to seek help is the mark of a pro.

There’s A Body Attached To That Arm – At the end of the day, though, everything really comes down to how safe and peaceful you make your patient feel. So treat each and every one as if they were a friend or relative, and remember that just because you see needles and blood samples many times a day, this is a fairly rare experience for them. They will often be nervous. Some may faint. Some may be nervous because they’re afraid they’ll faint. It’s up to you to coach them through it and make the experience as positive as possible. The better it goes, the better the chances of that person seeking medical attention in the future, and that’s always a great takeaway.

“Compassion is not antiquated,” writes Dr Larry Dossey. “It remains a crucial factor in healing and will never go out of style. It is always available for any healthcare professional who is wise enough to claim it.”

Interested in beginning your own career as a nurse or medical assistant? Unitek College can help! Contact us today for more information on our many available programs.

Memorial Day 2018: Nurses On The Front Lines

This past weekend, the nation paused to honor the military men and women who died in the line of duty. And we’d like to continue that theme of remembrance this week by focusing on some of the heroes in scrubs who also served on those front lines. These were the nurses who carried bandages in place of rifles, yet still put themselves in harm’s way for the sake of their country and their brothers and sisters in arms.

Here are a few of their stories.

Colonel Ruby Bradley

Colonel Bradley was already a military nurse when America entered World War II and was based in the Philippines when Japan bombed Pearl Harbor. Soon, the Japanese army was sweeping through the islands, and Nurse Bradley, another nurse, and a doctor hid in the hills after their base was evacuated. Unfortunately, the three were betrayed by two of the locals, and Nurse Bradley soon found herself a captive in a Japanese POW camp.

But rather than allowing this to end her story, Nurse Bradley chose this moment as the beginning. She began treating prisoners with any useful medicine or instrument she could get her hands on, earning her the nickname “Angel in Fatigues”. In a short time, Bradley set up a small pharmacy, a clinic, and a smuggling operation by which she and a doctor brought morphine and other medicines into camp.

In the 37 months that Bradley was a captive, she performed over 230 major operations and delivered 13 babies, all while using anything and everything on hand as instruments.

“Three days after [smuggling morphine into camp], we had an appendectomy,” Nurse Bradley recalled during a 1983 interview. “The Japanese thought it was wonderful that we could do all this without any instruments.”

Nurse Bradley was eventually rescued, but her story didn’t end there. She went on to serve as a combat medic in the Korean War, eventually becoming the Army’s most highly decorated nurse.

Lieutenant Reba Whittle

Nurse Whittle served as a flight nurse in the European theater of World War II, and like Nurse Bradley, fought her battle from behind the walls of a POW camp. When her plane was shot down over Aachen, Germany, Nurse Bradley became the only female POW in Europe during World War II. Her situation was so rare that the Germans themselves were confused as to how to treat her.

Eventually, she was allowed to attend to prisoners within the camp—falling back on her flight school nursing training where she learned to treat injury and illness in the absence of a physician. But when she wasn’t treating soldiers, she was kept in an isolated cell.

After the war ended and Nurse Whittle returned home, she began a second battle—one against the United States government for recognition as a veteran and POW. Because of her gender and the rarity of her situation, she was denied benefits and recognition, something she fought until her dying day.

It was a battle Nurse Whittle eventually won, earning recognition (posthumously) of World War II POW in 1992.

Lieutenant Elsie S. Ott

Nurse Ott was another flight nurse who served during World War II, treating evacuees as they flew from India to Washington, D.C. While this may seem run of the mill today, the use of airplanes to evacuate the wounded (and to bring in fresh troops) was considered experimental.

Nurse Ott was chosen as flight nurse for the first evacuation flight and within 24 hours was onboard, despite the fact that she had yet to board an aircraft in her life. But Nurse Ott took to the skies like a natural, treating soldiers for a wide assortment of maladies as the plane completed its six-day flight to the states.

But Nurse Ott didn’t just treat her patients during the flight. She also kept a detailed list of the endeavor, noting the equipment and changes needed to improve the process for both the injured and the medical personnel. She eventually returned to India with the 803^rd Evacuation Squad, and by 1946, she had been promoted to captain.

Her bravery and commitment lead to Nurse Ott becoming the first woman to receive the U.S. Air Medal.

If you’re interested in beginning your own career in nursing, Unitek College is the place to start. Contact us today for more information.