Anyone dislike needles, or overcome a fear of needles.

[x_prometheus_x]

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I'm not too fond of needles, but I don't faint around them and it's more receiving shots that displeases me. I can take in blood and gore, just fine. I'm looking forward to some interaction with needles to conquer the prob. Anyone share in this or have some good needle stories?

 

[Dave_D]

I'm not too fond of needles, but I don't faint around them and it's more receiving shots that displeases me. I can take in blood and gore, just fine. I'm looking forward to some interaction with needles to conquer the prob. Anyone share in this or have some good needle stories?

Yeah I've got a bit of a dislike of needles. Of course I'm getting better about it the hard way 😀 (Seriously, one of the side effects of my hepatitis is that I've been poked and prodded more times than I can count. Of course I've learned alot of it is technique. A good phlebotomist can get you blood and you'll barely feel anything. On the other hand a bad one can make your arm hurt for at least a few hours.)

 

[ShyRem]

Overcame that fear when I took IV class as an EMT. Now I *have* to watch the needle being used on me as it goes in and comes out. Weird, huh?

 

[x_prometheus_x]

That is funny. I have to look too for some reason, I'm just very curious like that. I think it's partially the fact that a foreign serum is entering my body that gives me the willies. I'm getting a tb test for my volunteer work at a hospital this week, should test my might.

 

[Dr Trek 1]

I have had a similar problem. I can see anything done to anyone, just not to myself, lol.

I can handle injections, but the worst for me is having blood drawn. So, I basically used a self-hypnosis desensitization technique on myself to prepare for having blood drawn and it went fine. I'd be happy to explain to you how to do this if you would like.

 

[x_prometheus_x]

I can tell you I've only had blood drawn once, and the process is so long, that any sort of mental stamina I had was shot to pieces after the first 30 seconds. But I maintained conciousness... what's your hypnosis method?

 

[JasonUD]

I don't have a problem with needles but I can't stand to see procedures done on the face/head...like rhinoplasty, brain surgery and anything with the eye. I haven't seen these in person yet but Dr. 90210 and the TLC shows are enough to skeeve me out when they're hitting a chisel with a hammar up someone's nose

 

[Whatsamatta U]

I am actually pretty worried about this. For some reason, everytime I get stuck with a needle for injections or blood drawing, I get super light headed and have to lie down for 15 minutes or so. I don't even have any kind of fear of needles or am grossed out by it. I guess my body just goes into this wierd "you've been attacked" state. Hopefully, watching a needle going in someone else won't cause this same reaction!

 

[ShyRem]

It's also different doing it yourself vs. watching someone else do it.

 

[Redneck]

Yup, I was to the point where I got lightheaded enough with blood draw I kind of half fainted. I can handle bleeding people, or gutting animals, but needles get to me. Soooo, I took a proactive approach. I would watch every needle I could go into myself and others. I then volunteered my arms to phlebotomists in training and let them at me. Getting several sticks done on each arm for several days in a row really helps. After you get a few really painful ones the others don't seem so bad.

Summary: Find phlebotomists in training and let them dry you out. Approach the pathology lab in a hospital.

 

[FutureDocDO]

Yup, I was to the point where I got lightheaded enough with blood draw I kind of half fainted. I can handle bleeding people, or gutting animals, but needles get to me. Soooo, I took a proactive approach. I would watch every needle I could go into myself and others. I then volunteered my arms to phlebotomists in training and let them at me. Getting several sticks done on each arm for several days in a row really helps. After you get a few really painful ones the others don't seem so bad.

Summary: Find phlebotomists in training and let them dry you out. Approach the pathology lab in a hospital.

Or become a phlebotomist yourself. That's what I did. 👍

 

[nerdgrrl]

I'm not too fond of needles, but I don't faint around them and it's more receiving shots that displeases me. I can take in blood and gore, just fine. I'm looking forward to some interaction with needles to conquer the prob. Anyone share in this or have some good needle stories?

I can't stand having my blood drawn or getting shots, but I do it to other people all day. it's really different when you're doing it to someone else.

that said, I'm totally skeezed out by anything involving broken or breaking bones of any kind. compound fractures? open skull flaps? *shudder* and this is why I want to be a gynecologist. no bones!

 

[Bull's eye]

When I was a Senior in High School, they just talked about blood and I passed out. When I started Med School they had this Blood Born Pathogens Video and I passed out. Somewhere down the line I stepped up to the plate and it has never been an issue since.

 

[Dave_D]

I am actually pretty worried about this. For some reason, everytime I get stuck with a needle for injections or blood drawing, I get super light headed and have to lie down for 15 minutes or so. I don't even have any kind of fear of needles or am grossed out by it. I guess my body just goes into this wierd "you've been attacked" state. Hopefully, watching a needle going in someone else won't cause this same reaction!

Everytime? Ok, I've gotten lightheaded and even fainted once on an IV.(Which the IV nurse botched the first time and I went down before she could make a second attempt.) The weird part with me is that I've never had this occur when they did my right arm but it's happened quite a few times with the left. Of course it's much easier to take this kind off stuff while laying on a gurney.(But I'm getting better at it mostly because I've been jabbed probably 40 to 50 times in last 6 months. 🙁 )

 

[doclm]

Or become a phlebotomist yourself. That's what I did. 👍

Yeah, drawing blood on people in a routine manner does help this fear. After two years of taking blood from peoples veins and arteries (ABG's) I have no problem getting my blood drawn. Actually when lab techs get bored sometimes (when work is really slow), we will practice drawing blood gases and venipuncture on each other for a sense of reality and self check ups.

I believe it is very important for us "student doctors" to have these invasive practices done on each other, so we get a sense of what the patient is going through. In my two years at a very intensive truama one medical center, I have seen doctors draw blood very poorly. E.G.- using the same needle to stick one patient multiple times in the wrist for ABG's after I failed to obtain a sample after two tries.(one puncture=one new needle) Also, I have seen a doctor try to obtain a venous blood sample by sticking the patient very deeply in the bicep versus trying the medial cubidal vein or hand vein after I missed. In addition I saw an artline being placed for over 15 minutes straight with a fully awake patient. (digging a 19 gauge IV like needle in someones wrist) 😱

I think it is great that some of you actually have some concerns with these procedues. It shows humanity that will make you become a better doctor. 👍

 

[mj1878]

I think it's impossible not to be at least a LITTLE bit nervous as someone comes at you with something very sharp. Even as a phlebotomist and having done literally thousands of needle sticks myself, I still get a teensy bit nervous when a trainee is coming at me.

Let's face it; much of medicine is controlled violence. Physicians cut, sew, debride, order blood tests, IVs, and I think that's where it behooves an applicant to med schools to have had some extensive healthcare experience and not just been cooped up in a research lab running gels and smearing dishes. We have to learn to cross that imaginary clinical barrier with aplomb while maintaining the patients' dignity and comfort, as much as is possible.

 

[alkapalka]

Not to go to far off topic from your original question, but besides the slight discomfort around blood, I get very uncomfortable in anatomy labs. So far, the times that I have been in there, I get very dizzy, go into a slight panic mode, and can't even look at the cadaver (even the ones covered by plastic). 😱

Any inspiring stories?

 

[x_prometheus_x]

I think there are alot of stimuli that contribute to the uneasiness we feel. I remember hating the smell of fermaldahyde and fly nap, for instance. Smell plays a big role in memory. I've read putting vicks vapor rub under your nose can help with that issue.

I feel ya tho. I've enjoyed the posts, it's been pretty amusing.

 

[doclm]

I think it's impossible not to be at least a LITTLE bit nervous as someone comes at you with something very sharp. Even as a phlebotomist and having done literally thousands of needle sticks myself, I still get a teensy bit nervous when a trainee is coming at me.

Let's face it; much of medicine is controlled violence. Physicians cut, sew, debride, order blood tests, IVs, and I think that's where it behooves an applicant to med schools to have had some extensive healthcare experience and not just been cooped up in a research lab running gels and smearing dishes. We have to learn to cross that imaginary clinical barrier with aplomb while maintaining the patients' dignity and comfort, as much as is possible.

I totally agree. 👍

Hey when clinicians check my blood for annual check ups, I tell them to use a 23 gauge butterfly versus that 21 gauge vacutainer they were just about to stick me with.

 

[87138]

I totally agree. 👍

Hey when clinicians check my blood for annual check ups, I tell them to use a 23 gauge butterfly versus that 21 gauge vacutainer they were just about to stick me with.

I do phlebotomy (among other things) at a Family Practice office, and if I'm drawing from someone I haven't done before, typically if they're older, female, or just have a look in their eye like this is the worst experience they've ever had to endure, I'll at least ask if they want a butterfly. Otherwise I go with a 22 vacutainer. If it's some tough guy who I know doesn't mind getting blood drawn at all, or if they have a huge hose for a vein, I'll use a 21g and get it done a little quicker.

 

[letsrun4it]

1 cycle of steroids and you get over..well everything

 

[87138]

1 cycle of steroids and you get over..well everything

And with 1 improper PCT you'll get over plenty: fear of balding, fear of gynomastecia, etc. 😛

 

[Dave_D]

I do phlebotomy (among other things) at a Family Practice office, and if I'm drawing from someone I haven't done before, typically if they're older, female, or just have a look in their eye like this is the worst experience they've ever had to endure, I'll at least ask if they want a butterfly. Otherwise I go with a 22 vacutainer. If it's some tough guy who I know doesn't mind getting blood drawn at all, or if they have a huge hose for a vein, I'll use a 21g and get it done a little quicker.

Really? Old or female are the kind of people that go down most? I just ask because the IV nurse was talking to me after the fact and said with her the people that go down are 20-40 year old healthy guys.

Anyway you've got me curious. What's a butterfly, vacutainer, etc? Also is large number gauge a wider or skinner needle? (Ok, I'm not a phlebotomist so I have no idea what half those terms mean.)

 

[FutureDocDO]

Anyway you've got me curious. What's a butterfly, vacutainer, etc? Also is large number gauge a wider or skinner needle? (Ok, I'm not a phlebotomist so I have no idea what half those terms mean.)

A butterly is often called a pediatric needle which has two "wings" at the base so you can hold onto when you draw blood. It has a long plastic tubing connected to it so that blood seeps into to let you "cheat" ... know when you're inside the blood vessel. The vacutainer is just a straight needle connected to a hub where you insert your tube in. It is harder to use this than a butterfly because you can't tell if you're inside the blood vessel or not until you put the tube in. FYI, the smalller the needle's gauge the bigger the needle.

 

[FutureDocDO]

I do phlebotomy (among other things) at a Family Practice office, and if I'm drawing from someone I haven't done before, typically if they're older, female, or just have a look in their eye like this is the worst experience they've ever had to endure, I'll at least ask if they want a butterfly. Otherwise I go with a 22 vacutainer. If it's some tough guy who I know doesn't mind getting blood drawn at all, or if they have a huge hose for a vein, I'll use a 21g and get it done a little quicker.

My favorite needle to use is a 22 gauge vacutainer. I will use butterfly on veins that are too small or look too fragile (i.e., if it looks like it's going to blow). I will also use them on those that are traumatized by previous experiences with needles . I will also use a butterfly on patients that aren't cooperative as you have more room to manuever/prevent from sticking yourself. If you act alll tough and or just rude than I'll use a 21 gauge .

To fellow phlebotomist, do you ever worry that your patients will grab your needle when you least expected and stab you with it?

 

[FrkyBgStok]

try running one cycle with ONLY 18 guage needles. That will get you over the fear. and running proper PCT you're fine.

 

[87138]

Really? Old or female are the kind of people that go down most? I just ask because the IV nurse was talking to me after the fact and said with her the people that go down are 20-40 year old healthy guys.

Anyway you've got me curious. What's a butterfly, vacutainer, etc? Also is large number gauge a wider or skinner needle? (Ok, I'm not a phlebotomist so I have no idea what half those terms mean.)

FutureDocDO hit all the nails on the head answering the butterfly/vacutainer questions.

And it's not that the old/female people "go down" the most, it's that old people generally have inelastic skin and thin veins (making it more difficult to maneuver a thicker needle into the vein), and a for some reason a lot of the women I end up drawing from just seem to have skinny veins. The worst combo is skinny vein/fat person, which I see a lot (occurs a lot with Type II diabetics).

As for the weakest/wussiest, I totally agree with that IV Nurse. Males in the 20-40 year old range are the biggest babies. I've done as young as a 5 year old boy before and he actually cooperated surprisingly well; and old men couldn't care less most of the time, they're so used to it by then (except the cranky ones who complain no matter how many times they've had it done, or how good you are to doing while causing minimal discomfort). It's that in between range of guys that try to act tough, but can't handle getting poked with a needle.

And to FutureDocDO, I don't legitimately worry about that, but sometimes my mind wanders (not during, but after drawing the blood) and I imagine someone suddenly going nuts while I'm getting the needle ready and lashing out to stab me.

 

[FutureDocDO]

And to FutureDocDO, I don't legitimately worry about that, but sometimes my mind wanders (not during, but after drawing the blood) and I imagine someone suddenly going nuts while I'm getting the needle ready and lashing out to stab me.

I'm out of that room if I turn to get a pair of gloves and turn back to the patient to find my needle missing.

 

[mustangsally65]

I am in my clinical rotation stage of my phlebotomy course this semester, and it sure would make things easier if we could choose the guages of our vacutainer needles. They buy 21 guage needles and ration the butterflies so we only get so many per week, so once they're gone they're gone. Not fair when some people over-use them and then we're left with nothing for the rest of the week.

I've never had a problem with needles. I could tell a cool story about watching a bunch of lidocaine be injected into both sides of my big toe, but I won't. 😉 I always watch if someone's sticking me, and in my phlebotomy class everyone always wanted to poke me because I have pretty good veins, and I didn't mind. It was kind of scary the first time I opened up a needle in class, and even though we were practicing on fake arms it was still a strange feeling. I was shaking so bad the first time I actually stuck a person, but it gets easier every time you do it.

I think physicians should have some phlebotomy training. My class was four weeks, with class three days a week, before going to clinicals and watching people draw/drawing from outpatients. Med schools should incorporate some kind of training for doctors, since they are the ones being called in to do femoral sticks when phlebotomists/nurses can't get blood the traditional ways.

 

[nikibean]

I was tortured as a child regarding needles. As the kid of a doctor in a family of high cholesterol lineage(which I didn't inherit, thanks), and after surviving epiglottitis (I have the trach scar), I always knew when my mom said, "we're going out to breakfast so *DONT* eat anything" that I was doomed.
I hated it. I still hate it. I just had my blood drawn for some testing and I warned the MA to let me lay down. Ugh! I'm not the best person to practice on.

*YET*
I love drawing it. I convince at least 6 people per day to let me draw their blood by using my fear of needles. I have piercings in places many people wouldn't (no, not *there*, think upstairs...) but I can't deal with getting my blood drawn. I'm such a weenie that way. So I do my best to make people feel better. My favorite line is, "Hey, I know you're scared, so I'm going to use the pediatric needle on you- it's teeny." B.S. I just had two tough draws on girls who were really scared- no visible veins- but I felt their deeper veins and aimed true. I love that. I love hitting it in someone who's freaked out and getting them through it.

I also had a woman faint the other day- she just couldn't handle it. Smelling salts! MAKE SURE you ask if they've eaten, and if not, get them a piece of candy and a cup of water. It helps a LOT.

 

[FutureDocDO]

I am in my clinical rotation stage of my phlebotomy course this semester, and it sure would make things easier if we could choose the guages of our vacutainer needles. They buy 21 guage needles and ration the butterflies so we only get so many per week, so once they're gone they're gone. Not fair when some people over-use them and then we're left with nothing for the rest of the week.

I've never had a problem with needles. I could tell a cool story about watching a bunch of lidocaine be injected into both sides of my big toe, but I won't. 😉 I always watch if someone's sticking me, and in my phlebotomy class everyone always wanted to poke me because I have pretty good veins, and I didn't mind. It was kind of scary the first time I opened up a needle in class, and even though we were practicing on fake arms it was still a strange feeling. I was shaking so bad the first time I actually stuck a person, but it gets easier every time you do it.

I think physicians should have some phlebotomy training. My class was four weeks, with class three days a week, before going to clinicals and watching people draw/drawing from outpatients. Med schools should incorporate some kind of training for doctors, since they are the ones being called in to do femoral sticks when phlebotomists/nurses can't get blood the traditional ways.

That's kind of strange when the 21 and 22 gauge needles cost about the same whereas the butterfly costs way more. Our hospital somewhat ration the use of butterflies when they leave out only a box for the entire shift! There are times when butterflies are necessary (i.e., small hand veins, spider veins (yes, I draw blood there as well), babies, fragile veins).

I think most medical schools, if not all, do train their students to draw blood. I know mine-to-be does.

 

[KateGia]

I think it's all just something you get used to. The first person i ever stuck I got a whole vial of blood, but then blew the vein something nasty. I felt terrible, but now I realize it happens sometimes, and the patient will get over it. I have some bad stories though. I've never had a patient attack me, however I did have to draw off a combative patient, so his niece was holding him down while i did it, and he bent down and bit her hand to where she actually started bleeding.

As for needle gauges.... When I was interning in a research lab, they were all excited that I knew how to draw blood, because it was cheaper than buying blood. I showed up one day, and the head of the lab was like "oh, you're gonna draw 2 60cc syringes from me today," and she hands me a 20g butterfly! I'd never seen anything like that in my life. Avoid them!!! However, she was impressed with me, and I drew several of the lab tech's blood throughout the semester.

 

[PlasticMan]

try running one cycle with ONLY 18 guage needles. That will get you over the fear. and running proper PCT you're fine.

That's insane. Those are harpoons! 😱 18 gauge should only be used for drawing.

 

[Spankete87]

My response to all of the above posts:

The D.O. that I was shadowing for actually had to draw from a girl's femoral vein after no one could draw off her anywhere else!! Needless to say she had collapsing, rolling veins and was dehydrated.

My least favorite patient to draw on are patients who are having panic attacks. They tend to thrash around a bit when you get anywhere near them and having to hold them down always sucks. And you certainly can't reason with them at that point either.

I personally like butterfly needles. They allow you to cheat. 😉 In derm though, taking large quantities of blood isn't necessary so no need for speed.

The population of patients that normally goes down for me are the 20-40 year old athletic men. Don't know why, but they seem to have it the hardest.

And my interesting story of someone passing out - we actually had someone pass out after a few cc's of local anesthesia (simply out of nervousness) and the pt actually started seizing! It's not something you see in derm every day.

 

[Dave_D]

That's insane. Those are harpoons! 😱 18 gauge should only be used for drawing.

No No, a menghini needle is a freaking harpoon, I'd know about that 😀 (Ok, like I've said before, they had me flying so high for my biopsy that I didn't really care when they got me.)

 

[mj1878]

My favorite needle to use is a 22 gauge vacutainer. I will use butterfly on veins that are too small or look too fragile (i.e., if it looks like it's going to blow). I will also use them on those that are traumatized by previous experiences with needles . I will also use a butterfly on patients that aren't cooperative as you have more room to manuever/prevent from sticking yourself. If you act alll tough and or just rude than I'll use a 21 gauge .

To fellow phlebotomist, do you ever worry that your patients will grab your needle when you least expected and stab you with it?

My weapon of choice for hard sticks is a 23 Gauge butterfly hooked up to a vacutainer holder. You don't have to worry about the blood clotting during tube transfer(say, if you had the butterfly connected to a syringe) and talk about control!

If I have to get cultures + regular blood work, I always use butterfly. Using a 35 mL syringe and a syringe needle can get ugly and destroy the vein. Using a butterfly, you can hold the needle completely still and pull back on that monstrous syringe.

My biggest draw ever was 140 mL, which were the following tubes:
4 Reds
5 SST(individually wrapped in heel warmers)
5 Blues
2 Tall PST
3 Lavendars
1 Gray
2 Sets of blood cultures

Oh yes, and I had to perform a bleeding time on her.

Mostly I worry that the homeless drunks with HIV/Hepatitis are going to jerk at the perfect moment for me to stick myself.

 

[doclm]

My weapon of choice for hard sticks is a 23 Gauge butterfly hooked up to a vacutainer holder. You don't have to worry about the blood clotting during tube transfer(say, if you had the butterfly connected to a syringe) and talk about control!

If I have to get cultures + regular blood work, I always use butterfly. Using a 35 mL syringe and a syringe needle can get ugly and destroy the vein. Using a butterfly, you can hold the needle completely still and pull back on that monstrous syringe.

My biggest draw ever was 140 mL, which were the following tubes:
4 Reds
5 SST(individually wrapped in heel warmers)
5 Blues
2 Tall PST
3 Lavendars
1 Gray
2 Sets of blood cultures

Oh yes, and I had to perform a bleeding time on her.

Mostly I worry that the homeless drunks with HIV/Hepatitis are going to jerk at the perfect moment for me to stick myself.

Yeah, that is some scary stuff. Although I have not yet stuck myself, the worst time I can remember is drawing a right brachial ABG on an AIDS patient that was going into violent seizures every 10 secs while I was trying to hold her arm down.

Currently, in our lab we run a rapid HIV test on high risk patients that were involved in employee accidents (sticking yourself). This test looks like a elongated pregnancy test that will give you control and positive lines within 15 minutes. If the patient had HIV, then the strong antiviral medications would be administered to the employee within that special 24 hour window of time. Personally knowing this makes myself feel much better about sticking possible high risk patients.

Oh I forgot, did you get those new butterfly needles that have that spring loaded button to contract the needle while it is inside the patients vein? I believe that the company vacutainer produces these. I guess they are to decrease the number of employee incidents after the needle is pulled out of the vein.

Bleeding time? Do you guys use the Activated Clotting Time (ACT) test much to determine the clotting time?

 

[mj1878]

Yeah, that is some scary stuff. Although I have not yet stuck myself, the worst time I can remember is drawing a right brachial ABG on an AIDS patient that was going into violent seizures every 10 secs while I was trying to hold her arm down.

Currently, in our lab we run a rapid HIV test on high risk patients that were involved in employee accidents (sticking yourself). This test looks like a elongated pregnancy test that will give you control and positive lines within 15 minutes. If the patient had HIV, then the strong antiviral medications would be administered to the employee within that special 24 hour window of time. Personally knowing this makes myself feel much better about sticking possible high risk patients.

Oh I forgot, did you get those new butterfly needles that have that spring loaded button to contract the needle while it is inside the patients vein? I believe that the company vacutainer produces these. I guess they are to decrease the number of employee incidents after the needle is pulled out of the vein.

Bleeding time? Do you guys use the Activated Clotting Time (ACT) test much to determine the clotting time?

We DO have the new butterfly needles, and they are awesome. The only drawback is that the tubing is really long, and so if you have a short sample, it becomes shorter because some of the blood stays in the tubing. The good thing is that they work like an IV; you retract the needle while it's in their arm, and there's no chance of sticking yourself.

Bleeding time just got eliminated as a means to measure clotting time because it's relatively invasive and archaic. We DO use ACT, but mostly on dialysis patients.

For a bleeding time, we use a poker kind of like the heel poker for newborns, except it has two blades and they make a swiping motion, creating two incisions. Then you blot the blood off with a filter paper every 30 seconds until the bleeding stops. It usually takes 25 minutes and is a royal pain in the a$$. Like I said, though, it's been eliminated.

Another trick if you have a short sample in a syringe is to put the chemistry and hemo in pediatric multivettes. Full tubes only use about a mL and a half, and you can use the rest for coag.

 

[FieldDoc]

I'm a big fan of humor to ease any situation.

For instance, if my patient tells me that they are afraid of needles then I causually reply, "So am I, so I usually just close my eyes. Maybe that will work for you." By the time they figure this one out, I have usually taped the thing down and they forget to freak out.

Another big one is when people tell you they have horrible veins. Most likely this was said by some new guy who has now convinced them that this is true to cover his boo-boo. When I'm doing IVs in the hospital, I try to tell people that I usually do this in the back of a moving ambulance, so this will be a cinch.

Phlebotomy is an art, and once you master it a lot of the nerves just fade away until you realize that this is no longer a big deal to you. Knowing where to look for the perfect vein may be a challenge to you, but could also really help your patient out. The fun may never end.