Not good with drawing blood or IVs...

[kl323]

---

Members don't see this ad.

I've only had 1 session to learn how to draw blood. Didn't have enough arms to get a good shot at learning it. I was able to draw blood from my partner once, even that time, I needed some help.

Anyway, I'm just a little concern with having an anesthesia clerkship first (in MS3). We are expected to start IVs and draw blood.

Has anyone been in my position? I'm not sure how receptive pt would be to having a med student "learn" how to draw blood on them...

Advice? Tips?

 

[RySerr21]

1) dont tell the pts its your first time doing this or that you are learning

the only way to get better is to do it. Yea you are going to stick a few pts more times than they would have liked, but the only thing you can do is apologize for having to do it more than once, learn from your mistake, and do it again. As with everything there is a learning curve. Theres really no other way to learn it. Your first few pts just got bad luck i guess - thats the downside of goin to a teaching hospital!

 

[VisionaryTics]

I've only had 1 session to learn how to draw blood. Didn't have enough arms to get a good shot at learning it. I was able to draw blood from my partner once, even that time, I needed some help.

Anyway, I'm just a little concern with having an anesthesia clerkship first (in MS3). We are expected to start IVs and draw blood.

Has anyone been in my position? I'm not sure how receptive pt would be to having a med student "learn" how to draw blood on them...

Advice? Tips?

Just remember: you're not the one getting stuck with a needle. Why worry?

 

[James Sacket]

1) dont tell the pts its your first time doing this or that you are learning

I'd immensely appreciate it if the care giver told me, though 😀

 

[kl323]

Do you think schools will allow me to take some supplies with me home? So that I can practice on my loved one? lol

 

[James Sacket]

LOL... Ask the school, and your loved ones 😀

 

[sonofva]

i'm pretty sure you can buy butterfly needles on amazon.com for cheap (like 25$ for a bunch)...this would do away with the need for hubs and vials and all that. just practice with the butterflies, and you know when you hit a vein cause you get that flash. good luck.

 

[HeyThere13]

There are a few decent videos on Youtube. It is not the same as drawing blood, but you can look at the technique.

 

[coralfangs]

when I worked on my research project, most of the fellows in my department were from MGH, Brigham, UCSF, etc.

None of them can draw blood to save their own lives.

Don't sweat it if you can't do it properly. Chances are your future field won't require you to draw blood. And no one will fault you for not being able to draw blood or start IV like a pro.

 

[Savage Henry]

Go buttonhole a phlebotomist. Ask if you can "shadow" them, or if they'll give you any hints. Do the same with a nurse or EMT for starting IVs. One place I work is an Urgent Care close to a med school and I teach those kids that stuff all the time.

Be humble, nice, and sincere and many folks will be happy to help. Make sure you ask at a slow time (a phleb struggling to get all the timed tests done on time is going to say no).

Starbucks and/or chocolate in hand goes a long way, too.

 

[turkeyjerky]

Once you start clinicals, steal a bunch of IVs from the supply closet and practice on yourself. Once you're good on yourself (which can be kinda tricky) practice on your gf/bf or friends. Also, when you're starting IVs on a real patient, if you can't get it in 2 tries then give up and get someone else to do it (otherwise it just looks bad and both you and the patient get all frustrated and stuff).

 

[CardiacIntensivist]

You won't become good at anything until you've done it more than a few times. Putting in IVs and lines is more about feeling the subtleties of inserting the catheter and you will only get that with experience. Yeah, the first few patients will have to suffer but what you'll need to do is fake the confidence and go with the flow. Never tell them it's your first time or that you're still learning, those statements are the best ways to have them lose faith in you. You can however, circumvent those types of questions by saying you've done them a number of times (the more vague the better). Ultimately, it's not like you're doing something to them that will maim or kill them. I guarantee you will blow veins and cause more bleeding than desired the first few times but that is the only way you will learn.

That being said, just always remember that patients are not pin cushions. If it's taking more than 2 tries, I'd hand it off to someone better. You'll get other opportunities.

 

[cowme]

Honestly, just go in with confidence any time you try an IV. The patient will be more at ease with the cocky MS3 who looks like he knows what he's doing than a fumbling, scared intern who may have more sticks under his belt.

If you can't get it on the 3rd try, ask for help. Some people are just hard sticks.

 

[ruiner]

Honestly, just go in with confidence any time you try an IV. The patient will be more at ease with the cocky MS3 who looks like he knows what he's doing than a fumbling, scared intern who may have more sticks under his belt.

If you can't get it on the 3rd try, ask for help. Some people are just hard sticks.

Listen to patients also, a lot of them know where it is easiest for their blood to be drawn.. I drew blood (you will not get me to give it a title) for 2 years and the drug users would always tell you right where you could currently find a useable vein. Other people can do it too (people who unfortunately had diseases that required multiple or extensive hospitalizations), but the users were the funniest. And make sure you get that confidence up because that will be picked up on.

 

[mrjohndaniels]

Ask a nurse to help you until you get the hang of it. Nurses usually are happy to help out if you are nice to them. Learn the nurses' name, and always be respectful of her/his suggestions and requests.

Review the technique (by watching videos or reading it until you know from memory) before you have to do it.

Every procedure you do will take practice and everyone picks up on these things at a different rate. Be bold and make sure you do as many as you need to until you are comfortable.

 

[Mattchiavelli]

Once you start clinicals, steal a bunch of IVs from the supply closet and practice on yourself. Once you're good on yourself (which can be kinda tricky) practice on your gf/bf or friends. Also, when you're starting IVs on a real patient, if you can't get it in 2 tries then give up and get someone else to do it (otherwise it just looks bad and both you and the patient get all frustrated and stuff).

Don't give yourself too many obvious track marks with this unless you want your team to think you're a junkie 🙄

Try to find men that lift weights and have big arm veins because they're like the training wheels of phlebotemy. Bonus is they have less sub-q fat for the vein to snake around in.

 

[ruiner]

Don't give yourself too many obvious track marks with this unless you want your team to think you're a junkie 🙄

Try to find men that lift weights and have big arm veins because they're like the training wheels of phlebotemy. Bonus is they have less sub-q fat for the vein to snake around in.

Pregnant women are the best. Some of the guys you are talking about tend to be the biggest wusses for this type of thing.

 

[justdoit31]

I also say to have the nurses help you. I went to a bleeding disorders camp on the medical team so I had access to a bunch of nurses that specialize in teaching kids/family members how to find a vein and inject factor. They were more than willing to help me learn and the NP, resident, and my attending all let me practice on them since I didn't want to stick a Hemophilia kid til I was very confident with the skill. Once you find and hit a vein you have a better idea what you are going for and it gets a little easier.

 

[ACSurgeon]

I've only had 1 session to learn how to draw blood. Didn't have enough arms to get a good shot at learning it. I was able to draw blood from my partner once, even that time, I needed some help.

Anyway, I'm just a little concern with having an anesthesia clerkship first (in MS3). We are expected to start IVs and draw blood.

Has anyone been in my position? I'm not sure how receptive pt would be to having a med student "learn" how to draw blood on them...

Advice? Tips?

Students at my school learn how to draw blood and start IV's on anesthesia. You are NOT expected to know how to do it on day 1. You see a few, try a few and you get better. My school's rule was you only get one shot at it, then a resident/CRNA/attending tries.

Also, asking to start an IV after the patient is asleep is a good time to practice, as the patient won't mind much. This is especially true if they need a second IV anyways.

 

[bruinhd]

1) dont tell the pts its your first time doing this or that you are learning

the only way to get better is to do it. Yea you are going to stick a few pts more times than they would have liked, but the only thing you can do is apologize for having to do it more than once, learn from your mistake, and do it again. As with everything there is a learning curve. Theres really no other way to learn it. Your first few pts just got bad luck i guess - thats the downside of goin to a teaching hospital!

THIS. this is so true.

just think about it. the same trick has been pulled on you throughout your own lifetime. ever had a nurse stick you so many times you wanted to be like WTH!? you probably assumed she was just having a rough time. Or...perhaps she had never done it before...

see what i did there? 😎

 

[unsung]

Do NOT repeat do NOT indiscriminately copy whatever you see the nurses doing!

I've seen a lot of really questionable techniques, including "slapping" the vein (hellllo K+ lvls?) beforehand, fist bumping, going for hand veins unnecessarily, etc.

I only learned it once during pre-clinicals too, and was able to draw on 1st stick, but also required help with switching the tubes, etc.

What I did was volunteer at a screening to do blood draws. It was about 4 hours and I gained a LOT more confidence just in that time.

One tip: Keep the arm straight! I had no idea how important this was until the lab docs who taught us initially told me to have the pt make a fist and put it under the arm that's getting blood drawn from (i.e. as a patient).

I have tiny veins and in the past people have stuck me multiple times trying to draw blood... but this time when I elevated/straightened my arm by putting a fist underneath it, my partner had NO trouble whatsoever drawing from me! AND, it was absolutely painless... no sticking that needle in, searching around (which is usually the painful part), etc.

This is so super important.. it doesn't even matter if you have the band on that tight.. I was able to draw from this old lady who came in saying "oh they always have a hard time drawing from me" on 1st stick, without any problems. Basically- need to make that arm straight, it will make your life a lot easier. From my (limited) experience, this has helped a lot.

 

[DrKnowLittle]

Asking a nurse to help you is highly dependent on the setting and the nurse, but I think it's a really good way to learn. Sometimes you have to grease the wheels a little by helping them out with cleanup for something or taking a temp for them but then they'll help. Sometimes if you grab the supplies for the draw they will be more willing to help out. I've actually had more luck with male nurses. I think they've felt some of the difficulty getting opportunities to learn. One of the guys in the ED was awesome - he walked through ultrasound guided central venous access with me on a patient we couldn't gain peripheral access or an EJ on.

I screwed up so many times my first few times. I could usually find a good vein but my approach was just awful. On my first "successful" draw using a butterfly I got the necessary amount of blood into the syringe and as I was grabbing the tubes I clumsily yanked the needle out and blood started dripping all over the sheets. I felt like an idiot but that's the learning curve, I guess.

When in the ED, I would ask nurses if they could get some practice and their response the first few days was invariably, "well, as long as I don't have to be there." It's really about catching them at the right time and if they aren't helpful, yet are supposed to be on your rotation, you might need to gently address this with your clerkship director.

 

[CardiacIntensivist]

I've seen a lot of really questionable techniques, including "slapping" the vein (hellllo K+ lvls?) beforehand, fist bumping, going for hand veins unnecessarily, etc.

Slapping the veins = histamine release = more vasodlation.
Fist pumping to move blood into the veins
Hand veins = usually very superficial and thus a quick stick

The "K release" you're referring to only really matters for 1) Blood draws, not IVs and 2) when you have the tourniquet on for too long leading to ischemia and burst RBCs. Unless you're beating the vein to a pulp, a flick or a slap shouldn't be release that much K to affect the levels.

 

[unsung]

Slapping the veins = histamine release = more vasodlation.
Fist pumping to move blood into the veins
Hand veins = usually very superficial and thus a quick stick

The "K release" you're referring to only really matters for 1) Blood draws, not IVs and 2) when you have the tourniquet on for too long leading to ischemia and burst RBCs. Unless you're beating the vein to a pulp, a flick or a slap shouldn't be release that much K to affect the levels.

Yeah, I'm only talking about blood draws. I have zero experience with IVs.

 

[Law2Doc]

Pregnant women are the best. Some of the guys you are talking about tend to be the biggest wusses for this type of thing.

Actually junkies are the best. They will usually talk you through it, show you where they still have good venous access, and aren't afraid of needles at all. Just don't forget to dispose of the needle when you are done, or they will be taking it home with them for future use.

 

[45408]

Students at my school learn how to draw blood and start IV's on anesthesia. You are NOT expected to know how to do it on day 1. You see a few, try a few and you get better. My school's rule was you only get one shot at it, then a resident/CRNA/attending tries.

My school was much the same way.

Also, asking to start an IV after the patient is asleep is a good time to practice, as the patient won't mind much. This is especially true if they need a second IV anyways.

The patient won't mind at all 😉 plus, they're all vasodilated up from the induction of anesthesia.

 

[45408]

What kind of doctor on your first day of residency will you be if you can't even draw 1 simple blood sample?

Who cares? This isn't Mexico. 👍 We have phlebotomists and nurses.