Ten Things Not to Say to Your Patients

1. You have rolling veins.

When a vein “rolls” it’s not the patient’s fault. It’s usually because the vein wasn’t properly anchored in the first place.

2. Your veins collapse.

When patients hear this, their confidence in your abilities is likely to collapse, too. As trained healthcare professionals, it’s our job to know what equipment is needed to access the vein the first time. Make sure syringes, small-bore needles and low-volume tubes are in your arsenal.

3. I promise I'll quit after four tries.

If twice you don’t succeed, don’t try, try again. According to CLSI, it is not advisable to attempt a venipuncture more than twice. If possible, have someone else attempt to draw the sample, or notify the attending nurse or physician.

4. Please pump your fist.

Studies have shown that vigorous hand pumping can spike the concentration of potassium in the blood below the tourniquet. When patients do this voluntarily, what they need to hear is “Please do not pump your fist,” along with the rationale behind your instruction.

5. You won't feel a thing.

To a child, misrepresenting the sensation of a venipuncture threatens their trust of all healthcare professionals. Be honest. but avoid terms such as "bite" and "sting," which they identify with a traumatic experience. Instead describe the sensation in less threatening terms such a "poke" or "pinch."

6. Is your name [state patient's name]?

Asking a patient to merely affirm his/her name is asking for trouble. Some patients may be hard of hearing or respond in the affirmative just to be polite. Instead, have patients state their full name, spell the last name and provide a second identifier such as the birth date, comparing all information with the test request and ID bracelet.

7. Have a seat here, Sugar pie.

Unless Sugar Pie is her real name, cutsie pet names like this might be considered disrespectful, inappropriate, and overly friendly. Unless the patient gives you permission or you have established a rapport that welcomes such terms of endearment, stick with Sir, Ma'am or the time-tested titles of Mister, Mrs., Miss, or Ms.

8. I don’t bother wearing gloves during phlebotomy procedures.

Patients expect them, OSHA requires them and facility exposure control plans mandate them. End of discussion.

9. Bend your arm up.

Having patients bend up their arm after a venipuncture isn’t a substitute for applying direct pressure and may not prevent hematoma formation. Besides that, it’s against the CLSI standards.

10. Hold this gauze in place until I come back.

Sure, cooperative patients may assist with applying pressure, but only under the constant supervision of the collector. Never leave a patient unattended, even for a moment. Patients should remain in your sight until dismissed from your care, assuring stasis is complete and that the patient tolerated the procedure well. Resisting the temptation to multi-task when a patient suddenly faints or experiences complications may mean never having to tell an injured patient “I’m sorry.”

#phlebotomists #phlebotomy #tips

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