This was once planned where I work at,  during a reengineering period.  It
never flew, I think because of a near nursing revolt.  It seems many nurses
consider it beneath their position to draw {*filter*}.

However, in previous places I have been, it was routine for the nurses to
draw.  This was at a federal VA hospital and a major naval hospital.  The
lab would take care of the morning routine draws, and then the nursing
staff would draw all stats and any other draw during the day.
Phlebotomists would do outpatient drawing only.

I don't mind drawing {*filter*}, but sometimes I work alone at night.  I'm not
going to drop everything at a moments notice to do a stat draw.  (Do I let
a stat ER crossmatch sit there and let someone bleed while I draw a stat
electrolytes in ICU)?  Considering they refuse to draw it, there may be
quite a delay in that ICU result.  I personally beleive in situations like
this the nursing staff should be doing the phlebotomy.  They don't have to
leave their work area and whatever they are working on to draw something.
They are already there.  But then that would make proper patient care too
easy.  It seems to work reasonably well in government hospitals I have
seen.  Why is the private sector different?

          Robert LaDean

Being good at drawing {*filter*} takes practice.  The more veins you locate
and puncture, the better you are.  If the nurses are going to be
starting IVs regularly, then they *should* be the ones drawing {*filter*}.
They know their patients best.

In any case, anyone performing venipunctures should always be
completely and well trained.  I think a lot of hospitals and schools
neglect the finer points of doing a good job with phlebotomy and just
assume that once you get an IV in or take a {*filter*} sample a couple of
times, that you're proficient and capable of handling any situation.

I think that many of us forget what a scary ordeal {*filter*} drawing is
when you're new at it.

YMMV.
Sandra

Sandra writes
If the nurses are going to be

Happily dancing in the Phil Zone and scattering Garcia Ashes!
http://www.***.com/
Healthcare: The bottom line is patients not profits!

I got sick at work with some post-surgical complications a few months
ago, and my partner Karen offered to place a catheter.  She did so in
my mid-forearm.  When I arrived at the hospital for admission, the
staff just about freaked at the placement of the site.  The head nurse
came in and said "Am I to understand you already have IV access?"
Since there wasn't one in my hand, they questioned whether they could
infuse through it.  I do NOT like people fiddling around with the
veins in my hands.  They let me keep the line I had.

OTOH, an anesthesiologist started a small gauge line on the volar
surface of my mid-forarm (OUCH), and then when I came out of surgery,
I found that one going, plus a very large bore catheter in the ulnar
side of my wrist ON THE SAME ARM.  One of these puppies was for a
central line.  

I believe there is some upstart company in California that operates a
phlebotomy school.  Now there's a novel idea.  Might actually get some
people out in the field that can FEEL veins rather than stick only
what they can see.

I'm not going to argue with you, Stev, because you're right.

I work at a hospital in Lake Forest Illinois

Being good at drawing {*filter*} takes practice.  The more veins you locate
and puncture, the better you are.  If the nurses are going to be
starting IVs regularly, then they *should* be the ones drawing {*filter*}.
They know their patients best.

In any case, anyone performing venipunctures should always be
completely and well trained.  I think a lot of hospitals and schools
neglect the finer points of doing a good job with phlebotomy and just
assume that once you get an IV in or take a {*filter*} sample a couple of
times, that you're proficient and capable of handling any situation.

I think that many of us forget what a scary ordeal {*filter*} drawing is
when you're new at it.

YMMV.
Sandra

stev

Happily dancing in the Phil Zone and scattering Garcia Ashes!
http://members.aol.com/steallight/index/
Healthcare: The bottom line is patients not profits!

Just for the record and my 2 cents worth, nurses like to start the
largest gauge they can but tend to use veins which are as low as
possible on the arm.  This way your infusion is not limited in the
volume you can push in, if necessary.  By using a site low on the arm,
you will have additional options further up the arm should the current
one go bad.  Nurses avoid the antecubital vein under normal condtions
since an IV in this site will affect the patients ability to bend his
arm while he is a patient.

Phlebotomists like using the antecubital since it is usually in about
the same place, tends to be large and easy to find.

Gary

concerning drawing {*filter*}:

During this time, budgets were better, so more people could be hired to do the
non-technical things, like draw {*filter*}.  Of course, these people (phelbotomists)
were hired in at a lower pay scale.  So if the payscale is lower, that must
mean the job is lower in status.  So now, with cutbacks in job positions, some
may feel that they are being 'demoted' to a lower job, even if their pay
doesn't reflect this.  The feeling may be that they have spent their time in
getting a degree, then are doing a job that doesn't take a degree.

In my position, I don't have to draw {*filter*}, but I wind up doing a lot of
clerical type work.  I look at it as, 'boy, are they nuts in paying me what I
get to do this'.  I find this attitude works a lot better than any bitter
feelings I may have had at one time.

Just my 2 cents,

Anne Czubek

Sandy mentioned a Phlebotomy school being a good idea, we have several
operating in SE Mass.  It's a tough course for the length of it.  I think it's
a 3 month program.  At my last job, we hired 3 program grads, all of whom
passed the ASCP exam.  They are great.  They really know their stuff and take a
lot of pride in it.  They could ask the right questions at the right time.  The
biggest plus was they are wonderful with the patients.
It's worth getting well trained phelbs.

Here, here, Anne..I couldn't agree more.  I've caught myself, too, thinking
"Heck, I must be the highest paid receptionist in this whole lab".

Mark G, MT(ASCP)