Teaching Update

There's a glimmer of light Waaaaaayyyyy down at the end of the tunnel. First hope I've had toward this new phlebotomist trainee.

It's really helped to have this blog to spit and fume over her inabilities, and my angst and dismay over *my* inability to get the point across to her. By talking it out, making everyone who reads this think I'm an anal bitch perfectionist (yes, all apply, but generally not all at the same time!), I've been able to forget the past history and concentrate on what I can do to make things easier for T to learn how to do this. I might bitch and moan, but I don't give up, and telling you all about this makes far more sense than maybe spilling my guts to another co-worker and chancing that T will overhear and be hurt.

Anyway, we began today with the paperwork. She's been doing so well, I didn't check things over as carefully as I might have, only after getting to the floor I find out she'd mixed up some of the paperwork. Not a big deal - just had to explain the importance of making sure everything matched so we didn't have to backtrack, or take the risk of drawing the wrong patient.

And right before we left the lab I pulled out a piece of scratch paper and began making some drawings for T to look at. I showed her some basic things: that a vein is *always* round, even if we can only see the top 180 degrees of it, there's still another 18o degrees *under* what is seen.
Then I drew a picture of a vein from the top and showed her where the needle should go into the vein. Another showed a cross section, another showed what happened if we went in from the side (which was one of yesterday's questions, if you remember...)

And then, I had a huge "light bulb" moment. I'm not an expert at math or physics by any means...but for some reason, I understand the physics of..."pool", i.e., "billiards". I can pretty much "read" what the ball is going to do if you hit it from a certain angle. Same with golf...I can "read" a green and see how a putt should go. (Understand, I absolutely SUCK at both of these sports - why I can accomplish reading a pool table or green I have NO clue!)

Anyway, suddenly the physics of *why* we stick the needles in the arm at certain *degrees* just flashed into my head. Then I drew a picture of the needle from a side view, demonstrating the beveled edge, then showed her how when a longer needle goes into a vein, you have to angle it so the bevel opening will allow the most blood to flow into the needle. Same-same with a butterfly needle which is shorter and thinner - you do a "shallower" angle because the vein is generally more surface, not deep, to get the same result as you would with the longer straight needle.

I didn't see total comprehension flash on T's face, but I definitely saw glimmers of enlightenment! I knew that if I'd made any sense to her at all, we'd find out on the floor.

So, wouldn't you figure? The first patient had had breast cancer years ago and was not supposed to have draws from the side with lymph nodes removed. Crap. There was a sign posted above her bed stating no draws or blood pressures in that arm, but the patient insisted we draw from that arm regardless...and she had bruises to indicate that *someone* had been doing just that. We went to find the nurse. The nurse took the responsibility for us to draw, but I drew because we needed to get the stick on the first try under the circumstances. *sigh*

Next patient was cranky. We identified ourselves, she 'threw' her arm out from the covers in irritation, informed us *how* we were going to do the draw (You WILL do this and you WILL do that) *rolls eyes* so T wasn't allowed to draw her because if anyone is going to take the rap from a patient it's not going to be my student!

She tried on the third patient. Missed the vein by a quarter inch. *sigh* I was really sad, she was disgusted with herself. I told her to take a deep breath and we'd get some successful draws for her by the end of the day.

And to make a long story a little shorter, by the end of the day she had attempted 6 draws, 4 of which were successful! And, then when we got back to the lab, I had her try a butterfly needle on my hand veins with another phlebotomist overseeing the procedure. (I can't watch the needle go in my own skin - I'm fine once it's in, but not until!)

So, T feels better because she's had some successful draws, and I feel better because once you can start helping them build their confidence, the rest of it is just repetition until it becomes second nature. So, for approximately the next six weeks, she'll be training Monday thru Friday, between Dean and I, with others taking her out on our weekday days off.

I'll bore you to death and keep you updated!

Kate