3...2...1...What will the verdict be?

T was checking reqs this morning when I got to work. We'd been assigned to one of the easier places in the hospital, which is what is always done with *brand new* people. This is week 6 for T - at this point she should be comfortable working on the floor with another phlebotomist sharing the floor with her, but working independently. That, sadly, is not the case.

T pulled me aside after the routine work was finished. She told me that Kathy had pulled her into the office yesterday and told her that if her work didn't improve by Friday, she would no longer have a job. And, she asked me how I felt about it. Because she was so direct, I chose to be direct with her also.

I explained to her that Dean and I, as her trainers had discussed this situation, and we were unwilling to give up on her, but we needed to see a great deal of improvement by Friday - that it was no longer acceptable for her work to be stagnant. There are three areas she needs to work on: 1. She needs to work on knowing how the equipment works; 2. She needs to consistantly anchor the veins down so she can get the stick on the first try; and 3. Keeping her hands out of the "death zone", which is the 180 degree area above the draw site.

We had a total of 9 patients today. In the business end of things, time factors are assigned to everything, so "man hour production" can be qualified to know the number of staff you need to employ. It has been determined that a typical blood draw takes 10 minutes or less. Sure some of them take far longer, but this was an easy floor and so, we should have been done with everything by 7:30. It was not to be. I ended up having to "recover" the draw on the first 6 patients. (We had some additional patients added on when we got to the floor.) The worst one was a draw in which T looked at the vein, we discussed equipment, angle of vein, etc., and she *still* came at that good vein from the side, and went through both sides of it. When I went to recover, I found that her complete pierce of the vein had resulted in the vein leaking so it effectively did not have its own vacuum to allow blood to go into the syringe.

She had several instances where we discussed the direction of the vein, yet she did not stick in that area. She had one equipment mishap which I had to try to recover for her, but then upon doing so, I found that she'd left a huge airspace in a syringe (a big no no) which left me no room to complete the draw properly.

Anchoring veins was a joke. This is something that we've talked about to her each and every day. Yet, she will tie the tourniquet on, find a vein, get prepared, do the stick and then she reaches above the stick site and pulls the vein from the top. That's not anchoring. So, I asked her what an "anchor" does. "Well, it holds something in place." "Yes, so why do you need to anchor a vein AFTER you do the stick?" She didn't have an answer. I added "anchor the vein" to my list of reminders.

And so tonight I'll have to write a report of the days findings to send to Kathy. Dean will be with her tomorrow until 8 a.m., then she'll finish the day with me, no doubt. Friday is up in the air as far as which one of us has her with us.

To top everything off, T's mobile home is still finishing up. I asked her what was left to do, and she said that trim needed to be installed in one of the other bathrooms, and some staining had to be completed in one of the other bedrooms. Now, I'm just a simple minded Iowa girl, but it sure seems to me that those items could be completed AFTER she gets moved in. So, they hope to have the place finished by the upcoming weekend, and then she'll have to move all her things out of storage.

And from her health point of view, she told me today that she has no insurance and is broke right now, so she hasn't even been taking her diabetes insulin pills...for at least a week or more.
I'm just pissed about that one. Dean was too...he said, "You mean she can spend money on repairing what was a perfectly good and liveable mobile home but she can't afford to buy something for her health needs?"

To T's credit, she finished the last five draws without a hitch and in about 40 minutes. But, we can't afford to have to go over old information every day to get to that point! So, out of ten draws today, only five of them were completely hers and successful.

I really hope things fare better for her tomorrow.