Training Time Whining Style

Today I had to get angry at T. I didn't *yell* at her or anything...just laid the facts down.

See, I found out something today - T is a diabetic. Now, that in itself means nothing, for I know lots of folks with diabetes. But, because I also understand a wee bit about reactions and insulin levels, etc., it makes some of the things that have happened more understandable.

Apparently, T does not eat anything prior to coming to work at 5:30 a.m. And, we don't go to break until our patient log is cleared, which can be anywhere from 8 a.m. to 11 a.m. This isn't a good plan for someone who needs to regulate her blood sugar.

And, she's in the process of remodeling a mobile home to live in. That's a long story in itself, but she's doing most of the work herself (more power to her!) and she's been keeping incredibly long hours with only two or three hours of sleep a night. Not good.

Monday, she complained of being tired. I assumed it was because she'd worked on the mobile home all weekend, which turned out to be correct. But, when she leaves the lab, she goes right back to work and gets no rest. I figured Monday was a day for her to regroup and get back in the swing of things after a couple of days off. She only 'got' six draws, and I had to bail her out of the rest of them. And, she was just....off. She was vague on things she has already shown she knows...but again, I attributed it to being Monday.

I wasn't even supposed to train her today. But my boss forgot that Dean was on vacation, so I ended up taking T to the transplant floor and the intensive care unit. It's not a good place for people to be if they're having an off day. Those labs are far too vital to be delayed, etc. So, Abir ended up doing most of the floor while I dinked around following T, trying to get her draws in for the day.

And it was just horrible. It was like having a little kid suddenly be given a very important job that is too advanced for him or her, and needing to follow at a close distance in case they have an accident.

There's an order of draw in which tubes must be drawn in order for the tests to read correctly. She had to be stopped on almost every draw because she wasn't going to start with the 'right' tubes. She had to restick a patient because she pulled the needle out of the arm before she was done with the draw. I handed her fingerstick tubes which needed to have lids put on them and she asked me which tubes had to have white lids put on them. We don't have any with white lids.

Then one of the other newer phlebs came and asked me if I'd do a "senior" draw for her - that's a draw that's difficult and usually takes a more experienced person to do. So, I went in, checked the patient, and assembled my own stuff....it's easier on the difficult draws to just do your own thing, your own way without the student's help. I had everything laid out, ready to use. The syringe, needle, gauze, alcohol pad, transfer device. I did the draw. I looked for the tubes and the transfer device. They weren't there. T had picked everything up and either put it back on my tray, or thrown it away. The final straw was when she palpated a vein, made a decision and then cleaned a totally different site. Something told me to check the site. So, I alcoholed my finger and palpated the vein...and found it was an artery, which I thought I could see pulsing slightly. T. hadn't even noticed the pulse when she palpated it.

When we got out to the nurses station, I told T she was being inaccurate and it was *because* she was exhausted and she needed sleep. I told her I was going to report her to Kathy and insist that Kathy send her home. I told her that we all come to work tired at times but we've all learned the value of taking naps when necessary. And that it was critical that she be rested in order not to mess up things for the patient's lab work. And T told me she couldn't be bothered to get any rest. And, I told her she *had* to take care of herself if she was going to take responsibility for patients. Then she literally whined at me that she has severe back problems and is on heavy medication all the time for said back problems. And I repeated that she needs to take care of her health first.

Back to the lab, and I told Kathy I'd made a judgement call and wanted T sent home, and why. Of course, Kathy couldn't let that happen...don't blame her, either. She made T sit at one of the computers and do some more of her required reading. And about 10 minutes later, T came to Kathy and said she really felt bad and that she needed to go home and sleep. I hope she did, indeed, do just that.

My job as an instructor is to do whatever I can within my power to make T successful at her job. But, I can't do that if harm is going to come to a patient because of ineptitude...on anyone's part. Tomorrow will be an interesting day.

This afternoon was the first class for the physician assistant students. Two other phlebotomists and myself worked with the students to teach them a mini course in drawing blood. They all did very well. I did get tickled, though, because in *every* single class I've worked with, no matter if it's phlebs, med students, nurses, PA's, whatever, *someone* always says, "Here comes a little prick"...which really cracks me up if it's a guy who says it. And, today it was. I just looked at him and without a smile (though I was laughing my arse off inside), said, "I think it would be an excellent idea if you would consider a different choice of word to use instead of "prick". Telling people a little prick is coming their way will probably not win you many friends on many counts!"

Anyway, I'm just worn out tonight. I've got a whole mindful of things I'd like to sit here and type, but I think I'm going to opt for sleep instead. Thanks for listening! I'll let you know what happens with T in the next few days.

Kate