The harder they fall...

I had such a good week with my training last week, so I was looking forward to this week.

But, just like I tell my students, time away has a way of smacking you right up the side of the head when you return to work.

My assignment after my three day weekend was to begin in NICU, then go do a.m. phlebotomy with the team from 6-7:30, then back to NICU for the rest of the shift.

A.M. team leader calls at 5:30, wondering why I'm not there yet, and asking that I come over immediately. Once I get there, she asks me to please take one of her trainees out and observe her and get her signed off on as much as possible. Guess she's missed me, huh?

So, I take Trainee O out with me. I'm glad Team Leader warned me about a couple of things. T.O. has this habit, you see. She doesn't want to do what has been asked of her, instead preferring to just do her own thing.

I took the biggest share of patients for T.O. and I to share. When she couldn't get some of the patients, she just grabbed more labels and blithely left on her own missions, never bothering to check with me to update me on the current situation. So, suddenly we find that some of the patients are waiting for their labs to be done.

"Oh...I couldn't get the stick on Patient A. She's too hard."

"Oh, Patient B needs fingersticks done and I couldn't get her fingers to bleed."

Okay.....

So, I headed to A's room, only to find the nurse in there attempting to draw. I had to return a little later because the nurse could not get the draw. Neither could I, for the veins blew at my two attempts. (Long term chemo patients are notorious for having uncooperative veins.)

Patient B had fingers so callused that a lancet would not pierce the skin deeply enough to get the labs. The nurse cancelled the tests, because if I, the Fingerstick Queen, could not get her fingers to bleed, it was going straight to the docs.

Now, that really doesn't have anything to to with T.O. other than she didn't communcicate in a timely manner. So, when I finally hooked up with her again, I asked her if she'd been signed off on isolation rooms.

"No, I haven't been signed off and I've been doing them for a long time."

"Okay, then. Why don't you go ahead and do this patient and let me observe everything you do so I can sign off on your paperwork and get that out of the way?"

T.O. was pissed. "HMMMMPPPPPFFFFFF!!!!!"

She slammed through her tray, grabbing the items she needed, and then pulled an iso gown out of the cabinet, slamming the door just as I was reaching in to get a gown of my own. I jerked back; this job has made me very protective of my hands.

With nary a "Sorry" or any other words, she stomped into the room and around the curtain. The patient, a man, probably in his early 70's smiled at her and said, "Oh, you're here."

She strapped the tourniquet on him, palpated his arm. Not a word has been spoken by her.

"By the way, I'm Kate and this is T.O. and we're from the lab. We're here to get a blood sample from you. I'll bet you already guessed that though!" I grinned at him.

T.O. glared at me.

I walked around to the other side of the bed to observe. She did the draw, quickly and cleanly. She bandadaged the wound, gathered her stuff and began to head out the door.

"I can't label the samples. I don't have a pen."

"I do." I gave her my pen. (Never got it back, either, but that's okay because I swiped it myself.)

She labeled the tubes and I left the room, listening.

She never thanked the patient, put his tray back in place, or asked about his light.

I met up with Team Leader, told her I'd be back at my break to fill out T.O.'s paperwork. And, I headed back to NICU to try to get in on some of the early morning draws.

Too late. They were all done. Damn...now that puts me behind in my training schedule.

When breaktime came, I went back to Core Lab. Grabbed T.O.'s paperwork and filled out as much as I thought was appropriate. I told her she needed to work on introducing herself to the patients.

"Oh...I never EVER tell patients my name. I just say I'm from the lab."

Ummmm. That may be all right, but if you are wearing a name badge which has your name publicly displayed, what difference does that make? Besides, giving our names has a way of letting the patients know we are humans too, not just some parasitic blood snatcher. Besides, the SOP states plainly that we're to introduce ourselves by name.

Next piece of paperwork was the form required for trainees to fill out and turn in once they've gotten 100 sticks. It's a requirement. She'd only filled hers out for the first seven days of her training.

When I queried her about this, she told me emphatically that she'd been a phlebotomist for a long time and she didn't need to keep track of her sticks.

"Uh, yes you do, T.O. It doesn't matter if you've been doing this for most of your life, as a new employee at BHTS you are required to fill out and turn in this piece of paper that can verify that you've done the required amount of sticks which can be signed off by your trainers, and also be verified by the patients logs each day."

"That's ridiculous!"

"That may be, but it's procedure here. You'll have to go back through all the logs since (last date listed) and count up how many draws you did."

She storms away, fuming.

I pull Team Leader aside to update her on T.O. When told about the lack of introduction, TL said that she'd reminded her often to introduce herself to the patient. Doesn't seem to be working.

And, T.O. had joined us by this time. I told TL that sticks weren't being recorded, so TL backed me right up and informed T.O. that the next day she'd have to go back through the logs and notate things because....THAT WAS THE PROTOCOL.

But, my day wasn't over, yet. Back to NICU I went.

I had a total of four sticks. I've been getting about 13 per day.

For my last stick of the day I was with the trainer who had the "sleepies" right along with me last week. She was covering lunch for the tech on duty in NICU.

We went to do the stick. I've stuck that Warrior Baby several times in the last week. He's easy to do most of the time. But, I told the trainer that I was going to try to do the stick the way my boss had asked me to do them.

The trainer didn't like it. She said I was putting too much stress on the baby's foot. I agreed with her assessment; I'm not stupid, after all. But, when the boss man wants me to do something else, I'll try to comply.

She readjusted my positioning to the style I learned to do (and prefer to do!) and I got the stick.

Then she told me something that flat out pissed me off.

"It's been discussed and until you develop some technique, we'll not be letting you stick by yourself."

Well, FUCK! That did it. I was SOOOO pissed. You see, I've been trying to be the good little trainee, doing what I'm asked without comment and in a cheerful manner. And every single person who takes me out wants to change my style to suit theirs. This person says that I have to do the sticks with no overhead lighting because the babies don't need the stimulation of the light. The next one says that I have to put the bandaids on like when putting a 'butterfly' bandage on. The next one says that regardless of the weight of the baby, I'm supposed to use the deepest cutting lancet.

COME ON PEOPLE!

There's too many chiefs and not enough indians, as the saying goes. No discriminatory offense meant, folks!

Give me ONE trainer. Give me one person whose methods are acceptable to the department and let him or her sign me off on sticks. I really don't care how long it takes me to finish the training quota of sticks, but don't ask me to change my colors on every single stick!

Now I'm going to be edging toward paranoia while I finish the training. This is the kind of stuff that makes me wish that probation was over sooner.

But, on the other hand, it's good for me to see and experience all this stuff. It will help me as I teach others in class, and boy, oh boy, do I see the need to get through this, be good at it and then do what I can to take over the training for the new folks coming in. After all, training is one thing I *know* I'm good at!

We'll see what the next few days bring. I'm assigned to NICU for the next two days at least, and hopefully the weekend as well.