There is a lot more to being a phlebotomist than people realize.
by Shanise Keith • April 28, 2022
Earlier today, I had the pleasure to serve as a virtual guest speaker for Texas Children's Hospital on the importance of phlebotomists. It's lab week, as you are probably aware, and the people at Texas Children's Hospital go out of their way to dedicate a lecture to the memory of Virginia Deeken, an exceptional woman who worked as a lab technologist there for a long time. I was delighted to be asked to speak about phlebotomists and how critical their role is in healthcare - something I am very passionate about, and I would like to share some of my thoughts with you.
During lab week, it's wonderful to be able to focus some appreciation for our amazing lab workers and phlebotomists. They deserve far more recognition for their work than what they typically receive, but unfortunately, they often go unnoticed. In a 2010 survey conducted by the Center for Phlebotomy Education, 63% of phlebotomists and lab workers reported that they did not feel respected by other healthcare professionals. Having worked as a phlebotomist myself, I can tell you that I have felt that way at times as well.
Part of the problem is that many other healthcare jobs have phlebotomy under their scope-of-practice, which allows for the misconception that phlebotomy is a 'basic' or 'easy' skill that most people can do. The truth is that phlebotomy requires skillful and knowledgeable people to do the job correctly. Sure, anyone may be able to pick up a needle and collect some blood, but can they recognize and prevent the myriad of things that can cause injury, inaccurate samples, and mismanagement of patients? Nope. Definitely not. That is why a properly trained phlebotomy team is crucial.
Physicians rely on blood samples for up to 70% of their information used to diagnose and treat patients. If blood is improperly collected or mishandled, it can cause test results to be inaccurate, leading to the patient suffering from mistreatment and mismanagement. Almost all errors that affect tests occur during or immediately after collection, so having a phlebotomist who can recognize and prevent these preanalytical errors is invaluable.
Let me give you some examples of common problems that affect blood tests and cause injury:
- Hemoconcentration - This is concentrated blood, which can dramatically change certain blood components. The scary part is that it's undetectable by the lab, and it's extremely easy for it to occur. The main causes? Fist pumping, tourniquet being on for too long, and posture changes before collection. Many people are unaware that these simple things can lead to serious complications, including death.
- Site selection - Did you know that phlebotomists are carefully trained in what sites should be avoided? There are certain locations that are well known for having a high risk of injury when accessed. A good phlebotomist is aware of these locations and will avoid them, saving patients from terrible debilitating injuries. Many people think that any vein is 'fair game,' but I can tell you that the patients who have experienced nerve injuries certainly wish that the person who caused the damage knew better so they could have prevented the injury.
- Hemolysis - The destruction of red blood cells. This is one of the most common causes of specimen rejection by the lab because damaged samples cannot be relied on for accurate results. It leads to more time, more money, and more stress for everyone involved. A phlebotomist can recognize what might cause a sample to be hemolyzed and avoid it, saving resources, energy, and frustration. Studies have shown that, on average, non-lab personnel cause 12.4% hemolysis, and phlebotomists cause 1.6% hemolysis. The results show the incredible difference a well-trained phlebotomist makes.
These three examples are just a small fraction of what a phlebotomist must consider every time they draw blood. They make dozens of decisions during every encounter to ensure patient safety and sample integrity. Replacing phlebotomists with other healthcare team members who can 'technically' perform blood collection is not in the patient's best interest, and leads to unknown and untold problems.
On top of all that, there is the added fact that most patients are not happy to see a phlebotomist walk into their room. Phlebotomists don't often have the time or opportunity to form many patient connections or build trust, which can be difficult because human connection is one of the most rewarding parts of working in healthcare. They have five minutes with a patient to get in, draw blood, and get out, which doesn't allow much time for chit-chat. They inflict pain as a part of their job, which is an unfortunate necessity, and it leads to a lot of negative emotion towards them. Imagine if every time you walked into a room, you had to deal with dread and fear because of your presence. It's draining, exhausting, and a common cause of phlebotomist burn-out.
The people who choose to be phlebotomists are incredible. They have chosen a demanding and challenging field that involves much more than people realize. Phlebotomists are specialists, experts, and masters at their craft. Especially phlebotomists like the ones at Texas Children's Hospital, who have to deal with all the same problems and worries that a regular phlebotomist does, but with the added difficulty of working with the pediatric population - which can be incredibly challenging.
In my opinion, a well-trained phlebotomist is worth their weight in gold. They have a hard job that doesn't get the appreciation it deserves. They are unsung heroes, essential to healthcare, and I am so grateful for the important work that they do. The next time you see a phlebotomist, please take a moment to say thanks. I know they will appreciate it.
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