Dear Center for Phlebotomy Education:

I am being asked by my administrators if our phlebotomists can collect nasopharyngeal swabs for Covid-19 testing. I can't find anything on whether it's in their scope of practice to do so or not. Nor do I know what must be considered when moving in this direction. What should we do?

My response:

Phlebotomy is not a very regulated profession, nor does it have an official scope of practice. Therefore, as long as there are no regulations where you work (governmental or facility), there's nothing we are aware of that would prevent you from training your staff to perform NP collections. Actually, we encourage phlebotomists to be trained to collect NP swabs. They're perfectly suited for it with minimal training. It enhances their skill set, and gives them greater professional recognition. Many labs have trained their phlebotomists to perform this function before the pandemic.

Your role is to make sure you train properly, document the training, and perform regular competency assessments just as you do for collecting blood samples. (For a short video on masks and other precautions for phlebotomists, visit our YouTube channel.) If you're going to add a skill to their repertoire and increase their risk, though, I would certainly approach management about a commensurate adjustment in their salaries. Now is the time. If their morale is low, it is about to get lower with the new skill.

Secondly, you want team players. If they grumble about it, that would be an indicator that you've got some team-building to do. Some will grumble no matter what, but if it's a concert of grumbles, you have to address the morale issue and why they don't want to step up to be a greater asset to their employer. Now is the time for that, too.

Keep in mind, for some, money is the highest priority. Job satisfaction comes down the list. Those for whom money is the prime (or only) motivator will never be satisfied or happy for the long-term. A raise will only have a temporary impact. These are people you need to encourage to seek training for a higher-paying position if they are goal-oriented. If not, they will continue to be a drag on your staff and department until they are purged or move on to something else.

It's a delicate balance, for sure. You want to pay staff commensurate with the risk, but you want staff to step up to the challenge these times bring as well.

Got a challenging phlebotomy situation or work-related question? Enter it in the comment section below or email it to me at [email protected]. By submitting it you give me permission to include it (or an edited version of it) in a future post with my response. Names and identifiers will be removed to assure your anonymity. Thank you!