Getting blood drawn prompts an array of different reactions. Some people are scared, some cry, and others don't skip a beat. But no matter the situation, it helps when the person drawing the blood is respectful of your mindset.
Becky Palsgrove is good at that.
The 35-year-old has been working as a phlebotomist since September 2019 at Carroll Hospital Center, which is part of LifeBridge Health in Maryland.
Why did you become a phlebotomist? And did you always want to do this?
I asked an RN friend for advice about what kind of work to pursue prior to nursing, and she suggested phlebotomy. It’s a skill that takes time and repetition to develop, and it’s not typically taught in nursing school despite being a valuable skill. I hadn’t considered working as a phlebotomist before that, but I’ve always been comfortable around blood and needles, and I find lab work really interesting, too. I plan to begin a nursing program in fall 2021.
What does a typical day for phlebotomist look like?
I work at a 168-bed hospital that staffs phlebotomists between 4:30 a.m. and 10:30 p.m. I typically work in the morning since that’s our busiest time. Routine morning labs are ordered at 4 a.m., and three or four phlebotomists collect specimens between 4:45 a.m. and 7:30 a.m. After the initial morning labs, routine orders appear every two hours until 10 p.m., and of course there are "stat" or timed orders that need to be collected as well.
At my hospital, most of the people from whom we draw blood are adolescents, adults and geriatric patients, although we do occasionally collect pediatric and neonatal specimens. We collect both venous and capillary blood according to the orders.
When we’re not working on the hospital floors, the phlebotomists function as front office staff for the laboratory, receiving specimens and delivering them to the appropriate lab departments, answering phone calls and completing paperwork. (Some are also trained to perform therapeutic phlebotomy. That's real-deal bloodletting! It’s part of the treatment plan for people with polycythemia [an increase in the number of red blood cells in the body, which causes the blood to be thicker] and some other disorders. But I haven’t learned that skill.) In short, our job is to collect high-quality blood specimens accurately and efficiently, and to ensure that everything reaches the appropriate lab departments so they can release accurate results as quickly as possible.
What do you like most about your job? And least?
My job can be very satisfying. When I’m able to collect blood from someone who’s a “hard stick,” I feel proud. Sometimes patients are upset – maybe they’re anxious about their health, maybe they have a fear of needles, maybe they’re just tired of being stuck — and I try to take the time to really listen to them and reassure them. When a patient thanks me for my time and gentleness, I feel appreciated. Finally, I know that the information I help to collect is critical to the quality of care that a patient receives, and I really do feel like a valued member of the care team when I do a good job.
Conversely, failing to collect a specimen is frustrating, especially if the patient is critically ill or especially upset. Fortunately, our team is strong, and we work together to get things done. If I have the time, I’ll accompany a coworker while they attempt to collect a specimen I wasn’t able to get, and I have a chance to watch them work and get some insight into how I can improve. Things like that make the misses easier to handle, even though they are disappointing.
What’s the most common misconception about your job?
Hmm … that’s a tough one! I think people have been surprised to hear that I could get a job as a phlebotomist without any previous experience besides my clinical training. Certainly some employers are more selective, but my hospital hired me knowing that I would need several months of extra support before I could handle everything on my own. It took me about six months to feel truly confident and comfortable — that may have happened sooner if I’d been working full-time. Sometimes patients ask me how long I’ve been drawing blood, and they’re often surprised to hear that I have only a year of experience. I try to save that bit of information for after I successfully draw their blood!
What do you wish you knew about the job before you got into it?
I wish I’d had a plan for managing the minor anxiety I felt when I first started working. Previously, I’d worked for nine years from home, and while I was no stranger to deadlines and time management, it was a different kind of stress compared to what I experience now. I have to wake sick people up at 4:45, turn on bright lights, and poke them with needles; patients are rarely pleased to see me at work! I also need to work quickly, but safely and accurately, and I have no idea how busy I’ll be before I arrive at work. Sometimes I have to draw blood from patients after trying and failing to do so a day ago. I had to learn how to avoid psyching myself out before I even walked through the door, and how to leave work worries at work. This is probably true of any new job, but it had been a while since I’d learned a new skill completely from scratch, and I had to learn new ways to handle the stress. It’s definitely paid off!
How did you train to become a phlebotomist?
I completed a phlebotomy technician training program at my local community college. This included 40 hours of classroom training and 100 hours of clinical training, during which we had to perform at least 100 successful venipunctures. If I had wanted to, I would have been eligible to take the American Society for Clinical Pathology’s (ASCP) certifying exam for phlebotomy technicians after completing this program. Since certification isn’t required by my employer, I chose not to pursue it. There are other organizations that certify phlebotomists too, but I haven’t investigated the requirements for those.
What’s the nicest thing anyone has ever said to you about your work?
Once I drew blood from a young woman who began our interaction by telling me that she was extremely uncomfortable with needles. She warned me that she would probably cry, and reassured me that she would remain still even though she would be upset. She asked me to leave the tourniquet tightened for as short a time as possible, and she requested that I palpate her veins as little as I could. Needless to say, I was concerned about how things would go. But I did my job while honoring her requests as best I could, and fortunately I had no trouble drawing her blood. As I was finishing up, the patient, with tears still in her eyes, thanked me and told me I did a good job. She said that other phlebotomists hadn’t taken her seriously or been as gentle as I was, and she appreciated the respect I’d given her. That meant a lot to me. I believe that it’s important not to diminish others’ discomfort or fear when reassuring them, and I felt like I struck a good balance during that encounter.
Where do you see yourself in five to 10 years?
I mentioned that I’m planning to begin nursing school in fall 2021, so in five years, I’ll hopefully be wrapping up my first year of employment as an RN. I've been interested in oncology and clinical research for the last several years, so I hope to find a nursing job in that field after getting some more general experience, possibly in emergency medicine. My phlebotomy skills will serve me well in both emergency and oncology nursing, where high-quality blood samples collected quickly are essential to providing necessary care. At my hospital, nurses are responsible for blood collection in these departments, and they may not have the opportunity to develop this skill until they’re hired.